- The Washington Times - Wednesday, May 31, 2000

Political minefields abound on every continent. Usually, it is American politicians who are accused of stepping all over them when trying to formulate policy towards Africa, being suspected in turn of being insensitive, condescending or indifferent. Oftentimes, domestic politics and interest-group lobbying get in the way of solutions to real and pressing problems on what the Economist recently called "the hopeless continent" which of course is hardly unprecedented in the annals of American foreign policy. One could even argue that it is the rule, more so than the exception.
Particularly interesting, therefore, was the controversy that erupted during the visit of South African President Thabo Mbeki last week. As it happened, Mr. Mbeki has managed to step into a uniquely American minefield; he never heard the end of it.
The problem is that Mr. Mbeki has had the nerve to suggest that AIDS is not the most pressing health problem that South Africa has to deal with, and that scarce public health resources have to be judiciously spent. Mr. Mbeki has refused to distribute the anti-AIDS drug AZT and has shocked the international AIDS establishment by placing on a newly created advisory panel several dissident scientists who have challenged the medical profession's conclusion that the disease is caused by HIV. Even considering the possibility is pure heresy to activists here in the United States.
What can Mr. Mbeki have been thinking? Didn't he know that President Clinton earlier this month declared the African AIDS epidemic to be a threat to U.S. national security? (Much as one may be concerned for the well-being of others, this has to be a stretch. How can it possibly be?) Mr. Clinton also signed an executive order aimed at making AIDS drugs more affordable.
Obviously, Mr. Mbeki failed to reckon with the passions of the AIDS lobby in the United States, and his bewilderment was plain to see. In a meeting with reporters at Howard University, the South African president tried to explain what he really meant to say. "There has been a misunderstanding. We have a permanent campaign against AIDS, trying to raise public awareness about safe sex, etc.
"We have never said there was no relationship between HIV and AIDS. Last week, five pharmaceutical companies announced a reduction in prices for AZT, but even if we were to buy the drugs at these prices, we would use up the entire public health budget of South Africa. We would be left with not as much as an aspirin. That's the extent of the AIDS crisis. It requires a much stronger health infrastructure than we have."
South African's foreign minister and previous minister of health, Nkosazana Dlamini-Zuma, continued to explain: "Although studies have shown that AZT causes a reduction in transmission, it is actually not very efficient in reducing the symptoms. It is not an efficient way to use our resources. Some studies have shown that vitamin supplements can do the same."
However, most striking was Mr. Mbeki's common sense statement that Africa faces other health issues of greater proportions than the AIDS epidemic. Unfortunately, since no one suffers from them here, they have no domestic U.S. lobby. "One of the biggest killer diseases on the African continent is malaria," he said. "To us Africans, it is wrong to leave out these other major diseases." Of course it is. Unfortunately, this is not very politically correct at all, and he had to explain himself in interview after interview.
This is not to minimize the problem of AIDS in Africa. An estimated 4 million South Africans are infected with HIV. As many as 34 million people are infected throughout sub-Saharan Africa. Eleven million have already died.
In some ways, AIDS in Africa has taken the place of favorite cause for the AIDS community here, insofar as the epidemic that threatened to engulf the Western world simply did not happen. This is true even though AIDS in Africa often has very different characteristics and transmission patterns than AIDS in the United States or Europe; in Africa it is a primarily heterosexual disease. Now you would think that an African head of state would have a right to have an opinion about public health in his own country, but then again, maybe not.
The irony is, of course, that Americans, too, face greater health risks than AIDS. Not that you would know it listening to the hype about the disease particularly in the 1980s and early 1990s. And there is also the impolite fact that AIDS for most adults is a disease you have to do something actively to catch as opposed to getting bitten by a mosquito carrying malaria.
In yet another twist, those pests have been proliferating in Africa in recent years. Particularly in the wake of the floods in Mozambique, malaria threatens to explode as a health hazard, and in South Africa itself cases have quadrupled over the past five years. The reaction of the U.S. government? As noted recently by Kenneth Smith, deputy editorial page editor of The Washington Times, Washington decided to pander to environmental interests by pushing a treaty that would restrict the chemicals most effective in the fight against the disease-bearing mosquitoes, particularly DDT. Indeed. Mozambique has stopped using DDT under international pressure from donor countries. Unfortunately for the victims of the malaria epidemic waiting to happen, DDT was suspected, but not proven, to cause cancer in laboratory tests and that was enough.
Far better were it for the people of Africa if we could somehow manage to keep domestic politics out of our efforts to help them. But that would mean asking a lot of people that is, to invite them to look beyond self-interest.
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