Damned Heretics

Condemned by the established, but very often right

I am Nicolaus Copernicus, and I approve of this blog

I am Richard Feynman and I approve of this blog

Qualified outsiders and maverick insiders are often right about the need to replace received wisdom in science and society, as the history of the Nobel prize shows. This blog exists to back the best of them in their uphill assault on the massively entrenched edifice of resistance to and prejudice against reviewing, let alone revising, ruling ideas. In support of such qualified dissenters and courageous heretics we search for scientific paradigms and other established beliefs which may be maintained only by the power and politics of the status quo, comparing them with academic research and the published experimental and investigative record.

We especially defend and support the funding of honest, accomplished, independent minded and often heroic scientists, inventors and other original thinkers and their right to free speech and publication against the censorship, mudslinging, false arguments, ad hominem propaganda, overwhelming crowd prejudice and internal science politics of the paradigm wars of cancer, AIDS, evolution, global warming, cosmology, particle physics, macroeconomics, health and medicine, diet and nutrition.

HONOR ROLL OF SCIENTIFIC TRUTHSEEKERS

Henry Bauer, Peter Breggin , Harvey Bialy, Giordano Bruno, Erwin Chargaff, Nicolaus Copernicus, Francis Crick, Paul Crutzen, Marie Curie, Rebecca Culshaw, Freeman Dyson, Peter Duesberg, Albert Einstein, Richard Feynman, John Fewster, Galileo Galilei, Alec Gordon, James Hansen, Edward Jenner, Benjamin Jesty, Michio Kaku, Adrian Kent, Ernst Krebs, Thomas Kuhn, Serge Lang, John Lauritsen, Mark Leggett, Richard Lindzen, Lynn Margulis, Barbara McClintock, George Miklos, Marco Mamone Capria, Peter Medawar, Kary Mullis, Linus Pauling, Eric Penrose, Max Planck, Rainer Plaga, David Rasnick, Sherwood Rowland, Carl Sagan, Otto Rossler, Fred Singer, Thomas Szasz, Alfred Wegener, Edward O. Wilson, James Watson.
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Many people would die rather than think – in fact, they do so. – Bertrand Russell.

Skepticism is dangerous. That’s exactly its function, in my view. It is the business of skepticism to be dangerous. And that’s why there is a great reluctance to teach it in schools. That’s why you don’t find a general fluency in skepticism in the media. On the other hand, how will we negotiate a very perilous future if we don’t have the elementary intellectual tools to ask searching questions of those nominally in charge, especially in a democracy? – Carl Sagan (The Burden of Skepticism, keynote address to CSICOP Annual Conference, Pasadena, April 3/4, 1982).

It is really important to underscore that everything we’re talking about tonight could be utter nonsense. – Brian Greene (NYU panel on Hidden Dimensions June 5 2010, World Science Festival)

I am Albert Einstein, and I heartily approve of this blog, insofar as it seems to believe both in science and the importance of intellectual imagination, uncompromised by out of date emotions such as the impulse toward conventional religious beliefs, national aggression as a part of patriotism, and so on.   As I once remarked, the further the spiritual evolution of mankind advances, the more certain it seems to me that the path to genuine religiosity does not lie through the fear of life, and the fear of death, and blind faith, but through striving after rational knowledge.   Certainly the application of the impulse toward blind faith in science whereby authority is treated as some kind of church is to be deplored.  As I have also said, the only thing ever interfered with my learning was my education. My name as you already perceive without a doubt is George Bernard Shaw, and I certainly approve of this blog, in that its guiding spirit appears to be blasphemous in regard to the High Church doctrines of science, and it flouts the censorship of the powers that be, and as I have famously remarked, all great truths begin as blasphemy, and the first duty of the truthteller is to fight censorship, and while I notice that its seriousness of purpose is often alleviated by a satirical irony which sometimes borders on the facetious, this is all to the good, for as I have also famously remarked, if you wish to be a dissenter, make certain that you frame your ideas in jest, otherwise they will seek to kill you.  My own method was always to take the utmost trouble to find the right thing to say, and then to say it with the utmost levity. (Photo by Alfred Eisenstaedt for Life magazine) One should as a rule respect public opinion in so far as is necessary to avoid starvation and to keep out of prison, but anything that goes beyond this is voluntary submission to an unnecessary tyranny, and is likely to interfere with happiness in all kinds of ways. – Bertrand Russell, Conquest of Happiness (1930) ch. 9

(Click for more Unusual Quotations on Science and Belief)

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TAC drug pushers joined by Tina of the Times


Ms Rosenberg can’t read science, but has her own sources

Manto hounded, even Barack throws in his two cents

Ever since Toronto, the South African press and the TAC have been piling on Dr. Mantombazana “Manto” Tshabalala-Msimang, demanding her head from President Thabo Mbeki for her booth at the AIDS 2006 Conference. In the frenzy of support for ARVs and suspicion of ordinary food even Barack Obama has added his two cents (“It is not an issue of Western science versus African science, it is just science and it’s not right.”). Today (Wednesday (Aug 30) the New York Times joined in, supporting the Treatment Action Campaign’s call for Mbeki to fire the Health Minister of South Africa for her booth at the Toronto conference.

To anyone familiar with the scientific literature in the field, her despised fruit and vegetable stand could be fairly described as an island of sanity in a sea of fantasy, a reminder of reality which reasonably suggested that basic nourishment might be a better answer to African “AIDS” than toxic drugs without proven scientific rationale. To the South African press and the TAC, however, who apparently have their own sources of information on the subject, the stand was a “joke” by a “clown” who “embarrassed South Africa” at AIDS 2006.

Having visited South Africa to research her long article, When a Pill Is Not Enough, published in the magazine on Aug 6, Tina Rosenberg, as the Editorial Observer columnist today (Wed Aug 30) in For People With AIDS, a Government With Two Faces, agrees. An editorial writer at the Times since 1996, when she won a Pulitzer following a MacArthur fellowship, she must have been briefed by the same inside sources at some point, because she now acts as the perfect propaganda mouthpiece for the TAC, the drug companies and NIAID, whose group view she expresses as if she had thought of it herself:

Mr. Mbeki and his health minister, Manto Tshabalala-Msimang, have now largely gone silent about AIDS —” undoubtedly an improvement. It would be a further improvement if Mr. Mbeki fired her, as many in South Africa have long demanded. The government should also be pushing the provinces that lag behind and encouraging South Africans to get tested and take their drugs.

What the government says and doesn—™t say still matters, unfortunately. I met some South Africans who can get antiretrovirals free at their local clinic but still prefer herbal medicines. They could live, thanks to the government—™s highly reluctant actions. Instead, they will die because of its words.

Sorry to say, Ms Rosenberg is evidently yet another victim of the AIDS meme, which renders its host blind to the scientific literature in HIV∫AIDS and deaf to any view other than “HIV bad, ARVs good.”

In other words, the papers indicating that a heterosexually driven pandemic in Africa and Asia is impossible, and that ARVs do not actually improve basic health or slow the death rate, and that it is nutrient deficiency and nutrient supplementation which are, with drugs and other assaults on the system such as starvation, both cause and cure of AIDS, might as well be written in invisible ink, as far as Tina is concerned, and the medically qualified and far better briefed Dr. Mantombazana “Manto” Tshabalala-Msimang is a no account ignoramus challenging modern science with primitive nostrums and an “embarrassment” to her administration, because the TAC tells her so.

On the contrary, as Dr Harvey Bialy has pointed out in Comments here, Dr. Mantombazana “Manto” Tshabalala-Msimang is a qualified MD and a member of the special AIDS panel Mbeki called together in 001, which examined the scientific dispute over the causes anmd cures of AIDS. According to Duesberg biographer Bialy, a microbiologist and member of the same panel, Dr. Mantombazana “Manto” Tshabalala-Msimang was a faithful believer in Western science and the HIV∫AIDS paradigm when she joined the deliberations, but emerged from the intensive review a convert to the dissenting camp.

The New York Times
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August 30, 2006
Editorial Observer
For People With AIDS, a Government With Two Faces
By TINA ROSENBERG

At the AIDS conference in Toronto this month, South Africa—™s booth included lemons, garlic and beets as part of its recommended treatment for H.I.V. South Africa—™s health minister has long touted salad, vitamins and assorted quack cures over antiretroviral drugs, which she has called toxic.

Such embarrassments are normal for the government of President Thabo Mbeki, who said not too long ago that he knew no one with AIDS. This in a country with the world—™s biggest AIDS epidemic. At the Toronto conference, Stephen Lewis, the United Nations special envoy for AIDS in Africa, broke all diplomatic conventions, saying South Africa—™s views were more worthy of a lunatic fringe than of a compassionate state.

And yet, more than a quarter million South Africans —” more people than in any other nation —” are now taking antiretroviral drugs. Most of them get the medicines free through the government health system. The AIDS budget has soared over the last two and half years. Among people being treated, deaths and hospitalizations have dropped tremendously. Can this lunatic government be compassionate as well?

South Africa is doing AIDS treatment on a mass scale even though the health system is close to nonexistent in some areas, clinics often have few nurses and no doctors, and rich countries are luring English-speaking health workers away.

But top officials can take little credit. They delayed the antiretroviral rollout, threw up obstacle after obstacle and have left large pots of money unspent. The program—™s progress so far is really a lesson in the power of balanced government and citizens—™ groups.

The courts have forced the government into action. This week an appeals court ordered officials to begin antiretroviral treatment for prisoners with AIDS and held the government in contempt for ignoring a June ruling to start doing so. Some regional governments, especially in the provinces containing Johannesburg, Cape Town and Durban, have leapt at the chance to provide antiretrovirals, and that is mainly where people are being saved.

The most important factor, however, is the Treatment Action Campaign, probably the world—™s most effective AIDS group. It was founded by Zackie Achmat, who chose not to take the antiretrovirals he needed until the government had agreed to make them available to all.

The group, financed largely by international and local foundations and European governments, became famous for distributing its “H.I.V. Positive” T-shirts —” Nelson Mandela wore one —” and organizing mass protests like its 2003 civil disobedience campaign, which pushed the government into the antiretroviral rollout.

Mr. Mbeki and his health minister, Manto Tshabalala-Msimang, have now largely gone silent about AIDS —” undoubtedly an improvement. It would be a further improvement if Mr. Mbeki fired her, as many in South Africa have long demanded. The government should also be pushing the provinces that lag behind and encouraging South Africans to get tested and take their drugs.

What the government says and doesn—™t say still matters, unfortunately. I met some South Africans who can get antiretrovirals free at their local clinic but still prefer herbal medicines. They could live, thanks to the government—™s highly reluctant actions. Instead, they will die because of its words.
But such TAC inspired contempt for the intelligence of Thabo Mbeki and Dr. Mantombazana “Manto” Tshabalala-Msimang is nothing new for Rosenberg, who has been an editorial writer at the Times since 1996 and is enlightened on some topics – she has called for the use of DDT to save lives, for example. But she dismissed the Mbeki position as “spectacular irrationality” in her Aug 6 piece on the horrendous reasons why South Africa women do not hurry to tell their men they are HIV positive or to take ARVs to save their babies from HIV (one husband greeted the news by pouring boiling water over his wife).

South Africa—™s post-apartheid government, besieged with problems, largely ignored AIDS. As president, Nelson Mandela did not publicly speak in South Africa on AIDS until 1998, more than three years into his term. Then came spectacular irrationality —” the government of Thabo Mbeki spent years insisting AIDS was a Western plot, that the drugs were poison, that it was better to use African —œcures,—? that all those people were dying of something else. Now the public troublemaking of government officials has died down. What has replaced it is not the crusade so badly needed but just an official silence.

The boiling water story was in her Times magazine story on Aug 6, When a Pill Is Not Enough, a lengthy piece which showed just how horrendous are the social problems created by the HIV∫AIDS AIDS meme as it sweeps across South Africa, contrary to science and sense. The stigma and its accompanying dangers are why African women resist being tested, according to Rosenberg. This is presumably true, but we also detect signs in her reporting that African women are also a little bit skeptical of the whole thing, based on instinct and Mbeki’s influence, presumably. It is this failure to accept the absolute authority of Western science that condemns Dr. Mantombazana “Manto” Tshabalala-Msimang and Mbeki in the mind of Tina Rosenberg, no doubt. But the irony is that she is the naive one, for the mainstream literature actually backs their assumptions, as she would find if she bothered to read it for herself.

(Here is her very long piece, When a Pill Is Not Enough, in all its thorough depiction of the South African scene through the lens of HIV belief. Expand it at your peril by clicking “Show::)

The New York Times
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August 6, 2006
When a Pill Is Not Enough
By TINA ROSENBERG

In the whole AIDS epidemic, no question is more heartbreaking and confounding than this: Why would a mother choose to condemn her baby to death?

Mothers with H.I.V., the virus that causes AIDS, pass it along to their newborns at birth 25 to 30 percent of the time, and in poor countries, some half a million babies a year are born with H.I.V. But the rate of transmission can be cut to 14 percent with a simple and cheap program: H.I.V.-positive mothers take a single pill of an antiretroviral called nevirapine when they begin labor, and their newborns are given nevirapine drops.

At the Alexandra Health Center and University Clinic in South Africa, pregnant women can get nevirapine free. The antenatal clinic is a complex of low brick buildings on a pretty hospital campus in the middle of the township of Alexandra, a bleak neighborhood on the outskirts of Johannesburg. The clinic has a doctor only on Thursdays, but an advanced midwife and two nurses attend a crowd of patients every day. I had been in South Africa for four days when I visited the clinic, and I had already seen the stigma that AIDS still carries in the country —” those dozens of funerals every Saturday in the townships? Oh, say family members, it was asthma, or tuberculosis, or —œa long illness.—? I thought I understood how powerful denial could be. But I was unprepared for what Pauline Molotsi, a registered nurse at the clinic, told me.

About twice a week, a woman who has tested H.I.V.-positive begins labor at the clinic but refuses to take the nevirapine that might save her baby—™s life. —œShe says, —˜Oh, no, I—™m not positive,—?—™ Molotsi told me. Even though the only person who will know her H.I.V. status is the nurse —” who knows already, since she is holding the patient—™s chart —” the woman won—™t take the incriminating pill. —œThey have not accepted their status,—? Molotsi said. —œThey are still in denial.—?

In most of the world, the biggest reason so many babies are born with the AIDS virus is that their governments do not offer nevirapine; because of shortages of health-care personnel, in many countries this program, like all AIDS programs, is available only in urban hospitals. But in South Africa, there—™s a different problem. Nevirapine is widely available, yet more than 70,000 babies a year are born there with H.I.V. The government can get nevirapine, condoms and AIDS treatment out to the most remote corners of the country —” by truck or wheelbarrow, to modern hospitals and to clinics with no electricity. But it cannot penetrate what has become the most difficult terrain in AIDS work: the insides of people—™s heads.

A significant minority of women in South Africa refuse to take an AIDS test. It—™s not only that they do not want to confront painful facts that could lie buried a while longer. It—™s also that being tested can be dangerous. At the Alexandra clinic, I listened to a tall young man named Vernon as he gave pretest group counseling to about two dozen pregnant woman. —œThink about your baby before you think about yourself,—? he urged them. He assured them the results of their H.I.V. tests would be confidential but encouraged the women to tell their families and partners. —œDon—™t hide it. Don—™t use the phone —” tell him face to face. You use the phone, he will hunt you down. Try to prepare him. Some people are very violent. He will beat you. But when he—™s alone, he will think about it. If anything happens to you, your family knows you went to tell him your H.I.V. status and never came home.—? This speech seemed unlikely to encourage many women to be tested. But it obviously reflected reality. Prudence Mabele, who works for a feminist organization, told me about a woman whose husband greeted her disclosure by pouring a kettle of boiling water over her.

Other women end up infecting their babies through breast feeding because they cannot follow the clinic—™s advice to bottle-feed only —” tantamount in some areas to announcing you have H.I.V. The very present danger posed by disclosure outweighs the future risk that the baby will get sick. And there are those whose denial is so deep it engulfs them. —œLabor is already a stressful environment,—? says Macharia Kamau, a Kenyan who is Unicef—™s representative in South Africa. —œYou are pregnant, poor, vulnerable, marginalized, uneducated. At that point, what do you rely on? What your mother told you when you left home? Your cultural beliefs —” or this stranger who—™s standing there saying, —˜Take this pill?—?—™

As AIDS passes the quarter-century mark, in several countries the epidemic appears to be declining. South Africa is not one of them. In 1990, South Africa and Thailand both had H.I.V. prevalence rates in adults of less than 1 percent. Today, Thailand—™s rate is 1.4 percent. But in South Africa, AIDS exploded in the 1990—™s, and now 18.8 percent of adults are infected —” and the number is still rising, though very slowly. Last year 300,000 new South Africans were infected with H.I.V. At the Alexandra Health Center, about 60 percent of women test positive. Choose any two 15-year-olds in South Africa; the odds say one of them will get AIDS.

South Africa is not even the worst of it. In Botswana, 24.1 percent of adults have H.I.V., and in tiny Swaziland, a third of all adults do. AIDS rates in southern Africa are far higher than they are anywhere else in the world. No one really knows why. South Africa has astronomical rates of sexual violence —” more than a quarter of the time, a young woman—™s first sexual experience is coerced —” and a strong culture of male entitlement to sex, but so do many other countries. Much of the blame may go to apartheid, which kept male workers in hostels and their families in villages far away. Similar geographical dislocations come from mining, southern Africa—™s main industry. Separating families encourages people to maintain ongoing relationships in two places. This is more dangerous than serial monogamous relationships, as H.I.V. is far more contagious when freshly caught.

South Africa—™s post-apartheid government, besieged with problems, largely ignored AIDS. As president, Nelson Mandela did not publicly speak in South Africa on AIDS until 1998, more than three years into his term. Then came spectacular irrationality —” the government of Thabo Mbeki spent years insisting AIDS was a Western plot, that the drugs were poison, that it was better to use African —œcures,—? that all those people were dying of something else. Now the public troublemaking of government officials has died down. What has replaced it is not the crusade so badly needed but just an official silence.

In the last few years, however, South Africans have forced their government to begin saving lives despite itself. The country is now spending millions to provide free antiretroviral drugs to AIDS patients, equip maternity clinics with nevirapine and run prevention campaigns. South Africa is successfully pushing services out to its people. But that doesn—™t mean people always use them. Mothers sometimes reject nevirapine. People decline AIDS tests. Some sick people refuse to take free antiretrovirals. Some orphans will starve —” even though help is available —” rather than make the shameful admission that their parents died of AIDS. And of course, millions of people who know better continue to risk their lives every time they have sex.

All over the world, human psychology, local custom and the pressures of poverty are AIDS—™s best friends. None of this should be foreign to Americans. We know we should quit smoking. We know we should go have that lump checked out. We know we should give up the French fries. But we don—™t. In America, as around the world, a good amount of sickness and death is at least in part self-inflicted. In all aspects of health care, the challenge of providing not just solutions but ones patients will embrace is only now beginning to get attention. We are accustomed to thinking of noncompliance as the patient—™s fault. But when a pregnant woman chooses to keep the nevirapine tablet in her pocket, the real failing belongs to the health system, which did not consider what would help her to follow medical advice. Such thinking is always crucial for health professionals but never more so than with AIDS, a disease that is shrouded in the dark and forbidden —” sex, drug use, betrayal, rejection, death, rape, the struggles of intimate relationships —” and that primarily hits the notoriously irrational young.

But the AIDS establishment has not yet assumed this challenge. —œThe technology is doing O.K., it—™s moving,—? says Peter Piot, executive director of the United Nations—™ AIDS agency, Unaids. —œBut we have grossly, grossly neglected the social, cultural and personal stuff that makes it work.—?

In a bland corporate research office in a strip mall in the Johannesburg suburbs one day late last spring, American and South African investigators were intently trying to prove Piot wrong. They were sitting behind a two-way mirror, watching five young women from Soweto talk about vaginal gel. The research office, normally employed to assess South Africans—™ views on laundry detergent or breakfast cereal, was now the site of a series of focus groups designed to solve one of the biggest problems in AIDS prevention: the failure of the condom.

It is a social failure, not a mechanical one. Condoms prevent AIDS transmission quite well when people use them consistently. But men would rather not, and in Africa men usually call the shots. One of the most chilling findings of AIDS researchers is that marriage can be a risk factor. Studies in Kenya and Zambia found that young, married, monogamous women had higher rates of AIDS infection than sexually active single women of the same age; if condom use is hard for single women to negotiate, it is nearly impossible for married women. Even women who know their husbands are unfaithful cannot demand condoms, for to do so indicates a lack of trust. Husbands can get violent, or accuse the woman of infidelity. Condoms are also not an option for couples who wish to conceive. Women need a method of H.I.V. protection that they can control, that does not impede fertility and that men do not object to. +

It does not exist —” yet. But one form of it, a vaginal microbicide, may be available within five years. The Johannesburg focus groups were designed to test three different gels, for use once a day, that may someday contain an ingredient that kills H.I.V. before it can infect the woman. The sessions were run by the International Partnership for Microbicides (I.P.M.), which is based near Washington. I.P.M. scientists realize that creating an effective medicine is just half the battle, and so they are taking a proactive approach to marketing the gel; before the microbicide—™s active ingredient has even been invented, researchers have spent years figuring out how to get women in a variety of cultures to use it.

—œA microbicide could be marketed as a sexual aid, or as something to make a woman feel more attractive inside and out,—? Dr. Zeda Rosenberg, I.P.M.—™s C.E.O., told me when I first met her in 2004. She was still puzzling it out when I spoke to her this year in South Africa. —œMaybe H.I.V. prevention would be a secondary selling point,—? she said. —œThis could be a lubricant that stops H.I.V. If the product made sex great, they would use it even if there were a trust issue.—?

The focus groups were a chance for I.P.M.—™s researchers to hear from their target market. Five young women from Soweto, all paid to participate in the study, sat around a table laden with platters of food and chatted in Zulu, Sotho and English about the gels, which they had been using for the last three weeks. The moderator asked whether they would want to use the gels to avoid getting H.I.V. All responded with enthusiasm. —œI would recommend it to women who are married but do not trust their husbands,—? said a participant. Just as important, they talked about how they handled the issue with their boyfriends. —œI didn—™t tell my boyfriend, but he noticed something different,—? said Dimakatso, a young-looking girl with a ponytail. She explained to him what she was using, and it was no problem.

But most women preferred stealth —” and it worked. Some didn—™t tell because South Africans don—™t normally discuss sex. Others said their boyfriends were superstitious. —œHe will think I am using something for witchcraft,—? said one woman. Overall, the women preferred the gel whose texture was easiest to hide from their sexual partners.

Women—™s groups have been talking about a microbicide for more than a decade, since it became obvious that AIDS was developing into a woman—™s disease. But the rest of the world wasn—™t listening. In the late 1990—™s, Rosenberg was senior scientist for H.I.V.-prevention research at the National Institutes of Health. She, along with some others, tried to focus money and research on developing an AIDS-prevention product that women could control. —œIt was difficult to get people—™s attention,—? she says. —œIt was not considered interesting scientifically. It was seen as a product-development issue, not a scientific problem. Scientists in drug and cosmetic companies don—™t get papers published.—? Research was slow to get moving. Rosenberg left N.I.H. and eventually became C.E.O. of I.P.M. It is one of several organizations working to develop a microbicide.

For a microbicide, the traditional public-health approach —” invent it, put it out there and tell people to use it —” won—™t cut it. Nearly as important as whether it kills H.I.V. is whether a microbicide feels acceptable, whether it can be used discreetly if necessary and how it is packaged and promoted. Dr. Mark Mitchnick, the group—™s senior scientific consultant, worked on sunscreens and other products before switching to AIDS prevention. —œOne thing I learned with sunscreen is that people will often need a second reason to buy,—? he says. —œYou want people to use sunscreen because it protects against melanoma. But people buy it because it prevents wrinkles.—?

—œThe cosmetics industry can get women to use all sorts of topical products they don—™t need,—? Rosenberg said. Maybe the same tools could be used to make a microbicide popular. —œIs there a way to think about it that isn—™t H.I.V.? Public health can—™t tell us that.—?

Every weapon in the fight against AIDS needs to pass these same two tests —” it has to work and people have to use it. But particularly in poor countries, where most of these services are by necessity free, AIDS treatments and prevention strategies are usually offered as if marketing were unnecessary. That is especially true for antiretroviral therapy. After all, the logic goes, it—™s a lifeline. Surely no one would throw it back.

And when they have access to it, most people donѪt. Antiretrovirals are now saving lives all over South Africa. The public-health system has gone from 0 to 175,000 people on antiretrovirals in two years. Add in programs run by businesses and nongovernmental groups like M̩dicins Sans Fronti̬res, and more than a third of South Africans who need antiretrovirals are now taking them, and the figure continues to rise. Patients who have agreed to start antiretrovirals are very good about taking their medicine, and when they do, few are dying.

But the surprise is that South Africa has indeed had to sell AIDS treatment —” and it—™s often a hard sell. —œPeople think the health department wants them to be dead,—? said Sylvia Maguma, a traditional healer, or sangoma, I met in the township of Bekkersdal. I heard many people say this. It may be a hangover from the apartheid years, when it was literally true, and more recently, the government has spent years criticizing as poisonous the same drugs it is giving out now. Some antiretrovirals do have awful side effects, especially at first. But denial and stigma make things worse. People with AIDS tend not to admit, even to themselves, that they are sick; they seek help only when death is imminent. They start the antiretrovirals too late, and then the rumor spreads: the medicines killed her.

But there is something else at work here: the weight of traditional culture. In the township of Tembisa I met Vusi Ziqubu, a 33-year-old who was dying of AIDS. He could get free antiretroviral treatment at his local clinic. But he preferred the herbal remedies of Grace Mhaula, his sangoma. —œHe was gone,—? said Mhaula of the moment she first saw Ziqubu. —œHe was frail, smelling of death.—? Mhaula gave him a solution of herbs to drink four times a day. When I visited him in his house, he was thin, but looked strong and was up and around.

It is commonly said in South Africa that 80 percent of blacks go to a traditional healer first when they are sick. To South Africa—™s poor, the bones of the sangoma are the reassuring and trustworthy medicine their families have used forever. It is the clinic—™s fabulous tales of invisible bugs that sound to them like hoodoo. The science of the rich is the magic of the poor, and vice versa. And the sangoma, unlike the nurses at the clinic, can spend time with the patient.

But traditional healers can be a dangerous first stop for people with H.I.V., and not just because they often mean a delay in starting antiretrovirals. Sometimes the consequences are more dire. —œI discourage older men from going to young girls to cure AIDS,—? said Mhaula, but horrifyingly, some healers do not, spreading the message that sex with a virgin is curative. Many sangomas, Mhaula said, induce diarrhea or vomiting to clean out the illness, which can be debilitating for someone sick with AIDS.

So South African officials have begun to train traditional healers about H.I.V. Training often lasts only a few days, and it varies greatly in quality, but it is nonetheless useful and has reached thousands of sangomas. Mhaula took the training and trained others herself. I met her in April, and I later found out that she died suddenly three weeks after I visited her, of an infection unrelated to AIDS. She was an enormous woman of 53 who greeted me in a muumuu and fuzzy pink slippers. The daughter of two traditional healers, she had been one herself since the late 1970—™s. But she also worked in the labs of a multinational drug company for 27 years, and the company paid her college tuition. Arthritis forced her into early retirement, but she was bored at home. At Tembisa—™s health clinic, she received training in H.I.V. counseling and caring for the terminally ill. Her own daughter died of AIDS six years ago, and Mhaula was raising her daughter—™s child.

Off her patio was a small room —” her indumba, or consulting room. The walls were lined with hundreds of glass jars and plastic tubs containing mixtures of herbs. Animal skins and straw mats covered the concrete floor. Hanging from the ceiling were candles, the clothes of her ancestors and beaded necklaces. There was a plate of bones. When her clients (she does not call them patients) visited her, she read the bones. When she was alone, she put on the clothes of her ancestors and called their spirits. There were seven different ancestors that she talked to.

Mhaula walked me through what she did when she recognized symptoms of H.I.V. —œI say: —˜Think about it. We live in the modern age. Don—™t you think we should go to the clinic? You will be in a safe environment.—™ They say, —˜Will you go with me?—™ I say, —˜Yes.—™ Sometimes they want me to go get their test results. They say, —˜Don—™t tell me the results, just give me imbiza—?—™ —” the herbal mixture she makes that she says boosts the immune system. —œI say, —˜How are you going to change your behavior?—™ They say, —˜I—™m not yet ready.—™ I tell them: —˜It—™s good to have one partner. You must use condoms.—?—™

Working with traditional healers is hugely important for fighting AIDS in South Africa. But it has a dangerous side. The problem lies in the stack of white tubs that were behind the door of the indumba —” Mhaula—™s imbiza. She was careful not to call it a cure. It might indeed strengthen the immune system —” it has never been tested in clinical trials, so we don—™t know. But it cannot be taken with antiretroviral drugs. That meant Vusi Ziqubu had to choose.

—œTraditional healing is being manipulated to put forth a political agenda,—? says Jonathan Berger, head of policy and research at the AIDS Law Project in Johannesburg. —œIt—™s a way to push the anti-Western-medicine line by appealing to culture and tradition.—? When I was in South Africa, a —œcure—? called the mopane worm was on the front pages of the tabloid papers. Health officials—™ embrace of a long line of charlatans has encouraged a thriving industry in such cures. Hundreds of sangomas sell them.

They are very tempting to people fearful of the impersonal clinic. —œWith us, you don—™t have to take it the rest of your life,—? Mhaula told me. —œAnd there are no side effects. Patients come in, and they are so afraid, and then I give them the imbiza and I give them some porridge to eat. And it—™s all right.—?

Imbiza seemed to be helping Ziqubu —” for now. But there was another patient taking Mhaula—™s imbiza, a close family friend, a mother of three children. She was doing well, Mhaula told me —” please come talk to her. Two days later, I came back to meet the woman. But she had already died.

AIDS is a disease of taboos. For its sufferers, psychological comfort, like that provided by traditional healers, is paramount —” sometimes more important than even staying alive. But over the next few years, word will spread about the Lazarus effect of antiretroviral drugs. Although logistical and personnel problems will no doubt remain, few people will be able to argue that the drugs are poison, and few will shun them for herbal remedies.

There is also reason for optimism that other weapons in the fight against AIDS will win more public acceptance. Improvements in service will encourage more women to protect their babies. In the Alexandra clinic, the resourceful nurse Pauline Molotsi has hit on a strategy that sometimes helps. If an H.I.V.-positive woman does not want to take the nevirapine, Molotsi thrusts a piece of paper and a pen toward the woman, essentially making her take responsibility for her decision. —œWould you really like your baby to have the virus?—? she asks. —œIf you don—™t take the pill, you will have to sign.—? At Chris Hani Baragwanath Hospital in Soweto, which has an unusually well-financed and -run antenatal clinic, 98 percent of pregnant women agree to be tested for H.I.V. There will always be psychological barriers, but good service can overcome them.

That may not be true with South Africa—™s most basic challenge: to bring down AIDS—™s astronomical prevalence in the general population. Help could come from the brand-new technology of microbicides, but it could also come from the very old one of circumcision, which may offer some protection from H.I.V. infection. (Clinical studies due to conclude next year may tell how much protection.) That—™s the future, though. For the moment, AIDS prevention is entirely a conundrum of psychology and culture —” one we know very little about how to solve. The small list of countries that have had some success with prevention includes such dysfunctional places as Haiti, Zimbabwe and Cambodia. Experts can point to some good programs in these countries, but plenty of nations with rising AIDS rates have the same programs. The country that had an early drop in AIDS prevalence, Uganda, probably achieved this because its particular culture of openness brought the disease into the public eye, and the country treated it like World War III.

In South Africa, where AIDS has already exploded through the general population, prevention is an even more overwhelming challenge. One disturbing fact: Surveys show that South Africa—™s teenagers know about AIDS and how it is transmitted. They know the behaviors that put people at risk. But they don—™t apply this information to themselves. There is no correlation between information and behavior change. Two-thirds of young people who test H.I.V.-positive —” in anonymous surveys, so they don—™t know it —” do not consider themselves at risk for AIDS. Especially for teenagers, the psychology of sexual behavior resides in some deep and mysterious place, apparently shielded from the reach of traditional public-health messages as if by a lead curtain. The question is whether anything can get through.

South Africa is trying to answer that question with a controversial H.I.V./AIDS-prevention program called loveLife, which generally serves youths from 12 to 17. It is as far from the traditional campaigns as it could be. I went to the community hall in Emzinoni, a black township in Mpumalanga province in the country—™s east, to hear a dialogue staged by loveLife. Outside, geese ran in the dirt yard next to purple loveLife banners. Inside the auditorium, vibrant music blared and balloons filled the stage. A pop star named Elle sang a song about believing in yourself. A woman in jeans and a pink hat and a man in khaki shorts strode back and forth in front of the crowd, each with a microphone in hand, bantering in Zulu and English with about 500 Emzinoni parents and children, leading them in games and discussions about AIDS. Sithembile Sefako, the woman, and Mnqobi Nyembe, the man, are trainers from loveLife—™s national office. They are local versions of a motivational speaker like Tony Robbins, traveling the country holding these events —” but the problems they are discussing are not the ones Tony Robbins usually has to confront.

Sefako asked for volunteers for a little play: a university student named Beauty comes back from college to tell her parents she is pregnant and has H.I.V. Afterward, the actors compared their skit to reality. —œOur parents scream at you and call you names,—? said the young man who played the father. —œThey say: —˜I—™ve seen you walking in the street! I knew you were going to fall pregnant!—™ They beat you.—?

—œWe use culture as an excuse,—? Sefako said. —œThey say, —˜I can—™t talk to my children, it—™s not right.—™ We hide behind culture.—?

Next Sefako opened a discussion about responsibility for teen sex. A girl in a flowered cap said: —œMost guys force us. Then they say if you are going to open a case with the police, we—™ll beat you. We—™ll come with a group and we—™ll kill you.—?

—œGuys compete,—? one boy said. —œYou say, —˜I—™m going to sleep with six girls before Sunday.—?—™

—œIs it true most women are falling pregnant to prove they can bear children?—? Sefako asked.

One girl said: —œWe mustn—™t lie. Most fall pregnant because they want the money—? —” the South African government—™s grant of $30 per month per child. —œThey think, I—™ll buy myself sneakers and jeans.—?

A man differed: —œThe reason women fall pregnant is that we see females in the street in a miniskirt.—?

—œAre you saying young girls are getting raped because of what they wear?—? Sefako asked.

—œYes, because of the way they are dressing, they end up in trouble.—?

A girl responded: —œThen what about someone who rapes a 3-year-old child?—?

—œA child from 10 upward knows how to sleep with a guy, and she knows the way she is dressing,—? the man responded. The crowd hooted.

These unnerving comments contrasted bizarrely with the festive tone of the event. What was most remarkable to participants, however, was not what people were saying but that they were saying anything at all. Nelson Mandela often said that when he told traditional chiefs that he planned to speak out about AIDS and sex, they told him he would lose their support. What passes for communication between parents and children about sex is often just a cryptic warning to girls to —œstay away from boys—? and to boys, nothing. Yet children whose parents do talk to them about sex abstain longer and are more likely to use condoms. In general, openness is the anti-AIDS —” if the sick came out of hiding, it would be easier for their friends and neighbors to accept that they, too, are at risk. That—™s one reason loveLife—™s principal slogan is —œTalk About It.—?

By 1997 AIDS was a crisis of biblical proportion in South Africa, with 13 percent of adults infected. The red-ribbon billboards that passed for an AIDS-prevention campaign were failing disastrously, especially with young people. For girls —” who tend to have sex with older men —” the riskiest age was between 12 and 17. The Kaiser Family Foundation, a health organization based in California, pledged that if South Africans could decide what was needed to prevent the spread of AIDS in young people, the foundation would pay the bill for the first five years.

Kaiser hired Judi Nwokedi to help plan the program. Nwokedi is a charismatic whirlwind who is head of government relations for Motorola in South Africa. A psychologist by training, she worked with sexually abused children and on AIDS projects while in exile in Thailand and Australia. Nwokedi met with AIDS groups, government officials and international experts to forge agreement on the basics. She also commissioned surveys of South Africa—™s teenagers. The surveys found that teenagers tuned out the traditional prevention messages and were most receptive to an AIDS campaign that was about more than just AIDS. The teenagers also said their parents didn—™t talk to them about sex or relationships —” and they desperately wanted that kind of communication and wanted their parents to set limits. Significantly, the study found that poorer girls realized their first sexual encounter would probably be coerced and violent.

The next question was how to reach the children and young people at risk. —œThe normal way of AIDS or any peer education with young people was to pack them into the church hall or the school hall,—? Nwokedi says. —œThey would have to sit there while someone would stand up there and talk at them. And whatever they told you, you went out and did the exact opposite because you were so angry that they kept you there for five hours. I wanted H.I.V. education to have another dimension —” it had to be interactive, engaging, question-and-answer, vibrant debate.—?

Under apartheid, young people identified with collective action. Now they were tired of politics, tired of —œwe.—? An expansion of electrical service in the late 1990—™s had allowed the number of households with televisions to soar. Young people were tuning into the global popular culture they saw on TV, with a very high level of awareness of brands.

The working title for the campaign had been the National Adolescent Sexual Health Initiative. Nwokedi, consulting with teenagers, public-health leaders and marketing experts, nixed it. —œYou—™re dead before you can even go out to young people,—? she said. —œThey—™d call it Nashi as an acronym —” that was soooo public health!—?

The AIDS-prevention program had to be branded. The closest model was a recent relaunch of Sprite. —œSprite took the brand off the shelf into the communities,—? Nwokedi says. —œThey did basketball, sponsored concerts, sent cool kids onto campus, talked up Sprite in Internet chat rooms. It was very driven by celebrities in the community creating the hype. I was looking at what is tactile about your brand, what experiences you create.—?

Instead of a fear-driven, preachy, stodgy Nashi, the AIDS prevention campaign became loveLife —” positive, hip and fun, —œan aspirational lifestyle brand for young South Africans,—? as the group—™s literature says. Today loveLife is one of the 15 best-known brands in South Africa. The country is dotted with 1,750 loveLife billboards. Radio call-in shows reach three million young listeners a week. LoveLife has TV spots and TV reality shows, including one that sent attractive young people into the wilderness to compete in AIDS-related games, like using the other sex—™s tools of seduction. A Web site (www.lovelife.org.za) and magazines feature not only graphic information about H.I.V. but also fashion, gossip and relationship advice.

There are very few South Africans who lack strong opinions about loveLife. South Africa has other AIDS-themed TV series and media campaigns and many other behavior-change programs. But at $25 million a year, loveLife is the giant, and it attracts most of the controversy. Initially, I was a skeptic. LoveLife struck me as empty cheerleading —” telling young people who live in cardboard houses and eat a few handfuls of cornmeal mush each day to look on the bright side, when there is no bright side.

LoveLife started out promising too much, pledging to halve the rate of new H.I.V. infections among young people in five years. More recently, it has suffered management problems. South Africans cluck about the fact that the Global Fund to Fight AIDS, Tuberculosis and Malaria cut off a loveLife grant last year —” one of only three grants stopped worldwide. The money was being used to, among other things, build rooms where teenagers could go, known as —œchill rooms,—? in health clinics. Brad Herbert, who was chief of operations at the Global Fund at the time, told me that the grant was canceled because construction was too slow and expensive, but that there were no charges of impropriety. (The grant arrived six months late, and loveLife officials argue that the delay caused cash-flow and exchange-rate problems.)

But many people also question loveLife—™s basics. Virtually every South African adult I met thinks that the messages on loveLife—™s billboards —” the media most visible to adults —” are incomprehensible. Many —” like —œGet Attitude!—?—” indeed appear to have nothing to do with AIDS. But loveLife—™s leaders argue that the billboards, like all of loveLife—™s media, are not there to educate young people but to draw them into the face-to-face programs. They promote loveLife as an exclusive club that you, as a teenager, can join. The celebrity gossip and fashion advice in loveLife magazines is also not a message but a delivery system. —œThe logic of the brand is to create something larger than life, a sense of belonging,—? says Dr. David Harrison, a tall, lanky, white physician who became head of loveLife in 2000. —œThat creates participation in clinics, schools —” people go because they like to be a part of loveLife.—?

As Sprite did, loveLife uses kids to recruit their peers. It has programs now in a third of the country—™s high schools, a seventh of the nation—™s health clinics, 130 community organizations and 16 loveLife centers. All these programs are run by what loveLife calls, with a typical typographical flourish, groundBREAKERs. They are young people between 18 and 25, trained and hired for one year at minimum wage to talk about sex, AIDS and relationships, help run school sports competitions (South Africa—™s only public-school sports in most of the country), radio stations and computer workshops. Perhaps most important, they are taught how to motivate young people by sharing their own personal histories. That is crucial, as loveLife—™s challenge is not to impart information but to cut through fatalism and denial to get young people to apply the information they already know.

I met Harrison in loveLife—™s headquarters in the Johannesburg suburb of Sandton, a pleasant campus of modern buildings with interiors painted in loveLife—™s trademark purple and white. He said that loveLife—™s research found that what particularly put young people at risk was coerced sex. Other factors were low self-esteem, absence of belief that the future offered any reason to make wiser choices today, peer pressure, lack of parental communication and the popular belief that a girl is not a woman until she has a baby. Poverty, low education and marginalization also led to higher rates of AIDS.

LoveLife cannot do much about those last three. Instead it tries to promote family and society communication and help young people acquire the skills and motivation to resist pressure to have sex, especially unprotected sex. —œWhen I ask young people what made them change, they never say, —˜You gave us information,—™ —? Harrison says. —œThey say: —˜I feel an identity with a new way of life. I can be like my friend whose life has changed.—?—™

There have been some good recent analyses about how to tinker effectively with teenagers—™ heads. A study last year led by Dolores Albarracín of the University of Florida examined evaluations of hundreds of H.I.V.-prevention programs. The group found that threats and fear don—™t work. This finding argues against —œAIDS kills—? messages and also against more sophisticated programs that encourage teenagers to confront how AIDS has ravaged their families. For young people, not surprisingly, one of the most effective arguments for making healthier choices is that their peers are doing the same. Programs that produced the most behavior change combined H.I.V. information, attitude change and training in skills like saying no to sex without a condom.

The most serious criticism is that loveLife is aimed in the wrong direction. —œLoveLife is too focused on individual choice,—? says Warren Parker, the executive director of Cadre, an AIDS group. —œWe need community organizing around the issues of sexual violence, gender imbalance.—? The question of whether to try to change an individual—™s behavior or a society—™s culture is a big debate in AIDS work. Certainly in South Africa, both seem necessary.

—œTo stop the epidemic in the long term we need to tackle sexual violence,—? says Piot of Unaids. —œBut the problem is we still have a crisis. If we—™re going to wait till men and women have equality and no one has to sell their body —” well, we can—™t wait for that.—?

LoveLife—™s message is the same public-health gospel a Nashi would have used: abstinence, fidelity, condoms. But that message is received very differently if it comes during a five-hour lecture in the church hall than it is if it comes from Sibulele Sibaca, a petite, enthusiastic, energetic 23-year-old from Langa, a township outside of Cape Town. Today she is a corporate social investment manager in Richard Branson—™s Virgin Group in South Africa. That, she says, is because of loveLife. When she was 12, her mother died of AIDS. When she was 16, her father followed. —œBefore I joined loveLife, I had a serious history of self-destruction,—? she said by phone from Cape Town. —œI saw my life ending up in the township, pregnant, not knowing who the father of my child is.—?

She got through high school. A friend told her about loveLife, and she began going to its programs. —œI had been engaging in highly risky behavior, but loveLife helped me realize there were things I wanted to achieve in my life, and I couldn—™t afford to have sex without a condom,—? she said. —œThe reality is that every young person has a dream, but a lot of us look at our situation and think, Who are we kidding? But the minute someone triggers in your brain that it is possible, you start looking at life in a different way.

—œSeeing billboards of a dying person didn—™t tell me about me,—? Sibaca says. —œBut when someone says, —˜You have such amazing potential that H.I.V. shouldn—™t be a part of it—™ —” then it wasn—™t about H.I.V. It was about me. No one is wagging a finger at me. These were people the same age as me. It wasn—™t a celebrity telling me their story living in a million-dollar house. It was another young person from the same township as me.—?

She applied to be a groundBREAKER. LoveLife trained her to do motivational speaking and gave her facts and ways to talk about teen pregnancy, peer pressure, H.I.V. and other issues. She went to work in a high school, visiting the same class every day for 21 weeks. I asked her whether she felt it helped anyone. She told me about one girl in her class two years ago, also from Langa. —œShe was 15 and came to me and said, —˜My boyfriend is pressuring me to have sex without a condom.—™ Her fear was that her boyfriend would break up with her if she said no, and she had to hold on to him because he gave her money and clothes that her family could not provide her with. I gave her all the different choices and consequences and said, —˜Are you willing to live with those consequences at age 16?—™

—œShe came to me the next week and said, —˜I—™m single.—™ She had broken up with her boyfriend. I hugged her and started crying —” she saw her fears and was willing to go through with it anyway.—? Sibaca saw the young woman again a few months ago. —œShe was not H.I.V.-positive and not pregnant, and she was going to study law next year.—?

This is cheerleading —” but it—™s not empty cheerleading. LoveLife cannot promise any South African teenager that life will be good. But living on one meal a day is even harder if you have AIDS. It seemed valuable to help young people realize that there were reasons to stay healthy and that the choice is theirs.

In Orange Farm, a forlorn and violent township southwest of Johannesburg, I visited a loveLife center, a complex of buildings that draws kids in with a basketball court, a radio-production facility and a computer workshop —” but first, kids have to do AIDS training. LoveLife seemed to be Orange Farm—™s only after-school alternative to drinking, gangs and sex. In a mining district in rural Limpopo, I visited several health clinics. Nurses at clinics are famous for simply yelling at kids who come in with gonorrhea or a request for contraception, or threatening to tell their mothers. Now these clinics have loveLife chill rooms manned by groundBREAKERs. They have persuaded nurses not to drive teenagers away and will escort teenagers into their appointments.

I watched groundBREAKERs give talks on H.I.V. in schools and after school. The quality of their programs varied with their skills and the local environment. Some were pretty good. At Serokolo high school in the Limpopo mining town, I watched 23-year-old Tebatso Klass Leswifi run a class through a quiz on H.I.V., with discussion that ranged from whether girls become pregnant because of the country—™s child grant to why you would want to know your H.I.V. status. He also works at the local health clinic and helps run a league with 10 basketball teams. The high school—™s aerobics team —” also coached in part by Leswifi —” put on a show to the music of the pop hit —œGloria.—? I met a 17-year-old named Princess who said she calls Leswifi every day for some words of wisdom to motivate her to stay in school. In another Limpopo health clinic, however, I watched about 20 bored-looking kids sit through a lecture by groundBREAKERs on H.I.V. and loveLife—™s programs. It was done in the rote-memorization style still typical in South Africa—™s rural schools, with practically no discussion. Still, I heard too many young people tell me loveLife had changed their lives to dismiss it. The organization seemed a little like a cult —” and that—™s good. Many young people I met told me that loveLife had saved them in big or little ways, and they said they were on a mission to pass that along to others.

There are strong indications that loveLife does indeed change young people—™s behavior. In 2003, the Reproductive Health Research Unit of the University of the Witwatersrand in Johannesburg did a survey of 15- to 24-year-olds. It found that people who had participated in loveLife—™s programs were only 60 percent as likely to be infected with H.I.V. as those who had not, and the risk diminished further for those who had participated in more than one program. There was also a strong association between loveLife participation and increased condom use —” although there was no statistically significant effect on abstention or partner reduction. Since the study was not a randomized, controlled one, it could not prove that loveLife programs caused the behavior change.

LoveLife has not, of course, produced the promised 50 percent drop in new H.I.V. infections. But loveLife—™s face-to-face programs have been working nationwide since only 2002. —œIt is too early to dismiss this,—? says Purnima Mane, the director of policy, evidence and partnerships at Unaids in Geneva. —œIt can take five or six years to see results.—? And last month, the South African government reported that new surveys of pregnant women showed that rates of infection in teenagers are holding steady, while the rates of other age groups are rising. This suggests something is working with teenagers.

LoveLife currently reaches around 40 percent of South Africa—™s youth with face-to-face programs. That—™s a lot, but more would be better —” given the scope of the catastrophe, $25 million a year is not that much. There are other programs that take a different but equally sophisticated approach, and it would help if they were broadened as well. Where the likelihood your partner is infected is as high as in South Africa, ordinary success might not be enough.

The thinking behind loveLife —” get into their heads —” needs to become part of every AIDS program, in South Africa and around the world. Governments are still setting goals of providing —œaccess—? to medicines or condoms, but access and accessed are very different things. It will be a complicated and expensive change, because what works in one culture may not work in another. It will also require people to take into account what works. It sounds strange to say it, but this is often not a factor. Across Africa, groups are turning to abstinence-only programs not because they work —” they don—™t —” but because that—™s what Washington wants to finance. Rigorous evaluation to show which AIDS programs are effective is also necessary, something that is only an occasional afterthought today.

Without attention to the social, psychological and cultural factors surrounding the disease, we are throwing away money and lives. This is the new frontier. Twenty-five years into the epidemic, we now know how to keep people from dying of AIDS. The challenge for the future is to keep them from dying of stigma, denial and silence.

Tina Rosenberg writes editorials for The New York Times. She has written for the magazine about AIDS, malaria and tuberculosis, among other subjects.To anyone who does read the science it is not possible to finish this saga without being amazed at how willing the sensitive liberal mind is to take a false premise and run with it into endless Ptolemeic extrapolations, cultural, social and intellectual, all demonstrating the infinite social and cultural enlightenment and sensitivity of the writer.

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She is one of the most ferociously intelligent people I have ever met, and certainly is unique in the public courage she displayed, and has maintained despite the vicious and untrue attacks from many quarters, in turning 180 degrees because she actually attended to all that those remarkable meetings had to offer.

She is my favorite person in South Africa.

Dr. Harvey S. Bialy:
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Misreporting Manto

Meanwhile Dr. Mantombazana “Manto” Tshabalala-Msimang’s intelligence and expertise isn’t recognised by anyone in the press, because the AIDS meme is ubiquitous in that realm both here and abroad, with the distinguished exception of Harper’s Magazine and a few others, not to mention two dozen books. During and after the AIDS 2006 the South African papers have pursued Dr Manto Tshabalala-Msimang with all the outrage of shared ignorance.

Allafrica.com reported her behavior as familiar quackery exhibited at three previous AIDS Conferences where Dr. Mantombazana “Manto” Tshabalala-Msimang had presented her alternative to ARVs in the form of beetroot, lemon, garlic and African potato.

South Africa’s exhibition stall was dominated by woven baskets of plump lemons, wilted beetroot, African potatoes and clumps of garlic.

A staff member hastily added his own two bottles of antiretroviral medication after journalists asked why ARVs – also part of government’s treatment plan – were not on show.

Shortly afterwards, Tshabalala-Msimang opened the stall and said it was important to allow people in the rural areas to make up their own minds on whether they “preferred alternative medicine or antiretrovirals”.

Anxious to have readers shaking their heads in disapproval, the reporter like everyone else hostile to Manto seems unaware that not having enough food or the right foods to eat creates exactly the major symptoms of AIDS and always has – the immune system becomes dysfunctional. That is what the mainstream literature shows repeatedly, as we have pointed out earlier.

But apparently ignorance breeds arrogance more often than humility and the stall was in tatters by the end of the Toronto conference, trashed by the TAC:

Dr Harry Moultrie of the paediatric Aids clinic at Chris Hani Baragwanath Hospital, who attended the opening, said the inclusion of the foods at the South African stall was “despicable”.

He added that there was “no scientific evidence showing that any of the products were effective” against HIV.

By the end of the week, the stall was in tatters after being trashed by Treatment Action Campaign (TAC) supporters chanting “Fire Manto now”…

The South African government stand, decorated with the lemons, beetroot and garlic linked to Health Minister Manto Tshabalala- Msimang—™s aversion to anti-retroviral drugs, was invaded by Treatment Action Campaign (TAC) activists, some lying on the ground to symbolise South Africa—™s Aids dead.

—œFire Manto now!—? they chanted to passers-by, charging that South Africa—™s Aids response was —œthe worst in the world and not the most comprehensive—?.

The TAC activists were also busy trashing Manto back home:

AIDS activists occupied several government offices Friday and took to the streets demanding the resignation and arrest of South Africa’s health minister, accusing her of allowing unnecessary and preventable deaths because of her policies on AIDS.

South African Health Chief’s Ouster Eyed

The Associated Press
Friday, August 18, 2006; 8:43 PM

CAPE TOWN, South Africa — AIDS activists occupied several government offices Friday and took to the streets demanding the resignation and arrest of South Africa’s health minister, accusing her of allowing unnecessary and preventable deaths because of her policies on AIDS.

The Treatment Action Campaign staged the protest against Health Minister Manto Tshabalala Msimang following the death in a Durban prison earlier this week of a prisoner with HIV/AIDS.

The campaign said government was to blame for not giving him antiretroviral medicines – a charge the prison department has denied.

The dead man was one of 15 prisoners who recently won a court case against the Department of Correctional Services and Department of Health for the government to provide medication to prisoners.

Activists have repeatedly demanded the dismissal of Tshabalala-Msimang, accusing her of delaying provision of ARVs. Friday, protesters carried signs reading: “Arrest Manto.”

She has attracted criticism at the international AIDS conference in Toronto for using the South African stand to promote beets, garlic and lemon as remedies for the disease.

Dozens of activists, led by the Treatment Action Campaign’s president Zackie Achmat, briefly occupied the offices of the Human Rights Commission _ an independent watchdog _ to pressure it to play a bigger role in securing treatment for AIDS patients.

“When good people keep silent, evil people triumph,” Achmat told human rights commission representatives. “We’ve had enough of evil people triumphing. We need good people like you.”

The demonstrators then moved into nearby local government headquarters, demanding that local authorities should do more against the disease.

South Africa has the highest number of people living with HIV in the world. A government survey, conducted in October 2005, estimated that 5.5 million South Africans are living with the virus, accounting for more than one-eighth of the estimated cases worldwide. UNAIDS estimates that nearly 19 percent of people aged 15 to 49 in South Africa country are HIV-positive.
© 2006 The Associated PressAs noted earlier, in Toronto there was quite a lot of official hostility too. A special session was aimed at bringing South Africa into line, since Mbeki and Manto have done fairly well in quietly discouraging the provision of scientifically unproven and toxic drugs to their electorate, frustrating the drug industry and its supporters among activists (estimates vary from 141,000 to 250,000 of nearly 500,000 candidates who are getting their ARVS):

At a special conference session devoted to the price of political inaction, the TAC’s Mark Heywood said South Africa’s response to HIV was presently in chaos with only 17 percent of people with AIDS receiving treatment while an outbreak of multi-drug resistant TB in KwaZulu-Natal was going unmanaged.

As Mark and the TAC pulled out all the stops in Toronto, they were joined on the warpath by Clinton, the UN special envoy and the WHO director of HIV∫AIDS, among others:

Stephen Lewis, United Nations Special Envoy for HIV/AIDS in Africa, told Health-e he believed that the political indifference in South Africa was a hurdle to people accessing treatment in South Africa.

HIV/AIDS Director at the World Health Organisation Dr Kevin de Kock said he struggled to understand why African leaders were resistant to making HIV/AIDS the single most important issue that they were dealing with…

Indian doctor Dr Jaya Shreedar said she was yet to hear anything good about South Africa.

“You guys are like a worst practice example,” she said, adding that government officials in India, also under fire for their lax response to the epidemic, were saying that “we can’t be as bad as what the South African health minister is.”

Meanwhile, Gregg Gonsalves of the AIDS Rights Alliance of Southern Africa said there was a sense that the South African government had moved beyond denial to betrayal.

“The virus of denialism is seeping around the region to neighbouring countries such as Lesotho. If South Africa cannot scale-up (treatment) what does it say to leaders in the rest of the region?” he asked.


All this was dismissed by an angry Dr. Mantombazana “Manto” Tshabalala-Msimang who fired back in remarks to reporters at the end of the Conference:

An angry Tshabalala-Msimang later said she didn’t mind being called “Dr Beetroot” and said she had never attended an AIDS conference where South Africa had not been bashed by its own media.

“People say ‘your stall is great’. I don’t know what they are reporting on at home. We haven’t shocked the world, we have told the truth,” she told South Africans at a party at the home of Nogolide Nojozi, the country’s consul-general in Toronto on Tuesday night.

Later at the end of the week she called the TAC antics “disgraceful”:

“I think the TAC was just a disgrace, a disgrace not only to the [health] department but a disgrace to the whole country. But I think, as South Africa, we really demonstrated that we are doing pretty well.”

Manto defends Aids policies

Manto Tshabalala-Msimang blamed South Africa’s poor media coverage at last week’s global Aids conference in Toronto on the Treatment Action Campaign (TAC), whose activists led criticism of her government’s policies.

“I think South Africa did very well,” Tshabalala-Msimang told the South African Broadcasting Corporation radio.

“I think the TAC was just a disgrace, a disgrace not only to the [health] department but a disgrace to the whole country. But I think, as South Africa, we really demonstrated that we are doing pretty well.”

TAC supporters were blamed for attacking South Africa’s stand at the Toronto conference, which included a display of Tshabalala-Msimang’s often-criticised prescription of olive oil, beetroot and garlic as a defence against HIV/Aids.

The conference ended on Friday with a broadside delivered by the UN special envoy on HIV/Aids in Africa, Stephen Lewis, who derided South Africa’s “lunatic” approach to an epidemic which infects an estimated one in nine of its 45-million people.

South African newspapers on Sunday joined the fray, describing the Toronto display as “a salad stand” and demanding President Thabo Mbeki — who is also often accused of mishandling the HIV/Aids crisis — sack his controversial minister.

“Tshabalala-Mismang has become a comic figure who comes across as a clown, if her behaviour in Toronto is anything to go by,” the influential Sunday Times said in an editorial.

“For how long must South Africans suffer the embarassment of a senior Cabinet minister who does not appear to take her work seriously?”

South Africa’s government has frequently been criticised for acting too slowly against HIV/Aids and remaining reluctant to provide sufferers with anti-retroviral (ARV) drugs, the only medication known to slow the progress of the disease.

The government did launch a public ARV programme in 2003 and is now providing the drugs to about 175 000 people.

But activists say the drugs only reach a fraction of the people who need them and accuse Tshabalala-Msimang of creating deadly confusion by continuing to promote her home-grown approach to the disease.

City Press Sunday columnist Khathu Mamaila wrote that Tshabalala-Msimang’s determination to promote natural foods such as beetroot and garlic instead of ARVs had “reduced South Africa to an international joke”.
And when asked about the issue, Bill Clinton had supported her attention to nutrition, though as always emphasising that it was no substitute for the ARVs he has attached his reputation to.

In an earlier session, former US president Bill Clinton was asked to comment on the fact that Tshabalala-Msimang “has been particularly keen on nutrition, encouraging olive oil and African potato and things like that to boost the immune system.”

“Improving nutrition will increase our capacity to deal with HIV and AIDS, as long as it’s not a smokescreen of denial, but another part of what it takes to give people a healthy life,” Clinton replied.”

But since Manto returned home she has faced a continual barrage from the TAC and the press, and now the Times’ Tina has piled on.

Worries that Mbeki’s caution will spread

Why is all this fury erupting? There seem to be two reasons. One is that the spread of the “virus of denialism” has ARV marketers worried. What if India really does follow in South Africa’s footsteps in questioning the rationale of ARV delivery to Indian children? Their Academy of Sciences Journal of Biosciences had the temerity (independence of mind) to publish Peter Duesberg’s masterpiece of evisceration of the HIV∫AIDS ARV rationale in 2003, after all. Denialism spreading in Africa and India, with China next?

This concern seems to be the main reason for the mounting attack on Manto and her sanity about nutrition, and on Mbeki’s long held skepticism about whether the mainstream knows what it is doing in HIV∫AIDS, that culminated in the New York Times editorial today.

The second reason appears to be that the TAC, at first refused admittance to the UNAIDS conference in New York earlier, then allowed in after making a fuss, has been emboldened by the support it found there and in Toronto.

South Africa: Beetroot Battle At World Aids Conference

August 21, 2006
Posted to the web Monday August 21, 2006

Anso Thom

Beetroot, lemon, garlic and African potato were at the heart of a bitter conflict between Health Minister Dr Manto Tshabalala-Msimang and AIDS activists over government’s AIDS programme at the International AIDS Conference in Toronto over the past week.

From the start of the conference, it was clear that Tshabalala-Msimang was going to repeat the controversial behaviour she has displayed at the past three international AIDS conferences, by once again emphasizing nutrition as an “alternative” to antiretroviral medication.

South Africa’s exhibition stall was dominated by woven baskets of plump lemons, wilted beetroot, African potatoes and clumps of garlic.

A staff member hastily added his own two bottles of antiretroviral medication after journalists asked why ARVs – also part of government’s treatment plan – were not on show.

Shortly afterwards, Tshabalala-Msimang opened the stall and said it was important to allow people in the rural areas to make up their own minds on whether they “preferred alternative medicine or antiretrovirals”.

Dr Harry Moultrie of the paediatric Aids clinic at Chris Hani Baragwanath Hospital, who attended the opening, said the inclusion of the foods at the South African stall was “despicable”.

He added that there was “no scientific evidence showing that any of the products were effective” against HIV.

By the end of the week, the stall was in tatters after being trashed by Treatment Action Campaign (TAC) supporters chanting “Fire Manto now”.

South Africa took top spot in many guises at the world’s biggest AIDS conference, but usually for the wrong reasons.

Our country had the highest HIV/AIDS deaths in the world last year – 320 000 – and it has the second highest number of people living with AIDS in the world, over five million.

At a special conference session devoted to the price of political inaction, the TAC’s Mark Heywood said South Africa’s response to HIV was presently in chaos with only 17 percent of people with AIDS receiving treatment while an outbreak of multi-drug resistant TB in KwaZulu-Natal was going unmanaged.

“There has been an absence of moral, political and strategic leadership from the African National Congress and the government.

“(Our government) has been unique in the way it has sought to make a virtue out of its refusal to be pressured into responding to AIDS. This has very directly facilitated the spread of the HIV epidemic,” Heywood told the large audience.

He accused Tshabalala-Msimang of repeatedly promoting and juxtaposing the value of traditional medicine as opposed to “western medicine”, thus “creating a pseudo politics around “Western vs African” traditions of health care.

In an earlier session, former US president Bill Clinton was asked to comment on the fact that Tshabalala-Msimang “has been particularly keen on nutrition, encouraging olive oil and African potato and things like that to boost the immune system.”

“Improving nutrition will increase our capacity to deal with HIV and AIDS, as long as it’s not a smokescreen of denial, but another part of what it takes to give people a healthy life,” Clinton replied.

Stephen Lewis, United Nations Special Envoy for HIV/AIDS in Africa, told Health-e he believed that the political indifference in South Africa was a hurdle to people accessing treatment in South Africa.

“Gauteng, KwaZulu-Natal and the Western Cape are doing moderately well, but [the treatment programme] would be happening far more quickly if the political leadership drove it.,” he said.

HIV/AIDS Director at the World Health Organisation Dr Kevin de Kock said he struggled to understand why African leaders were resistant to making HIV/AIDS the single most important issue that they were dealing with.

Indian doctor Dr Jaya Shreedar said she was yet to hear anything good about South Africa.

“You guys are like a worst practice example,” she said, adding that government officials in India, also under fire for their lax response to the epidemic, were saying that “we can’t be as bad as what the South African health minister is.”

Meanwhile, Gregg Gonsalves of the AIDS Rights Alliance of Southern Africa said there was a sense that the South African government had moved beyond denial to betrayal.

“The virus of denialism is seeping around the region to neighbouring countries such as Lesotho. If South Africa cannot scale-up (treatment) what does it say to leaders in the rest of the region?” he asked.

An angry Tshabalala-Msimang later said she didn’t mind being called “Dr Beetroot” and said she had never attended an AIDS conference where South Africa had not been bashed by its own media.

“People say ‘your stall is great’. I don’t know what they are reporting on at home. We haven’t shocked the world, we have told the truth,” she told South Africans at a party at the home of Nogolide Nojozi, the country’s consul-general in Toronto on Tuesday night.
A third factor may be that, now with the price of AIDS drugs forced down to unprecedented low levels, the drug companies are twice as keen to deliver them to as many people as possible.

Whatever the reasons, the storm has built since, into what may be a watershed showdown between the two views, at least in South Africa. As in the States, this may well benefit dissenters by bringing attention to their case, and the fact that it rests on a more honest reading of the scientific literature than the one promoted by NIAID.

The press attack at home was led by the Sunday Times of South Africa calling for Mbeki to sack (fire) his Health Minister for being a “clown” who doesn’t care to do her job responsibly:

Tshabalala-Msimang has become a comic figure who comes across as a clown, if her behaviour in Toronto is anything to go by.

For how long must South Africans suffer the embarrassment of a senior Cabinet minister who does not appear to take her work seriously?

This is from the Sun Aug 20 edition:Time to sack Health Minister

Time to sack Health Minister
20 August 2006
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—˜AS PRESIDENT of the Republic I have come to the conclusion that the circumstances dictate that, in the interest of the Honourable Deputy President, the government, our young democratic system, and our country, it would be best to release the Hon Jacob Zuma from his responsibilities as Deputy President of the Republic and member of the Cabinet.—?

This is what President Thabo Mbeki said as he dismissed his deputy after Judge Hilary Squires had condemned what he called a generally corrupt relationship between Zuma and his financial adviser, Schabir Shaik.

This was a brave move by the president, a clear indication that he was not prepared to keep in his Cabinet a politician who was compromising the integrity of our government.

It is a move that he should perhaps repeat.

It is tragically ironic that a country like South Africa, which has one of the largest antiretroviral programmes to combat the spread of HIV/Aids, is the country with the highest number of Aids deaths in the world.

South Africa—™s Comprehensive Plan for Management, Care and Treatment of HIV and Aids is supposed to give hope to more than five million people living with HIV/Aids in this country.

But when there are only 141000 receiving treatment out of the 453000 people targeted by the plan for the current year, it becomes difficult to figure out whether it is political posturing or a lack of political will that is responsible for this sorry state of affairs.

This partly explains the bizarre exhibition of garlic, lemon, African potato and beetroot displayed by Health Minister Manto Tshabalala-Msimang at the 16th International Aids Conference, which ended on Friday in Toronto, Canada.

Tshabalala-Msimang has become a comic figure who comes across as a clown, if her behaviour in Toronto is anything to go by.

For how long must South Africans suffer the embarrassment of a senior Cabinet minister who does not appear to take her work seriously?

Few people, if any, deny that nutrition is an important weapon in the arsenal to combat HIV/Aids.

However, pretending that antiretrovirals come second when there are so many people infected and dying of this epidemic is dangerous.

Why Tshabalala-Msimang chose not to display her own government—™s comprehensive plan for HIV/Aids treatment at the conference boggles the mind.

The silence by President Thabo Mbeki in the face of the embarrassment dished out by Tshabalala-Msimang in Toronto this week begs the question of whether he agrees with his Health minister.

It is now time Mbeki took action against Tshabalala-Msimang.
c Sunday TimesA South African Web discussion

A web discussion followed at Should Manto Tshabalala-Msimang lose her job? This has allowed their main arguments to be posted by some of the brightest dissenters in the US, including the whiplash defense of the Minister of Health’s competence by Dr Harvey Bialy (you saw it here first!):

A few words of truth concerning the very Hon. Manto Tshabalala-Mismang.

When I first was introduced to the Minister at the opening reception of President Mbeki’s AIDS Advisory Panel in 2000, the ice in her eyes and the frost in her handshake made me think the tip of the Motherland had broken off and was closing on the antarctic.

By the end of the Panel meetings a few weeks later, we were dancing Pata Pata into the wee hours.

She is one of the most ferociously intelligent people I have ever met, and certainly is unique in the public courage she displayed, and has maintained despite the vicious and untrue attacks from many quarters, in turning 180 degrees because she actually attended to all that those remarkable meetings had to offer.

She is my favorite person in South Africa.

Dr. Harvey S. Bialy:

And Barack Obama can go bugger himself, and preferably in front of the TV cameras too.

What this expansion of debate can achieve is to back Manto by pointing out how her President’s stance rests not on ignoring the scientific literature, as the TAC and Tina would have people believe, but on a correct reading of it. Unfortunately, it seems clear that neither she nor Mbeki will ever make this point themselves, presumably for fear of contradicted by officials from NIAID and their allies.

Here is the ANC Mbeki page message yesterday, on the topic of understanding the South African government’s position on AIDS. It emphasizes how African AIDS is quite different from European and American AIDS, and thus needs different policies:

HIV AND AIDS

Understanding South Africa’s approach to AIDS

Can Africa follow in the footsteps of the countries of the North in addressing the challenge of HIV and AIDS in the region? What lessons can be learnt? The challenge of HIV and AIDS in Europe and North America has been portrayed as a
problem facing marginalised communities – Africans in diaspora, immigrants, men who have sex with men, injecting drug users and so on. Very few cases of HIV infection are attributed to heterosexual relationships.

These countries have many more resources to support their social security system and their populations have access to much more complex health systems. With the advent of antiretroviral drugs, many of the people living with HIV and AIDS in these countries were put on antiretroviral treatment.

However, UNAIDS, the joint United Nations programme on HIV and AIDS, has reported that new cases of HIV infection and other sexually transmitted infections are increasing in these countries. UNAIDS says, the rate of new cases of HIV infection in Canada, which hosted the recent International AIDS Conference, has increased by 20% over the past five years.

In an article entitled “The real story of HIV rates in UK”, published in July 2004, this is how BBC News reported on HIV infection in Britain:

“The number of people living in Britain with HIV is increasing every year because more people are joining this group than are leaving it. People join the group in two ways: people with HIV migrate to Britain from abroad (imported infections); and people living in Britain pick up HIV (domestic infections).

“Because HIV is still incurable, people only leave the group by moving away from Britain or by dying. The two communities that are bearing the brunt of HIV in Britain are the gay community and the African community.”

Despite the difficulties in reducing infection rate, it is necessary to discuss whether South Africa and Africa in general would have been able to follow the path of the North in responding to HIV and AIDS. Is it feasible for Africa to
meet expectations that are based on a model from the North?

In sub-Saharan Africa, HIV and AIDS is a generalised challenge not limited to a specific and small section of the population. Most of the cases are attributed to heterosexual relationships.

Our understanding of the difference in the manifestation of this challenge in Africa as opposed to the North is that Africa has high levels of poverty and underdevelopment affecting the vast majority of its population. There are
serious health system challenges in our continent, including shortage of human resources and inadequate infrastructure. Access to affordable and quality medicines and limited social security support for the poor, who constitute the
majority of our populations, remains a challenge.

With all these challenges, and the fact that we have significantly higher numbers of people estimated to be living with HIV and AIDS than Europe, adopting
a model which focuses exclusively on antiretroviral (ARV) therapy would not solve our problem.

As we developed the most appropriate response to the epidemic on the continent, we had to acknowledge that the high prices of antiretroviral drugs as they
entered the market meant that we would have had to divert resources from other social needs – education, water, housing and so on – to provide ARVs. Even if we
had done so, the probability of these drugs reaching the patients and patients taking them at a required frequency was very low.

What did South Africa do under these circumstances? We said that since there is still no cure or effective vaccine for HIV and AIDS, let us focus on prevention as the first element of our response. Simply put, our first challenge was to make sure the problem did not get any worse than it was.

Secondly, we encouraged our people to find out their HIV status, and made voluntary counselling and testing services available in more than 80% of our facilities.

We then had to look at how to respond to the needs of those already infected. We asked ourselves: what can we do to prolong the period between HIV infection and development of an AIDS defining condition? What can we do to maintain optimal health for people living with HIV and AIDS?

We introduced the Healthy Lifestyle campaign that promotes regular physical activity and encourages people to avoid health risks like smoking, alcohol and substance abuse, as well as unprotected sex to deal with the challenge of both
re-infection and new infections.

To deal with the broader problem of the poor nutritional status of our population, we introduced interventions that encourage intake of necessary micronutrients, like providing appropriate vitamin supplementation to pregnant women and children. Vitamins and minerals are now added to staple foods like maize meal and wheat flour and communities are encouraged to produce and eat fruits and vegetables.

These interventions are aimed at strengthening the body’s ability to fight infections and maintain good health for a longer period. When infections occur, we provide appropriate treatment as most of the opportunistic infections can be
treated even in the presence of HIV.

There is also another element that is peculiar to Africa and that is African traditional medicines. The World Health Organisation (WHO) estimates that 80% of our people use traditional medicine for various conditions including HIV and AIDS. So we decided to encourage research and development of these medicines and create an appropriate regulatory environment for them.

Over the past few years, we made progress in reducing the price of medicines, increasing social expenditure and, to a certain extent, improving our health system. Progress in these three areas created a possibility, by the end of 2003, of introducing antiretroviral therapy. Based on WHO recommendations, we made antiretroviral therapy an option for HIV positive people whose CD4 count had dropped to 200 and less.

We evaluated facilities that could provide this treatment with a target of having at least one service point in every district by the end of the first year of implementation and we achieved that. We took this approach because we wanted to ensure that people in both rural and urban areas have access to more or less the same level of care. We now have 231 health facilities providing ARVs free of charge and they are spread across 72% of local municipalities.

Our targets are set in terms of establishing infrastructure and making services available to our people. While we make all the efforts to market these services, we avoided setting targets based on the number of people using the services because there are a number of factors influencing uptake and some of these factors are outside the control of the state.

The WHO, for instance, launched an initiative to put three million people on antiretroviral therapy by 2005 popularly known as the ‘3by5’ initiative. At the AIDS conference in Toronto, it was reported that about 1,6 million people were on ARVs almost 8 months after the ‘3by5’ target was missed.

In South Africa, the experience in the mining industry has been similar. Only a quarter of the HIV-positive workers at AngloGold Ashanti who need AIDS drugs had taken up the company’s offer of free treatment, a local newspaper, Business Day, reported on 22 April 2005. About 2,700 were estimated to be requiring treatment but just 730 workers were taking antiretroviral medicines after one and half years of providing free drugs. This represents 27% of people initially targeted by AngloGold.

Experts can discuss the AngloGold’s experience in detail. But it highlights the complexities involved in implementing a programme of this nature.

We should not mislead the public and claim that there can be easy victories in our efforts to curb the spread of HIV infection and reduce the impact of AIDS. Our collective duty is to emphasise prevention and ensure understanding of all
the interventions that government is making available at different stages of the progression of this condition.
Special note: No trials have ever shown that HAART is better than doing nothing.

In her aversion to Clinton’s campaign to feed the Kool Aid of ARVs to her people, Dr. Manto Tshabalala-Msimang reminds us of a vital point, emphasized in Comments here recently by Robert Houston in response to Mark Niernbaum, that no trials of the HAART regimen for defeating HIV∫AIDS have ever included placebos. Apart from a handful of AZT studies earlier, one of which showed that AZT killed you earlier than HIV by seven to seventeen years, there has been not ONE trial conducted where any of the AIDS patients have not been medicated, in the last ten years, with ARVs.

Let’s state that clearly. There has never been a placebo group in any AIDS drug trial in the era of HAART – never a group which are not given any ARVs at all, so that the trial could then compare the effect of not giving drugs at all to a group, with the other groups that are given different combinations of medications.

The rationale for this is the supposed “ethical” necessity of giving people ARVs because we “know” that they are beneficial. But it conveniently avoids the possibility of producing results that would allow us to see if they are indeed beneficial, or whether they are in fact soon detrimental, (contrary to the misleading experience of the patients), and ultimately fatal, as many indications suggest, including the recent Lancet study that demonstrated death rates have not been improved in ten years of expanded use of HAART.

But of course to the agitators in AIDS there is nothing better than HAART pills, which they wish to swallow at the earliest opportunity. After all, the companies that produce them are the main source of funding for activists in HIV∫AIDS, even if TAC has somehow recently persuaded a court in South Africa to agree they are not directly funded by the drug companies.

How better could they express their gratitude than by helping their patrons market drugs with grotesque side effects to the hapless millions of South Africa, who had no idea they had anything unusual wrong with them before the Aids meme arrived, other than the degradation and danger of poverty and zero hygiene, the ubiquitous TB microbe, starvation and a range of diseases that we are sure that only “Coming Plague” author Laurie Garrett has completely investigated

Now they “all have AIDS”.

24 Responses to “TAC drug pushers joined by Tina of the Times”

  1. Dan Says:

    What the government says and doesn—™t say still matters, unfortunately. I met some South Africans who can get antiretrovirals free at their local clinic but still prefer herbal medicines. They could live, thanks to the government—™s highly reluctant actions. Instead, they will die because of its words.

    Once again, Ms. Rosenberg doesn’t give ordinary Africans much credit.

    She’s telling us that even though these people may have access to ARVs, they choose herbal medicines. Could there be more reasons they choose herbs other than assuming that they’ve been brainwashed by the government? Could they be relying on something comforting and/or familiar to them, rather than the frightening, deforming “AIDS drugs”? If Ms. Rosenberg truly cared about these people, she wouldn’t dismiss their reluctance to take western poisons, and she’d be supportive of their decision to take herbs, as the mental state of a patient is an extremely important factor in their health.

    Instead, Ms. Rosenberg displays typical western arrogance. She’s quite sure these people will die of “AIDS” if they don’t take ARVs. How is it that she’s so absolutely certain about this?

  2. Robert Houston Says:

    It’s possible that some “treatment action” believers might doubt the assertion in Truthseeker’s Special Note: “No trials have ever shown that HAART is better than doing nothing.” For the benefit of these unenlightened holdouts, here’s a recent citation from Britain’s leading medical journal:

    “Evidence on the effectiveness of HAART for HIV-infected individuals is limited. Most clinical trials examined surrogate endpoints over short periods of follow-up and there has been no placebo controlled randomized trial of HAART” (J. A. Sterne et al. Lancet 366:378-84, 2005).

  3. Celia Farber Says:

    I want to re-iterate here at a randomly chosen juncture that the juggernaut we speak of is a rapidly spreading bio-ideology. In his breathtaking non-fiction long form essay “Koba The Dread: Laughter and The Twenty Million,” Martin Amis explores the differences between communism and fascism, particularly as they were perceived by the intelligentsia. Looking back over it today, I came across this, and it made me think, wincingly, of HIV ideology:

    “Bolshevism was exportable, and produced near identical results elsewhere. Nazism could not be duplicated.”

    This is what is terrifying. All differences between all cultures is expunged by new sex-meds ideology.

    It is only in South Africa that the HIV Bolsheviki choked on a bone; The bone is history, the pseudo- defeat of white supremicism, and the fact that the power skeleton–the media most jarringly–is intact from the Apartheid era, ie it is white, ie it is inherently racist, ie it is filled with self-hate which it must continually deflect onto other imaginary guilty parties. Dissidents are depriving them of their rituals of holiness, and that is very dangerous work. This is something they will NOT be denied. They’ll kill you first.

  4. Celia Farber Says:

    From Koba The Dread, pp 254:

    “Means define ends, as Kolakowski said–and means, in the USSR, were all you were ever going to get. And the contradiction within the contradiction is this: the militant utopian, the perfectibilizer, from the outset, is in a malevolent rage at the obvious fact of human imperfectibility. Nadezhda Mandelstam talks of the “satanic arrogance” of the Bolsheviki. There is also infernal insecurity and disaffection, and infernal despair.”

    wow.

    I found the phrases “satanic arrogance,” as well as “infernal despair,” quite applicable to the deniers of scientific freedom, unified under the Red Ribbon symbol.

    How do I justify “satanic arrogance?” I’ll tell you. A reminder from very recent history. Harper’s published a 15 page article authored by me, which was two full years in the pipes, and was fact checked for over three months. It was, from its inception and built into its narrative design, in no way dependent upon the ANSWER to whether or not “HIV causes AIDS.” It was concrete.

    And yet the attack, when it came, was orchestrated from South Africa (TAC/Geffen et al) to NY (Moore, Golzalves et al) attacked something that was not even THERE. A vapor. This extreme reaction frothed rapidly into a 35 page manifesto filled with demands that included top editors resigning, the author, (myself) being “denounced” an “apology” to what they called “the community,” and finally, an invitation for them, it, that THING, to publish (write? is this writing?) a 15 page “article” in a forthcoming issue of Harper’s that would be fact-checked by them, it, as they, dementedly, accused Harper’s of allowing “Farber” to bring her own fact checkers.

    The MOST worrying thing about it, when one had stopped laughing, gasping, etc, was how dislodged it was from all truth, reality, and factuality about how modern journalism functions. That they are crypto-facsists we already knew, but that they think writers bring their own fact checkers to magazines…suggests they are clinically mad.

    What is to be done? They have louder drums, that’s all. And they are Satanically arrogant–that’s all. I have never met an organic, thinking, sane human being, not part of IT, that THING, who thinks their stance is sound or even makes sense. They are alone. Rich, powerful, but widely and deeply despised. I pity them.

  5. McKiernan Says:

    This seems to belong to this topic:

    Living with AIDS # 232 (a sound file)

    by Khopotso Bodibe

    29.09.2005

    The health minister Dr Manto Tshabalala-Msimang, denied in Parliament that she ever said that traditional medicines, nutrition and vitamins should be offered as an alternative to antiretrovirals. Health-e, spoke to the health department’s Director-General Thami Mseleku, and asked him what point the Minister seeks to make when she talks about AIDS treatment.

    THAMI MSELEKU: The message of the Minister is clear. The message of the Minister says —˜we will give you information about what works and about what is on the table. Let—™s talk about ARVs. You—™ve got this treatment. You can actually take it at a certain point, but it does have side-effects. Full stop.

    KHOPOTSO: That can be managed.

    THAMI MSELEKU: That can be managed if you say so. I—™ll add another word —” —˜in some instances—™ —” because in others it—™s not manageable. We cannot deceive our people. We must be very clear about what we are saying to our people. You yourself saying —˜that can be managed—™ is not actually completely true. It—™s partly true. So, let—™s not try and get to the Minister to say you must say it this way. She says nutrition and I—™ll stand by nutrition and no one can challenge the Minister on nutrition—¦ There—™s nothing wrong with that. I don—™t understand where the mixed message is.

    KHOPOTSO: The thing is you can take nutrition, however much of it as you want. But, ultimately, you—™re going to need—¦

    THAMI MSELEKU: That—™s fine. If you need ARVs know that there are side-effects. That—™s fine. What—™s the issue?

    KHOPOTSO: What are you saying to people —” are you saying to people —˜take ARVs—™ or are you saying to people —˜don—™t take ARVs—™?

    THAMI MSELEKU: No, we are saying to people the government provides you the possibility, if you need to take ARVs, take them. But those people that are actually working in the forefront will tell you about the side-effects that they have. That—™s all we—™re saying. We have never said don—™t take ARVs. The Minister has never said so, otherwise this Plan wouldn—™t be rolling out. So, I don—™t know what the issue is about. Just because she says I will not stop to say ARVs have side-effects? That—™s what you—™ll hear also when you go to any site. They—™ll tell you that we must observe you this way, that way, that way because these things have side-effects. But that doesn—™t mean I—™m saying don—™t take them—¦

    If you have to take ARVs, here, they are available, but you have got other alternatives, too. So, I don—™t know what the confusion is, where this mixed message is. We—™re just imagining a mixed message. There—™s nothing mixed about that. Where is the mix?

    KHOPOTSO: The Medicines Control Council is currently investigating allegations of impropriety against vitamin businessman Dr Matthias Rath, who feeds high doses of multi-vitamins as an alternative to antiretrovirals to people with AIDS in townships of the Western Cape. Two families have each reported the loss of a loved one shortly after being on Rath—™s pills. I put the scenario to Mseleku, thus:

    KHOPOTSO: Allegations that are actually levelled against Dr Rath are quite damning. The people that are being persuaded to take these pills are uneducated, they are poor, they are very vulnerable and they will take anything to actually get respite.

    THAMI MSELEKU: Our people are poor, vulnerable, they are everything. But they also are very intelligent. They know what works for them. If you asked me, for example, 80% of South Africans currently will consult a traditional healer before they go to a hospital. We, as the Department of Health, have a responsibility to our people to look at all the options that are available to them, especially in the context of there being no cure for HIV and AIDS.

    KHOPOTSO: At the end of the interview with Mr Mseleku, it was clear to me that it—™s up to me and you, the listener, who are either infected or affected by HIV and AIDS to figure out government—™s stance on the care, management and treatment of the infection. Furthermore, we will live or die as a result of whatever we read into the messages that government provides us.

  6. pat Says:

    I love how this piece ends:

    “…Furthermore, we will live or die as a result of whatever we read into the messages that government provides us”.

    Perhaps KHOPOTSO needs a mommy to tell him what to do. Apparently KHOPOTSO missed it when told:

    “We, as the Department of Health, have a responsibility to our people to look at all the options that are available to them, especially in the context of there being no cure for HIV and AIDS“.

    (my emph.)

    What is any government to do WHEN THERE IS NO CURE FOR HIV AND AIDS ???

    More puzzling is that at the end of the article he goes on to describe the comforting things the health ministry DOES do and I couldn’t expect any ministry to do better.

    I found some momentary comfort, however, in the Department of Health—™s own National Guidelines on Nutrition for People Living with TB, HIV and AIDS, and other Chronic Debilitating Conditions. The book has a section on —œScientifically unproven nutritional treatments.—? In short this part states that —œvitamins are expensive and are sometimes even harmful when too much is taken—?. It further goes on to say, in no uncertain terms, that —œthere are a number of other treatments on the market, including traditional and alternative treatments that people living with HIV/AIDS are encouraged to follow. People with HIV/AIDS are vulnerable to try all sorts of treatments, which are claimed to be beneficial, but may sometimes actually be dangerous—?. And it cautions that you should —œalways discuss treatments with a health worker—?.

    And then this:

    I shudder to think what decisions HIV-positive South Africans make who don—™t have access to such information.

    The South African Joe-Jane can’t access his/her own government? Only if the roads have been washed away and even then. I really don’t understand all the fuss about SA’s health minister.

  7. pat Says:

    Come to think of it, I’m always surprised at how people demand democracy without compromise and with all the bling-bling yet refuse the idea that they must think for themselves to operate one. For those expecting decisions to be made for them by government, I might suggest N. Korea, Myanmar, China, Iran,Libya, Egypt, Somalia…hell, just spin the orb and plant your finger at random; the odds are in favor of the finger landing on a despotic regime (when it doesn’t land on the oceans).

  8. McKiernan Says:

    Aids Experts Condemn SA Minister

    Arrest Manto

  9. john_fr Says:

    Aids Experts Condemn SA Minister

    Aids Experts!! LOL!!!

  10. McKiernan Says:

    Oh come now john_fr…..tsk, tsk re: frivolity:

    Letter to South Africa’s President Thabo Mbeki

    EXPRESSION OF CONCERN BY (82) HIV SCIENTISTS

    Read the 82 names and associated degrees.

  11. Dan Says:

    McKiernan,

    are you telling john_fr to in effect read it and weep? 82 “experts” expressing concern is about as convincing as the term “overwhelming evidence” that we hear so very often, or maybe it’s closer to the saying “50,000 frenchmen can’t be wrong”.

    I suppose these people have got to do something, since they’ve staked their careers on chasing shadows.

    Sounds like many citizens in South Africa are going with their instincts on this issue, making it harder for the “experts” to convince them that they’re dying from a retrovirus capable of all feats virological and bacteriological.

  12. Truthseeker Says:

    Read the 82 names and associated degrees.

    A roll call of infamy, in this case. The only issue is whether they are excused on the grounds of stupidity or condemned for their mental inertia, self interested bias, and malice, the latter personified by Dr Mark Wainberg.

    After 22 years, it is hard to put it down to just stupidity, unless one calls it wilful stupidity.

  13. nohivmeds Says:

    I think McK is just saying, it’s all the usual suspects (and it is). Someone should take this list of 82, and figure out how much pharma money each person and the list in total are receiving. Right away I noticed Catherine Willfert — 1 million from Boehinger. And John Moore’s got his “unrestricted” award from GSK of $500,000. It’s like — how much do you have to pay a scientist to get them to sign this letter?

  14. Michael Says:

    A rather impressive list. Doing some homework on who these 82 fools are brings us a veritable who’s who of cashing in on HIV/AIDS and medications. One of my favorites is:

    Number 63: Richman, Douglas D., M.D., Professor of Pathology and Medicine, University of California San Diego

    Funny thing is, the statement does not mention that he was one of the two original AZT trial study directors, that was being paid by Burroughs Wellcome at a rate of $10,000 per head to give the gay boys of San Diego High Dose AZT in a poorly run 4 month trial. Nor does it mention that his study was sloppy, and unblinded. His Aids Clinical Trials Group is paid directly by the drug manufacturers to get the gay boys onto drugs and get enough bodies on the drugs to get the drugs approved by the FDA. One of his assistants told me face to face that they get $3000 to $10,000 and up, per patient, per drug, per study from the pharma companies, and they do not tell any of their volunteers of the conflict of interest. And many patients are on more than one drug, and in more than one study.

    And what does the study volunteer get out of it? Free Aids drugs, and perhaps a case of liver or kidney failure or lipodystrophy or neuropathy to boot. How special!

    In my opinion, this guy alone is in a major way responsible for the iatrogenic deaths of hundreds of thousands who were poisoned by high dosage AZT.

    He was also elected to be on the HIVnet012 Institute Of Medicine nevirapine review, but at the last minute, he reconsidered, as he had received funding from both the dept of NIAIDS under question, and the drug’s manufacturer. The panel decided it was OK for members to recieve money from one or the other, but not from both. Gee, how is that for an impartial review of nevirapine?

    I can’t help but wonder who some of the other clowns on this list are! Looks to me, like a perfect starting list for the next Nuremburg Trial proceedings.

  15. Orwell's Ghost Says:

    Celia Ferber posted earlier in this thread, so here’s an alert about a new interview with her that just went online from the September 2006 issue of Bookslut. The URL is http://www.bookslut.com/features/2006_09_009885.php

    There’s a nice picture of Celia on the publication’s home page: http://www.bookslut.com/

  16. Orwell's Ghost Says:

    Oops, sorry… Celia Farber, I meant to write in my previous post.

  17. Celia Farber Says:

    I once had a phone conversation with Orwell’s ghost. I had a dream that I had a phone on my desk that, when you lifted it, put you through to George Orwell. I lifted the receiver and I asked him: “Am I on the right track?”

    “Yes sweetheart,” he said.

    It was a very reassuring dream that I suppose was coughed up by my psyche in times of tremendous self-doubt and fear. I assure you I don’t take it to mean that Orwell actually came to the phone.

    As for the interview posted here, I only wish to say that if I said anything un-brushed, wrong, over-heated, stupid, self-serving, or un ladylike, I apologize in advance. I will read it eventually, but I avoid such things to the last moment because I know that AIDS Warfare is now mangled beyond all outposts in what Orwell called The English Language, so it is almost impossible to speak cogently about it. I liked the interviewer Joanne McNeil very much, through, because she was young and independent minded and not suffering from the political hallucinations of my generation of journalists. I felt hope for the future. But my generation has to cede all control of the levers, and admit that we betrayed the mandate and ran the whole thing into a bog. I have said before and will say again that this transfer of power from the Bloated to the Rugged is reminiscent of the seismic cultural shift that occurred circa 1977, (leaving out Stooges and such) Led Zeppelin found itself shot down by The Sex Pistols. Only Pete Townshend seemed to grasp what was happening.

    Journalism’s Bloated Zeppelin is hopefully psshhhhing slowly down down down to the ground. Who needs a single one of us to tell other people what is true, right, moral, north or south, when each person can communicate en masse via computer?

    Please do me the favor of not imputing any exaggerated importance to anything I say, because I am a wool gatherer just like any other and I am not sure I believe in the notion of the “journalist” as cultural authority of any kind. Every day brings a new crop of question marks, that belong to us all, that we seek to transform into exclamation marks.

  18. Celia Farber Says:

    Here is a little ditty I wrote about magazine writing v. blogging. But really it’s about missing my friends.

    http://www.deanesmay.com/posts/1151564711.shtml

  19. Jeffrey Jay Says:

    Celia, your portrayal of the South African media is shocking, but truthful. They are venomous in their attack on the dissident perspective, even allowing profanity in their editorials. I see desperation. What will they say when population stats are released at the year’s end and they show no population decline as predicted? There is the potential for a great deal of embarrassment, this year.

    (A web search “population stats south africa” and the CIA’s current post has a population loss for 2006, scary that they actually believe these things!)

  20. pat Says:

    SA’s population exploded inspite of their suffering the brunt of AIDS and their mortality figures for 2003 announced 420-450’000 total deaths. AIDS Inc. wants us to believe that between 250-350’000 of them died of AIDS. Someone has the numbers completely wrong. In this case probably AIDS Inc since their numbers come from extrapolated number crunches and SA’s numbers are actual body counts. According to AIDS Inc numbers, were AIDS curable then the S. Africans would have a mortality rate similar to or lower than the Swiss!

    CNN claimed that in twenty years time there will be 9 million HIV sufferers in SA and they go on to say it will be one fifth of the population! One fifth of TODAY’s population is what they calculated but did not say. There is no reason to believe SA population will not continue to grow at the same rate.

  21. Jeffrey Jay Says:

    In 20 years time? In 2025 SA will have a population of about 80 million. It will have doubled from the 40 million in 1990.

    There was another editorial in a South African paper today comparing government with the Nazi regime, and asked who will be blamed for not confronting them, who will be responsible for genocide? A pathetic piece that went on for about ten paragraphs. The paper’s are actually inciting TAC to march in the streets.

    Yesterday there was a story about nevirapine and in the second paragraph it reported that SA was one of only seven countries to have an increasing infant mortality rate. Any increase in numbers is due to better death registration in the post apartheid era.

    I can’t wait for the 2006 population statistics.

  22. john Says:

    Mid years population estimates :

    2005

    2006

    Population growth : + 1,07%

  23. Jeffrey Jay Says:

    I see, the mid year 2006 is already out.

  24. david burd Says:

    As cited by many others including the United Nations latest 2003 estimates, populations for African countries (see also Duesberg, Rasnick, and Koehnlein in their 2004 paper The Chemical Bases of the Various AIDS Epidemics), most sub-Saharan countries have doubled (or more) to their current populations since 1980. An excellent example is Botswana (with an area the size of Texas), cited many times over the last several years as having 35% to 40% of their adult poplulation being “infected” with HIV, yet with a population rising from 908,000 to 1,700,000+ (sources: populstat site by Jan Lahmeyer, and United Nations). Since “HIV” has now been rampant (according to the Establishment position) in Botswana for several decades, it defies common sense that “HIV” is lethal and consistent with this ever-growing population. Yet, story after story in such as The Washington Post newspaper heralds the imminent population collapse of Botswana.

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