South Africans should move beyond the counterproductive debate about the cause of AIDS to an engagement with President Thabo Mbeki’s main thrust of argument – seeking solutions that are appropriate to our circumstances in Africa, according to Professor Daniel Ncayiyana, editor of the SA Medical Journal (SAMJ).

Ncayiyana said Mbeki’s argument had become obscured in the HIV-AIDS link “side-show”.

“In Mbeki’s own words, a simple superimposition of Western experience on African reality would be absurd and illogical,” Ncayiyana wrote in the May issue of the SAMJ.

Commenting on Mbeki’s flirtation with dissident scientists, Ncayiyana said it would appear as if South Africans had not yet attained the maturity to debate deeply divisive national issues without the need to attribute malice, dark conspiracy, insanity or imbecility to the opposing side.

He said, however, that HIV caused AIDS was now beyond reasonable doubt, but that it was also clear that HIV/AIDS manifested itself in a different, more aggressive mode in Africa than in the USA.

“Furthermore, and as Mbeki points out, there seems little doubt that poverty and low socio-economic status are aggravating factors.”

Ncayiyana said Mbeki was “baffled” by the portrayal in South Africa of the “Group for the Scientific Reappraisal of the HIV/AIDS Hypotheses”, as “half-witted nitwits, dissidents, heretics or rogue scientists”, when in fact many of these sceptics were highly accomplished researchers in their own fields.

Ncayiyana described Walter Gilbert and Kary Mullis as Nobel laureates and Peter Duesberg as “a professor in good standing of molecular and cell biology at the prestigious University of California-Berkeley and an accomplished retrovirologist”.

Ncayiyana said, however, it would have to be put to Mbeki that none of these scientists were themselves actively engaged in the HIV/AIDS field and that they had not produced any groundbreaking work to buttress their alternative hypotheses.

“Their interpretation of AIDS is based purely on rhetorical argumentation and critiquing of the work of others.” He said South Africa’s war against HIV/AIDS consisted largely of the promotion of condoms and campaigning for AZT for pregnant women.  

But little or no useful epidemiological research had emerged from South Africa outside of the isolated instances of “parochial bean-counting to help us better understand the epidemic”, and to apply these measures in a manner that was attuned to our own circumstances.

“We have a somewhat vague idea of the prevalence of HIV in South Africa, extrapolated from an unrepresentative sample of pregnant women.

“We don’t know why pregnant women attending clinics in KwaZulu-Natal have higher prevalence rates that women in Transkei. We have very little

knowledge about the effectiveness of condoms in the South African context.  

“The challenges are large, the dangers urgent, but if we choose to strive for co-operation rather than confrontation, we may yet win this battle.”