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NEWS: Pat Sidley Mbeki plays down AIDS and orders a rethink on spending BMJ 2001; 323: 650b [Full text]

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A bold step? - Agreeing with Mbeki

Stuart W Dwyer   (22 September 2001)

Mbeki should take a cue from Obasanjo

Idris Mohammed   (23 September 2001)

A bold step? - Agreeing with Mbeki 22 September 2001
Stuart W Dwyer, part time district surgeon [forensic medical officer] Grahamstown, South Africa Send response to journal: Re: A bold step? - Agreeing with Mbeki	As a prison medical officer, I am in a position to partly agree with President Mbeki's sceptical view of current Hiv/Aids statistical research. The research data tends to be formulated from actuarial 'models' and short testing trials of pregnant women attending antenatal clinics. Pregnancy is a know cause of an elevated rate of false positive results from HIV Elisa testing. The results of this kind of research tend to reveal frightening statisitics giving the impression that the whole of Southern Africa will be depopulated within the next 24 months! In South Africa's prisons there is a vast, overcrowded [often 30 per cell], captive [mostly], population where homosexuality is very widespread and condom use practically non-existent. The perfect breeding ground for the rapid spread of HIV. STD's are very common in the prison in which I work and all prisoners who have any STD are tested for HIV. Prisoners with any other illnesses that do not resolve rapidly [one to two weeks] are tested for HIV. As a result of this 'liberal' testing, a large number of HIV tests are done every week as the vast majority of sub-acute pathology results in HIV testing. This prison, which holds 550 inmates, and is always full or overfull, has an HIV rate of 2% to 4 % and has had only two AIDS deaths in the seven years I have been working there. The HIV infection rate for all South Africa's prisons is currently 2.3%. The prison population should have a higher or at least the same rate of HIV infection as the general population. However the figures of HIV infection rates in prison in South Africa are way below the figures generated by actuarial models and antenatal data and which are purported to reflect the incidence of infection in the general population. There is a widespread, mystical and surreal attitude towards Hiv/Aids, which gives this disease recognition out of all proportion to its incidence [cf number of deaths in Southern Africa from malaria, TB, malnutrition, road deaths, murders, et c et c]. The legal and ethical implications resulting from this wierd attitude ensure that there is no statistical research based on random testing of the general normal healthy population. Data from this kind of reasearch -were anyone brave enough to conduct it -would probably reveal figures more like those found in the prisons.
Mbeki should take a cue from Obasanjo 23 September 2001
Idris Mohammed, Professor of Medicine University of Maiduguri Teaching Hospital, Nigeria Send response to journal: Re: Mbeki should take a cue from Obasanjo	It is rather strange and certainly sad that President Thabo Mbeki continues to trivialise the HIV/AIDS problem in South Africa, for whatever reason. It is poor leadership for Mr. Mbeki to deny the scale of the problem because he does not wish to spend money addressing it adequately. He should take a cue from President Obasanjo of Nigeria, who is devoting time and recources to tackle HIV/AIDS headlong in Nigeria, and encouraging other African leaders to do the same.