Is the President of South Africa really so irrational about AIDS?

The UK's Guardian says today (10 July) that "Mbeki makes doctors despair" with his "rejection of the conventional wisdom that AIDS… is caused by HIV." And that report was by no means alone in the world media reaction to the opening speech by Thabo Mbeki, President of South Africa, at the 13th International AIDS Conference, currently running in Durban. Press, radio and TV all carried much the same horrified reaction, as did the conference web site itself.So what did he really say? Well, he focused heavily on poverty, which is certainly a major socio-economic factor in AIDS transmission in Africa; he announced his commitment to a classic anti-AIDS campaign in South Africa; and he only hinted that he questioned the role of HIV."We will continue to intensify our own campaign against AIDS" said Mbeki, "including: a sustained public awareness campaign encouraging safe sex and the use of condoms; a better focused programme targeted at the reduction and elimination of poverty and the improvement of the nutritional standards of our people; a concerted fight against the so-called opportunistic diseases, including TB and all sexually transmitted diseases; a humane response to people living with HIV and AIDS as well as the orphans in our society; contributing to the international effort to develop an AIDS vaccine; and, further research on anti–retroviral drugs."A vaccine? Anti-retrovirals? Can this be the man who doesn't believe in HIV?Alright, he also says "as I listened and heard the whole story told about our own country, it seemed to me that we could not blame everything on a single virus."But this remark is en passant and brief. The overwhelming impression from the speech is that this is not the key issue for him. Poverty is. What we see here is an arch politician, a 58-year-old long-time African National Congress revolutionary, who rose to head the ANC communications division and knows all about the media, who is manipulating opinion for his own political aims. And those are, I believe, to refocus attention on the social and economic determinants of AIDS, which are the hardest pieces of the equation to solve - because a solution would require real investment in poorest Africa.For example, take another African country far away, Burkina Faso, where I recently spent two weeks investigating a new approach to AIDS control, the so-called 'local responses initiative', a promising approach in which communities take responsibility - and funding - for their own AIDS care and prevention. We filmed and interviewed ordinary folk in Gaoua, a village a few miles from the border with Cote d'Ivoire, a country where AIDS levels have recently risen enormously. Burkina Faso is currently relatively unaffected by AIDS, but is threatened by the same high levels as neighbouring Cote d'Ivoire through villages like Gaoua.Why? Of course because of HIV, unprotected sex, high levels of other STDs, and lack of male circumcision - the usual physical factors.But also because there is no investment in Gaoua. There are no oxen, no ploughs, no good roads. To farm they must scratch with hand hoes. So the young men, as soon as they are able, run off to the coffee and cocoa plantations of richer Cote d'Ivoire, to find work, buy a radio and a moped and some good clothes, to come back and impress the girls in a few years time and afford a dowry. Young and sexually active, they meet prostitutes while they are away and many come back with HIV. Every young person we met in Gaoua had a friend or friends who had died of AIDS.Similar stories can be told all over Africa.So does HIV or poverty cause this AIDS? Clearly it's both, and the politician in Mbeki is denying the first only to throw light on the second. Or so this writer believes.Robert Walgate

Is the President of South Africa really so irrational about AIDS?

Robert Walgate asks: Do Thabo Mbeki's opening words at the 13th International AIDS Conference in Durban at the weekend justify the reported reaction?

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