South African president meets with Clinton on fighting AIDS

Some consider Mbeki an impediment because of unconventional ideas

May 23, 2000|By Jonathan Weisman | Jonathan Weisman,SUN NATIONAL STAFF

WASHINGTON - President Clinton and his South African counterpart, Thabo Mbeki, danced delicately around the issue of AIDS yesterday, agreeing to disagree on the disease's cause while moving forward on infrastructure and poverty issues that could combat AIDS indirectly.

The controversy surrounding Mbeki's questions on the cause and treatment of AIDS threatened to overwhelm the South African president's first state visit to Washington since he succeeded Nelson Mandela as president last year.

The White House made it clear the two presidents wished to focus on areas of agreement, such as the need to alleviate poverty and improve basic health care in southern Africa.

Administration officials stressed that Mbeki fully grasped the scope of the AIDS epidemic.

One out of 10 South Africans are believed to be infected with HIV, the virus that a vast majority of medical experts believe causes AIDS, and an estimated 250,000 will die this year.

That infection rate is expected to rise to 25 percent of the southern African work force within five years. Life expectancy is projected to fall to 45, from a high of 59 in the early 1990s.

"These are hard challenges without easy answers," Clinton said in greeting Mbeki at the White House. "And they will test our partnership."

But administration officials also conceded Mbeki still has "a series of questions" that remain unanswered in his mind.

Those questions include whether HIV causes AIDS, whether the drug AZT can reduce transmission of HIV from infected pregnant mother to fetus, and whether AZT is too dangerous to distribute widely.

To the scientific establishment, all three of those questions have long been answered: HIV does cause AIDS and AZT is effective and not dangerous.

AIDS activists and public health experts fear that while Mbeki ruminates, his nation's AIDS crisis is going unaddressed.

"Every day that goes by while he tries to find answers to questions like this, people are dying," said Kris Torgeson, spokesman for the international health organization Doctors Without Borders.

Senior administration officials sought to strenuously deflect that criticism, even as they conceded their differences with Mbeki.

"President Mbeki has not faltered one step in fighting this disease in Africa," a senior administration official said after a series of discussions between Mbeki, Clinton and Vice President Al Gore.

Mbeki also tried to distance himself from the controversy, telling reporters much of the issue is "pure invention." His concern over AZT was that simply handing out such drugs without proper medical supervision could do more harm than good.

"When you dispense them, you've got to have a strong enough medical infrastructure because of the potential toxicities and counterindications," Mbeki said.

Mbeki's public misgivings have proven to be an embarrassment to AIDS activists, who have battled the Clinton administration -especially Gore - to force officials to adopt new policies to speed the introduction of cheaper AIDS drugs to Africa.

During their fight with the administration, activists painted Mbeki as the hero and Gore, the likely Democratic presidential nominee, as the villain.

This month, Clinton issued an executive order to allow South Africa to seek the best prices for AIDS drugs worldwide, then import them in bulk, or to find a drug maker to manufacture generic versions, despite existing pharmaceutical patents.

U.S. Trade Representative Charlene Barshefsky had sided with the pharmaceutical industry, which contended such efforts would violate international intellectual property law.

Now, however, Mbeki, by questioning the efficacy of these drugs, might be the greatest impediment to their distribution. His deputy president, Jacob Zuma, has compared dissident scientists who believe HIV does not cause AIDS to Galileo, who was persecuted for proving that Earth revolved around the sun.

The South African president convened a panel of AIDS scientists this month in Pretoria that included dissenters who maintain that HIV does not cause AIDS.

The meeting broke down in acrimony after mainstream scientists argued for traditional AIDS treatments, as dissidents contended the disease was caused by malnutrition and poor sanitation.

The dissidents argued that the drugs Mbeki had once fought so hard to introduce could cause the maladies that kill AIDS victims.

"A waste of time is putting it mildly," University of California molecular biologist Peter Duesberg said of drug therapy.

Duesberg even questioned reports of an AIDS crisis in southern Africa, calling them overblown.

AIDS activists will pack a speech Mbeki is to give today in San Francisco, hoping to persuade the South African to meet with more mainstream scientists.

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