Surrounded by several health department heavyweights, national health minister Dr Manto Tshabalala-Msimang last week shared details with the media on an investigation into tuberculosis (TB) drugs of questionable quality.
She spoke of the health department’s decision to investigate a batch of drugs after a whistleblower alerted them that TB tablets that are part of two combination medicines may deteriorate if stored.
She described how health department officials had acted swiftly, immediately subjecting the drugs in question to a battery of tests at a World Health Organisation accredited laboratory and withdrawing the drugs affected when their concerns were confirmed.
Tshabalala-Msimang and her department have shown that they are not afraid to act when patients’ lives or well-being are possibly endangered by conventional medicine or scientific processes, and rightly so.
There have been other examples.
In February last year the minister immediately ordered a probe into microbicide trials when it became apparent there may be problems. The South African leg of the trials was part of a larger research project being carried out in several countries. The trials were halted after it was found that the product possibly increased the risk of contracting HIV.
Then in November last year the health minister again acted and put on hold all HIV vaccine trials following the failure of the Phambili HIV vaccine trial. The minister immediately summoned the researchers who worked on the Phambili study to her Pretoria office to explain the reason why the vaccine trial was stopped.
The trial in South Africa of the experimental vaccine was halted in September and then suspended in October after trials in the United States showed signs that the vaccine somehow raised the risk of infection.
Earlier this year the minister again referred to these incidents when she told a colloquium on HIV vaccines and microbicide research that the government had a responsibility to protect the ‘vulnerable members’ of society used in the trials.
So far, there have been no reports of any deaths due to the TB drugs, or either of the trials.
The minister is right on the score of protecting people. The government, and in the case of health, her department has the responsibility to protect the vulnerable members of society who are increasingly being enticed by individuals or companies selling so-called natural remedies under the guise of immune boosters to treat HIV or AIDS and alternatives to ARVs.
But is the department of health following a strictly selective criterion when it comes to who or what it will protect citizens against?
Rewind a few years to around 2005 when desperately ill people living with HIV in Khayelitsha and Gugulethu were convinced by fellow residents to attend ‘clinics’ where they were reportedly stripped to their underwear, subjected to blood tests and told to take high dosages of what is believed to be multi-vitamins.
After participating in what is now accepted to have been unethical scientific trials, they were told the VitaCell tablets, brought into the country by the Dr Rath Health Foundation, would boost their immune systems and that they would be healthy.
Families spoke of mothers and sisters who died at home, their bodies wracked with diarrhea and thrush. But they refused to return to the state clinics as they had been told by the distributors of these tablets that they should rather attend the clinics being run under the banner of the Rath Foundation.
Throughout this sad chapter in our history Rath enjoyed tacit support from the health minister who admitted to meeting with him and on more than one occasion stated she saw nothing wrong with what he was doing. Her Director General Thami Mseleku has echoed her sentiments asking a New Yorker journalist during an interview: ‘What, exactly, was Rath’s crime?’
For years the German vitamin seller was allowed to spread his vitamin and anti-ARV gospel mainly in Khayelitsha and Gugulethu and was in the process of going national when civil society, in the form of the Treatment Action Campaign, and the South African Medical Association, used the courts to put an end to his crusade.
But not before several people died.
The court has ordered the health department to investigate Rath’s activities, but there are no indications of this happening.
In fact, court papers have revealed that Mseleku’s claims that they had investigated Rath, involved two telephone calls to Rath employees, one who now denies ever being contacted.
As Rath’s operations have waned a new questionable healer in the form of Zeblon Gwala, a former truck driver has appeared. Gwala is making a stack of money selling a brown liquid called Ubhejane (Zulu for Rhinoceros), the contents of which had been revealed to him in a dream, to people living with HIV.
He has openly stated that he discourages his patients, most who live in AIDS-stricken KwaZulu-Natal, from continuing with their ARVs if opting to take his liquid.
In a TAC report, a doctor has told of a 36-year-old patient who had been on ARV treatment for 15 months before dumping it for Ubhejane.
The patient was doing well, with no reported side-effects and complications, but he consulted a traditional healer who stopped the ARV treatment and gave him Ubhejane. Within two weeks the patient developed complications and died.
‘We win some and lose some, but we are facing a huge challenge of dealing with such cases and it is an unending, continuous battle that we are facing,’ the doctor said.
Have there been any moves by the health department to investigate Gwala? To the contrary.
As was the case with Rath, Gwala is enjoying the tacit support of the health department.
Although Mseleku has challenged critics to produce evidence that any of his officials has said ‘use Ubhejane’, he has refused to take any action and has fobbed off any criticism as ‘colonialist’.
In May the KwaZulu-Natal Health MEC hosted a bizarre “HIV information workshop” addressed by Gwala as well as AIDS denialists and opponents of antiretroviral therapy. The national health minister was the keynote speaker.
Gwala has also addressed parliament’s health portfolio committee.
Again, there has been no action, despite reports of people dying.
Sadly Gwala and Rath are a drop in the ocean. Buoyed by signs that the health department is showing no political will to act against untested ‘natural remedies’ many others have set up shop pushing potions and snake oils for anything from HIV to cancer to TB.
Some are sophisticated operations with a phalanx of workers who walk the streets to spread the gospel and sell their bottles of wares. Others are one-man shows who sell murky liquids and promises of cures.
And time and time again government, the health department and the health minister are failing to take steps to protect the ‘vulnerable members’ of society.
While they may not have the legislative framework to take such steps, they certainly have not shown any political will to even try to come to grips with this minefield.
It is time they showed the same vigor in tackling the snake oil salesman as they have in tackling conventional medicine and science.