A PRESIDENT CRAZILY at odds with medical science. A nation reeling from disease that rampages through its ranks. But the man at the top merely sows confusion, and vindictively punishes those who might contradict him.
An ex-President, fondly remembered as a unifying national icon, speaks up for rationality and clarity, and for a strong new policy to counter the disease. He is lashed politically by the incumbent, but he eventually wins the day – and the nation finally beats back the disease.
Is this an utterly fanciful picture of America in 2020? Maybe … But it is a true record of actual events in another country: South Africa, at the turn of our current century. Let me tell the parable …
Thabo Mbeki, immediate successor to the iconic Nelson Mandela, took office in 1999 and within a year he was astonishing the world with his ‘response’ to the HIV/AIDS epidemic. The disease was by then infecting an estimated four million South Africans, about 11% of the entire population. Instead of tackling it seriously and head-on, he started promoting the theories of ‘denialists’ who claimed that HIV did not cause AIDS. And moreover, he distorted the undeniable truth that poverty is a huge scourge in itself into a blindered form of tunnel-vision. Mbeki claimed, completely without any scientific foundation, that malnutrition and poor housing conditions were much more important causal factors for AIDS than the human immunodeficiency virus.
In the interests of full disclosure, I should point out that while I encountered Nelson Mandela up-close and personal only once (just as he was becoming the country’s first black President), I did spend a lot of time in the company of Thabo Mbeki, years before he became so prominent.
It happened while Mbeki was a trusted representative for Mandela, at liberty but in exile, when the latter was serving the life-imprisonment sentence imposed on him by the old white-supremacist regime. (Mandela was of course to be released after 27 years, in 1990.) I was in touch with Mbeki for a decade or more, and for a particular span of several months I worked very closely with him, to make a 1986 documentary about his and Mandela’s historic liberation movement, the African National Congress (title still-frame, right) [Full video of the documentary can be viewed at Vimeo – https://vimeo.com/233342940]
Cultivating a journalistic relationship with Mbeki was difficult – he was mercurial, sometimes affable and yet quick to take offence. Often headstrong, he once dragged me out of the Pamodzi Hotel in Zambia’s capital, Lusaka, to lead me on an exhaustive tour of the city’s nightspots, long into the wee small hours – and on the way substantially outpaced my own prodigious alcohol-consumption.
I was not surprised when two decades later news reached me from his Presidential quarters in Pretoria and Cape Town that he was spending his nights with a liter-bottle of single-malt whisky, cruising the internet in search of support for his crackpot notions of how to cure AIDS. These included free distribution of vitamins and the use of homeopathy, Indian ayurvedic medicine and, yes, even what he called “light therapy”. We could see that last notion as a prefiguring of recent musings (more lately disavowed as mere ‘sarcasm’) from the White House podium: “supposing we hit the body with a tremendous – whether it’s ultraviolet, or just a very powerful – light.”
Mbeki’s nocturnal browsings also led him to claim that the real cure, anti-retroviral medicines, were poisons that would kill patients more quickly than the disease. I hear a chime of that in the all-CAPS cry from our current Tweeter-in-Chief: “WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF” (an outburst transmitted, incidentally, at ten minutes to midnight – albeit from a psyche whose pathology is evidently unaided by alcohol).
SOUTH AFRICA’S EQUIVALENT of Dr Anthony Fauci was then the Medical Research Council’s chief, Professor Malegapuru Makgoba – and his despair over his President’s waywardness made him confer with the immediate-past-President Mandela. Makgoba’s warning was dire – that Mbeki was “acting in a way that could be judged as genocide … the greatest genocide of our time”.
Makgoba galvanized Mandela into visiting a clinic on World AIDS Day (December 1st 2001) where he publicly – and daringly – accused Mbeki of dereliction of duty in not leading a unified national fight against HIV. And then in a newspaper interview he said provocatively: “It is not one man who decides. This task of nation-building is not just done by one individual.”
But his most striking sally against the feckless Mbeki came when he awarded a Mandela Human Rights Prize to two perinatal HIV researchers in 2002. He lauded the virtues of medical science, expressing special gratitude for his own recent treatment as a prostate-cancer patient. And when this now 83-year old father of the nation lost his way a little in his scripted remarks, he unexpectedly took advantage of the slip to launch an ad-lib of searing impact against his successor. Everyone knew exactly whom he meant when he said, with an arch upturned glance from his notes: “At least I am willing to admit when I have made a mistake.”
Mbeki reacted with fury. Within a hallowed forum for both men, the ANC National Executive, the sitting President unleashed his supporters on the old man to savage him for disrespecting party discipline. A veteran of the liberation war era who witnessed the scene, Ngoako Ramatlhodi, likened the attack at the time to “a pack of wild dogs tearing their prey”, and he told me later that the ‘vicious mauling’ had a shattering effect on Mandela, making him look “twice his age, old and ashen’.
But Mandela was in fact undaunted. At the international level, he spoke at World AIDS Conferences, and took meaningfully symbolic action at home. He paid a house-visit to Zackie Achmat, the physically declining leader of the AIDS patients’ group, the Treatment Action Campaign.
As well as pursuing legal action against Mbeki in the courts, Achmat had pledged not to take antiretroviral drugs himself until they were made freely available by Mbeki’s health ministry to all those who needed them. When he left the ailing activist, Mandela was wearing a T-shirt that Achmat himself had designed, emblazoned with the slogan ‘HIV-POSITIVE’ (pictured left). It was a shirt being worn in the streets by hundreds of thousands of anti-AIDS protestors.
Another prominent anti-AIDS activist at the time was the Constitutional Court’s Justice Edwin Cameron, the equivalent of a US Supreme Court Justice. He’s a notable figure in modern South African history for coming out as gay and as HIV-Positive. Writing a few years later, he ascribed a pivotal role to Mandela and the staging of his canny public relations coup:
[Mandela’s] smiling famous features atop the white cotton ‘HIV POSITIVE’ T-shirt may have marked a turning point in our national struggle about the meaning of AIDS. Perhaps it was his intervening moral voice that made the change in the government’s resistance to antiretroviral drugs inevitable’.
Mbeki’s position did change, though with little good grace. His government began to provide anti-retrovirals to all HIV-positive pregnant mothers at all public hospitals, free of charge – but only after high court rulings were handed down against him. It took a while – another four years in all – for a full-fledged program to be instituted that was aimed at providing AIDS drugs for all who needed them.
By then, though, 1 million people had died from AIDS in South Africa, and the number of people infected with HIV had reached 5.3 million. And as Mbeki’s time in office ended ignominiously in 2008, reliable studies, including the Journal of Acquired Immune Deficiency Syndromes were estimating his policies had led directly to a total of needless deaths amounting to over 330,000.
NOW, WE SHOULDN’T REGARD Mandela’s own presidential record on AIDS as blameless. He did little about it while in office himself, as the disease was beginning to take hold. He confessed later to letting other priorities take precedence – other priorities like the massive shift from racist white-minority rule to a shared governance nationwide, and the enormous uphill battle against racially-skewed poverty. “It’s not use crying over spilt milk … I had no time … I had to concern myself with nation-building,” he told the national press agency, SAPA.
His approach certainly changed when out of office – and was deeply reinforced by the death from AIDS of his own 54-year old son Makgatho Mandela.
Underpinning Mandela’s belated but valiant AIDS efforts was his insistence on clarity and precision – as against sloppy untruths and obfuscation.
The constantly-quoted Mandela gets a lot of credit these days for things he never actually said. But he definitely did say the following, while he was addressing the International AIDS Conference of 2000 when it met in his own country’s coastal city of Durban, an occasion which AIDS scholars say marked the point when a global consensus crystallized that anti-retroviral therapy must be made available to all who need it.
“It is never my custom to use words lightly. If 27 years in prison have done anything to us, it was to use the silence of solitude to make us understand how precious words are, and how real speech is, in its impact upon the way people live, and die.”
