For some in Africa, it's `magic' over pills

Doctors say that HIV potion does more harm than good


PINETOWN, South Africa -- The 35-year-old high school teacher named Bheki was lucky to be alive, thanks to the free antiretroviral pills that kept his HIV in check. He felt strong and had no side effects. Life was normal, as normal as it gets with an incurable disease.

Then in February, he ditched the pills and started taking a mystery potion sold here outside Durban. It is made by a former truck driver who says his late grandfather came to him in dreams with the recipe for an herbal drink that could reverse HIV's march to full-blown AIDS and death. Eager to banish from his body the virus that stalks one in five South African adults, Bheki instead found himself sicker than ever. Three months later, he begged his doctor to put him back on antiretrovirals, only to find that he has built up a resistance that makes the pills less effective.

The makers of the herbal remedy "said I was going to be cured," said a weak-voiced Bheki, who gave only his first name because of HIV's powerful stigma. "They're putting people's lives in misery."

Across Africa, untested and unregulated traditional therapies are flourishing even as Western medicine becomes more widely available. Despite the health risks, many people prefer the old ways for various reasons, such as suspicion of "white" science or evidence that some home-brewed tonics can alleviate some ailments.

And South Africa's government loudly champions such age-old practices that for decades were dismissed as witchcraft by the apartheid regime.

Nowhere are the stakes higher than with HIV/AIDS, which kills nearly 900 South Africans a day. Doctors say uBhejane, the herbal drink Bheki took and some 2,000 others still take, is the latest in a long line of alternative therapies.

When Bheki visited the uBhejane "clinic" tucked off a busy street, he said the staff warned him not to continue taking his antiretrovirals, or ARVs. "I have to stop using them and then use this stuff," he recalled being told.

"It's a horrible disservice," said his physician, Dr. George Chidi. Nine other patients of his, including a nurse, have taken the same path. Bheki's tuberculosis has come roaring back, and Chidi suspects that the uBhejane damaged his liver.

"He's quite ill now," Chidi said. "He restarted the treatment, but I don't think it's working."

When told about Chidi's 10 patients, the chief spokesman for South Africa's health minister expressed no concern. "As we have heard that story," said Sibani Mngadi, "we have also heard the stories to the opposite of that" - that is, success stories.

South African law does not regulate traditional health practitioners or the remedies they dispense, he said. And his boss, Health Minister Manto Tshabalala-Msimang, a physician, avidly supports natural remedies as "African solutions."

"We emphasize there needs to be choice," the spokesman said. "People who want to use antiretrovirals, let them use them. But those who think through consultation with their traditional health practitioner and feel they need to use traditional medicine, they have a right to do so."

Zeblon Gwala, who makes uBhejane and whose supporters include the mayor of Durban, defends his product. "You talk to the wrong people," he said when asked about Bheki. "All the results I got, I never find a negative." Citing confidentiality, he said he could not arrange a meeting with patients who have thrived.

Gwala says while people should not take both ARVs and uBhejane, he denies telling anyone that they should stop ARVs or that his product can eliminate HIV.

"I never say it is a cure; my staff would never say that. I say uBhejane is healing people who [cannot work]. I'm waiting for the result from scientific people to say what uBhejane does, a cure or whatever. People are suffering. They can choose, if they want, to take my concoction."

Treatment of HIV/AIDS has long been a touchy subject in South Africa, a land of 47 million. President Thabo Mbeki once asserted that HIV could not be the sole cause of AIDS. Today he seldom speaks of the disease that afflicts some 5.5 million South Africans - more than anywhere after India.

Critics of Tshabalala-Msimang, the health minister, have long claimed that she overstates the side effects of antiretrovials and the benefits of garlic, olive oil and other nutritional supplements. They have denounced her for voicing support for Matthias Rath, a German vitamin seller who calls ARVs "poison." At last week's Toronto AIDS conference, members of the Treatment Action Campaign vandalized the country's booth, with its display of garlic, lemon and beetroot, and chanted "Fire Mantow now," according to news reports.

Despite a belated rollout of ARVs that began two years ago, South Africa has pumped nearly $1 billion into treatment, though doctors say waiting lists are common for free drugs. Since fall 2004, the United States has devoted $162 million to help South Africa with drugs and support services. All health insurance plans here now must provide coverage for ARVs.

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