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South Africa: AIDS Denialism Speech
Africa Policy E-Journal
May 9, 2003 (030509)
South Africa: AIDS Denialism Speech
(Reposted from sources cited below)
This posting contains a speech by Edwin Cameron of the Supreme
Court of Appeal in South Africa, "The Dead Hand of Denialism,"
delivered at Harvard Law School on April 8.
According to recent news reports on a related issue, a South
African government task force has concluded that antiretroviral
drugs are an effective and affordable means of treating HIV/AIDS.
The report is being considered by a meeting of provincial health
ministers with the South African health minister this week.
According to the Actuarial Society of SA, last year an estimated
13% of SA's population was infected with HIV, and 500,000 people
were in the advanced stage of the disease, which would make them
eligible for antiretroviral treatment.
Additional resources on the topic of denialism include:
UNAIDS, "Myths and Facts relating to HIV as the cause of AIDS"
Dr. Malegepuru William Makgoba,
President of the Medical Research Council, South Africa
Preface to AIDS Mortality Report, 2001
National Institute of Allergy and Infectious Diseases,
National Institute of Health
NIAID Fact Sheet, The Evidence that HIV Causes AIDS
Treatment Action Campaign page with links on "Debunking Denialists"
The dead hand of denialism
by Edwin Cameron
Edwin Cameron is a judge of the Supreme Court of Appeal in South
This is an edited version of his Edward A Smith Annual Lecture at
Harvard Law School's Human Rights Programme on April 8.
Mail & Guardian (Johannesburg) - April 17, 2003
My theme touches on two momentous issues from the past century.
The first is the Holocaust - the Nazi state's methodical
extinction during World War II of approximately six million
people, mostly Jews. The second is the Aids pandemic - the global
pandemic of disease and death, particularly in Africa and the
developing world, resulting from infection with the human
immuno-deficiency virus (HIV).
Each in different ways seems emblematic of the past century's
terrible legacy of human vulnerability and failing - the Holocaust
because of what it says about the capacity of supposedly
cultivated humans to commit systematised murder on a vast scale;
Aids because of what it seems to be saying about the incapacity of
supposedly cultivated humans for systematised intervention, within
their means, to prevent avoidable death from disease on a massive
scale in the developing world.
No one here would, I think, deny that nearly six million Jews,
together with gypsies, homosexuals and other outcasts, were
systematically done to death in German concentration camps during
World War II. Nor would anyone deny that a virally specific
contagious condition, mostly sexually transmitted, is ravaging the
heterosexual populations of Central and Southern Africa.
Yet both these facts are denied - persistently, vigorously,
vehemently, and sometimes venomously.
For denialists, the facts are unacceptable. They therefore set out
to render them untrue. They engage in radical controversion, for
ideological purposes, of facts that, by and large, are accepted by
almost all experts and lay persons as having been established on
the basis of overwhelming evidence.
Holocaust denialism seeks to deny the systematised massacre of the
Jews of continental Europe that took place during World War II.
Aids denialism involves a group of dissident historians, social
commentators and scientists who have set about denying the
forbidding fact of Aids.
Denialists assert that the "hypothesis" that Aids is caused by a
sexually transmitted virus is unproven and irresponsible. Aids in
North America and Western European they attribute to "the
long-term consumption of recreational drugs" and to the widespread
use of drugs as sexual stimulants by homosexual men and, more
recently, to the administration of anti-retroviral drugs that
doctors wrongly prescribe for Aids.
They refute the "impression" that there is a microbial epidemic in
Africa, ascribing it instead to "non-contagious risk factors that
are limited to certain sub-sets of the African population". The
millions of deaths attributed to Aids they characterise as "a
minor fraction of conventional mortality under a new name".
The methods each group employs to controvert the facts include
distortions, half-truths, misrepresentation of their opponents'
positions and expedient shifts of premises and logic. The
denialists' "standard recipe" is described on one Holocaust
website as "the half-truth, the distortion, and quite a lot
besides the truth".
Both forms of denial make great play of the inescapable
indeterminacy of figures and statistics. Precisely how many died
at Auschwitz, and of what causes? Exactly how many HIV infections
and Aids deaths are current in Africa? We shall probably never
Denialists seek to suggest that the inability to achieve
historical or epidemiological exactitude renders the Holocaust and
Aids themselves imaginary.
Both rely, spuriously, on the fact that history is replete with
orthodoxies that have been supplanted by the heterodox, and invoke
the memory of Galileo Galilei, who was nearly martyred for
The analogy could be invoked by every non-Galilean absurdist to
advance his or her theory. The difference is that heterodoxies
that have achieved acceptance have complied with the basic logic
of scientific and evidentiary postulates, whereas it is precisely
these qualities that the denialists' assertions lack.
In each debate the antagonists need to account for their
opponents' conduct. Why, if the Holocaust never happened, would
many thousands of reputable historians commit themselves to the
assertion that it did? Why would more than 5 000 HIV/Aids
specialist physicians and scientists from 82 countries subscribe
to a declaration - as they did in the Durban Declaration of June
2000 - that the evidence that HIV causes Aids is "clear-cut,
exhaustive and unambiguous"?
To explain this, denialists in each case resort to
conspiratorialism. In the case of the Holocaust, Jewish historians
and Holocaust specialists have a close-knit racial interest in
fabricating its existence.
In the case of Aids, many scientists are mere fools, trapped in
dogmatic error. But all too many of them have a baser motive.
According to Professor Peter Duesberg, the "deceptive Aids
propaganda" alleging the existence of a microbial Aids epidemic in
Africa has been "introduced and inspired by new American
biotechnology", one that - at least in the case of HIV testing -
"provides job security" for virologists and doctors, "without ever
producing any public health benefits".
African Aids denialism also employs a theory of racial conspiracy.
The deniers depict the facts about Aids as the product of a
grotesque racist conspiracy of untruth and deception by
corporations, doctors, scientists and healthcare workers - a
monstrous plot against Africans because they are black.
A document of disputed authorship, which was distributed last year
under the authority of the ruling party in South Africa, the
African National Congress, propagates the belief that a syndicate
of white Western interests - an "omnipotent apparatus", engaged in
"a massive political-commercial campaign to promote
anti-retroviral drugs" - seeks to degrade, exploit and by the
administration to them of toxic medicines, kill, Africans.
For South Africa, the significance of Aids denialism is momentous.
It has to be, since our president, President Thabo Mbeki, has
publicly countenanced and officially encouraged it. The
president's stand has caused predictable confusion and dismay
among ordinary South Africans - with unavoidably devastating
consequences in an epidemic where public education about
self-protection and the necessity for behaviour change is a
But more important still, it has bedevilled and unfortunately
continues to bedevil our national response to the disease. Instead
of taking immediate and unflinching action to stem the epidemic
and to minimise the devastation it is wreaking, the government has
continued to respond with ambivalence and inaction and distraction
For some time Mbeki has maintained silence in regard to his
endorsement or otherwise of the Aids denialists. Yet in one of his
rare references to Aids earlier this year, he described it as a
disease "of poverty and underdevelopment" - echoing one of the key
dogmas of denialism.
In January 2003 his Minister of Health, Manto Tshabalala-Msimang
invited a prominent Aids denialist, Dr Robert Giraldo, to address
the meeting of the Southern Africa Development Community's
ministerial health committee, which she chairs. Giraldo,
unsurprisingly, informed the meeting that "the transmission of
Aids from person to person is a myth" and that "the homosexual
transmission of the epidemic in Western countries, as well as the
heterosexual transmission in Africa, is an assumption made without
any scientific validation".
The government has now apparently retained his services to advise
it on "nutrition". Recently the Minister of Finance, Trevor
Manuel, doubtless unwittingly, echoed dissident talk by accusing
proponents of anti-retroviral treatment of speaking "a lot of
voodoo" and "bunkum".
Until September 2002 the most the government would say was that
its policies were based on the "assumption" that HIV causes Aids.
Even now, government will still say no more than that its policies
are based on the "premise" that HIV causes Aids. The ambiguity of
expression, the ambivalence of the underlying belief, the doubt
about the commitment, are all too tragically apparent. It is as if
a formerly avowed racist were to undertake to treat black people
on the "assumption" or "premise" that they are his equals.
Some advocate criminal proscription of Holocaust denial, and
several states have prohibited speech that denies events
associated with the Nazi persecution of the Jews. The motivation
is that these laws proscribe "hate speech" with its attendant
injury to the human rights protections of those whom it
But many have misgivings about the efficacy and justification of
these laws, considering that they may be counter-productive, and
that they obscure the role that public debate, refutation and
education should play in resisting untruth.
A second role that the law can play, however, is as an arbiter of
fact and truth. And civil, rather than criminal, litigation may
offer useful strategies in responding to denialism. Holocaust and
Aids denialism have each recently been challenged in court, with
In the Royal Courts of Justice in the Strand, in the United
Kingdom between January 11 and April 11 2000, the trial matter
between David Irving, plaintiff, and the defendants Penguin Books
and Deborah Lipstadt was conducted before Mr Justice Gray. The
case arose from a libel suit the writer David Irving brought
against the defendants for publishing Lipstadt's assertions that
Irving was a "Holocaust denier" who had distorted historical
materials in order to bolster Hitler's reputation.
The trial resulted in the dismissal of the plaintiff's claim and
the vindication of the defendants' assertions about the plaintiff,
including their claim that Irving was an anti-Semite. Even more
importantly, the dispute required the trial judge to make detailed
historical findings regarding the Holocaust and the central areas
of difference between Holocaust historians and denialists.
Justice Gray's judgement scrutinises the contentions at the centre
of the deniers' claims, and finds them wanting not only in force
but in integrity. His conclusions entail that those who persist in
denying the Holocaust are devoid of professional integrity and
lack commitment to truth.
Of particular interest to the broader issue of denialism are his
findings in relation to the "convergence" of Irving's
historiographical errors. He found they all tended to exonerate
Hitler, and to reflect Irving's partisanship for the Nazi leader.
"If indeed they were genuine errors or mistakes, one would not
expect to find this consistency." The judge concluded that this
was a cogent reason for supposing that Irving had deliberately
slanted the evidence.
The same pattern of convergence marks the "errors" of Aids
denialists. Eleven months to the day after Mbeki began his public
endorsement of the Aids denialists, the Constitutional Court
delivered a judgement in a case involving discrimination by a
state agency against a work-seeker with HIV.
Even though the medical issues were undisputed on appeal, the
court went out of its way, in a pointed exercise in public
education and affirmation, to set out in detail the uncontested
scientific evidence that HIV is the cause of Aids.
Eighteen months later the Constitutional Court was confronted with
one of its largest challenges since the transition to democracy -
the government's refusal to introduce a national programme to
counter transmission of HIV from pregnant mothers to their
infants. Although exhaustively documented evidence supports the
efficacy, attainability and simple monetary good sense of such
programmes - leaving aside the humane imperative for them - and
even though the drugs are available free, the government refused
to implement such a programme.
Its refusal, as documented in its court papers and in argument on
its behalf before the high court and Constitutional Court, was
based in large measure on the alleged toxicity of the drugs - a
tenet central to the entire conspiratorialist theory of the Aids
Invoking its exposition in its earlier judgment of the causes of
Aids, the court held there was no evidence to suggest that a dose
of the anti-retroviral drug in question "to both mother and child
at the time of birth will result in harm to either of them".
Observing that Aids was "the greatest threat to public health in
our country", the Court ruled that the Constitution required the
government to devise and implement within its available resources
"a comprehensive and coordinated programme to realise
progressively the rights of pregnant woman and their newborn
children to have access to health services to combat
mother-to-child transmission of HIV".
The Constitutional Court's judgements assert that irrationality
and obfuscation have no place in South Africa's response to the
worst threat to its national life.
It has directed the government onto a road that, if followed,
would lead to the effective and coherent national response to the
epidemic. There is unfortunately little evidence that the
government has taken the path on to which the court has beckoned
Despite two important and hopeful Cabinet statements in April and
October 2002, there is increasingly a dualism between governmental
statement and action concerning Aids. The evidence points to the
dismal conclusion that the dead hand of denialism still weighs
down all too heavily on the development of a rational and
effective response to Aids.
Although HIV is now a medically manageable condition, the
government still refuses to commit itself to a national treatment
plan for Aids - even though late last year substantial progress
was made in negotiations between business, NGOs and the heads of
two government departments in devising such a plan.
The cost in human lives and suffering of denialist-inspired
equivocation in national Aids policy can be described only as
horrendous. A leading Aids activist, Zackie Achmat, has referred
to government's policies - with resonant imagery - as "a Holocaust
against the poor".
Death from Aids is now avoidable. With carefully administered
treatments, and subject to monitoring and with appropriate medical
care, Aids is no longer a fatal disease. I know this from my own
life, which without those treatments would have ended three or
more years ago.
Neither as a person living with Aids nor as a judge can I stand
apart from the struggle for truth and for action about Aids, and
the role lawyers and the legal system are called to play in it.
Both Holocaust and Aids denial remind us of our own terrible
weaknesses and vulnerabilities as humans, and of the reluctance we
all feel to own them. But the struggle for truth they involve also
inspires us to greater thought and action.
For truth, classically, is freedom, and from freedom in truth
comes the capacity to build and plan and act better. Aids in
Africa calls us with imperative force to unleash that capacity.
Date distributed (ymd): 030509
Region: Southern Africa
Issue Areas: +health+ +political/rights+
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