Should Mbeki be held to account for HIV-Aids related deaths?

Zackie Achmat, a loyal member of the ANC and a Zuma supporter, as well as leader of Treatment Action Campaign (TAC) has accused Thabo Mbeki of having “blood on his hands”, referring to deaths related to HIV/Aids. Achmat is emboldened in his reckless statements by an inconclusive study conducted by a group of professors from Harvard School of Public Health. They miraculously arrived at the finding that the refusal by the Mbeki administration to dispense HIV/Aids drugs between 2000 and 2005 had resulted in deaths of more than 330 000 people and that almost 35 000 babies were born with HIV during the same period because of mother-to-child transmission, because the Mbeki administration denied them access to nevirapine.

This is an exciting moment for Aids activist who have, for a protracted period, been clamouring for Mbeki and Manto Tshabalala-Msimang’s heads. This is their moment and they are demanding that a commission of inquiry for the deaths of these people referred to in the study be instituted. President Motlanthe has the power to institute this commission in terms of powers conferred to him under the constitution. Mbeki and Tshabalala-Msimang would be subpoenaed to give testimony before the commission if that eventuality materialises.

The TAC had fought the government tooth and nail in an attempt to force it to implement the antiretroviral treatment programme. The Mbeki administration during the said period of the alleged mass culpable homicide was contesting the toxicity of these drugs. There existed an overwhelming scientific literature that confirmed the dangers of these drugs. A responsible government leader would not ignore such warnings and proceed to subject thousands of patients to immediate deaths, without the safety of these drugs being reliably validated. Mbeki was heavily criticised and ridiculed for his cabinet to take this decision.

Mbeki said: “… because lots of questions had been raised about the toxicity of the drug, which is very serious. We, as the government, have the responsibility to determine matters of public health, and therefore we can take decisions that impact directly on human beings, and it seemed to me that doubts had been raised about the toxicity and the efficacy of AZT and other drugs, so it was necessary to go into these matters. It wouldn’t sit easily on one’s conscience that you had been warned and there could be danger, but nevertheless you went ahead and said let’s dispense these drugs.”

While the study by these learned professors make for sensational headlines, it is riddled with factual inaccuracies. First it claims that Mbeki “argued that HIV was not the cause of Aids and that antiretroviral (ARV) drugs were not useful for patients …” and secondly, it estimates that “about 320 000 persons died of Aids.” It is disappointing when learned individuals, with unrestricted access to information about issues they make pronouncements on, decide to rather ignore the facts and advance a particular line of argument that serve whatever interests unbeknown to the rest of us.

Time Magazine in 2000 conducted an interview with the former president. This question of HIV/Aids came up and this what he said:

“If the scientists … say that the virus is part of the variety of things from which people acquire immune deficiency, I have no problem with that. But to say that this is the sole cause and therefore the only response to it is anti-retroviral drugs, [then] we’ll never be able to solve the Aids problem … If you accept that there can be a variety of reasons, including poverty and the many diseases that afflict Africans, then you can have a more comprehensive treatment response.”

I have said before that it would take only a person challenged to fully employ his/her mental faculties or a mischievous person with a malicious intent, to take the above statement and conclude that Mbeki blatantly denied the causal link between HIV and Aids. How the learned professors arrived at such a ridiculous conclusion is astounding! It is even more astounding that members of the pre-eminent institution such as the Harvard School of Public Health would conclude that about 320 000 persons “died of Aids.” It is medically impossible for any person to die from a syndrome. People die from opportunistic diseases that intensified as a result of the collapse of the immune system.

The figure of 320 000 bandied about by these learned professors appears to be taken as fact by Mbeki’s detractors, although it is clear that it is only an “estimate”. The learned professors based their estimate on the reported number of infections by the Actuarial Society of South Africa and the Department of Health and then conclude that, given the lower coverage of the Prevention of Mother to Child Transmission (PMTCT) and the ARV treatment programme, so many people died as a result of the decision to delay the distribution of these drugs who otherwise could have lived longer.

The study conveniently does not address the issue of poverty and the critical importance of nutrition with regard to the said treatments. The learned professors fail to estimate what the probable scale of deaths might have been had these drugs been dispensed wholesale to patients who had no adequate nutrition. It is evident that political vultures would exploit whatever available information, however discredited, to advance their narrow cause. The responsibility for prevention of HIV infections remains with the promiscuous lot who refuse to exercise good judgment when engaging in pleasures of the flesh. It is mischievous to blame government for the irresponsible behaviour of adults who have full appreciation of their faculties, but rather elect to ignore messages of caution.