Fighting the gospel of garlic

2012-07-19 00:00

I LEFT the world of HIV/Aids way back in 1995. Back then, people afflicted by it were few and far between. I was working on a project in KwaZulu-Natal, which was largely engaged in Aids education and prevention strategies, among a very broad range of people, but aimed primarily at young people.

Back then, use of the word “condom” was daring. The young Aids educators we were training would drop their eyes in a charmingly embarrassed way, and squirm when we taught them how to speak about sex in rural communities. Demonstrating how to put on a condom using a life-sized (albeit generous) dildo would routinely send adults fleeing from the room, and sometimes generate letters of outrage to The Witness.

It was a time of relative innocence, I suppose. And a time of rampant infection, because of it. To get taken back into that time in Nicoli Nattrass’s new book, The Aids Conspiracy — Science Fights Back, was a bit like watching a movie on a period before the advent of cellphones. You wonder at the strangeness of it all.

The book is about Aids conspiracy theorists. About who they are and the environment they work within. It is about the strange ideas of the kind of belief-system they peddle, and about the damage they inflict. It is a harrowing and disturbing tale. For myself, I could not help but draw personal parallels within the work environments I have found myself working in. Take the church, for instance, where I began my working career. There, one learns very quickly what is orthodox and what is not. And it really all depends on which side of the divide one positions oneself, but the other is consistently demonised.

Nattrass begins by examining what she calls the “conspiratorial move” — the range of conspiracy theories about HIV/Aids — from it being manufactured as part of an arsenal of biological warfare, to theories which assert that it does not exist at all, and that it is actually caused by antiretrovirals. All of these conjectures are fundamentally aimed against the science of HIV, and purport to expose the scientific community either as venal or as duped by pharmaceutical companies in a grand and elaborate plot to sell more of their toxic wares to a vulnerable and easily fooled public. The effect of this mistrust of the science is utterly devastating, with evidence of a corresponding rise in risky behaviour, a decrease in consumption of antiretrovirals and a lowering in testing for HIV.

“What does Aids stand for?”, I would routinely ask the hundreds of black youth in remote rural areas, as part of my job as an Aids educator in the mid nineties. They would scoff at me. They would click their tongues. They would dismiss any notion that the thing I was talking about could be in any way serious. “American ideas to discourage sex”, one of them would chime, inevitably. “Yes. American ideas to discourage sex,” they would all respond. It was a plot, a white idea to stop blacks having children — that was the form of the denialism in the beginning.

In South Africa, the earlier genocidal theory was hatched in the eighties, where apparently Israeli and South African scientists had, together, managed to create the virus. This “ecotype” of the theory gained some credence, particularly as more information became available of the experimental biological warfare waged by the infamous “Dr Death” — Wouter Basson. It was not a difficult leap, from the nihilist designs of the apartheid state to its cosy relations with Israel and America — where there was absolute proof of malintent in the famous Tuskegee Study, where black patients infected with syphilis were left completely untreated in order for scientists to follow the full life span of the disease.

The connection, for some powerful black South Africans, was part of a cocktail of beliefs, mistrusts and prejudices, which went towards creating the unforgivable tragedy of the president of the country (Thabo Mbeki) and the Health Minister (Manto Tshabalala-Msimang), denying infected people (mostly poor and mostly black) the advantages of antiretroviral drug therapies. It worked together, because they were both, in some ways, extremely damaged people. The consequences were tragic in the extreme — with some 300 000 people dying unnecessarily.

I remember Tshabalala-Msimang very well. I worked with her in the same primary health-care organisation that I spoke about earlier. I remember her on her return to the country as ambitious, greedy, bullying and immovable when she got a particular idea in her head. Her medical qualifications, from Bulgaria, were frequently the butt of jokes. She was certainly a damaged person, paranoid and suspicious, arrogant in the extreme.

Nattrass precedes the chapter on the South African tragedy with a look at what she calls instances of poor community leadership, and the devastating effects which that has on the community in which it is displayed. In an extraordinary and frightening reminder of the madness of it all, Nattrass gives us some detail on the way in which Mbeki appeared simply incapable of accepting the science of HIV. When Mbeki succeeded Mandela as President in 1999, almost one in five South Africans were already infected with the disease. A cabinet member at the time described it to me as being similar to the President having some kind of gogga in his head, which wouldn’t allow him to see reason. Instead of basing government policy on scientific consensus on the issue, Mbeki deliberately chose to take seriously — more than that, he chose to elevate — the views of “dissidents” within the scope of HIV/Aids analysis. The beliefs of these “dissidents” ranged from the belief that antiretrovirals were toxic, to beliefs that HIV/Aids did not exist at all. So mad were some of these people, that they would even allow their own children to suffer and die from the disease, when treatments were readily available.

Mbeki convened an Aids advisory panel, consisting of half the members from within the scientific community and the other half from this “dissident” community. Tshabalala-Msimang went further, to reject credible and scientifically based reports from the Medicines Control Council, that antiretrovirals were safe and effective — and described them, instead, as “poison”.

Nattrass has helpfully identified four types of Aids denialists in this book: the “hero scientist”, the “cultropreneur”, the “living icon” and the “praise singer”.

Mbeki and Tshabalala-Msimang employed the full suite while in power. And, again, because of my particular background, I could not help but see the “religio-cultural” similarities between what Nattrass was describing and the way in which Aids denialism appears to operate (indeed, she explores this herself). Essentially, it becomes a kind of “faith” and it operates in the same way. It has its high priests. It has its preachers and witnesses. It has its orthodoxy. And in the end, it has a very economic root for its sustenance.

I will not spoil the centrepiece of the book for you, where Nattrass explores the psycho-social, historical and scientific environment in which the Mbeki/Tshabalala-Msimang duo (together with a largely silent cabinet and government structures) preached their gospel of garlic and beetroot cures.

She also explores the entire and extraordinary enigma of Mbeki’s questioning of the science. Was it because this formed part of a political struggle which was being waged with civil society? Was it because he saw the environment as fatally corrupted by industrial interests? Was it because of his anticolonial, Africanist ideology? Was it sheer narcissism?

The religious, messianic theme is explored fully. Because, says Nattrass, “Aids denialism is not simply about intellectual beliefs, it is about identity”. And more than that even, it is not simply intellectual conversion, it is about group adherence. These are the common features of any religious sect, those of the insiders and the outsiders; the elect few speaking truth to power; pushing the boundaries of knowledge and received doctrine.

To end, she argues for the primacy of the scientific method. For rigorous peer review. For evidence-based medicine. For “health” rather than the paradigm slide into “wellness”. The HIV/Aids terrain is contested territory. It remains true that there are reasons for public suspicion, and many of these reasons are based on the belief that profit is the motive for the production of drugs.

“Defending science,” she says, “is a quintessentially enlightenment project”. One of the most contested terrains for this project remains the Internet. The challenge for pro-science advocacy work there, is to ensure an abiding and credible presence within that space.

• The Aids Conspiracy — Science Fights Back by Nicoli Nattrass is published by Wits University Press.

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