‘For very great is the number of the stupid’

‘We South Africans are losing the battle against this disease. This is, in no small measure, the result of the refusal by Mbeki to accept the guidance of best science. That refusal is irrational and perverse. More than four million South Africans are infected with HIV. These four million odd South Africans will die as a result. ... It is not too late for Mbeki to change the growing perception of him as an extremely intelligent man, but one whose intellect contains islands of irrationality that are impervious to reason, who has difficulty in conceding an error of judgement, and who prefers verbal play to the practical tasks at hand.’

‘Mbeki – described by friends and even critics as among the smartest and most capable leaders in the developing world – has become better known internationally for his skepticism about conventional AIDS treatments than for any other reason.’

‘In the last few months, Thabo Mbeki has been introducing himself to the world as a loon … making a spectacle of himself. … He read the scientific papers and now talks confidently about “toxicities” and “the phosphoral relation [sic: the AZT triphosphorylation problem].” He portrays himself as an educated skeptic about AIDS. But his late night Web-trolling, credulity about what he read online, and $10 scientific phrases smack less of skepticism than obsession. The president of South Africa is acting like a nutter. It’s a shame that Mbeki has been diverted by this bizarre AIDS twaddle, because he is normally rational. … Mbeki’s AIDS paroxysm, in short, is uncharacteristic of his lifetime of reasonableness. Why is he fixated on questioning the Western consensus about AIDS? … Mbeki faces a health catastrophe of unimaginable proportions. The West keeps haranguing him to buy drugs that he can’t afford, without trying to find a solution that he can. For 58 years, he has never succumbed to desperation or folly, no matter how dire the situation. If South Africa has become so troubled that even the unflappable Mbeki is coming unhinged, the world should worry.’

‘… his continuing personal musings [have provided] a year-long Christmas present to [the government’s] detractors, both here and abroad. Much of this has been, frankly, Mbeki’s fault. But as the dust settles now and his government continues its multibillion rand assault on Aids, we must not forget that this ordeal was not only – or even principally – a story of presidential error. Aids – an opportunistic disease – has attracted its fair share of opportunistic commentators. … Impatience with testing [i.e. with Mbeki’s questioning of the reliability of HIV antibody tests] is a natural instinct which I personally share. It seems like mere fiddling while Rome burns.’

‘President Mbeki’s persistent questioning of the link between HIV and Aids has been an unmitigated disaster for South Africa. It has distracted the country from dealing decisively with a social catastrophe, it has embroiled it in a long, destructive debate with bitter racial overtones, it has weakened the president internally after barely a year in office, and it has isolated him internationally, with most of the world’s scientific community and political leaders looking on in horror at his stubborn crusade to back the so-called Aids dissidents. … Tragically … a whole range of critically important issues … are getting sidetracked by the president’s personal obsession.’

‘It is this implicitly racially governed as well as homophobic mindset that lies behind Mbeki’s refusal of the judgment of the overwhelming majority in contemporary science on the nature of the AIDS virus. On the one hand such a view endorses an Africanist myth of a pure and primal Africa contaminated by a sinful West, a reversion to the race theory of the apartheid state. It reflects on the other hand the cloistered, driven mindset that produced the sham biology of Lysenko in the final years of Stalin.’

‘… scientists don’t know what they are looking for when testing for HIV.’

‘The universal human response to Aids is denial. It is as though nobody can face the awful reality of a calamity that rivals the great plagues of history.’

‘The year 2000 has been filled by weird and wonderful events. President Thabo Mbeki’s questioning of whether HIV does in fact cause Aids, must fall into the category of “weird.” His statements have caused uncertainty and have confused people.’

‘… too often … [the] African National Congress under President Thabo Mbeki … continues to view all politics through the lens of the national liberation struggle, identifying racism as the basic problem … Among the tragic consequences of this fixation [has] been Mbeki’s almost bizarre response to the AIDS epidemic.’

‘… not even the most skilled and devious spin-doctor in the world would be able to explain our president’s views and strategies on HIV/Aids.’

‘The year during which President Mbeki openly gave sustenance to denialist beliefs was a year of horror – for AIDS prevention, for AIDS implementation, for everything. It was a year of nightmare.’

‘Basically he doesn’t believe that HIV causes AIDS. That is why everything is in a mess.’

‘Thabo Mbeki’s legacy is in danger; tragically, “the president with the inexplicably contrary views on HIV/AIDS” would be most apposite at this stage.’

‘President Thabo Mbeki has sentenced many thousands of our fellow citizens to death by pretending that HIV does not cause Aids.’

‘Certainly with respect to AIDS, the president’s views have prevented the effective marshalling and direction of public resources and social energy.’

‘If you think the nutritionists and vitamin peddlers in the UK are weird, you really want to go to South Africa, where President Thabo Mbeki has a long history of siding with the HIV denialists, who believe that HIV does not cause Aids (but that treatments for it do) [namely] Anthony Brink ... the man who is credited with introducing Mbeki to HIV denialism, who has helped cost the lives of tens of thousands of people needlessly deprived of effective treatments.’

‘HIV/Aids has decimated the population and perpetuated poverty. … Mbeki’s reluctance to sanction large-scale provision of anti-retroviral medication to HIV/Aids patients and his personal association with dissident Aids denialists have, until recently, undermined official efforts to curb the pandemic.’

‘Our President, Thabo Mbeki, is a truly miserable piece of work. He is bitter, narrow-minded, vainglorious, officious, arrogant, pompous and racist. … He has the effrontery, in his hysterical, illogical and ignorant denial of the HIV-Aids scourge, to tell us that he does not know anyone who has died from Aids. When he makes such outrageous remarks, does he not see what a fool he is making of himself?’

‘In our country the issue of HIV/AIDS has for some time been fraught with an unusual degree of political, ideological and emotional contention. This is perhaps unavoidable, having regard to the magnitude of the catastrophe we confront.’

‘“The central problem,” says Achmat, “is the absence of political will. Why is the president like this?” … Achmat’s theory is this: “The president doesn’t want to believe that people in Africa have a lot of sex.”’

‘Central to the problem [of Mbeki’s desire ‘to change the world’] is the issue of whom Mbeki most comfortably allies himself with. The social forces represented in the AIDS treatment example [i.e. the Treatment Action Campaign] are emblematic of the challenge, for they evoke enormous potential for real solidarity, for changing the balance of forces.’

‘No one trusts Mbeki on this topic. He has already rejected advice from former president Nelson Mandela, thousands of health professionals and advocacy groups, by refusing to make anti-retroviral drugs readily available across the country. … the terms genocide and infanticide are now regularly used by even professionals and journalists to describe Mbeki’s Aids policies. A slow, painful death also awaits South Africa’s economy.’

‘Thabo Mbeki’s interventions in the AIDS debate resulted in widespread confusion. As Judge Edwin Cameron (himself HIV-positive) put it when he addressed the Durban AIDS Conference in 2000, Mbeki’s “flirtation with those who in the face of all reason and evidence have sought to dispute the aetiology of AIDS … has shaken almost everyone responsible for engaging epidemic. It has created an air of unbelief amongst scientists, confusion amongst those at risk of HIV, and consternation amongst AIDS workers (Cameron 2000).”’

‘The whole point of the TAC and other Aids activists is that the country can never deal with its Aids problem while the president is an Aids denialist, and while the government keeps putting back the timetable for providing ARVs. … [Gordimer:] “I just can’t understand his [‘wholly incomprehensible’] attitude. Yet in many ways he is an excellent president. He is so intelligent and such a well-read man.”’

‘The dangers posed by the lone righteous gunman are all too apparent in Elaine Epstein’s [documentary film] State of Denial, which (like Samantha Power’s recent article in The New Yorker) details South African president Thabo Mbeki’s blind, suicidal opposition to HIV-fighting drugs in a country grievously beset by AIDS as well as ignorance. (Health workers report that patients eschew condoms and medication, according to what they interpret as the president’s wishes.)’

‘AIDS campaigners who lobby for useful drugs for patients are accused of being stooges of foreign drug companies. Mr Mbeki has now stopped espousing his dreadful view that AIDS is not caused by a virus, but still shows little enthusiasm for the anti-AIDS measures that almost everyone believes are needed. ... who will tell him that his policies on AIDS ... are useless or dangerous?’

‘This is Anthony Brink, the biggest liar’

‘Mbeki is responsible for the deaths of thousands of people.’

‘Mbeki’s handling of the AIDS issue has reinforced his image as a lone, remote intellectual and contrarian battling against the world. … In dealing with AIDS, Mbeki may have wandered off on a deadly diversion that has helped place an entire nation in denial and needlessly taken the lives of millions of its citizens. … Underlying the [government’s reluctance to provide antiretroviral drugs] was an unspoken belief among Mbeki’s inner circle that spending money on ARVs would be futile, since the real problem lay with the reasons for South Africa’s masses being particularly vulnerable to AIDS. At its most cynical, the view suggests that the exchequer was to be spared the cost of subsidising treatment for the poor and unemployed, who were a drain on resources rather than contributors to the state coffers.’

‘It seems we need a South African version of Professor Alfred C Kinsey [who] became famous in 1948 when he released his seminal work, Sexual Behaviour in the Human Male … It is well known that part of Thabo Mbeki’s HIV/Aids denialism flows from his contempt for those who consider African sexual habits different to those of other groups. It is also well known that we suffer from one of the highest, if not the highest, levels of rape in the world. It is also likely that we have the highest recorded incidence of baby and child rape in the recorded history of mankind. We know of the belief, allegedly fostered by some traditional healers, that sex with a virgin will protect or even cure a man of HIV/Aids. Then there is the cultural aspect of male domination…’

‘Tragically he still shows signs of AIDS denialism. We at the TAC say, how can we engage the comrade President, because he is not carrying out the policy of the government and the ANC.’

‘When did we last hear our President mentioning HIV and AIDS? … These failures start with a failure of leadership, beginning with the Presidency and the Ministry of Health. … This lack of leadership on HIV is a betrayal of our people and our struggle.’

‘There are few rivals to Lysenko’s position in the South African AIDS debate. I wish to give this dishonourable achievement to Anthony Brink, an AIDS denialist who seems to have found the ear of the President.’

‘Now, with freedom and democracy, we did not expect a government that questions the existence of HIV and tells us that antiretroviral drugs are poisonous.’

‘Something has gone wrong with the post-Mandela government. Every senior UN official, engaged directly or indirectly, in the struggle against Aids, to whom I have spoken about South Africa, is completely bewildered by the policies of President Mbeki.’

‘The fact is that Mbeki has systematically shut down opposition and debate in … the country at large. … He has even had the effrontery to tell towering figures such as Nelson Mandela and Desmond Tutu to shut up. … Buffoons such as denialist campaigner Anthony Brink imagine the pressure on the president came from white journalists. The real heat came from ordinary people whose family members were dying while an ideologically perverse and stiff-necked administration continued to withhold drug treatment.’

‘[The Constitutional Court] helped the Treatment Action Campaign acquire AIDS medicines for pregnant women because the judges agreed the state was needlessly killing tens of thousands of infants each year.’

Q: ‘You’ve condemned South African President Thabo Mbeki’s view that HIV doesn’t cause AIDS – as well as his opposition of HIV treatment.’
Cameron: ‘At the time, no one else in South Africa was speaking out about this. All that I did was draw attention to what President Mbeki had done and said and what that meant for HIV positive South Africans.’

‘In the course of the HIV and AIDS debate, a demand was made that President Mbeki should subtract himself from the debate, partly on the grounds that he was making comments about issues of medical science on which he was not scientifically qualified to comment. He responded positively to this demand a few years ago. Since then, he has not commented on this subject, except to explain and support the government’s comprehensive programme of action against HIV and AIDS.’

‘How sad, how unfortunate that the president of the country with one of the highest rates of HIV infection in the world is now effectively muzzled from speaking about the subject. … it is regrettable that this is a president who, like King Lear, is apparently blind to the harm that his personal obsession with he issue is doing to his reputation, to his government’s health policy and to the patient community. … Mbeki’s legacy, for all his other immense achievements, will always be seriously blighted by his quixotic preoccupation with the linkage between HIV and AIDS.’

‘… it’s not uncommon for my dear activist friends in the Treatment Action Campaign to describe the government’s policy as genocidal, based on [Mbeki’s] denialism. I’m so sorry, it’s such a life-and-death issue to the civil society forces I work with across SA … the damage done to the progressive movement – and the society as a whole – by AIDS denialists is so intense and deep ... It is … perhaps the most serious problem here, with at least five million HIV+ people and a government unwilling to provide proper care, justifying its resistance by using Duisberg [sic: Duesberg], Rasnick, Brink et al.’

‘Given your public and vocal position in the debate surrounding AIDS and HIV (a debate which many see as prolonging the suffering and dying of many human beings), it is possible that some people may have difficulty in spending time socially with you.’

‘Do you think it ever worries Brink that he may be responsible for millions of deaths?’

‘Been reading the brilliant Mbeki biography by Mark Gevisser and it’s amazing to see the influence Brink had on him. Fuck man he must be responsible for millions of lives!! Where is his head at – he’s not even a medical person. Look I stick with homeopathy and my kids haven’t ever had antibiotics but with a mass epidemic you have to bend a bit.’

‘No-one has sounded the alarm where I work daily in the presidency and … said there is a particularly alarming tendency of people dying. … nobody has said we are losing 10 percent of our staff every year because of AIDS. … There has not been any [such] indication.’

‘Yesterday, City Press published views indicative of AIDS denialism by President Thabo Mbeki. … Tragically, President Mbeki continues to belittle HIV/AIDS related deaths to justify his personal denialism. He undermines government and ANC policy but he lacks the courage to do so openly as an AIDS denialist. More seriously, the President’s denialism contributes directly to delayed testing, prolonged illness and premature deaths. TAC demands that the Cabinet and ANC NEC act to save lives. The time has come to put loyalty to the Constitutional rights to life, health, dignity and equality before loyalty to a leader in denial. President Mbeki deliberately minimizes deaths from HIV/AIDS related illness. His denial is deeply offensive to people who live with HIV/AIDS and our families who bury us.’

‘… the President remains an HIV denialist.’

‘… a disturbing rise in anti-science opinion … has permeated important public health and public policy debate … the anti-HIV nihilist rhetoric [has had] tragic consequences in lives lost. One need look no farther than South Africa, where such AIDS-nihilism has infected the leadership of the country and disrupted access to life saving prevention and treatment programs.’

‘The biggest problem we have in South Africa is that we have a president who doesn’t believe that HIV causes Aids.’

‘It is precisely because Mbeki’s undermining of the science of HIV treatment costs lives, that his position is so controversial. … Mbeki was portrayed as severely out of step with scientific opinion … and as stupidly pig-headed in his insistence that all avenues should be explored. In mid-October [2000] he announced his withdrawal from the public debate on AIDS science because it was causing confusion and widening divisions between the ANC, Cosatu and the SACP. Despite this “public withdrawal”, Mbeki continued to espouse denialist views … He was also linked (via an electronic signature) to a notorious ANC dissident document probably written by Peter Mokaba claiming, inter alia, that antiretrovirals were poisonous. … The most pernicious legacy of President Mbeki’s dissident stance on AIDS has been the erosion of the authority of science and of scientific regulation of medicine in South Africa.’

‘President Thabo Mbeki … is still stewing in the cesspool of his denialist views … Millions of South Africans live daily with the fallout from the HIV/AIDS scourge … [thanks to] Mbeki’s dalliance with AIDS dissidents, and a refusal to accept the seriousness of the peril SA faces. … Neither Mbeki nor the inept Manto Tshabalala-Msimang really believe HIV causes AIDS, despite government spin doctors’ efforts to get them to shut up about the science of the disease. They do not believe in the efficacy of antiretroviral medicine, the only globally accepted method for prolonging and improving the lives of people infected by the virus. … The ANC has still to overcome its own deep denial about the virus. Despite having lost many of its finest cadres to HIV/AIDS, the ruling party is yet to foster a climate of true and genuine acceptance of the scale of this pandemic within its own ranks. … SA’s former apartheid rulers presided over a crime against humanity, a fact confirmed by the United Nations. But their crime was not genocidal. It has taken a democratic ANC government, with a legitimate popular mandate, to be the true architects of a holocaust.’

‘Tragically, President Mbeki continues to display all the symptoms of denialism.’

‘It’s under the president’s term of office that these deaths are occurring, so the person responsible for dealing with it has to be the president.’

‘SOUTH AFRICA’S TOP TWELVE AIDS DISSIDENTS: 1. Anthony Brink … 3. President Thabo Mbeki … A DEMOCRATIC ALLIANCE PUBLIC HEALTH WARNING! … President Thabo Mbeki, Anthony Brink … deny the existence of the human immuno-deficiency virus itself. … The DA’s objective in compiling this list is to make it clear why these individuals are so dangerous, and raise public awareness about who they are and what they stand for. These individuals hide behind the excuse of promoting scientific debate in order to promote views that are false and dangerous. … The DA calls on the media, the public, and professional organizations to … exclude these individuals from positions of authority; deny their dissident views publicity; and take vigorous steps to pursue official action in respect of any infringements of the law.’

‘I personally think the kingpin of denialism is Anthony Brink, who rages about ARVs being toxic. His relationship with the President is first-class.’

‘A dangerous AIDS dissident … Anthony Brink, one of the most notorious AIDS dissidents in the country … Brink, for those of you who don’t know it, is someone who has caused a great deal of harm, to say the least of it. Many people claim that his theories have had a considerable influence over President Thabo Mbeki’s disastrous views on HIV/AIDS.’

‘You must read [the writing of] a crazy man called Anthony Brink and read all the bad things they say about me. Do I care a damn? No, because I know it’s not true. You can never base your policy, your work or your principles on what people think of you.’

‘Brink could probably spell AIDS without consulting a dictionary, but that as far as his real knowledge goes. He has a twisted, perverse anti-science agenda that is based on him trying to “prove” the pre-conceived notion that AIDS is caused by the therapies used to treat it – an utter and manifest nonsense. He has no scientific qualifications that I am aware of nor any scientific publications.’

‘… Anthony Brink [is] South Africa’s loudest AIDS denialist.’

‘I just wish that Mr Mbeki and the African National Congress would fight [AIDS] the way they fought apartheid.’

‘Mbeki has not recanted his eccentric views on HIV. Instead of showing leadership, he has retreated into a sullen silence on the subject.’

‘[South Africa] is the only country in Africa, amongst all the countries I have traversed in the last five years, whose government is still obtuse, dilatory and negligent about rolling out treatment. It is the only country in Africa whose government continues to propound theories more worthy of a lunatic fringe than of a concerned and compassionate state. The government has a lot to atone for. I am of the opinion that they can never achieve redemption. … I was appointed as envoy for AIDS in Africa. I see my job as advocating for those who are living with the virus, those who are dying of the virus, all of those in and out of civil society who are fighting the good fight to achieve social justice. It is not my job to be silenced by a government when I know that what it is doing is wrong, immoral, indefensible.’

‘I don’t think we have any lessons to learn from South Africa. ... its President is an HIV-denialist.’

‘We as a world have sat back for far too long, watching South Africa continue to deteriorate in terms of thousands of people dying of HIV. Why it is that a government can continue to remain in power in a country despite all of the evidence that it has abysmally failed to deliver the essentials to its population is something that I clearly do not understand ... It’s something that burns a hole through my heart. [At the 13th International AIDS Conference in Durban in 2000, AIDS scientists had expected to find] a South African government that would be onside with us. Instead … We found a denialist President in South Africa who immediately turned his back on us and who immediately began to convene committees that would articulate on his behalf that somehow it was in dispute whether HIV was truly the cause of AIDS. … We were 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 have waited far too long to make this the crucial issue of this time.’

‘What is happening in South Africa is a human rights violation that needs leadership from outside of South Africa to address the crisis being created by the South African government. [But there’s] a terrible silence … Bill Clinton can’t get the words out of his mouth to criticise Thabo Mbeki. Kofi Annan can’t criticise Thabo Mbeki ... The long-term consequences for South Africa are enormous. This crisis has to be broken somehow. The African Union and the G8 and the EU have to speak out about it. The British government, who are silent on this question, have to find a way to intervene.’

‘The Treatment Action Campaign (TAC) demands that President Mbeki … Dismiss Health Minister Manto Tshabalala-Msimang and her director-general Thami Mseleku immediately. Since her appointment in 1999 and reappointment in 2005 [sic: 2004] by President Mbeki, she has … failed to address the HIV denialism in the Presidency.’

‘Calling for Health Minister Manto Tshabalala-Msimang to resign because of government’s failure to deal adequately with HIV/AIDS is like condemning the puppet for stupidity while letting the puppeteer off the hook. … what we are faced with when looking at the spectacle of Tshabalala-Msimang is the wholesale betrayal of the poor … and her expedient refusal to defend them against the unscientific, lunatic extremities of her political master. … Whatever Mbeki and his government manage to achieve for South Africa’s future, nothing can remove the culpability of millions of preventable deaths that will forever stick to his name. And the message from Toronto is that the rest of the world has woken up to this culpability. After 12 years as the toast of the international stage, SA has been returned to its familiar place as the world’s pariah.’

‘[Mbeki] stop killing your countrymen. … everyone [ought] to rise up and tell Mbeki to save his reputation and stop killing thousands of his own people. … [Tshabalala-Msimang is] killing tens of thousands [of people by advocating nutrient rich foods for AIDS instead of ARV drugs].’

‘This government is not doing enough … [It] is killing thousands of its own people. … the little that they are doing could be seen as genocide.’

‘You could call … the president’s original lack of sympathy and public questioning of both the causal link between HIV and Aids, and the effectiveness of anti-Aids drugs [that] resulted in confusion and paralysis in the nation’s management of the epidemic … genocide by sloth.’

‘Mbeki’s own appalling insistence that his lay research could trump the wealth of scientific knowledge built up around the world cannot be forgotten or ever forgiven. He must carry to his bed each night the knowledge that his stubbornness has sent thousands to their graves earlier than a more humble and humane approach might have allowed. His semantic juggling with the definitions of “virus” and “syndrome” to mock the life work of good men and women of medicine will be forever on his conscience. … Mbeki may wish to contemplate the origins of the perception that he would put personal pride ahead of the welfare of his people. … Let that be his personal torment.’

‘I do not believe [Mbeki] was in denial as much as he saw it as a conspiracy, a much more traditional African response. Both Vice President Gore and I argued with passion with him to move on this issue. And you know, we had polite responses. … He simply listened politely and basically said to us, “We understand what we need to do in our country,” and, “Thank you very much.”’

‘What disturbs me greatly inasmuch as we say people are aware of HIV, is the continuing denialism among our people and some of our political leaders. … the time for denialism is over.’

‘Tshabalala-Msimang, in an open letter on the ANC website last Friday, complained that her recent illness had been seen as “an opportunity to turn others into champions of a campaign to rid our government of the so-called ‘HIV and Aids denial at the highest level’”.’ Despite this, Madlala-Routledge confirmed this week that “denialism has cost us time and lives”.’

‘She has publicly admitted for the first time that the government has been in “denial at the very highest level” over Aids. … Mrs Madlala-Routledge has broken new ground by taking her family with her for an HIV test – and has called on the president, Thabo Mbeki, to do the same. … “To me it is logical that people in the leadership see the need to do this,” she said. … What has happened in South Africa … is sad and tragic … people are confused about treatment … and this has come about because of the confusing messages coming from the very top.’

‘… the changes Mbeki’s handling of AIDS has effected upon South African national culture … has been far more destructive than we care to admit. Until he stopped speaking of these matters, Mbeki’s talk about AIDS was a mixture of ersatz science and sociology. The science was primarily about the social and organic factors that cause disease. The sociology was a treatise on the force of white racism and the ways in which it has corrupted scientific knowledge. Yet these things may well shroud the heart of Mbeki’s response to AIDS, which was neither scientific nor sociological, but profoundly political. As the historian John Iliffe writes in his recent book, The African AIDS Epidemic, the government’s early resistance to antiretroviral treatment is perhaps best understood as “an insecure regime’s anxiety to maintain control over a situation perceived as threatening. The threat was that pressure from a coalition of HIV-positive people, AIDS activists, political opponents within and outside the ANC, pharmaceutical companies, and international opinion might oblige the government to undertake an antiretroviral programme that it could neither administer nor afford at current drug prices, at the expense of its authority, its health priorities and its wider developmental programme.” … [Mbeki’s] ideas [about] AIDS and antiretroviral treatment [have] in common [a] frenzied anxiety about an erosion of authority – perhaps even of national sovereignty. … What Mbeki coaxed to the surface of SA’s political culture was an anxious man’s nationalism and a paranoid’s nativism – both of which instinctively lash out at the arrival of technology and ideas from abroad. … Mbeki … treated the AIDS epidemic as a pernicious attack on our sovereignty launched from abroad … he has made his own sense of besiegement a nation’s sense of besiegement. In diffuse and unhappy ways, he has triggered a flurry of trench digging across large strata of SA. It is a troubling legacy to leave behind.’

‘The deepest stigma impeding effective management of AIDS today appears to come from the President’s continuing unwillingness or inability to lead effectively and speak unambivalently on this issue.’

‘For far too long, the world was in denial. But over the past 10 years, attitudes have changed. The world has started to take the fight against AIDS as seriously as it deserves. Financial resources are being committed like never before. People have access to antiretroviral treatment like never before. … Leaders must hold themselves accountable – and be held accountable by all of us. That is why accountability is the theme of this World AIDS Day. Accountability requires every President and Prime Minister, every parliamentarian and politician, to decide and declare that “AIDS stops with me”.’

‘Mbeki’s recent bout of denials can be equated to his HIV/Aids quackery at the turn of the century in which he fatally refuted the scientific link between HIV and Aids. … “He hasn’t been any more of a denialist in this case than any other leader. All leaders defend their record,” said Richard Calland, executive director for the open democracy advice centre at the Institute for Democracy in South Africa. “But any leader who lacks empathy with his or her people [demonstrates] bad politics.” … How to squander a legacy … Deny Aids. In 2001, President Thabo Mbeki began to question the links between HIV and Aids. He established a presidential advisory panel comprised of the world’s most notorious dissident scientists. … Mbeki does not say anything substantive or persuasive about HIV and Aids.’

‘President Thabo Mbeki [has] an awful lot of explaining to do. So far he has never been made to do it.’

‘For years Mbeki has pandered to fringe commentators who question the incontrovertible link between HIV and Aids, retarding government’s roll-out of the ARVs that might to date have saved hundreds of thousands who have succumbed to the disease.’

‘[In promoting Lysenko’s] doctrine of environmentally (as against genetically) acquired inheritance … Stalin too imagined that biology was susceptible to his own ideological fetishism. … President Mbeki’s forays into biological science on HIV/AIDS, in which he is as ignorant as Stalin in plant genetics, offer a parallel deriving from an imposed overriding ideological imperative. Still more, Mbeki is deeply conservative in not wanting – for whatever reason – to confront the historically developed current sexual mores of African men in South Africa. All the more then does the dogma of “poverty” – so apparently radical, with the blame always pointed elsewhere – serve as a blind.’

‘South Africa really does have an odd head of state in Thabo Mbeki. … his strange views on HIV/Aids … have cost South Africa tens of thousands of lives.’

‘… the government’s disastrous policy on HIV/Aids – which has led to the loss of many thousands of infected black women and babies’ lives – has been largely attributed to the dissenting views held by Mbeki. In fact, many believe, even some in the ANC, that the shadow of Mbeki always hung over the wayward and sometimes shocking comments on HIV/Aids of Health Minister Manto Tshabalala-Msimang, whose own health could have been affected by the strain she must have taken for the enormously disparaging public criticism she faced for years. It is arguable that the catastrophic handling of the Aids crisis … was the single biggest indictment of the Mbeki administration over the past decade.’

‘Speculation is developing once again in South Africa that President Thabo Mbeki is planning to circumvent the constitution, leading the country into one-party rule. … Fundamentally, suspicion of Mbeki’s motives with regard to the presidential succession is based on the belief that he simply will not surrender power. It is a belief based on his record in power and what can perhaps best be described as his curious personality. It is a belief and a record examined in detail by James Myburgh, a former speechwriter to South Africa’s opposition leader, Tony Leon. In a PhD dissertation at Oxford (The Last Jacobins of Africa – Thabo Mbeki and the making of the new South Africa 1994–2002), Myburgh argues that the South African president is no friend to democracy … Myburgh goes on to give a fascinating account and analysis of Mbeki’s perverse stance on HIV/Aids, arguing that his insistence that immune deficiency was caused primarily by malnutrition and poverty, rather than a sexually transmitted virus, was ideologically driven. It offered a defence of the dignity of the black majority; absolved the ANC of moral responsibility “and placed the blame for the epidemic back onto the ‘legacy of the past’”.’

‘Without question, he is personally responsible for the deaths and illness of many thousands of his countrymen and women.’

‘In SSA [sub-Saharan Africa] the vast majority of HIV infections are attributed to heterosexual HIV transmission while in the USA epidemic heterosexual HIV transmission is virtually absent. … The answer of mainstream medical science to the question – why is epidemic heterosexual transmission so rampant in SSA and not in most other regions – should be simple and direct. Epidemic heterosexual HIV transmission requires a high prevalence and frequency of sex partner exchange (i.e., having multiple sex partners on a concurrent basis) and the pattern and prevalence of these heterosexual risk behaviours in most SSA populations are sufficient to sustain epidemic HIV transmission whereas the patterns and prevalence of these risk behaviours in most other populations are not sufficient to fuel epidemic heterosexual transmission. … During the 1990s, as major political and social changes were underway in South Africa, HIV spread steadily … An accelerated decrease in HIV incidence in South Africa cannot be expected until there is full acceptance by policy makers, especially the President, and the general public of the need to significantly reduce risk behaviours … According to AIDS dissidents, the African AIDS diseases by their conventional and widespread causes – malnutrition, parasitic infections and poor sanitation – and have nothing to do with sexual risk behaviours. This hypothesis offers a simple and politically correct explanation for the predominant heterosexual distribution of AIDS in SSA, a view that has apparently been accepted by President Mbeki of South Africa. … Another false assertion is that because of poor nutrition due to poverty most Africans have an “undermined” immune system that makes them more susceptible to HIV infection and the development of AIDS. … The best that can be said about President Mbeki and his Minister of Health is that they have been extremely unhelpful in developing adequate HIV prevention and treatment programs: they are now hindering rather than promoting anti-retroviral treatment (ART) programs. … President Mbeki of South Africa and probably the majority of Africans are sceptical and just don’t want to believe in the African origin of HIV/AIDS and are all too willing to listen to … conspiracy theories and the theories of dissident scientists who do not believe HIV is the causative agent of AIDS.’

‘… it is a matter of common knowledge that the HIV/AIDS pandemic is wreaking havoc on our economy and has already substantially lowered the life expectancy of South Africans ... At best, government tends to smother civil society; at worst, it is downright antagonistic towards it. For example, the relationship between the Treatment Action Campaign (TAC) on HIV/AIDS and the government and the Department of Health is seriously skewed. There is no doubt that the TAC has done an enormous amount of good work in making people conscious of the threats and dangers of HIV/AIDS and on challenging the big pharmaceutical companies about their pricing structures. What should have been a relationship of independent allies working toward a common goal is perceived as a relationship of antagonists. And the fault lies primarily on the side of the government.’

‘One hopes history will come to judge Mbeki’s AIDS dissidence as an aberration in the African nationalist project. For an African nationalism congenitally suspicious of foreign knowledge and technology beckons a future of low expectations.’

‘Thabo Mbeki is not now, nor has he ever been, an AIDS dissident.’

‘[Alluding to Ronald Suresh Roberts’s Fit to Govern: The Native Intelligence of Thabo Mbeki, Judge Edwin] Cameron warned against “the massive historical fraud” of revisionist historians who would sweep under the carpet the four to five years of Aids denialism, a nightmare period when the coherence and substance of the Aids programme was on hold.’

‘Recent attempts by President Thabo Mbeki’s official biographer, Ronald Suresh Roberts, to airbrush Mbeki’s Aids denialism from the historical record smell of Stalinism – the era in which history was most cynically and viciously rewritten – and trivialize the responsibility Mbeki carries for thousands of lives lost because he gave credence to ludicrous denialist tenets about the cause of Aids and the efficacy of antiretrovirals. … According to demographic modelling, if during the Mbeki presidency South Africa had rolled out ARVs for pregnant women with HIV and for treating those sick with Aids … then at least 170 000 HIV infections could have been prevented and more than 340 000 deaths averted. This amounts to what European commissioner Peter Mandelson once described as a form of “genocide by sloth”.’

‘HIV denialism is lethal. It is responsible for the infections of at least several hundreds of thousands more people around the world than would have otherwise been infected and died. South African President Thabo Mbeki and his health minister, HIV denialists until last year, were among those in Africa whose refusal to be content with mere ostrich-like obliviousness, whose insistence on propagating flagrant disinformation about the disease, amounted to an arguably criminal abrogation of leadership. Last summer, when political pressure generated by the International AIDS Conference in Toronto caused them to finally reverse their position, a scientific presentation there estimated that the number of HIV-infected people in South Africa was approximately 25 per cent higher than otherwise because of that country’s policies.’

‘Treatment delivery is working and there can be no more excuses for losing this momentum or letting millions die of AIDS.’

‘While Brink is an AIDS denialist, to compare him with Lysenko would only be justifiable if Brink had been placed in overall control of South African AIDS policy. … Fortunately, in the end and in this instance, good sense prevailed over rhetoric. Treatment did indeed eventually materialise … a happy ending …’

‘Mbeki is arguably the most intelligent national leader this country has ever had.’

‘Mbeki is an exceptionally intelligent man, one of the sharpest and brightest analysts I have ever met.’

‘… he read books at an early age which we thought were not for his standard. And he was not talkative. He was reserved, even as a young person. And he had very few friends because, you know, his mind was above average.’

‘The 2005 Nobel Prize Winners for Medicine, Robin Warren and Barry Marshall, were forced to relearn the message that to be a questioner of accepted truths, was to expose oneself to denunciation as a permanent public nuisance. Their own curiosity, expressive of the human urge to know, led them to engage in a labour of love to unravel the workings of the natural world.’

‘There is also a “Socratic” inquisitiveness to which Mbeki is predisposed and which underpins his leadership style and management practice. In this regard, his thinking finds expression in questions. He holds no concept or view sacred and aims at it a quiver of questions, all of which have to be answered before he is content to move on. … This is a powerful intellectual asset for any president, but can also be dangerous, as we have seen in his overt curiosity in unorthodox approaches to understanding the HIV/AIDS pandemic. … Mbeki is a man with … an egocentric view of his own epic place in history; he knows his own mind, stubbornly so at times (as on HIV/AIDS).’

‘President Thabo Mbeki stunned and outraged campaigners yesterday by sacking the country’s deputy health minister, the woman credited with ending a decade of Aids denialism at the heart of the South African political leadership. Activists fear that the decision spells a disastrous political regression on Aids, which could cost the lives of hundreds of thousands of people. … by sacking his cabinet’s most forceful advocate of an aggressive campaign to provide drug treatment, Mr Mbeki has reopened questions about his own acceptance of the science surrounding Aids. “He has once again shown his contempt for those seeking scientific approaches to Aids,” said Professor Nicoli Nattrass of the University of Cape Town. “This is a dreadful error of judgement. It indicates that the President still remains opposed to the science of HIV,” the Treatment Action Campaign (TAC), South Africa’s biggest Aids advocacy group, said yesterday.’

‘Idasa analyst Richard Calland condemned Madlala-Routledge’s dismissal as “a shameful error of judgment”.’

‘In many ways, Thabo Mbeki has been a successful leader of South Africa since he took over from Nelson Mandela in 1999. … But there is one particular area in which President Mbeki has been a scandalous failure: in confronting the scourge of HIV/Aids. More than one in 10 of the population are infected. It has been estimated that 1,000 South Africans are dying of an Aids-related illness every day. Yet President Mbeki for a long time refused to put his weight behind a safe-sex awareness campaign and the rolling out of anti-retroviral drugs to prolong the lives of the infected. In the face of all credible scientific research, he has argued that Aids was a “disease of poverty” rather than a sexual infection. Even now, when the link between the HIV virus and Aids is beyond dispute, President Mbeki is begrudging of anti-retrovirals and criticises outside attempts to help to ease the problem as a manifestation of neo-colonialism. … The social stigma and denial surrounding Aids in South Africa will only be eradicated through strong political leadership. The tragedy for South Africa is that such regressive attitudes seem as entrenched at the top as they are throughout wider society.’

‘What is it about South Africa’s devastating AIDS epidemic that President Thabo Mbeki just doesn’t want to understand? Mr. Mbeki has catastrophically failed to face up to his country’s greatest challenge. For years, he associated himself with crackpot theories that disputed the demonstrable fact that AIDS was transmitted by a treatable virus. He also insisted that he knew nobody with AIDS, even though nearly 20 percent of South Africa’s adult population are estimated to be living with H.I.V. And he suggested that antiretroviral drugs were toxic, and he encouraged useless herbal folk remedies instead. As a result, thousands of South Africans have needlessly sickened and died. ... Unlike other African countries, South Africa has the financial resources and the medical talent to successfully take on its H.I.V./AIDS epidemic. What it lacks is a president who cares enough about his people’s suffering to provide serious leadership. Only two more years remain in Mr. Mbeki’s presidential term. Unless he finally starts listening to sensible advice on AIDS, he will leave a tragic legacy of junk science and unnecessary death.’

‘I’ll never understand [Mbeki’s] disastrous response to the AIDS virus. I don’t think I’ve ever met anyone, inside or outside of South Africa, who fully understands. After all, this is a man of immense intelligence, who fought against apartheid with every intellectual and organizational weapon at his command. But his place in the annals of South Africa is forever sullied by the inexplicable unwillingness to confront HIV/AIDS. No matter the astuteness of his economic policy, social interventions, financial acumen, or peace-keeping initiatives across the continent, he will always be known as the President who presided over the AIDS apocalypse. It’s a terrible legacy with which to haunt the pages of history. … It is said that 900 men, women and children die every day in South Africa of AIDS-related illnesses. It’s Armageddon every 24 hours. Other than South Africa, every government in the high-prevalence countries is moving heaven and earth to keep its people alive. There are no excuses left for President Mbeki and his Minister of Health. The day of reckoning is surely coming.’

‘The former UN special envoy on Aids in Africa, Stephen Lewis, accused Mr Mbeki of presiding over an “Aids apocalypse” and said the dismissal of the widely praised deputy health minister crushed a glimmer of hope in the fight against Aids. “Other than South Africa, every government in the high-prevalence countries is moving heaven and earth to keep its people alive,” he said. Mr Mbeki, Mr Lewis said, would always be known as “the president who presided over the Aids apocalypse. It is a terrible legacy with which to haunt the pages of history.”’

‘[The death of 900 people a day from AIDS is] like three jumbo jets crashing every day. … too many died unnecessarily because of bizarre theories held on high.’

‘... what‘s difficult about tackling Mbeki is that he is so obviously an enlightened man. He reads, he is erudite, he‘s good company.’

‘[Mbeki] may well be the world’s most intelligent head of government.’

‘I have been concerned for a long time about the way in which Mbeki seems to be drifting from reality. … Some of the worrying patterns of behaviour include his continued duplicitous position on HIV and Aids.’

‘Thabo Mbeki … rank[s], with his friend Robert Mugabe, among the worst Presidents in the world. The backdrop is Mbeki’s twisted relationship with Aids, a disease that affects one in nine South African people and kills 900 of them a day. Specific events this past month concern two women, rivals in South Africa’s Aids drama: former Deputy Health Minister Nozizwe Madlala-Routledge, whom Mbeki fired on 8 August, and Health Minister Manto Tshabalala-Msimang in whom he has retained total faith. Beyond the sycophants who surround Mbeki and his loyal-to-a-fault cabinet, the consensus is widespread in South Africa that he fired the wrong minister. And that in so doing he has laid bare the wilful ignorance and criminal neglect with which he has responded to a humanitarian crisis of such vast proportions that any half-decent leader anywhere else would not hesitate to flag as his country’s overwhelming national priority. Yet Mandela’s heir, the man charged with preserving the admirably principled tradition of the African National Congress, behaves as if South Africa’s Aids disaster is no such thing. … During Mbeki’s first five-year term, he used to say, with the enthusiastic backing of his Health Minister, a doctor, that Aids was not a sexually transmitted disease and that the anti-retroviral drugs that have saved hundreds of thousands of lives around the world were poisonous. He also famously declared that he knew no one who has Aids. Since then, Mbeki has been bludgeoned into grudgingly starting to have anti-retroviral drugs handed out. The government’s official policy on Aids today is medically sound at last. But Mbeki continues to show an abject lack of leadership, indicating – as his firing of the Deputy Health Minister shows – that he is less than half-hearted in his commitment to the cause; that the great $64,000 question of South African politics – what the hell is going inside Mbeki’s head on Aids? – remains unanswered. Because he is an otherwise eminently rational, intelligent man. While Mbeki has battled with repression, the crisis has cried out for Diana-like theatrics. Mbeki should have gone out into the worst-affected areas and held the hands of Aids patients; he should have publicly celebrated the Lazarus-like return to life of people on the anti-retroviral programmes; above all, he should have gone out of his way to set people straight on Aids, to counter the ignorance and confusion he himself has sown, contributing immeasurably to the scale of the catastrophe. … He seems oblivious to the callousness of the message he is sending in persisting with the buffoonish Tshabalala-Msimang, a drinking buddy of long-standing, in a ministerial post that Mandela would have considered the most critical in his government by far.’

‘Today I speak to you as a person living with HIV/AIDS. I am healthy and I have the hope of decades of natural life ahead because of my use of antiretroviral medicines. I speak to you also as chairperson of the Treatment Action Campaign and a lifelong ANC member. … Since the advent of President Mbeki’s tenure more people have died in their 30s than in their 70s. …President Mbeki has made a calamitous mistake because of scientific denialism. … President Mbeki does not have the power to bring people who have died back to life. … Fortunately, President Mbeki also has the power to address this mistake. He has power to unite all of us with the demand of science, human rights, accountability and hard work. He has the power to appoint a new Minister Health and a new Director-General of Health. He has the power to make science work for all of humanity and for the African Renaissance he dreams for all of us. That brings me, nearly in conclusion to science. In a recent debate, the Director-General of Health claimed equality for “African science” and “Western Science” with the treatment of HIV/AIDS. This a red-herring. It aims to cause a racist division and will further undermine traditional healers and most importantly lead to an unnecessary loss of life.’

‘Today, public debate in South Africa tends to be characterised by the absence of reason, and the font of that unreason is President Thabo Mbeki. After all, if Archbishop Tutu (among many others) is correct in claiming that 900 South Africans die each day of Aids, many of them unnecessarily, surely that points to unreason? In fact, it is a record which should earn him a place in the dock at the International Criminal Court in The Hague.’

‘… supporting [Mbeki] at the outset of the Aids-denial debate [were] such loathed personalities as Anthony Brink.’

‘The international media are very interested in the story of the Joe Slovo informal settlement. Your arrogant behaviour towards its residents will bring world-wide discredit on our government, as has the president’s silence on Zimbabwe and the health minister’s ‘denialism’ on AIDS.’

‘The Mbeki regime has been an unmitigated disaster from the onset [for its] ineptitude [in its] failure to deal with HIV/Aids.’

‘HIV causes AIDS. So, what’s difficult? Which tyrant will stop me from saying that? ... We wasted time in debating the causality of AIDS in this country. People were dying. When there is a fire, you don’t discuss the theory of combustion; you pick up a bucketful of water and you fight the fire.’

‘Yet another prominent former ANC public representative has attacked President Thabo Mbeki for his Aids denialism … [Speaking] at the Cape Town Press Club … former ANC MP Andrew Feinstein … said yesterday: “The greatest tragedy … is … the years we prevaricated in dealing with HIV and Aids due to the president and health minister’s denialism. … And let’s not beat about the bush … they are Aids denialists.” … He said the fact that their actions had “unnecessarily” cost tens of thousands of lives was “unforgivable”. … Feinstein said the darkest days since apartheid for him were when his conscience forced him to betray the confidentiality of the ANC caucus and speak out over how Mbeki had told members that Aids was a notion invented by the Americans to help pharmaceutical companies recoup their investments. “We must never allow a return to a denialism that encompassed not just the science of HIV/Aids, but a denialism that saw the party adopt the view that a leader is always right (and) can do no wrong.” He also said Mbeki had failed the party and the public through his “hubristic and inexplicable ongoing support” of the “embarrassing minister of health” … Feinstein argued that [Mbeki] lacked the necessary moral leadership [to lead the ANC and its] moral regeneration.”’

‘I feel