DURBAN, SOUTH AFRICA--When South African President Thabo Mbeki rose to address the opening ceremony for the XIII International AIDS Conference here yesterday, thousands of researchers packed into Kingsmead Stadium hoped he would say three simple words: HIV causes AIDS. He didn't. "He waffled while Rome is burning," said Glenda Gray, a pediatrician who co-runs a perinatal HIV clinic at Soweto's enormous Chris Hani Baragwanath Hospital.
Mbeki recently convened a panel to help his government develop policies to tackle the growing AIDS crisis, but he included so-called "dissidents," who insist that HIV does not cause disease and question whether AIDS is a new disease or old diseases collectively given a new name. Scientists around the world have berated Mbeki for giving new lifeblood to the dissidents, whose arguments the community had thoroughly dismissed years ago. Many were hoping that the president would finally distance himself from eccentric views.
But Mbeki addressed the issue only indirectly. Much of his speech quoted from a 1995 World Health Organization report that fingered "extreme poverty" as "the greatest cause of ill-health and suffering across the globe." Mbeki did note, however, that his government would continue to intensify its anti-AIDS campaign by encouraging the use of condoms, supporting research on AIDS vaccines and anti-HIV drugs, and responding humanely "to people living with AIDS and HIV." But he made no mention of his decision not to supply relatively cheap courses of anti-HIV drugs to infected, pregnant women, which studies have shown can cut by 50% transmission of the virus to their babies.
Mbeki's failure to acknowledge directly that HIV causes AIDS has angered AIDS researchers from South Africa and elsewhere. "This was a good opportunity for him to put a closure on the whole thing, and he didn't," complained virologist Lynn Morris, who works at the National Institute of Virology in Johannesburg and sat on the panel that Mbeki convened. Indeed, several researchers and activists walked out during Mbeki's address.
Still, some top South African researchers saw the speech as a step forward. "Considering all we've gone through over the last few months it's an excellent speech," said Malegapuru William Makgoba, head of the country's Medical Research Council and another member of Mbeki's panel. "He had the option of just talking about AIDS. But he always talked about HIV-AIDS. So he links HIV to AIDS." What some saw as wordsmithing, Makgoba concluded was a "clever way" for Mbeki to extricate himself from the debate. Those who criticized the speech, Makgoba said, were being "churlish."