Mbeki’s AIDS denial: Grace or folly? Part II
Pambazuka News continues to serialize William Gumede's chapter on Mbeki and the controversies surrounding his AIDS policies. This is from his book "Thabo Mbeki and the Battle for the Soul of the ANC." Be sure to look for parts three through five in upcoming issues.
In 1996,researchers linked to Pretoria University and representing a biotech company called Cryopreservation Technologies claimed they had found a cure for AIDS.[10] Zigi Visser and his ex-wife Olga lobbied senior officials in the department of health and in the ANC, who put them in touch with Nkosazana Dlamini-Zuma.
The go-between, Joshua Nxumalo, a former MK cadre, played a crucial role in setting up meetings between the Virodene drug researchers, Dlamini-Zuma and eventually Mbeki. Nxumalo was later part of a BEE consortium that bought the rights to Virodene. Dlamini-Zuma was sufficiently impressed with the Vissers’ report on their research to secure a quicker meeting with Mbeki, then deputy president and whose diary was notoriously almost always full. The Vissers were looking for government endorsement and money. Their scientific peers had been sceptical. The Medical Control Council had refused to issue the company with a licence to produce Virodene. Following a review of their research, the MCC, Gauteng health department and senior scientists at the University of Pretoria had rejected the application for a licence on the basis that the drug was ineffective, even dangerous. The Pretoria group hoped that Mbeki would prove more receptive. Shortly before Christmas 1996,Dlamini-Zuma and Mbeki set aside protocol and convention and secured for the researchers a cabinet hearing for their preliminary findings, which had not been subject to peer review.
The Virodene researchers arrived at the Union Buildings in January 1997 with a posse of ‘cured’ patients who testified to the ‘positive’ effects of the treatment. An excited Mbeki had primed his colleagues well. The cabinet received the group warmly, and almost without question accepted the researchers ’claims[11] and their accusation that the MCC had rejected them because it was in cahoots with inter- national pharmaceutical companies.[12] Jakes Gerwel, Mandela’s cabinet secretary, said later that ministers were overwhelmed with ‘awe and pride ’as the Virodene researchers’ ‘patients’ related tales of miracle cures.[13] Mbeki would later write in the ANC’s journal Mayibuyewhat a ‘privilege’ it had been to hear the moving testi- mony of AIDS sufferers who had been treated with Virodene,with seemingly very encouraging results.[14]
The Virodene team’s sales pitch was that not only was the product much cheaper, but it was also home-grown. The latter particularly aroused Mbeki’s interest. At the time, he and most of the cabinet ministers saw themselves as being under siege from a vast conspiracy of local white critics, black trade unions and civil society activists, Western governments and international business. The Virodene researchers appeared to be a godsend. The deputy president had already just about settled on an idea (after much contemplation) that would define his upcoming presidency.[15] Mbeki hoped his term of office would be defined by an African Renaissance, which would see the continent, under the leadership of a democratic South Africa, undergoing social, political and economic renewal that would finally make it an equal partner ofmore prosperous regions, especially the West. An important component would be African solutions for African problems.[16] Mbeki latched onto the Virodene proposal as a possible African solution to one of Africa’s greatest challenges.
Virodene was later shown by an independent panel, led by the South African Medical Research Council, to contain dimethylformamide,a toxic industrial solvent used in dry-cleaning. A month after the Virodene researchers so persuasively addressed cabinet, the MCC announced that Olga Visser and her associates were flouting accepted testing norms, and promptly banned them from testing their product on humans. Mbeki and Dlamini-Zuma were severely embarrassed. Oppo- sition parties and the media hit out at the government. DA leader Tony Leon accused Mbeki of being obsessed with finding African solutions to every problem’.[17] He said Mbeki’s support for Virodene amounted to resorting to ‘snake oil cures’ and ‘quackery’.[18] The Sunday Times lashed out at a cabinet whose ‘combined technical knowledge of the HI Virus fits on the back of a postcard’.[19]Both Mbeki and Dlamini- Zuma viewed the attacks as racist, if made by whites or the political opposition, or personal, if made by blacks or those associated with the ANC family. Mbeki called Leon ‘the white politician’ who ‘practices in Africa’.[20] Dlamini-Zuma said bitterly:‘If they [Leon and the DA] had their way, we would all die of AIDS.’[21]
Sadly, neither Mbeki nor Dlamini-Zuma admitted to being wrong, instead persistently presenting themselves as victims of racist baiting, and nursing grudges against their critics. In fact, Mbeki would continue to support Virodene’s pro- moters, later even mediating in a feud between the biotech company’s leading researchers.[22] Mbeki and Dlamini-Zuma now also saw the MCC, especially its chairman Peter Folb, as representatives of the ‘racist conspiracy’ against which battle must be joined. Folb was fired a year later.[23]Partly as a result of the Virodene conflict, Dlamini-Zuma abolished the MCC in March 1998 on the recommen- dation of a review team she set up to evaluate the council’s operations, which concluded that the MCC was too intimately linked with the pharmaceutical industry. A new institution, the Medicines Regulatory Authority, replaced the MCC in September 1998.In June 1998,a group of investors, including Nxumalo, who had originally introduced the Vissers to Dlamini-Zuma and Mbeki,bought the rights to their AIDS ‘cure’.[24] Virodene is not officially registered in South Africa, but it is still punted on the Internet as a cure for HIV/AIDS.[25]
However dubious these early government forays into the AIDS field were, they were based on the accepted scientific consensus that HIV is the principal carrier of AIDS, rather than the dissident argument that the virus is a ‘harmless’ passenger, and that symptoms associated with AIDS are due to ARV therapy, malnutrition and poverty. From the Virodene saga onwards, the AIDS issue became racially charged in South Africa, and it has remained so. All future responses would be coloured by race, as had already happened in some parts of greater Africa, and even among some Afro-American groups who gave credence to the urban legend that the deadly virus had been brewed in a laboratory as part of a covert Western intelligence plot to decimate blacks – the CIA’s ‘final solution’. For example, a study conducted by the Rand Corporation and the University of Oregon revealed that almost half of all African-Americans believe that the virus that causes AIDS is man-made; more than a quarter believe it was produced in a US government laboratory; and one in eight thinks it was created and spread by the CIA.[26]
Bizarre as they were, such rumours were fuelled by revelations from the mid-1990s that the apartheid defence force had run a top-secret germ warfare programme, which included experiments on ethnic-specific killer bugs. The Truth and Reconciliation Commission heard senior former security policemen confess that HIV-positive agents had been instructed to have unprotected sex with black prostitutes as part of a diabolical state-sponsored plan to spread the infection. In 1995,the South African government launched a battle against international tobacco companies by instituting stringent anti-smoking laws, and with the pharmaceutical giants over the high price of essential medicines.
The ANC had worked hard to make medication more accessible and more affordable to the majority black population. This led to repeated skirmishes with drug manufacturers, and a protracted trade dispute with America and various countries in the European Union. At the heart of the matter was an amendment to the Medicines and Related Substances Control Act, which gave government the power to fast-track compulsory licensing and parallel imports of medicines.
The government argued, correctly, that this was consistent with the World Trade Organisation’s Trade Related Intellectual Property Rights Agreement (TRIPS), which stipulates certain exceptions to normally strict commercial regulations. In times of health emergencies, for example, poor countries are allowed to circumvent patent laws in order to produce cheaper generic versions of desperately needed drugs. Compulsory licensing allows a country to manufacture a drug in such circumstances without the permission of the patent holder, provided that ‘adequate remuneration’ is paid to the company. Parallel importing permits a country to buy a drug from the lowest bidder without the consent of the patent holder. But there is huge resistance from developed countries and pharmaceutical companies to these concessions, and South Africa was placed on an American ‘watch list’ of potential offending countries. The drug manufacturers exerted enormous pressure, both directly and indirectly, on the South African government, outraging Mbeki, Dlamini-Zuma and the ANC leadership.[27]
The pharmaceutical industry in the US lobbied the Clinton administration, which threatened sanctions if South Africa went ahead with plans to push through legislation to facilitate the import of cheaper generics. American vice-president Al Gore found support in the South African media and with opposition parties for his demand that the amendment be repealed.
It was particularly galling for Mbeki, his policy guru Joel Netshitenzhe, his ‘enforcer’ Essop Pahad and his trusted ally Nkosazana Dlamini-Zuma to have their political opponents and the predominantly white-owned media support foreign opinion against what they saw as South Africa’s interests.[28]
The tussle ended when thirty-nine companies joined forces under the banner of the Pharmaceutical Manufacturers’ Association of South Africa and took the government to court. They poured millions into their campaign, which was vigorously opposed by the government and, importantly, the TAC and several trade unions.
Dlamini-Zuma herself was an energetic campaigner against both international pharmaceutical and tobacco companies. This made her very unpopular with busi- ness groups, so much so that many business leaders view the possibility that she could replace Mbeki as leader of the ANC at the end of 2007 with undisguised horror. Shortly before the 1999 elections, she told members of the TAC: ‘If you want to fight for affordable drugs, then I will be with you all the way.’[29] Marking the end of his first six months as president of South Africa, Mbeki launched a tough attack on pharmaceutical companies:‘(A)s long as [AZT] is only available at exorbitant prices, it is impossible for the government to make it available to ordinary people.’[30]
In the face of local and international protests organised by the TAC, the pharma- ceutical companies reached an out-of-court compromise with the government and withdrew their legal action. By that time, the amendment to the Medicines Act, which applied to all drugs, not just ARVs, had become law.
Finally, government seemed to waken to the gravity of the AIDS crisis. Billboards were erected, condom distribution increased and the ABC (Abstain, Beware, Condomise) campaign put in place. Yet, despite what amounted to a victory against the pharmaceutical companies, the government still refused to make ARVs available to the masses.
Activists were enraged when the health department announced that AZT would not even be given to pregnant women as a matter of course. There was ample evidence that the drug greatly reduced the risk of foetal HIV infection, but the government stuck to its claim that AZT was both toxic and unaffordable.
In December 1998, Zackie Achmat announced that he would go on a hunger strike until ordinary South Africans could be given ARVs at state hospitals. ‘On principle, I won’t take ARVs until they are freely available to the poorest,’[31]he said. His decision coincided with the TAC’s launch of a campaign to prevent mother- to-child infection. By 1999,an estimated 40 000 babies were being born with HIV in South Africa annually, their mothers too poor to pay $75 for a short course of AZT,which would lower the risk of transferral by half. The TAC would maintain its relentless pressure on the pharmaceutical companies for the best part of a year, with NGOs in America staging solidarity protests at various points on US vice- president Al Gore’s campaign trail until the threat of sanctions was withdrawn.
The TAC’s sustained efforts to shame Western governments and highlight their indifference to the plight of AIDS victims in South Africa compelled President Bill Clinton to pledge in 2000 that the US would ensure that ‘people from the poorest countries won’t have to go without medicines’. His announcement came as the United Nations revealed that it had negotiated a deal with five multinational pharmaceutical companies to reduce the price of AIDS drugs in the developing world.
The South African government’s response was guarded. Mbeki, Pahad, Netshitenzhe, Manto Tshabalala-Msimang, who had replaced Dlamini-Zuma as minister of health, and trade and industry minister Alec Erwin now argued that price reductions negotiated with manufacturers were neither substantive nor a permanent solution. If costs could not be decreased any further, it would be better to obtain the drugs through local generic production or parallel importation from Brazil, Thailand or India, where they were successfully being made at a fraction of even the discount price.
In the event, it soon became clear that the high-profile offers of cheaper drugs from the US administration came with punishing strings attached. South Africa could avail itself of some $1.5 billion in the form of export–import loans, at commercial interest rates, to buy American drugs at market prices. In addition, by May 2001, five of the world’s biggest pharmaceutical companies had agreed to enter into talks with African nations on reduced prices, provided the countries concerned agreed to health action plans being drawn up by McKinsey, a leading business consultancy!
The offers were turned down, but they had reinforced suspicions that Western governments and the drug manufacturers were locked in a conspiracy against Africa. As Mbeki’s views hardened, the relentless pressure applied by the TAC and various NGOs was starting to pay dividends. Drug companies squirmed under accusations of greed, and some began privately to offer significant discounts on their products. By mid-2001,Boehringer Ingelheim was offering Nevirapine, a drug commonly used by HIV/AIDS sufferers, free for a limited period to pregnant women in South Africa. Glaxo offered AZT at 30 per cent of the average inter- national price.
But government still refused to buy the drugs, claiming they were toxic. According to some of Mbeki’s close advisors, the offers were seen as a piecemeal strategy to stave off production of cheaper generics. Yet no moves were made to launch local production or import generics. In fact, keen to play a leading role in the global economy and to be seen as playing by the market rules, the government started back-pedalling on earlier threats to import generics.
In November 2001, British trade minister Richard Caborn wrote to the London-based Action for Southern Africa, an organisation that campaigns for Thabo Mbeki and the battle for the soul of the ANC peace, democracy and development across the region: ‘I don’t believe that this or related measures such as parallel importing are the answer here.’[32]
South Africa had had the option all along of circumventing TRIPS by citing ‘national emergency’, but Mbeki had come to believe that the pharmaceutical companies were greatly inflating the AIDS threat in order to exploit developing markets.
*William Gumede is the author of Thabo Mbeki and the Battle for the Soul of the ANC - Published by Zed Books (http://zedbooks.co.uk). His latest book, "The Democracy Gap - Africa's Wasted Years", will be published later this year.
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