H.I.V. causes AIDS. This is not a controversial claim but an
established fact, based on more than 20 years of solid science.
It is as certain as the descent of humans from apes and the
falling of dropped objects to the ground.
So why reiterate the obvious? Because lately, a bizarre theory
has gained ground -- one that claims that H.I.V. is harmless, and
that the antiretroviral drugs that curb the growth of the virus
cause rather than treat AIDS. Such talk sounds to most of us like
quackery, but the theory has emerged as a genuine menace to
public health in the United States and, particularly, in South
The theory, which we call AIDS denialism, has gained such
currency with President Thabo Mbeki of South Africa that his
administration is reluctant to expand access to antiretroviral
drugs. Despite generous allocations from the country's Treasury
and substantial assistance from foreign donors, only a quarter of
those needing antiretrovirals receive them. This response is poor
by the standards of middle-income countries, but it is especially
troublesome in South Africa, which has more H.I.V.-positive
people than any other country.
American AIDS denialists are partly to blame for South Africa's
backsliding AIDS policy. Manto Tshabalala-Msimang, the health
minister, has described antiretrovirals as poisons. She is
supported in these views by Roberto Giraldo, a New York hospital
technologist who says AIDS is caused by deficiencies in the diet,
and who served on President Mbeki's AIDS advisory panel in 2000.
The minister promotes nutritional alternatives like lemons,
garlic and olive oil to treat H.I.V. infection. Several prominent
South Africans have died of AIDS after opting to change their
diets instead of taking antiretrovirals.
Another American AIDS denialist, David Rasnick, a regular
letter-writer to South African newspapers, absurdly claims that
H.I.V. cannot be transmitted between heterosexuals. Mr. Rasnick
now works in South Africa for a multinational vitamin company,
the Rath Foundation, conducting clinical trials in which AIDS
patients are encouraged to take multivitamins instead of
In the past, South Africa's Medicines Control Council acted
swiftly to curb such abuses, and the Medical Research Council
condemned AIDS denialism. But recent high-level political
appointments of administration supporters to both bodies have
neutered their influence. In South Africa, AIDS denialism now
underpins a lucrative nutritional supplements industry that has
the tacit, and sometimes active, support of the Mbeki
By courting the AIDS denialists, President Mbeki has increased
their stature in the United States. He lent credibility to
Christine Maggiore, a Californian who campaigns against using
antiretrovirals to prevent transmission of H.I.V. from mothers to
children, when he was photographed meeting her. Two years later,
Ms. Maggiore gave birth to an H.I.V.-infected daughter, Eliza
Jane, who acquired an AIDS-related infection last year and died
at age 3.
Mother-to-child H.I.V. transmission is now rare in the United
States, thanks to the widespread use of preventive therapy and
the activities of organizations like the National Institutes of
Health and the Elizabeth Glaser Pediatric AIDS Foundation. Sadly,
this is not so in South Africa, where many children are born
infected and then face short, painful lives. The health and lives
of American children are also still under threat: a small clique
of AIDS denialists is trying to block the provision of
antiretrovirals to H.I.V.-infected children in the New York City
foster care system.
Until recently, AIDS researchers and activists in the United
States tended to regard the denialists with derision, assuming
they would fade away. Unfortunately, this has not happened.
Harper's Magazine recently published an article by Celia Farber
promoting the denialist view. There is a real risk that a new
generation of Americans could be persuaded that H.I.V. either
doesn't exist or is harmless, that safe sex isn't important and
that they don't need to protect their children from this deadly
virus. A resurgence of denialism in the United States would have
far reaching effects on the global AIDS pandemic, just as it
already has in South Africa.
The AIDS denialists use pseudoscience and non-peer-reviewed
Internet postings to bolster their false claims about H.I.V. The
real facts about this virus have been uncovered by scientists
supported by the National Institutes of Health, the British and
South African Medical Research Councils, the Pasteur Institute
and many other national research organizations. The public should
seek AIDS truth from the latter sources.
It is sad when selling magazines and vitamin supplements is
considered more important than promoting public health and
scientific truth. The truth is that H.I.V. does exist, that it
causes AIDS and that antiretroviral drugs can prevent H.I.V.
transmission and death from AIDS. To deny these facts is not just
wrong -- it's deadly.
John Moore is a professor of microbiology and immunology at
Cornell University. Nicoli Nattrass is the director of the AIDS
and Society Research Unit at the University of Cape Town.