South Africa has the largest HIV/AIDS epidemic in the world. According to statistics from UNAIDS, in 2017, South Africa had 7.2 million people living with HIV/AIDS. The country has a HIV prevalence rate of 18.8% amongst ages 15-49, 270,000 new HIV infections and 110,000 AIDS-related deaths.
In recent years, South Africa has made huge improvements in getting people to test for HIV and is reported to now almost meeting the first of the 90-90-90 targets, with 86% of people aware of their status. The country has the largest antiretroviral treatment programme in the world, with the programme undergoing even more expansion in recent years with the implementation of ‘test and treat’ guidelines. The country was the first in sub-Saharan Africa to fully approve PrEP, which is now being made available to people at high risk of infection.
With all these measures in place, one has to wonder: how did South Africa end up having the world's largest HIV/AIDS epidemic? Well, it all goes back to one Peter Duesberg and the Thabo Mbeki administration.
Peter Duesberg is a German-American molecular biologist. He became famous for his early research into the genetics of cancer. He, however, became infamous due to his role as a proponent of AIDS denialism.
As a proponent of AIDS denialism, Duesberg spread the notion that HIV does not cause AIDS. He began to gain public notoriety with an article in Cancer Research in March 1987 titled "Retroviruses as Carcinogens and Pathogens: Expectations and Reality". In this and later articles, Duesberg claimed that AIDS is caused by long-term consumption of recreational drugs or antiretroviral drugs and that HIV is a harmless passenger virus. Duesberg's views on HIV/AIDS are contrary to science. Nevertheless, Thabo Mbeki's government embraced this stance.
In 2000, Thabo Mbeki created a 44-member panel to advise on HIV/AIDS. Duesberg was the most prominent AIDS denier in the panel. Additionally, his career as a scientist somewhat gave him some credibility.
Among the claims that Duesberg made were that AIDS in Africa is misdiagnosed, that the AIDS epidemic in Africa is a myth, that the diagnostic criteria for AIDS are different in Africa than elsewhere, and that the breakdown of the immune system in African AIDS patients can be explained exclusively by factors such as malnutrition, tainted drinking water, and various infections that he presumes are common to AIDS patients in Africa. He also argued that retroviruses like HIV must be harmless to survive and that the normal mode of retroviral propagation is mother-to-child transmission by infection in utero. These views are not in the least bit backed by any science and are incorrect.
Under the advice of this panel, Thabo Mbeki's administration rolled back antiretrovirals. The failure to provide antiretroviral drugs in a timely manner is largely blamed for hundreds of thousands of preventable AIDS deaths and HIV infections in South Africa. In fact, two independent studies concluded that Thabo Mbeki's administration, fueled in part by Duesberg's erroneous advice, was responsible for over 330,000 excess AIDS deaths and many preventable infections, including those of infants.
Thabo Mbeki would later face fallout from his party and country due to his role in the country's HIV/AIDS crisis, including his opposition to the treatment of pregnant HIV-positive South African women with ARVs.
Commemoration of these events remains in the Durban Declaration, a statement signed in the year 2000 by over 5,000 physicians and scientists affirming that HIV is the cause of AIDS. The declaration was aimed in particular to Thabo Mbeki and the AIDS denialists in his council.
Duesberg would later go on to face investigations of academic misconduct and have several of his articles pulled from journals. Although Duesberg is now a pariah in the scientific community, he still holds his professorial position at the University of California, Berkley, where he teaches molecular and cell biology. He denies his role in the South African HIV/AIDS crisis.
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