MAIL AND GUARDIAN
Johannesburg, South Africa. May 9 2000

Open letter to President Mbeki

Three South African scientists working in the field of HIV/Aids research respond to President Mbeki's controversial letter questioning the link between HIV and Aids.

DEAR Mr Mbeki;

We, as concerned scientists working in the field of HIV/Aids research, are extremely concerned over the letter you sent to Heads of State which has recently been publicised in the USA. While we appreciate that you as an individual are fully entitled to whatever point of view you care to hold, as our Head of State the kinds of views you are expressing appear to bind the nation to points of view that we feel are untenable.

You say "We have now also established a National Aids Council, again chaired by the Deputy President and bringing together the government and civil society" - which, we will note, does not include any recognised local HIV/Aids medical or scientific experts.

You comment that "... the five years to which Dr. Coll Seck refers [during which time HIV incidence increased hugely] coincide closely with the period since our liberation from apartheid, white minority rule in 1994". You do not mention that there was no concerted campaign, of the kind that proved successful in Uganda, for example, to stop this spread, either before this period or during it.

You say "...whereas in the West HIV-Aids is said to be largely homosexually transmitted, it is reported that in Africa, including our country, it is transmitted heterosexually... as Africans, we have to deal with this uniquely African catastrophe that:
* contrary to the West, HIV Aids in Africa is heterosexually transmitted;
* contrary to the West, where relatively few people have died from Aids...
millions are said to have died in Africa; and,
* contrary to the West, where Aids deaths are declining, even greater numbers of Africans are destined to die."

and this is all true - but you do not mention that Aids deaths are declining in the West because of successful education campaigns among the affected populations, and that India, Southeast Asia and China have their own well-established HIV epidemics, which are also very largely associated with heterosexual transmission. In fact, the African epidemic will probably shortly be overtaken, in its scale and human impact, by the Asian epidemics.

You say - and we agree to some extent - that: "It is obvious that whatever lessons we have to and may draw from the West about the grave issue of HIV-Aids, a simple superimposition of Western experience on African reality would be absurd and illogical." This is true because the Western epidemic is largely one of male homosexuals and intravenous drug abusers, while the African and Asian epidemics are of heterosexuals; it is true because the populations affected in the West are generally more affluent and have access to far better health care than do those in Africa and Asia. It is not true, however, that the Western experience of research into HIV/Aids should not be taken into account in understanding our own epidemic.

You say: "We will not, ourselves, condemn our own people to death by giving up the search for specific and targeted responses to the specifically African incidence of HIV-Aids", which we feel is a highly laudable sentiment. However, it ignores the fact that the "African" incidence of HIV/Aids is shared by the Asian epidemic(s), so the African experience is by no means unique - and we could learn a lot by considering the Asian experience, which is well documented.

However, the comments that distress us most are these:

"It is suggested...that there are some scientists who are 'dangerous and discredited' with whom nobody, including ourselves, should communicate or interact.... In an earlier period in human history, these would be heretics that would be burnt at the stake!"
This is an overstatement of the case: the scientists with whom you are supposed to have been in contact, and whose names have been mentioned in the media, are non-mainstream people who are largely debating something that the mainstream settled to its satisfaction some time in the 1980s: that is, that HIV is an infectious retrovirus which is associated with the vast majority of cases of Aids which have been diagnosed since Aids was first described.

"Not long ago, in our own country, people were killed, tortured, imprisoned and prohibited from being quoted in private and in public because the established authority believed that their views were dangerous and discredited."
This is an unfair comparison: these people have been and are still being heard; they are in precisely the same position as any scientific dissidents who disagree with mainstream opinion - that is, sidelined as being irrelevant to the debate.

"We are now being asked to do precisely the same thing that the racist apartheid tyranny we opposed did, because, it is said, there exists a scientific view that is supported by the majority, against which dissent is prohibited."
Again, this is unfair: simply because, under apartheid, people were unfairly silenced, does not mean that the "Aids dissidents" 's views are being prohibited, or that they have been unfairly silenced. On the contrary, their views were very publicly aired when the debate was current; the fact that they are largely ignored now is due to the fact that - as happens in any scientific disagreement - the majority does not believe their views have any currency in light of our current knowledge.

"The scientists we are supposed to put into scientific quarantine include Nobel Prize Winners, Members of Academies of Science and Emeritus Professors of various disciplines of medicine!"
This is a misleading statement: at least one of the Nobel Prize winners (Kary Mullis) is a non-medical biochemist who has never published on viruses, let alone retroviruses and has not been an active scientist for some time; Peter Duesberg, while a member of the National Academy of Sciences of the USA, has made a recent career of being a professional doubter of many things, including most recently one of the most widely- accepted bases for the causation of cancer. The same goes for these two as well as for distinguished Emeritus Professors, most of whom are probably not presently active in HIV research: they may have strong opinions, but these may well not be relevant in the modern scientific era, or sufficiently well informed as to have any credibility in this debate. It would be very illuminating to discover just how many of the world's biomedical community agree with these scientists!

"Scientists, in the name of science, are demanding that we should cooperate with them to freeze scientific discourse on HIV-Aids at the specific point this discourse had reached in the West in 1984." With respect, this is even more misleading. The premier "dissident" information Web site - www.virusmyth.com - does not list any scientific literature more recent than 1992; nor have Peter Duesberg or other prominent "dissidents" ever published any material based on clinical or molecular biological research that bolsters their claims; thus, their part of the debate stalled years ago. The mainstream discourse has continued right up to date, on the other hand.

"People who otherwise would fight very hard to defend the critically important rights of freedom of thought and speech occupy, with regard to the HIV-Aids issue, the frontline in the campaign of intellectual intimidation and terrorism which argues that the only freedom we have is to agree with what they decree to be established scientific truths." This is simply incorrect: while Aids dissidents may point to unholy alliances of pharmaceutical companies and funding bodies bent on silencing them, the simple fact of the matter is that if one's scientific views are very obviously not being backed up by other people's findings, then one's scientific credibilty is lessened. The kinds of people who espouse a non-HIV cause for Aids, or who deny that Aids exists at all except as a collection of symptoms caused by AZT or by a pre- existing disease complex, do not have any scientific credibility for just this reason. Internationally, science is a very democratic institution - which sentiment you, Mr President, should have some sympathy for, given your history. In modern times at least, there is no precedent for the kind of scientific revisionism that these people are attempting, or of their claim for your favour. The only historical parallels we can find for the weight of the State being thrown behind a flawed scientific premise are of the championing of Trofim Lysenko by the old Soviet Union, and of the "scientific" justifications of apartheid by the old South Africa - neither of which is a good example to be followed. History is replete with groups who have argued for "special representation" after they have been sidelined in a democratic process; these have usually not deserved anything of the kind, any more than the Aids dissidents do now.

"Some agitate for these extraordinary propositions with a religious fervour born by a degree of fanaticism, which is truly frightening.... The day may not be far off when we will, once again, see books burnt and their authors immolated by fire by those who believe that they have a duty to conduct a holy crusade against the infidels."
Any fanaticism is to be condemned in this debate, except perhaps for that which acts to lessen the impact of Aids which is demonstrably killing people in Africa as elsewhere. However, refusals to accept the enormous bulk of scientific research which points to HIV being the only necessary and sufficient cause of Aids, and which shows that Aids is a very real disease threat, also smack of a fanaticism which has no place in scientific discourse.

"It may be that these comments are extravagant. If they are, it is because in the very recent past, we had to fix our own eyes on the very face of tyranny."
With respect, your comments are indeed extravagant. With respect again, the face of tyranny as experienced by South Africans in the so- recent past is completely irrelevant in the current Aids-related crisis we face in this country, except as a tool to be used to justify a debating position. The previous government was guilty of inaction in the face of a threatening epidemic; the current government has done little - compared to what could have been done - in the last five years to stave off the disaster which now threatens us. We do NOT need to revisit the debate on the causation of Aids now; what we DO need to do is to educate, train and medicate, in order to save lives.

Mr President, consider how the mass of people in this country would react if you or any other influential politician were to insist on publicly revisiting the "scientific" justification for the policy of apartheid by giving a public platform to, and a sympathetic ear to, unrepentant proponents of the policy. Then consider that your apparent willingness to listen to and be influenced by people with little or no credibility in the national or international scientific establishment is as offensive and causes as much anguish to those of us working to combat HIV/Aids as it would to someone who voted your government into power. The simple facts of the matter, as evidenced by a huge volume of scientific and medical research, is that HIV causes Aids, that in Africa as in other developing regions it is mainly spread heterosexually, and that Aids kills poor people in disproportionate numbers.

We note that you conclude your letter with: "I am greatly encouraged that all of us, as Africans, can count on your unwavering support in the common fight to save our continent and its peoples from death from Aids. "

Mr President, we wish we could count on your unwavering support in our common fight against an insidious and implacable disease agent. However, as long as you insist on being advised by people without any specific credibility in the scientific arena that has to do with HIV/Aids, we will feel ourselves to have been dangerously marginalised in the search for solutions to the problem of HIV/Aids.

Sincerely,

Assoc Prof Edward Ryckbi Dept Microbiology
University of Cape Town

Assoc Prof Anna-Lise Williamson Dept Medical Microbiology
University of Cape Town

Lynn Morris, PhD National Institute for Virology
Sandringham, Johannesburg

TORONTO

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