What makes Thabo Mbeki run? was the question the international AIDS community began asking about the deeply private South African president in 2000 when he famously publicized his doubts that HIV causes AIDS. Since then, his national AIDS policies have been condemned as obstructionist, even murderous, by a growing chorus of critics -- from his own government to the editorial desk of The New York Times. At the start of 2002, when he ordered his ministry of health to rebuke hospital doctors for giving anti-HIV meds to a 9-month-old baby who was gang-raped by six HIV positive men, the mystery of Mbeki hit critical mass. With his leadership and legacy -- not to mention his nation -- in grave danger due to his HIV denialism, the question now is: What is Mbeki running from?
Rumors are rife in South Africa -- where one out of every four people has HIV -- that the president himself may be infected, and therefore mortally invested in minimizing both the virulence of the virus and the reality of the epidemic. In January, Mbeki made an uncharacteristically public show of donating blood, officially to mobilize response to a shortage. But, according to one member of the National Association of People With AIDS (NAPWA), who spoke (as did everyone POZ interviewed) only on condition of anonymity, "Whether this was just an act so that maybe people would stop thinking he is positive, I don't know. Rumor has it, though, that many top government officials [such as Mbeki] who were in political exile are positive."
Others dismiss HIV denial as an explanation. "I don't think it's true," says a Treatment Action Campaign (TAC) member. "That's too cynical -- he'd be letting a lot of people die because of his own issues." But even to longtime comrades in the liberation struggle, Mbeki has long been a curious, complex figure, a man who has submerged his own personal identity in the cause of his nation. As Mark Gevisser, Mbeki's authorized biographer, writes, "Mbeki seems to be saying, 'If you want to know me, listen to my message. My policy is my personality.'"
What are those policies? In 1999, Mbeki's questioning of HIV as the cause of AIDS provoked an uproar in the global scientific community and threatened to hijack the 13th International AIDS Conference hosted by his homeland. Next, he radically restricted the distribution of HAART in public clinics and hospitals. In 2000, he stacked an advisory council with AIDS denialists. He has raised long-refuted doubts about the validity of the HIV-antibody test. His administration is appealing a court mandate that it provide pregnant women with nevirapine (donated by the manufacturer) that could cut in half the rate of HIV transmissions to newborns; cracking down on post-exposure prophylaxis (PEP) for rape survivors; threatening confiscation of AIDS drugs from Doctors Without Borders; and refusing to declare AIDS a national emergency.
When pressed to defend his aggressive opposition to anti-HIV meds, Mbeki mentions "caution" and, as if reading from the ACT UP/San Francisco website, questions the drugs' safety and efficacy. But AIDS activists speculate that Mbeki is at war with corporate Big Pharma. "Mbeki is embracing the AIDS denialist position to prove a point," says the TAC activist. "He won't be told what to do by either scientists or the West." Indeed, his presidential mission is to prove that an African economy can withstand global pressure. "But HIV is destroying the economy, and Mbeki is denying that," says the TAC member. So rumors persist that his divisive and self-destructive agenda has some dark psychological cause. His own press secretary, Parks Mankahlana, wasted away and died from AIDS as the whole nation watched. But to this day, Mbeki denies that Mankahlana had AIDS.
Even as a revolutionary, Mbeki was known for taking unpopular stands. While his African National Congress (ANC) comrades cried for militancy, Mbeki embraced mediation. He ultimately seduced friends and foes to the bargaining table, setting the stage for the victory of the anti-apartheid movement. But now Mbeki is steering the ANC, South Africa's leading party, toward political suicide. Many members who advocate for drugs into bodies have been silenced, not least those who have HIV. Meantime, activists and health officials are openly defying Mbeki's sweeping laws and offering anti-HIV meds to treat and prevent infection. Even Nelson Mandela, who passed the torch of statesmanship to Mbeki, leveled at press time what can only be described as a veiled threat: "Very soon we will solve the problem and many people are thinking very seriously about...the policy of the government." For his part, Mandela has stated that it is Mbeki's pride -- not denial -- that keeps him on his crash-and-burn course. Whatever the tragic flaw of this once-beloved liberationist, the greater tragedy is his nation's.