UNAIDS: The First 10 Years

Chapter 5Piot recalled: “There had been a massive failure of leadership in all sectors in tackling AIDS,but this started to change around 2000. UNAIDS was a key catalyst in this change, and maybethat is all we’ve contributed”. The greatest change took place among African leaders; ithappened more slowly among those in Asia, in the donor countries and in Eastern Europe.107Mbeki’s involvement with AIDS “denialists” causesconsternation“There had beena massive failureof leadership in allsectors in tacklingAIDS, but thisstarted to changearound 2000.UNAIDS was akey catalyst in thischange, and maybethat is all we’vecontributed”.One African leader took a very independent and controversial stance on the epidemic.There was consternation when news broke in March that President Thabo Mbeki of SouthAfrica was conferring with AIDS dissident researchers who did not believe HIV to be thecause of AIDS. By 2000, an estimated 4.3 million South Africans were living with HIV – thehighest number in any country in the world.Mbeki had written a letter on 3 April 2000 to the Secretary-General, copied to UnitedKingdom Prime Minister Tony Blair and US President Bill Clinton, strongly questioningthe efficacy of drugs such as AZT, and asking why the pharmaceutical companies wereprepared to pour millions into drugs while failing to address such contextual factors aspoverty and lack of education. Many interpreted his stance as reinforcing the views ofthose who questioned the link between HIV and AIDS.Apart from his unwillingness to publicly acknowledge the scientifically proven link betweenHIV and AIDS, Mbeki’s comments were fair. Perhaps at the heart of his belief was hisassertion in the letter that: ‘It is obvious that whatever lessons we have to and may drawfrom the West about the grave issue of HIV/AIDS, a simple superimposition of Westernexperience on African reality would be absurd and illogical. Such proceeding would constitutea criminal betrayal of our responsibility to our own people’.Elhadj As Sy, then team leader of the UNAIDS Eastern and Southern Africa Inter-CountryTeam based in Pretoria, consulted with Piot. A private meeting between Mbeki and Piotwas quietly arranged at the President’s home in Pretoria one Saturday evening in earlyApril. As Sy stressed that it was essential, if the situation was to be ‘salvaged’, to ensure themedia was not involved. Piot flew to Johannesburg and was met by As Sy who drove himstraight to Mbeki’s house in Pretoria. Piot recalled: “I thought, let’s talk. That’s my preferredapproach when there’s a problem. We had a very long meeting that went on well into thenight. I tried to make a case that HIV causes AIDS, that AIDS is a big issue for developmentin Southern Africa, and I obviously failed”.In early May, the South African Government organized a two-day meeting of a PresidentialAIDS Panel of scientists to debate the cause of HIV. Awa Coll-Seck, UNAIDS Director ofPolicy, Strategy and Research, and previously an academic, was invited to join.