A confidential document written by the leaders of the ANC's national health committee has called on President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang to publicly acknowledge that HIV is the cause of Aids.
The document, part of which was leaked to the Cape Times this week, reflects dissatisfaction in the ruling party about Mbeki's ambiguous statements on the disease that affects over four-million South Africans.
"We have identified the cause (of Aids). The infectious agent is HIV, which is a retrovirus," the document says. "The predominant scientific view that HIV causes Aids is the view that the ANC, its leadership and its membership has to publicly express."
Both Mbeki and Tshabalala-Msimang have recently refused to say whether they believe HIV causes Aids, but, in a public relations strategy certain to confuse the public, also deny saying that the virus is not the cause of the syndrome.
The clearest indication of Mbeki's stance was contained in a recent Time magazine interview. Asked if he acknowledged a link between HIV and Aids, the President said: "No, I am saying that you cannot attribute immune deficiency solely and exclusively to a virus."
The draft document, which was distributed to Mbeki's office, Tshabalala-Msimang and other senior ANC officials on Monday, has already caused a fallout in the organisation.
"The (health) minister was furious and demanded that we withdraw the document," said a member of the committee who asked not to be named. "We refused because this is a moral stand that we need to take."
The ANC's national health committee was formed in 1990 and reports to secretary-general Kgalema Motlanthe. It does not have decision-making powers, but is intended to advise the health ministry on policy. Although Tshabalala-Msimang is named the committee chairperson, deputy chairperson Confidence Moloko effectively runs the group.
Moloko, who wrote the document, said it did not reflect the official views of the ANC.
"This is a confidential discussion document intended to stimulate debate within the organisation," Moloko said. "There is nothing secretive about it but it is only intended for people in the ANC. We are not ready to release it to the public yet."
He said the debate around the President's position on Aids demonstrated there were no "holy cows" within the organisation.
The nine-page document is intended to:
- Examine the ANC's response to the Aids epidemic, both before and after coming to power in 1994.
- Acknowledge that several mistakes have been made (such as the R14,2-million education play Sarafina 2), apologise for these and move on to better strategies.
- Clarify the causes of Aids.
- Acknowledge that despite the good work done on raising awareness about HIV and the resources ploughed into prevention campaigns, health authorities have failed to stop the epidemic.
Committee secretary Saadiq Kariem, who helped draft the document, said the organisation had to be frank about its successes and failures in combating HIV.
"We need to re-examine our strategies and bring in all the available expertise to help us," he said. "We hope this will raise the level of debate in the ANC."
The ANC's alliance partners, the SACP and Cosatu, recently stated their belief that HIV is the cause of Aids and called on the government to provide affordable treatment for people living with the virus.
Observers believe that fears about the costs of treatment to the health care system could be responsible for Mbeki's reluctance to accept conventional theories about the cause of Aids.
In the Time interview, Mbeki said: "If you come to the conclusion that the only thing that destroys immune systems is HIV then your only response is to give them anti-retroviral drugs."
At current prices, these life-saving drugs cost between R1 000 and R5 000 a month, but Aids lobby groups believe the prices could be reduced if the government issued licenses for these drugs to be manufactured locally or imported them from countries where they are available more cheaply.
"Instead of spending all this time and money debating what causes Aids, our government should be leading the movement for affordable treatment for all South Africans," said Mark Heywood of the Aids Law Project. "Let's hope this document will get us out of the starting blocks."