In South Africa, HIV/AIDS denialism had a significant impact on public health policy from 1999 to 2008, during the presidency of Thabo Mbeki. Mbeki criticized the scientific consensus that HIV is the cause of AIDS beginning shortly after his election to the presidency. In 2000, he organized a Presidential Advisory Panel regarding HIV/AIDS including several scientists who denied that HIV caused AIDS.

In the following eight years of his presidency, Mbeki continued to express sympathy for HIV/AIDS denialism, and instituted policies denying antiretroviral drugs to AIDS patients. The Mbeki government even withdrew support from clinics that started using AZT to prevent mother-to-child transmission of HIV. He also restricted the use of a pharmaceutical company's donated supply of nevirapine, a drug that helps keep newborns from contracting HIV.

Instead of providing these drugs, which he described as "poisons", shortly after he was elected to the presidency, he appointed Manto Tshabalala-Msimang as the country's health minister, who promoted the use of unproven herbal remedies such as ubhejane, garlic, beetroot, and lemon juice to treat AIDS, which led to her acquiring the nickname "Dr. Beetroot." These policies have been blamed for the preventable deaths of between 343,000 and 365,000 people from AIDS.

Since 2008, Mbeki has been silent about his views and policies on AIDS; according to The New York Times, his spokesman, Mukoni Ratshitanga, said Mbeki would not discuss his thinking on HIV and AIDS, explaining that policy decisions were made collectively by the cabinet and so questions should be addressed to the government. Upon becoming president in 2008, Mbeki's successor, Kgalema Motlanthe, appointed Barbara Hogan as health minister to replace Tshabalala-Msimang on the first day of his presidency. Hogan told The New York Times, "The era of denialism is over completely in South Africa."

Origin The reason Mbeki became so enamored with HIV/AIDS denialism remains unclear, but some have suggested that it was influenced by Christine Maggiore meeting with him in the 1990s. Another factor may have been when, in 1999, Anthony Brink published an article entitled "A Medicine from Hell", which described AZT as dangerous and ineffective. Brink would later claim that this article was responsible for Mbeki's policies banning the use of the drug. Brink contacted Mbeki after the article was published, and was welcomed as an expert. Mbeki, in a 2002 document of which he was the co-author, also cited John le Carré's novel The Constant Gardener as influencing his fear of pharmaceutical companies and their influence on scientific research. Given that Mbeki explicitly accused supporters of the consensus position on HIV/AIDS of racism, it has also been proposed that his denialist views arose from a history of racist portrayals of black people in South Africa under the apartheid system.

An article in Race & Class by Joy Wang proposes that both of these factors influenced Mbeki's embrace of AIDS denialism, and cites Frantz Fanon's essay "Medicine and Colonialism" to explain what Wang describes as "...the impasse between scientists and Mbeki's government." Martin Asser has also proposed that Mbeki's views on AIDS may have been influenced by the high price of ARV therapy relative to the relatively small amount of money his country's citizens have at their disposal. In 2004, Theodore F. Sheckels of Randolph-Macon College argued that Mbeki, while discussing HIV/AIDS as president of South Africa, attempted to portray "the West" as the scapegoat in order to unite the country's black majority. Barton Gellman has proposed an alternative explanation for Mbeki's views—namely, that he is "a sort of restless, roving intellect who likes to surf the Internet and is accustomed to being a dissident who allies himself against establishments. After all, he spent his whole adult life fighting apartheid." He also noted that even if Mbeki followed every recommendation of the mainstream scientific community regarding AIDS he still wouldn't solve the problem, so, according to Gellman, Mbeki is "keeping the scientific uncertainties alive because he doesn't want to portray himself as helpless."

Timeline

1994 On 10 May 1994, Nelson Mandela became President of South Africa, remaining in that office until replaced by Thabo Mbeki five years later. During his presidency, which lasted from then until 1999, Mandela remained largely indifferent to HIV/AIDS, and did not speak out about the danger it posed to South Africa until the early 2000s. Mandela had reportedly expressed regret that he did not do more to combat AIDS during his presidency.

1997 In early 1997, Mbeki, who was then the Deputy President of South Africa, approached the other members of the African National Congress to pitch the idea of using a new anti-AIDS drug, developed in South Africa, called Virodene. The advantages over existing ARV drugs which proved appealing to Mbeki included being 200 times less expensive than antiretroviral triple therapy, and the possibility of bypassing the Western medical establishment if it was proven to work. This led to a group of AIDS patients who had been treated with Virodene being invited to testify before the Cabinet of South Africa. Their testimonies included many statements that they had gained weight and seen boils on their faces vanish after they started being treated.

However, the fact remained that the makers of Virodene had previously been denied a license by the South African Medicines Control Council (MCC). The company argued that this happened because the South African AIDS establishment did not want any drugs other than ARVs to become available, because the establishment was funded by Western drug firms. Mbeki found this argument compelling. The drug was then legalized and heavily and favorably promoted in the popular media, until it became apparent that it posed a severe health hazard. The MCC subsequently declared the drug unfit for human consumption.

1999

June On 14 June 1999, Mbeki was elected President of South Africa.

October On 28 October, Mbeki gave a speech to the National Council of Provinces in which he touched upon the issue of HIV/AIDS, and especially whether his government should distribute ARV drugs. He argued that they shouldn't be so quick to do so because of their adverse effects, and recommended that the members of the council read the information on the Internet on the topic.

2000

March On 19 March 2000, it was reported that Mbeki had consulted biochemist David Rasnick and history professor Charles Geshekter, both of whom are AIDS denialists, for advice on HIV/AIDS. Awa Marie Coll-Seck reacted to the news by saying, "At first, we were thinking we would just ignore it, but now we think this confusion can really undermine all the efforts people have made to prevent this disease."

April On 20 April 2000, Mbeki sent a five-page letter to Bill Clinton in which he describes AIDS as a "uniquely African catastrophe", and compared the "persecution" of HIV/AIDS denialists to the treatment of black people in South Africa during the apartheid era. The letter was leaked to The Washington Post shortly afterward, which provoked condemnation from many commentators and "infuriated and embarrassed" Mbeki. The following day, Jacob Zuma, then South African deputy president, compared those criticizing HIV/AIDS denialists to critics of Galileo during the 17th century. "His views were considered to be so threatening to the scientific establishment that he was forced to publicly recant", Zuma was quoted as saying in a statement released by the office of the presidency.

May Later that year, Mbeki convened a panel of 33 scientists whom he referred to as "experts", of whom about half were AIDS denialists such as Peter Duesberg and Harvey Bialy. The panel, known as the "Presidential Advisory Panel on AIDS", also included AIDS researchers who supported the scientific consensus that HIV causes AIDS, and was split about evenly between the two groups. Their first meeting was held from 6 May to 7 May. Nicoli Nattrass has blamed Duesberg and his supporters on this panel, as well as Mbeki, for the popularity of AIDS denialism in South Africa.

July The Presidential Advisory Panel on AIDS's second meeting took place on 3 and 4 July in Johannesburg. Both meetings were closed to the general public and to nearly all journalists, with the exception of Mark Schoofs of the Village Voice. Schoofs reported that David Rasnick, another AIDS denialist member of the panel, had called for HIV testing to be completely banned, and had argued he hadn't seen "any evidence" of an AIDS catastrophe. The meeting also culminated in research proposals by both supporters and denialists of the HIV/AIDS hypothesis. South African health official Khotso Mokhele praised both proposals, saying that once concluded, one side of the HIV/AIDS debate might "shut up once and for all." The AIDS denialists at the meeting recommended that the disease be treated not with antiretroviral drugs, but rather with vitamins and "alternative" and "complementary" therapies including "massage therapy, music therapy, yoga, spiritual care, homeopathy, Indian ayurvedic medicine, light therapy and many other methods." On 6 July, the scientific community responded with the Durban Declaration, signed by 5,000 scientists and published in Nature. The declaration stated, among other things, that "HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives." Nevertheless, when the International AIDS Conference in Durban was held just three days later, where Mbeki was scheduled to give the opening speech, he openly rejected the mainstream view that HIV is the cause of AIDS, and instead argued that it was caused by poverty, bad nourishment and general ill-health. The solution was not, Mbeki continued, expensive western medicine, but the alleviation of poverty in Africa. He also invited Maggiore, an outspoken AIDS denialist, to give a talk at the conference, and, in one of his own speeches, exhorted the other delegates at the conference to "...speak to one another honestly and frankly, with sufficient tolerance to respect everybody's point of view, with sufficient tolerance to allow all voices to be heard." His speech met with largely negative reception from the delegates attending the conference, hundreds of whom walked out.

September In September 2000, Mbeki told the South African Parliament that "The programme of the government in this country is based on this thesis that HIV causes Aids and everything in the programme says that." However, he later stated that he still did not think HIV caused AIDS, and that it could, in his view, only be a contributing factor, not a sole cause.

October In mid-October, the South African government announced that Mbeki would be "reducing his role" in the HIV/AIDS debate, with Mbeki himself acknowledging he may have caused "confusion" by publicly challenging the mainstream view of the cause of AIDS. Nevertheless, his approval rating had already dropped from 70 to 50 percent in the previous year. Many senior American politicians had expressed private doubts about his judgment, though other South African politicians were even more outspoken in their criticism. For example, many South African trade and banking officials expressed concern that Mbeki's statements were driving away potential investors. In a 2007 interview, Mbeki told his biographer, Mark Gevisser, that he only did this because he was pressured to by his cabinet and he regrets his decision to do so.

2001

August