Letter to South Africa's President Thabo Mbeki

Mr Thabo Mvuyelwa Mbeki
President
Republic of South Africa
Union Buildings
West wing
2nd Floor
Government Avenue
Pretoria
4 September 2006
By fax: +27 12 323 8246 and +27 21 461 6456

Dear President Mbeki

EXPRESSION OF CONCERN BY HIV SCIENTISTS

We are members of the global scientific community working on HIV/AIDS who wish to express our deep concern at the response of the South African government to the HIV epidemic.

HIV causes AIDS. Antiretrovirals are the only medications currently available that alleviate the consequences of HIV infection. The evidence supporting these statements is overwhelming and beyond dispute. Much credit for the impressive advancement of HIV science belongs to scientists and clinicians based in South Africa and elsewhere on the African continent. Their expertise should play a critical role in alleviating the awful consequences HIV has caused to South African society. We are therefore deeply concerned at how HIV science has been undermined by the South African Minister of Health, Dr Manto Tshabalala-Msimang.

Before and during the XVI International AIDS Conference, Dr Tshabalala-Msimang expressed pseudo-scientific views about the management of HIV infection. Furthermore, the South African government exhibition at the Conference featured garlic, lemons and African potatoes, with the implication that these dietary elements are alternative treatments for HIV infection. There is no scientific evidence to support such views. Good nutrition is important for all people, including people with HIV, but garlic, lemons and potatoes are not alternatives to effective medications to treat a specific viral infection and its consequences on the human immune system. Over 5 million people live with HIV in South Africa. According to the best estimates of South African actuaries, over 500,000 people without access to antiretrovirals have reached the stage of HIV-disease when they now require these medicines to save their lives.

We commend the South African Department of Health's Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa released on 19 November 2003. This plan committed to treating over 380,000 people by this time in the public health sector. Unfortunately, fewer than half of that target number are currently receiving treatment in the public sector. Many people are therefore dying unnecessarily.

We are also deeply concerned by the proliferation of unproven remedies being marketed in South Africa, some of them with the implicit or even explicit support of the Minister of Health. Slick marketing practices cause people not to take proven medications, or at best to waste money on false hopes. We condemn all those who profit from this type of quackery, at the expense of the sick and dying.

We echo the words of Mr Stephen Lewis, special advisor to the UN Secretary General, that South Africa's response to AIDS is "obtuse, dilatory and negligent".

Dr Mark Wainberg, chairperson of the XVI International AIDS Conference, stated in his Closing Address:

"We went to the Durban meeting, expecting a South African government that would be on the same side as us. Instead, we found a denialist president who turned his back on us... and who began to convene committees that would articulate on his behalf that somehow it was in dispute whether or not HIV was truly the cause of AIDS ... We were all completely taken aback, we were all insulted. ... I for one am no longer prepared to take a back seat as a scientist and not express my personal concern that this situation seems to have continued unabated."

We support and endorse Dr Wainberg's words.

To deny that HIV causes AIDS is farcical in the face of the scientific evidence; to promote ineffective, immoral policies on HIV/AIDS endangers lives; to have as Health Minister a person who now has no international respect is an embarrassment to the South African government. We therefore call for the immediate removal of Dr Tshabalala-Msimang as Minister of Health, and for an end to the disastrous, pseudo-scientific policies that have characterised the South African Government's response to HIV/AIDS.

Signed (in alphabetical order):

1. Abdool Karim, Quarraisha, Professor, Head, CAPRISA Women and AIDS Programme, University Kwazulu-Natal, South Africa
2. Anastasi, John, MD, Associate Professor, Director, Residency Training Program, University of Chicago, USA
3. Aubertin, Anne Marie, PhD, Directeur de recherche INSERM 778, Institut de Virologie, Université Louis Pasteur, France
4. Baltimore, David, President Emeritus, California Institute of Technology, USA
5. Bardeguez, Arlene, MD, MPH, Director, HIV Services, Department Obstetrics, Gynecology & Women's Health, New Jersey Medical School, USA
6. Barin, Francis, Professor, Virology lab and National Reference Center for HIV, Université F Rabelais, France
7. Barnett, David, Dr, Consultant Clinical Scientist and Honorary Senior Lecturer, UK
8. Barnett, Tony, ESRC Professorial Research Fellow, London School of Economics, UK
9. Bartlett, John G., MD, Chief of Infectious Diseases, Johns Hopkins School of Medicine, USA
10. Bellos, Nicholaos, MD, Southwest Infectious Disease Associates, USA
11. Berkman, Alan, MD, Associate Professor and Acting Chair Department of Epidemiology, Mailman School of Public Health, Columbia University, USA
12. Bomsel, Morgane, Research Director at CNRS, Mucosal entry of HIV and mucosal immunity, et Immunité muqueuse, Cell Biology dept, Cochin Institut, France
13. Bourne, David, School of Public Health, University of Cape Town
14. Burton, Dennis, Professor of Immunology, The Scripps Research Institute, USA
15. Campo, Rafael, MD, Professor of Clinical Medicine, University of Miami Miller School of Medicine, USA
16. Carpenter, Charles, MD, Professor of Medicine, Brown University, USA
17. Cohen, Mardge, MD, Director of Women's HIV Research, CORE Center, USA
18. Cohen, Robert L., MD, USA
19. Colebunders, Robert, Institute of Tropical Medicine, Belgium
20. Coovadia, Hoosen, Professor, Co-Director Centre for HIV/AIDS Networking, lson Mandela School of medicine, University of Kwazulu/Natal, South Africa
21. Coutsoudis, Anna, Professor, Senior Research Scientist, Dept Paediatrics and Child Health, University of KwaZulu-Natal, South Africa
22. Crowe, Suzanne, Professor, Head, AIDS Pathogenesis and Clinical Research Program, NHMRC, Principal Research Fellow, Macfarlane Burnet Institute for Medical Research and Public Health, Australia
23. Cu-Uvin, Susan, MD, Associate Professor, Obstetrics-Gynecology and Medicine, The Miriam Hospital Brown University
24. Cullen, Bryan R, James B Duke Professor and Director of the Center for Virology, Duke University Medical Center, USA
25. D'Aquila, Richard, MD, Director, Division of Infectious Diseases Director, Vanderbilt AIDS Center Professor of Medicine Professor of Microbiology and Immunology, Vanderbilt University School of Medicine, USA
26. Danel, Isabella, MD MS, USA
27. Del Rio, Carlos, MD, Professor of Medicine Director of the Emory AITRP Grady Memorial Hospital Director for Clinical Sciences and International Research, Emory University, USA
28. Denny, Thomas N., MSc, Principal Investigator, NIH-NIAID-Division of AIDS, Immunology Quality Assessment Program, USA
29. Desrosiers, Ronald C., PhD, Professor of Microbiology and Molecular Genetics, Harvard Medical School
30. Doms, Robert W., MD, PhD, Chair, Department of Microbiology, University of Pennsylvania, USA
31. Elion, Richard, MD, George Washington University School of Medicine, USA
32. Gallo, Robert C., MD, Professor and Director, Institute of Human Virology; Co-Discoverer of HIV as the cause of AIDS; Developer of the first HIV blood test. University of Maryland, USA
33. Gathe, Joseph, MD, Therapeutic Concepts, P.A., USA
34. Girard, Marc P Lyon, Professor, (retired and formerly of Pasteur Institute and Mérieux Foundation), France
35. Groenewald, Pam, Public Health Researcher, South Africa
36. Gulick, Roy M., MD, MPH, Associate Professor of Medicine, Director, Cornell HIV Clinical Trials Unit Division of International Medicine and Infectious Diseases, Weill Medical College of Cornell University, USA
37. Harries, Anthony D, Professor, HIV Unit, Ministry of Health, Malawi
38. Helbert, Matthew, FRCP FRCPath PhD, Head of Service, Immunology, Manchester Royal Infirmary, UK
39. Holmes, Harvey, Dr, Division of Retrovirology, National Institute for Biological Standards and Control, UK
40. Hoxie, James A., University of Pennsylvania, USA
41. Hviid, Lars, Professor and Head of Research, Centre for Medical Parasitology, Department of Infectious Diseases, Rigshospitalet, Denmark
42. Jarlais, Don Des, Director of Research, Chemical Dependency Institute, Beth Israel Medical Center, USA
43. Johnson, Leigh, Senior Researcher, Centre for Actuarial Research, South Africa
44. Keeney, Michael, ART,FIMLS, Technical Specialist Hematology/Flow Cytometry, Associate Scientist Lawson Health Research Institute, London Health Sciences Centre, Canada
45. Kharsany, Ayesha BM, Dr, CAPRISA, Nelson R Mandela Medical School, University of KwaZulu-Natal, South Africa
46. Kiepiela, Photini PhD, Associate Professor, University of KwaZulu Natal, Faculty of Health Sciences, Nelson R Mandela School of Medicine, South Africa
47. Kourilsky, Philippe, Professor at the College de France, Member of the French Academy of Sciences, Honorary President of the Pasteur Institute
48. Kuritzkes, Dan, Director of AIDS Research, Brigham and Women's Hospital, Associate Professor of Medicine, Harvard Medical School, Chair, HIV Medicine Association, USA
49. La Via, Mariano F., Professor Emeritus, Pathology and Laboratory Medicine, Medical University of South Carolina
50. Lange, Joep, MD, PhD, Professor of Medicine, Executive Director, Center for Poverty-related Communicable Diseases, Academic Medical Center, University of Amsterdam, Netherlands
51. Lawrence, Robert S., MD, Director, Center for a Livable Future, Professor of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, USA
52. Lederman, Michael M., MD, Scott R. Inkley Professor of Medicine, Director, Center for AIDS Research, Case Western Reserve University, USA
53. Lenkei, Rodica, MD, PhD, Capio Diagnostik/Calab Research, Flow Cytometry Laboratory, Stockholm, Sweden
54. Levine, Alexandra M., MD, Distinguished Professor of Medicine, Chief, Division of Hematology, University of Southern California, School of Medicine, Medical Director, USC/Norris Cancer Hospital, USA
55. Levy, Yves, Professeur, Service d'immunologie Clinique, Hôpital Henri Mondor, France
56. Malim, Mike, Professor and Head, Dept of Infectious Diseases, King's College London School of Medicine, UK
57. Mayer, Kenneth MD, Professor of Medicine and Community Health, The Miriam Hospital, USA
58. Miller, Veronica, PhD, Associate Research Professor, Department of Prevention & Community Health, The George Washington University SPHHS
59. Moore, John P., Professor of Microbiology and Immunology, Weill Medical College of Cornell University, USA
60. Nattrass, Nicoli, Professor, Director of the AIDS and Society Research Unit, University of Cape Town, South Africa
61. Nixon, Douglas F., MD, PhD, Professor of Medicine, Associate Chief, Division of Experimental Medicine
62. Powderly, William, MD, Head Professor of Medicine, UCD School of Medicine and Medical Science University Dublin, Ireland
63. Richman, Douglas D., MD, Professor of Pathology and Medicine, University of California San Diego
64. Rosenfield, Allan, MD, Mailman School of Public Health, Columbia University
65. Rybicki, Ed, Professor, PhD, PI, Subunit Vaccines Group, Institute of Infectious Disease and Molecular Medicine and Department of Molecular & Cell Biology, University of Cape Town, South Africa
66. Saag, Mike, MD, Director, UAB Center for AIDS Research Professor of Medicine, University of Alabama At Birmingham, USA
67. Schrager, Jeffrey A., MD, Assistant Professor, University of Cincinnati Academic Health Center, Department of Pathology and Laboratory Medicine, USA
68. Smith, Kimberly MD, MPH, Associate Professor of Medicine, Rush Presbyterian St. Luke's Medical Center, USA
69. Spear, Greg, Professor, Dept. Immunology/Microbiology, Rush University Medical Center, USA
70. Stetler-Stevenson, Maryalice, Chief, Flow Cytometry Unit, LP, NCI, NIH, USA
71. Stevenson, Mario, PhD, Professor, Program in Molecular Medicine, Director, Center for AIDS Research, University of Massachusetts Medical School, USA
72. Stone, Valerie, MD, MPH, Massachusetts General Hospital Harvard Medical School, USA
73. Trigg, Bruce G., MD, USA
74. Vance, Carol S., PhD, M.P.H., Mailman School of Public Health, Columbia University, USA
75. Veazey, Ronald S., DVM, PhD, Professor and Chair, Division of Comparative Pathology, Tulane University School of Medicine
76. Volberding, Paul, MD, Professor and Vice Chair, UCSF Department of Medicine, Co-Director, UCSF-GIVI Center for AIDS Research
77. Watkins, David, Dr., University of Wisconsin, AIDS Vaccine Laboratory
78. Weiss, Robin A., Professor of Viral Oncology, Wohl Virion Centre, Division of Infection and Immunity, University College London
79. Whiteside, Alan W, Professor, D Econ, AIDS Researcher, South Africa
80. Whitman, Steven, PhD, Director Sinai Urban Health Institute, USA
81. Wilfert, Catherine, MD, Professor of Pediatrics and Microbiology, Duke University Medical Center, USA
82. Williams, Paul, DM FRCP FRCPath, Chairman, UK National Quality Assurance Advisory Panels in Immunology, Consultant Clinical Immunologist, Department of Medical Biochemistry & Immunology, University Hospital of Wales, UK