Still recovering from an era of AIDS denialism and quackery under former health minister Dr Manto Tshabalala-Msimang and then President Thabo Mbeki, South Africans read in a weekend newspaper that the minister of co-operative governance and traditional affairs believed that herbs ‘€œsurpasses antiretrovirals because your body gets used to them’€ and ‘€œarrests the spread of the viral load’€.

Offered an opportunity to explain his comments, Shiceka’€™s spokesperson Vuyelwa Vika this week sent an e-mail response to a set of questions.

‘€œThe Minister believes there is enough space for both herbs and antiretrovirals within the health management environment in our country. His statement to the journalist was that since we live in a democracy where people have a choice, people should have choices even in terms of their health and wellness and the kind of medical treatment they choose for various illnesses and conditions, including living with HIV.

‘€œHe said he knows of people who have used herbs and have reported a marked decline in their viral load. He also said because we live in Africa and Africans use herbs and other forms of indigenous knowledge systems, they should not be embarrassed and use these secretly because it is a choice they have, but the one thing that the system of indigenous medicine needs to be rid of are charlatans who can take advantage of our people.

‘€œHowever, the presence of charlatans does not take away from the fact that for some in society, traditional herbs and ways of medicine do work and have been proven scientifically to work,’€ Vika said.

Asked to share the evidence on which the minister had based his claims that herbs could reduce the viral load of a person living with HIV/AIDS, Vika said he had witnessed it in his community and among family and friends. She added that he was unable to name the specific herbs he was referring to as he was not a herbalist, but urged the journalist to ‘€œdo your research and go to herbalists in the country’€.

Invited to explain his statement that herbs ‘€œsurpassed’€ antiretrovirals Vika responded that ‘€œin some instances the herbs have surpassed antiretrovirals where people reacted negatively to ARVs but reacted far more positively to herbal medication which indicates that people should exercise their choices and work with what their bodies work the best with.

‘€œRather than this being turned into an either or situation, the Minister believes that it is primarily a health management issue and there can never be a one size fits all’€.

Vika also confirmed that the minister knew of instances where ‘€œmore than just one person living with
HIV arrested or contained the increase of the viral load in their body after using herbal medication – meaning instead of spreading/increasing, the viral load stabilised and after some time actually went down’€.

In the weekend report Shiceka states that he was planning to meet with the health department with the aim of making traditional medicine available in every health facility.

Vika said the Shiceka was planning to bring together traditional healers and the health department to explore means of mainstreaming alternative African indigenous health and medicinal systems and getting rid of charlatans through legislation ‘€“ ‘€œto the extent of making these ways of healing and preventative medicine accessible in hospitals and clinics, without demonising them and making African people feel ashamed of their ways of doing things’€.

Vika said the minister’€™s thinking was in line with Eastern societies, ‘€œincluding the example of Chinese herbal remedies, which are not a source of shame to the Chinese and have actually gained the respect of the rest of the world. There cannot be a one method fits all in health management, so ARVs can co-exist with African indigenous ways of herbal medication’€.

Reminded of the confusion caused by Tshabalala-Msimang’€™s statements on nutrition and other natural remedies being superior to western medicine, the Vika responded that ‘€œPeople living with ARV (sic)are living with the virus but have minds which work very well, so they are not easily (be)”confused” by clear statements like what the Minister said.

Asked pertinently whether the minister supported ARVs as part of the various tools in the fight against HIV/AIDS, Vika said agreed that it was acceptable as an ‘€œalternative for those who prefer them, because people have a democratic right to choose what works for them – for some it is ARVs, for others, herbs.

‘€œThis is the democracy the Minister sacrificed his youth to see unfolding in South Africa, so that everyone of us can exercise some of these fundamental choices.’€

Mark Heywood of the AIDS Law Project said Shiceka’€™s comments were worrying and disappointing.

‘€œComments such as these set the country back to an era that we thought we had gone moved from. We hope that the minister can retract his statement and that the health department can take a stand against it’€, he said.

Nathan Geffen of the Treatment Action Campaign said it was not the state’s role to say that people have choices in how they treat HIV.

‘€œObviously people have choices. The state’s role is to inform people what choice will save lives on the basis of scientific evidence. There is no evidence that any intervention other than antiretroviral medicines suppress HIV viral load, it is this message that all representatives of the state should be conveying,’€ said Geffen.