Civilization: South Africa AIDS folly

WASHINGTON, Sept. 22 (UPI) -- If a novelist had come up with the plot in 1980, his editor would have vetoed it.

A deadly epidemic ravages Africa. People by the millions die a slow, wasting death in the worst health calamity since the Middle Ages, when the bubonic plague killed its victims relatively quickly. In some places, as many as one-third of pregnant mothers are infected, passing the disease on to their babies in utero or through breastfeeding. More than 13 million children lose a parent, and 4 million lose both parents. In devastated communities, some orphans are simply abandoned by surviving adults.

Medical science determines that a virus, usually transmitted sexually, gradually destroys the body's immune system, leaving the victim vulnerable to opportunistic infections and otherwise rare cancers. The disease has no cure and is difficult and costly to treat symptomatically with medicines, which most Africans can't afford, but "safe sex" campaigns slow the rate of transmission in some areas.

This, however, requires vigorous government intervention.

But the leader of the country with the region's greatest resources does little to counter the scourge. Bizarrely, he denies that a virus can cause the disease, saying poverty and the legacy of white oppression are the culprits. He mobilizes the full force of the ruling party behind his self-delusion.

He fights a court ruling ordering the government to provide pregnant women with a drug that reduces the chance of mothers passing the disease on to their babies. He denounces life-extending medicines as "toxic."

Welcome to a reality that is stranger than fiction, to South Africa and its president, Thabo Mbeki.

Is the source of Mbeki's fatuity some surviving sub-Saharan primitivism? Probably not.

"The best explanation I've heard recently is that he was educated at Sussex University during the rise of postmodernism," said documentary filmmaker Elaine Epstein in a phone interview from New York City. Epstein, a South African, is producer-director of "State of Denial," which premiered last week and is being broadcast in PBS's Emmy Award-winning P.O.V. (Point of View) series.

In other words, Mbeki is more correct than he knows. It is indeed an excrescence of the West that is killing South Africans in untold legions. But it is not the residue of apartheid. Rather, it is a poisonous worldview that glorifies pure subjectivity (every individual generates his own truth) and degrades inter-subjective scientific inquiry as an illusion that deceives oppressed peoples, especially in the Third World.

Not that sub-Saharan primitivism doesn't spread AIDS. (Buzz off, cultural relativists.) Three factors, not mentioned in the film, are:

- Forcing widows and unmarried women who lose a parent or child to have sex with the village idiot or town drunk to "cleanse" her of evil spirits (The Washington Post, Aug. 18, 2003).

- Forcing women to insert desiccating herbs or other substances into their vaginas because "Our African husbands enjoy sex with a dry vagina" (The Village Voice, Dec. 1-7, 1999). The resulting lacerations and abrading make transmission of the virus more likely.

- Raping ever-younger victims, down to infants in their cradles, in the belief that if a "dirty" girl gave you the disease, sex with a "clean" one will cure it (personal communication with a South African anthropologist and published sources too numerous to list).

"State of Denial" is alarming and moving. It also is heartbreaking, infuriating, and imbues the viewer with a sense of helplessness.

"It's incredibly frustrating," Epstein told United Press International. "Great work is being done at the grassroots level. People are doing a magnificent job. And if they just had more support from the government -- strong leadership - it would make all the difference."

Epstein said it was very frustrating to interview people who have since died, knowing they probably would be alive today if they lived elsewhere.

"Mbeki talks about anti-retrovirals being toxic," she said. But when Epstein first met Chipho - a child whose family appears in the documentary -- she was a shell of a little girl. After Chipho had been on therapy for a few months, the difference was remarkable. "I would like to put this in front of Mbeki's face and say, 'How can you deny that these drugs are helping people? That this is saving lives? That people need this therapy desperately?'"

Last year Mbeki's ruling African National Congress Party produced a document that Britain's left-leaning Guardian newspaper called "bizarre."

"Among its claims is that Nkosi Johnson -- the 12-year-old black boy who publicly criticized Mr. Mbeki and who died of AIDS (on June 1, 2001) -- was really poisoned by the anti-retroviral drugs given to him by the white woman who adopted him," the Guardian reported.

One of the authors of the document was ANC firebrand Peter Mobaka, who said that HIV doesn't exist, that South Africans are not dying of AIDS, and that anti-retroviral drugs - which he said benefit only the drug companies --"could lead to genocide."

Mobaka, looking wasted and ill, took an extended leave from parliament and dropped out of sight. He reappeared looking well, denied that he had AIDS or had taken anti-retrovirals, and then died suddenly at age 43 on June 9, 2002.

Epstein said the strongest argument against Mbeki's assertion that poverty, not a virus, causes AIDS is the fact that government officials are dying from the disease. She cited the case of Mbeki's own spokesman, Parks Mankahlana, who died at age 36 on Oct. 26, 2000, "and there have been others."

Months before his death, Mankahlana attacked a statement by 5,000 scientists, which said HIV causes AIDS. That statement belongs in the trash, the spokesman said. He also said that treating pregnant women infected with HIV to prevent transmission of the virus to their babies would lead to too many orphans for the country to cope with.

The ANC document said Mankahlana, like Nkosi Johnson, had been "vanquished by the anti-retroviral drugs he was wrongly persuaded to consume."

South African Embassy press spokesman Tfhepo Mazibuko told UPI that the situation depicted in "State of Denial" is out of date. He e-mailed a two-page "Update on South Africa's National HIV and AIDS Program" dated Sept. 12, 2003.

Highlights are:

- That South Africa's comprehensive five-year strategy adopted in 2000 was "further enhanced by the Cabinet statements of 17 April 2002 and 9 October 2002 reaffirming HIV and AIDS linkage."

- The government has an "expanding program" to prevent mother-to-child transmission of HIV through intensified efforts toward universal access to Nevirapine (a measure Mbeki fought in court in April, 2002).

- The cabinet's decision in April 2001 to offer anti-retroviral drugs to survivors of sexual assault. On Aug. 8, 2003, the cabinet affirmed that "anti-retroviral drugs do help improve the quality of life of those at a certain stage of the development of AIDS, if administered properly."

- The indefinite extension in November 2002 of the Diflucan partnership with Pfizer pharmaceuticals. Diflucan is effective against the devastating fungal infections AIDS victims are prone to.

Epstein said she has seen recent government statements.

"I wish the film were outdated," she told UPI. If so, people in South Africa would have access to anti-retroviral therapy.

"Mbeki has withdrawn from the debate," she said. "He hasn't taken a leadership position in addressing this epidemic."

Epstein said she has been monitoring the situation since she finished shooting the documentary in the hope the ending could be rewritten.

"Only in the last month have I even been able to say that the South African government is beginning to plan. BEGINNING to plan! What have they been doing for the past three years since I started filming? And it's just tragic, because it is such wasted time."

Epstein said if the cabinet now affirms the link between HIV and AIDS, "that's great."

"Actually, Mbeki still denies it. Mbeki has been silent on this epidemic for a long time now. And I think that the silence is problematic." She said other African countries that have had some success in dealing with the epidemic, such as Uganda, have had strong political leadership.

In the vacuum the Congress of South African Trade Unions has spoken out, as has Anglican Archbishop Desmond Tutu. "And Nelson Mandela has been very critical of Mbeki of late," Epstein said.

"The government has made this announcement now. I'll give them that. I just hope that they go through with providing anti-retroviral therapy through public-sector clinics. It's done elsewhere in Africa. South Africa definitely has the resources."

Check local listings for "State of Denial."