President Thabo Mbeki has never said that HIV does not cause AIDS, but he is prepared to consult all players and question all theories  including “the unwavering belief that HIV is the sole cause of AIDS — in his quest to get to grips with the disease.So said presidential spokesperson Parks Mankahlana this week in response to the controversy caused by Mbeki’s contact with a group of scientists who deny HIV causes or plays any role in AIDS.

Mankahlana said government had been disturbed by the “rabid intolerance” displayed in the media in response to Mbeki’s contact with the so-called AIDS “dissidents” and emphasized that government remained committed to promoting safe sex as “one of the elementary responses” to HIV/AIDS.

“Government is strong in its resolve that we cannot confine our response to the problem of HIV/AIDS as an injunction not to talk to [microbiologist and AIDS “dissident” Dr David Rasnick or telling people how to think,” said Mankahlana. “Whether we talk to Rasnick or not, whether there are thought police to monitor what others think, human beings will continue to die from AIDS.”

Young, sexually active South Africans are dying as never before of diseases such as TB, pneumonia, cancer and diarrhea because the Human Immuno-deficiency Virus (HIV) is destroying their bodies’ immune systems, making them too weak to fight back.

“We used to always be sure when we got a young TB patient that we could cure them. But the picture has changed dramatically since 1990. Nowadays the younger ones are so ill and many are dying,” says Matron Duduzile Ndwandwe, TB and HIV co-ordinator at Hlabisa Hospital in Northern KwaZulu-Natal.

In the past nine years, the intake of TB patients at her hospital, situated in an area with a high HIV/AIDS rate, has increased by 360%. Seventy percent of TB patients are also HIV positive.

“We are burying the cream of Mamelodi – youngsters who are in the process of completing their degrees,” says Veronica Khoza, a retired nurse who now runs Tateni, a community-based home care project that gives daily care to the many people dying of AIDS-related illnesses in the Pretoria township.

But Dr Peter Duesberg, a researcher at the University of California in Berkeley’s Department of Molecular and Cell Biology, believes AIDS in underdeveloped countries is just another name for fatal diseases aggravated by lack of sanitation and malnutrition.

He started questioning HIV 13 years ago when he claimed there was no virological or epidemiological evidence to back-up the HIV/AIDS hypothesis.

Instead, he said, the virus was biochemically inactive and harmless, and AIDS was not behaving as a contagious disease.

The “dissidents” believe that AIDS is caused by “lifestyle” factors, especially the use of various recreational drugs, homosexuality and even by anti-HIV drugs such as AZT.

Duesberg claims that the lure of money and prestige, combined with powerful political pressures, have tempted otherwise responsible scientists to overlook – even suppress – major flaws in current AIDS theory.

“It is very difficult to say you were wrong when you are spending three billion dollars a year and 180 000 people have been given AZT. They’re trapped in so many ways,” Duesberg said in an interview with a London newspaper.

Rasnick recently revealed that he had a “very nice” 10-minute telephone conversation with Mbeki in January, during which Mbeki “asked me if I would support his efforts regarding AZT and AIDS”.

Rasnick has agreed to be part of an international panel to discuss AIDS and anti-HIV therapies before the international AIDS conference, to be held in Durban in mid-July.

The Department of Health recently announced that it would be convening such a panel, apparently at the instigation of Mbeki.

Mankahlana said the international panel was being set up to “re-evaluate what we know and which is clearly not complete and therefore not the answer”.

“Someone must explain the different strains of the virus and why it seems to take different forms depending on one’s geographic location,” he added. “Frankly, we cannot satisfy ourselves with the definition that the foreskins of the Zulus are the explanation for the rapid spread of the disease in one section of the country.”

Mbeki’s interaction with the “dissidents” has been met with disbelief by the mainstream scientific community and AIDS organisations.

Although scientists agreed at the time the controversy started that there were still some questions unanswered on the precise mechanisms of the HIV disease, 10 years later there is a more complete understanding of how HIV causes AIDS. Furthermore, HIV has been shown to be a necessary factor for the occurrence of AIDS.

According to a report from the US National Institute of Allergy and Infectious Diseases: “Individuals as different as homosexual men, elderly blood transfusion recipients, heterosexual women, drug-using heterosexual men and infants have all developed AIDS with only one common denominator, infection with HIV.”

Responding to Mbeki’s actions, the Joint United Nations Programme on HIV/AIDS (UNAIDS), which includes the World Health Organisation and the World Bank, said “HIV has been decisively established as the cause of AIDS”.

UNAIDS said that although the scientific community has rejected Duesberg’s contentions, he has attracted the attention of the mainstream press and specific groups outside the scientific community in South Africa and a few other countries.

Dr Mamphela Ramphele, the World Bank’s managing director-designate of human development, described Mbeki’s actions as “irresponsibility that borders on criminality and I know those are harsh words”.

A medical doctor, Ramphele told a recent gathering in Johannesburg that if the government gave credibility to “this voodoo science, there’s a real danger that people might say, ‘I don’t have to worry about condoms.”

“The current government position is nothing short of irresponsibility for which history will judge it severely. The disregard for the value of science is a worrying phenomenon that has crept into our new democracy,” she said.

Other prominent South Africans involved in HIV/AIDS do not want to take on the president in public, but expressed their shock in private.

Speculation on why Mbeki is consulting with the “dissidents” ranges from “the president does not yet intellectually understand the disease” to government’s determination not to let drug companies and developed nations dictate the approach to HIV/AIDS.

Mary Crewe, director at the University of Pretoria Centre for the Study of AIDS, said the dissidents’ debate was 10 years out of date, adding that government’s position was contradictory: “On the one hand they are supporting the AIDS vaccine initiative while on the other they are suggesting that the dissidents may be right.”- Health-e News