http://bmj.com/cgi/content/full/323/7314/650/b
BMJ 2001;323:650 ( 22 September )
News
Mbeki plays down AIDS and orders a rethink on spending
Pat Sidley
South African president Thabo Mbeki has once again alarmed doctors and
health professionals with a letter he wrote to his health minister
last month ordering a re-examination of health and social policy,
spending, and research in the light of figures on deaths from AIDS.
In citing the number of deaths he chose figures from 1995, when deaths
from AIDS were considerably fewer than they are today, and when the
figures did not include the many deaths from diseases related to
AIDS. He suggested to the minister, Dr Manto Tshabalala-Msimang, that
there were fewer deaths from AIDS than conventional wisdom claimed.
The letter, which was written on 6 August, is set against a background
of increasing speculation in the research community that the
government is trying to stall the release of up to date "cause
of death" figures compiled by the Medical Research Council.
Much of the raw data that researchers use is controlled by the government,
and some scientists have reported being unable to get hold of
critically important data. These researchers, who often depend on
the government for funding as well as data, have also been unwilling
to talk openly to the media on the issue.
In the letter Mbeki instructs the health minister to look at
1995 figures, which he had extracted from the World Health Organization's
website. At that time AIDS was shown as accounting for only 2.2% of
deaths in South Africa. Other diseases and disorders were shown to
be killing many more people.
Mbeki made three points for the health minister and her colleagues to
consider. He asked whether current health policies dealt adequately
with preventing death, given the chief causes of death in the
country. He then questioned whether priorities for health and social
spending were appropriate. Finally, he asked whether state funded
medical research was appropriate. The letter repeated a proposal
from the presidential AIDS panel to question AIDS figures "that
are regularly peddled as a true representation of what is happening
in our country."
The letter continued, "Needless to say, these figures will provoke a
howl of displeasure and a concerted propaganda campaign among those
who have convinced themselves that HIV/ AIDS is the single biggest
cause of death in our country."
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Rapid Response responses to
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responses
A bold step? - Agreeing with Mbeki
STUART W DWYER, part time district
surgeon [forensic medical officer] , Grahamstown, South Africa
bmj.com, 22 Sep 2001 [Response]
Mbeki should take a cue from Obasanjo
Professor Idris Mohammed, Professor
of Medicine , University of Maiduguri Teaching Hospital, Nigeria
bmj.com, 22 Sep 2001 [Response]
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