iClinic - September 21, 2000
In one of the clearest explanations of his position on HIV/AIDS
yet, President Thabo Mbeki shared his doubts that HIV can cause
AIDS when answering questions posed by Democratic Alliance
leader Tony Leon and the ACDP's Cheryllyn Dudley in parliament
on Wednesday. But he emphasised that all government HIV/AIDS
policies are based on the premise that HIV causes AIDS.
"All HIV/AIDS programmes of this government are based on the
thesis that HIV causes AIDS," said Mbeki, adding "There is
absolutely no confusion about what to do."
But he went on to ask "Does HIV cause AIDS? Can a virus cause a
syndrome? How? It can't, because a syndrome is a group of
diseases resulting from acquired immune deficiency." He said
that the question still unresolved by scientists is: what
contribution does HIV make to the collapse of the immune
"Indeed, HIV contributes, but other things contribute as well,"
He said that what is not yet resolved and what is being
investigated by the International AIDS panel is: what do HIV
tests measure? "Scientists from both sides of the divide have
identified this as an essential question to be resolved in
order to provide comprehensive treatment," says Mbeki, adding
that "We need to understand all these complexities so that our
intervention can be more effective, even though many people do
not want to study this question."
Leon wanted to know whether the SA National AIDS Council has
made any recommendations about the use of anti-retroviral drugs
to prevent mother-to-child transmission of HIV (MTCT).
Mbeki replied that antiretroviral nevirapine has not been
registered for MTCT anywhere in the world and that the World
Health Organisation is still considering its use for this
"A National Steering Committee on MTCT has already met and will
finalise its report mid-October," says Mbeki.
On the question whether he believes that HIV is a minor or
major cause of AIDS, Mbeki replied that "there is a serious
On the question of AIDS orphans, Mbeki replied that "orphans
result from the health crisis in SA, caused by many diseases".
He pointed to 1999 WHO estimates of the causes of death in
Africa, which stated that 12% of deaths are caused by HIV/AIDS,
but heart diseases is still the biggest killer. "All these
cause orphans," says Mbeki.
On the question why there is a delay in MTCT in other provinces
when the Western Cape, the only province not controlled by the
ANC, has successfully implemented free treatment, Mbeki replied
that "This matter will be dealt with through the Steering
Committee on MTCT".
On the call to go for an HIV test by PAC spokesperson Patricia
de Lille, who went for a public HIV test recently to spur on
other politicians to lead by example, Mbeki replied that "It is
important to know what the state of one's health is - in my
capacity as president of this country I go for regular health
On the controversial debate whether HIV causes AIDS sparked by
Mbeki's courting so-called AIDS dissidents in his presidential
AIDS panel, Mbeki replied that "The way we have handled the
complex scientific questions around HIV/AIDS may have been
confusing, but there is nothing confusing about what government
HIV/AIDS programmes are based on and are trying to do".
It was the second time this year that Mbeki replied to
questions from MPs in parliament, in terms of new rules for
parliamentary question time.
The questioning follows weeks of controversy over Mbeki and
Health Minister Manto Tshabalala-Msimang's refusal to state
outright whether HIV causes AIDS.
Standard government replies to this question have been that
AIDS has multiple causes and that the answer can be read in the
policies and programmes set up by government, which operate
from the premise that HIV causes AIDS.