- AIDS Discourses and the South African State:Government denialism and post-apartheid AIDS policy-making 1
Post-apartheid AIDS policy-making in South Africa has been characterised by conflict between the government, civil society and the medical profession (Schneider 2001). At the heart of this conflict has been the controversy over South African President Thabo Mbeki's denial of the causal link between the HIV and AIDS, and claims that anti-retroviral drugs are ineffective and lethally toxic in the face of scientific evidence to the contrary. Against the backdrop of policy conflicts, which stem from government AIDS denialism,2 the question has often been asked: what drives this denialism? It is this central, yet largely unresolved, question that this article will attempt to answer. The central claim of this paper is that government AIDS denialism is a response to a history of racist understandings of African sexuality as inherently pathological in AIDS science and linked discriminatory public health policy responses to the epidemic by the last apartheid government and internationally. As will be demonstrated later in this article, unlike AIDS dissidence internationally, the South African version of denialism espoused by Mbeki and other high profile government officials has been obsessed with colonial and late apartheid discourses of race, sexuality and disease in Africa.
This paper argues that AIDS denialism can be understood as driven by five main factors:
• The medical findings of certain dissident scientists, which have been appropriated by government officials in South Africa;
• The extent of the crisis brought about by the epidemic, which has prompted denialism because government cannot deal with it; [End Page 104]
• As a strategy to avoid conflict over intellectual property rights of essential medicines;
• The impact of poverty on the course of the epidemic, which has led to government denialists positing poverty as a counter explanation to the virological cause of AIDS. Simultaneously, denialism may be a smokescreen for the government's adoption of poverty sustaining neoliberal economic policies, which may be blocking further public spending on AIDS; and
• The history of constructions of 'the African' as the inherently diseased racial and sexual other in both colonial and post-colonial times.
I will deal briefly with the first four, before turning my attention to the main core of this article —the exploration of the last and, I will argue, most important driver of denialism.
Science and denialism
Early into Mbeki's presidency, in 2000, it became obvious that he and some key ministers had adopted denialist views that were referred to in the media as 'dissident/unorthodox' views on AIDS. In May of that year, the President (with the full support of the Health Minister) convened a Presidential Advisory Panel on AIDS including both AIDS dissident scientists such Peter Duesburg and David Rassnick (from the USA) and medical and scientific researchers holding orthodox views on AIDS to debate the basic mainstream science of AIDS. The advisory panel was briefed to debate both the accuracy of HIV tests and the causal link between HIV and AIDS. Little came of the Presidential Panel process as, in 2001, the panel released an interim report, which mostly highlighted the differences between the mainstream and denialist scientists. More research was agreed to by participants, but certain members of government claimed that they based their programmes on the 'premise' that HIV causes AIDS (Tshabalala Msimang 2001), a claim that was belied by the continuation of denialist utterances by other members of the government, as shall be shown.
International scandal over the President's denialist views grew after a speech he delivered at the opening ceremony of the 2000 International AIDS Conference, which was hosted in Durban. Whereas he was expected to repudiate his denialist views in the speech, he merely restated them by arguing that not everything could be "blamed on a single virus" and that poverty kills more people around the world than AIDS (Mbeki 2000:4). The link between poverty and inequality and AIDS was not new and in [End Page 105] itself would not have attracted widespread criticism had it not been for the president's simultaneous questioning of 'the reliability of and the information communicated by our current HIV tests...