Ethics of Omission: AIDS, AZT and the Power of Denial

Just say yes, Mr President: Mbeki and AIDS, is a new book in the publication pipeline, authored by South Africa’s most prominent AIDS dissident, Adv Anthony Brink. Brink’s denialist claims about the HIV/AIDS pandemic have moved from arguments that HIV does not cause AIDS, to the widely publicized conviction that scientifically proven treatments for HIV/AIDS, specifically AZT, are ineffective and severely toxic. He is the founder of the Treatment Information Group (TIG), the engine of AIDS dissent in South Africa. It was Brink’s first manuscript, Debating AZT: Mbeki and the AIDS drug controversy, that caught Thabo Mbeki’s attention shortly after he became president, marking the beginning of an ongoing and controversial association between government and the cohort of AIDS dissidents.

After years of ambiguity, and vocal action by the Treatment Action Campaign (TAC), the government announced its provision plan for the nationwide roll out of ARVs in 2003. Hardly silenced by this decision, Brink teamed up with Dr Matthias Rath, who claims that the vitamins he produces, Vitacor, are a cure for AIDS. This, despite reports that his products, while claiming to have medicinal qualities, have not been approved by the necessary clinical trials; certain countries do not permit the sale of his products; and Rath’s insistence that his vitamins can be substituted for ARV drugs has already proved fatal for some willing volunteers. And our government continues to fuel the controversy by refusing to publicly distance itself from the AIDS dissenters. Rath is “undermining the government’s ARV programme and confusing people in a cynical bid to sell his products,” but our Health Minister, Dr Manto Tshabalala-Msimang, seems to be encouraging his efforts.

It is hard to quantify the likely costs of the government’s silences and delays with respect to the controversy enshrouding HIV/AIDS and the drugs produced to treat it. Some claim that the President still seems reluctant to speak about the ARV programme, “perhaps because he still supports the dissidents, or because it is difficult for him to admit he was wrong.” Indeed, the issue of HIV/AIDS was given negligible air time in the President’s State of the Nation address last week. Which begs the question: how intentional – and ethical – is omission?