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The whole dissident idea attracted a lot of crazies. And then all of a sudden, without realizing it, you’ve become one of them.
—Peter Duesberg, 2009

It [South Africa] is the only country in Africa … whose government is still obtuse, dilatory and negligent about rolling out treatment… It is the only country in Africa whose government continues to promote theories more worthy of a lunatic fringe than of a concerned and compassionate state .
—Stephen Lewis, UN Special Envoy for AIDS in Africa, 2006

I have blogged previously about the dangerous and deadly effects of science denialism, from the innocent babies unnecessarily exposed to deadly diseases by other kids whose parents are anti-vaxxers, to the frequent examples of how acceptance of evolution helps us stop diseases and pests (and in the case of Baby Fae, rejection of evolution was fatal), to the long-term effects of climate denial to the future of the planet we all depend upon. But one of the strangest forms of denialism is the weird coalition of people who refuse to accept the medical fact that the HIV virus causes AIDS. What the heck?  Didn’t we resolve this issue in the 1980s when the AIDS condition first became epidemic and the HIV virus was discovered and linked to AIDS? Yes, we did—but for people who want to deny scientific reality, it doesn’t matter how many studies have been done, or how strong the scientific consensus is. There are a significant number of people out there (especially among countries and communities with high rates of AIDS infections) that refuse to accept medical reality. I described all of these at greater length in my new book Reality Check: How Science Deniers Threaten our Future.

The strangest of all the factors that contributes to the rapid spread and high death rates of Africa’s AIDS epidemic is totally unnecessary. In nearly all countries of the world, the political leadership listens to the medical community and helps when they can. Not so in Africa. The brutal dictator Robert Mugabe, who has ruled Zimbabwe with an iron fist for decades and driven it into poverty and bankruptcy, has done little to fight the rampant epidemic in his country. Even more shocking were the actions of the former President of South Africa, Thabo Mbeki, who ruled from 1999 to 2008. In 2000, when the International AIDS Conference was held in Durban, South Africa, Mbeki convened a presidential advisory panel that featured several prominent AIDS denialists. One of them, David Rasnick, argued AIDS testing should be legally banned, and that there wasn’t “any evidence” of an AIDS catastrophe in South Africa (even though the disease was killing thousands at the time). Another prominent AIDS denialist, Peter Duesberg “gave a presentation so removed from African medical reality that it left several local doctors shaking their heads”.  Mbeki himself addressed the conference and claimed that poverty and not HIV was responsible for AIDS, and hundreds of delegates walked out of his talk at the outrage. Because of his bizarre statements, activists and scientists at the Durban Conference prepared a document affirming that science has conclusively shown that HIV is the sole cause of AIDS, and more than 5000 scientists and doctors signed it.

Nevertheless, Mbeki installed a Health Minister, Manto Tshabalala-Msimang, who was a committed AIDS denier. She used her government agency post to call anti-retroviral drugs “poison” and curb their use, and prescribed old witch-doctor potions like garlic, beetroot, olive oil, and lemons instead. (She got the nickname “Dr. Beetroot” for her strange ideas). The South African medical community fought hard against her dangerous policies, calling for her removal, even though Mbeki kept his hard-line stance throughout most of his term. He even fired Deputy Health Minister Nozizwe Madlala-Routledge for speaking out against the pseudoscience that his government promoted. Only after a group called the Treatment Action Campaign brought suit in South African courts over the rights of sick people for ARV medication did his government gradually relent late in 2004. Mbeki called Malegapuru Makgoba, one of South Africa’s leading scientists, a racist defender of “Western science” for opposing AIDS denialism. Nonetheless, it became a political issue as Mbeki’s followers savaged the father of their country, revered former President Nelson Mandela in 2002 for challenging the government’s AIDS policy. When Mandela told the world that his son had died of AIDS in 2005, his public statement served both as an effort to combat the stigma associated with AIDS, and as a “political statement designed to… force the President [Mbeki] out of his denial.”

How could something as weird as the pseudoscience of AIDS denialism become the prevailing policy in a country with hundreds of thousands of AIDS patients? Some of it may be the individual quirks of Mbeki and his political followers, but a lot has to do with the fact that only recently have the majority of non-white people in South Africa become familiar with western medicine. Deprived of modern medical techniques by years of oppression by the white minority and apartheid, they have come to mistrust anything that originates from the “white devil”, and think of western medicine as “racist” and a “tool of oppression.” Even today, in most villages there are local “witch doctors” and most people still practice folk medicine. Another factor appears to be the false hope that AIDS denial promises to people who have suffered for a long time with the disease, and don’t want to face the harsh reality that (so far) AIDS is 100% fatal and there is no cure. As reporter Mark Schoofs wrote in the Village Voice during the 2000 International AIDS Conference in Durban:

“Winstone Zulu, a prominent HIV-positive activist on the panel, welcomed the discussion because it gave him hope. “For 10 years I’ve lived with HIV,” he told the Voice, “and for 10 years I’ve preached the main line. To hear that I could be wrong is good news. If you were in my shoes, you could understand.” Indeed, Zulu comes from Zambia, where people are so poor that the costly drugs that have reduced the AIDS death rate in rich nations amount to a cruel mockery. Yes, people must “face reality,” Zulu said, but added, “Ideas from the other side will find very fertile ground in Africa because the conventional thinking hasn’t been of much use”.

Providing people with hope where there is none is a powerful incentive for people to believe is false cures and snake oil, but unfortunately, such “cures” don’t stop the problem. Much worse is the fact that during the period from 2000-2008 when Mbeki and his minions were in power, there were about 340,000 AIDS deaths, and about 171,000 new AIDS infections that might have been prevented if the government had promoted the real methods of avoiding infection, such as safe sex. Even sadder, 35,000 infants were infected with HIV during that time, innocent victims of political endorsement of pseudoscience and stupidity. If there is any happy ending to this sad tale, Mbeki was ousted from office in 2008 by Kgalema Motlanthe. In his first day in office, the new Prime Minister fired the ignorant Health Minister, “Dr. Beetroot.” His new Health Minister, Barbara Hogan, declared, “The era of denialism is over completely in South Africa.”