Former president Thabo Mbeki has once again come under harsh criticism by the Treatment Action Campaign (TAC) over his views on HIV/Aids.
"The impact of Mbeki’s Aids denialism was catastrophic," the group said in statement in response to the former statesman's letter, which forms part of a series of letters attempting to reframe Mbeki's presidency.
The letter, titled A brief commentary on the question of HIV and Aids, comes seven and a half years after Mbeki was forced to step down as president of South Africa.
"Many of our family members, friends and comrades died while Mbeki’s government dragged its feet and indulged pseudo-scientific nonsense. Yet, neither in his letter, nor in any other forum that we are aware of, has Mbeki apologised or showed any remorse or acknowledgement of his role in the over 300 000 avoidable Aids deaths in South Africa. Instead, he has chosen to repeat many of the flawed arguments he used in the early 2000s."
In his letter, Mbeki writes: "[I must also mention that I never said 'HIV does not cause Aids'. This false accusation was made by people who benefitted from trumpeting the slogan 'HIV causes Aids' as though this was a religious edict. What I said is that 'a virus cannot cause a syndrome'. As you know, Aids is an acronym for 'Acquired Immune Deficiency Syndrome' – therefore Aids is a syndrome, i.e. a collection of well-known diseases, with well-known causes. They are not, together, caused and cannot be caused by one virus! I said that HIV might be a contributory cause of immune deficiency – the ID in Aids!]"
TAC said Mbeki was simply wrong. "A virus can cause a syndrome and it has long ago been proven that HIV causes Aids. His word games in this regard are a cowardly form of confuscation."
The TAC has a long history of struggling against the state-sponsored Aids denialism of Mbeki and his Health Minsiter Manto Tshabalala-Msimang.
In 2002, the group won a landmark case in the Constitutional Court compelling the state to make antiretroviral treatment available to HIV-positive pregnant women.
"Following this ruling, we monitored the provision of treatment to pregnant women and advocated for a wider rollout of treatment to HIV-positive people. Even with a judgment from the highest court in the land and continued public pressure, the HIV treatment programme only gained significant momentum once Mbeki and Msimang were removed from office in 2008."
Mbeki also quoted Stats SA figures from 2006, ranking HIV as the ninth highest cause of mortality in South Africa. However, the TAC noted that he failed to place the data in proper context.
"The data he quotes is based on the cause of death written on death certificates. There are a number of reasons why this underestimates the role of HIV.
"Firstly, for stigma-related reasons, HIV was often not written on death certificates. Secondly, in many cases where the cause was indicated as TB or pneumonia, HIV would in fact have been the underlying cause. Thirdly, many people would have died of Aids-related diseases without ever having known their HIV status – especially so given the much lower testing rates in Mbeki’s time."
TAC said Mbeki’s misuse of Stats SA data was nothing new.
Two independent studies have estimated that delays in making antiretroviral treatment available in the public sector in South Africa resulted in more than 300 000 avoidable deaths. It also resulted in an estimated 35 000 babies being born with HIV who would not otherwise have been HIV-positive.
"Under Mbeki’s watch, life-expectancy in South Africa dropped to 54 in 2005. Life-expectancy has recovered dramatically in the post-Mbeki era to 63 in 2015."
TAC said this increase was widely attributed to the ambitious rollout of antiretroviral therapy in the public healthcare system under the leadership of Health Minister Aaron Motsoaledi.
"The important point, and the point Mbeki still refuses to face, is that he intentionally delayed the introduction of life-saving treatment to the people he was trusted to serve," said the TAC.
"He has refused to take responsibility or to apologise to any of those who suffered directly or indirectly because of his actions. For this history will judge him harshly. He deserves it."