Health HIV and AIDS

Open letter to Thabo Mbeki by a clinical associate

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Written by Sanele Sano Ngcobo

Sanele Sano Ngcobo is a clinical associate. He pens this letter to Former President Thabo Mbeki in the wake of Mbeki’s latest letter attempting to explain his controversial stance on HIV.

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Sanele Sano Ngcobo is a University of Pretoria junior lecturer. He is an executive member of the International Academy of Physician Assistants and the Secretary General of Professional Association of Clinical Associates in South Africa. Picture supplied

Dear Honourable Thabo Mbeki,

In response to your latest letter, I would like to challenge you to admit that you took a wrong decision. Your article is indirectly denying the proven facts that antiretrovirals (ARVs) have saved lives of many South Africans.

I would like to share few ARV success stories with you.

In 2005, life expectancy in South Africa was 51 years and today it is 61 years. Zimbabwe’s life expectancy in 2000 was 44 years and today it is 60 years. Both South Africa and Zimbabwe introduced massive ARV programmes.

Due to ARVs, HIV-related deaths went down by:

  • 58 percent in South Africa
  • 71 percent in Ethiopia
  • 64 percent in Thailand, and
  • 87 percent in Senegal.

All these countries started massive ARV programmes. What more proof do we need that ARVs are saving lives of our people?

You have argued that the US pharmaceutical companies wanted to benefits from provision of ARVs, however on 19 April 2001 your government successfully protected a law allowing the domestic production of cheaper, generic medicines – including ARVs – against a lawsuit filed by transnational pharmaceutical companies.

Why didn’t you invest in domestic companies to produce ARVs?

Asking questions wasn’t wrong. Not acting was

[quote float= right]”You were doing the right thing by asking questions, but while you were asking questions there should have been some interventions rather than watching our people helplessly dying”

I am not saying you shouldn’t have asked questions. You were doing the right thing by asking questions, but while you were asking questions there should have been some interventions rather than watching our people helplessly dying in the eye of the so-called democratic government.

In your letter, you make many good points with no solutions. There is no alternative.

You had two options: Give ARVs to our people or let them die. You chose not to give them ARVs and they died.

The letter you wrote is an insult to the victims of your decisions. You are not sympathising with those who lost their loved ones because of you. Instead, you are saying there is no need to give ARVs.

Your decision resulted in more than 300 000 people unnecessarily dying from HIV. More than 35 000 babies were born HIV positive because of your decisions. How do you feel about this?

It doesn’t help to hide behind a 2006 Statistics South Africa report, saying “HIV disease” was the 9th leading causes of death in South Africa in that year.

Do you believe this?

If you were living in South Africa in 2006, you would know that most of our people were dying of AIDS and that AIDS-related deaths were misclassified. An HIV-positive patient who died of tuberculosis wouldn’t be counted amongst those who died of HIV and you know that fact. According to the World Health Organisation, as many as 94 percent of all AIDS-related deaths were misclassified from 1995 to 2006.

You are saying we couldn’t afford ARVs. The big question is can we afford ARVs today?

The same US government that you keep on accusing has spent more than R65 billion in a fight against HIV through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

Out of touch

In 2002, your government was ordered by the court to provide the ARV nevirapine to pregnant woman to prevent the mother-to-child transmission of HIV. You appealed a decision to prevent children from getting HIV from their parents. [2002 links to ]

Even Honourable Former President Nelson Mandela tried to intervene by saying:

“If the government says, ‘Don’t make any move until we have completed our research’, young people and babies are going to die in scores every day. The government must allow people, while it conducts its research, to go anywhere they want (to get nevirapine). If we do that, we will remove the perception that we don’t care about our people who are dying.”

You argued we couldn’t give the ARVs to pregnant woman because it was expensive. Were you more concerned about money versus lives of our children?

It seems as if you never took HIV seriously. Instead of promoting HIV counselling and testing, you had better things to do and so a 2000 article quoted your former spokesperson Parks Mankahlana as saying:

“The president is not prepared to engage in trivia. He has got more important things to worry about than testing for HIV/Aids. Those who want to go and test for HIV/Aids must do so.”

In 2003, you confessed HIV had not personally affected you. You were disconnected from the reality. You were not a good example to our people.

I would advise that as an expert in economics, your articles focus on that field and leave the health-related issues to the health experts.

Your article undermines the hard work of Health Minister Dr Aaron Motsoaledi and we are not going to allow you to take us back.

You did enough damage in the health sector. Now please allow those who are fixing it to do so peacefully.

Thank you.

Best Regards,

Sanele Sano Ngcobo

Sanele Sano Ngcobo is a University of Pretoria junior lecturer. He is an executive member of the International Academy of Physician Assistants and the Secretary General of Professional Association of Clinical Associates in South Africa (PACASA). He writes in his personal capacity. Follow him on Twitter at @sanosanele

An edited version of this opinion piece was also published on

About the author

Sanele Sano Ngcobo


  • Well explained , thank you very much. One question I have is keeping on blaming Thabo Mbeki will it bring back the lifes of those perished due to so called reckless decision regarding the matter at hand. I would suggest that this matter is placed to rest and move on with what you say is good work by the current health minister.

  • I see no use of trying to engage President Mbeki on this Matter , He mis-Juged the matter and He Paid the Price no need My Brother .

    What a wastefully energy young Man .

  • @Vukile I think at some point one has to take responsibility of their wrong decisions. Leaving it to rest will make him feel less responsible. We are not blaming him as such, but making him aware of the blander he made and he must take responsibility. him trying to justify the matter won’t bring back the lives lost anyways.

  • In addition, the fact that he is an economics expert does not disqualify his views from this discussion as you are as a lawyer would equally have no bearing if that was the case. Perfect article, concluded badly.

  • It is inhumane what happened and Thabo Mbeki’s spokesperson what he said was adding fuel on fire. We all can see that nowadays the government is more concerned about money rather than focusing on South African citizens. It would be best that Health experts carry on doing the wonderful job they’ve been doing,and we should focus on creating a better tomorrow and save those lives we have. HIV is a perfectly manageable desease provided you have the correct prescriptions.

  • Thank you sanele for your opnion, forgive me for my broken English as I write, 1, Mr Thabo Mbeki’s focus was in economics, that is why he didn’t make a budget available for ARVs , So was he wrong on focusing on what he knows best as you suggested, which is saving the money?, He didn’t dispute the fact that ARVs are working thus he was attempting to find other solutions for less expenditure, so was he wrong on that I ask?, We need a powerful economy to solve mojar health issues so without that economy which Mr Thabo Mbeki was focusing on, we can’t solve anything, then people will still die, if u have noticed health and money is tantamount to each other, so an expert in economics he chose economy, if he was a doctor I’m sure was going to put his focus on health related issues, so ur letter becomes invalid on the point of economy.

  • …But you are right, i `m angry too. But look at it this way, aids come before Mr Mbeki become the president and there were there massages all over electronic & social media encouraging every one including every body in your statistics to use condoms (ABC), but guess what, they continued to be reckless engaging in sex without protection…

  • Thanks for a sharing such a beautifully written article that cuts through the nonsense with surgical precision.

  • In as much as the info you are providing is helpfull to understand the effect of the decision taken by Former president Thabo Mbeki. But is there anyone who is willing to answer his questions around the matter? Cause we also want to know the answer.

  • Sanele you are not saying anything new that was not said in newspapers in the past, the only thing that i want to tell is that where did you get the statistics from

  • Tilana, you seem to miss the point here. The author has indicated that Mr. Mbeki erred in his judgement, did not care for the poor and ill including babes and rape victims.

    He correctly advise Mr. Mbeki to stop defending his stand of justifying the death of many who left orphans who are now house-hold heads.

    As long as he does not lay the matter to rest and not keep on justifying himself because really, the late can’t come back;he shall not be left alone.

    Frankly, he has blood in his hands.

  • Great factual response Sanele. However I’m concerned about a potion of your statement which Say ” … called democratic government…” Pres Mbeki was simple wrong with Hiv but that doesn’t reduce our democratic government into a “so called democratic government”. Mistakes of our leaders should not be used to undermine the dignity of our country and the democratic system we have in our country.

  • Thank you Sanele, well-put.
    @Vukile- the point that Sanele is trying to drive home is that Thabo caused chaos and must now stop with this nonsense of his and allow for the current efforts to run peacefully. Thabo is an influential person but he can’t be choosing to use it this way. He must please shut up and concentrate on what he understand to be his strengths.
    We can’t be undermined by his lack of compassion.

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