South Africa’s new health minister broke dramatically on Monday from a decade of discredited government policies on AIDS, declaring that the disease was unquestionably caused by HIV and must be treated with conventional medicine.
Health Minister Barbara Hogan’s pronouncement marked the official end to 10 years of denial about the link between HIV and AIDS by former president Thabo Mbeki and his health minister Manto Tshabalala-Msimang.
Activists also accused Tshabalala-Msimang of spreading confusion about AIDS through her public mistrust of antiretroviral medicines and promotion of nutritional remedies such as garlic, beetroot, lemon, olive oil and the African potato.
“We know that HIV causes AIDS,” Hogan told an international AIDS vaccine conference. Monday’s speech was her highest-profile public appearance since she became health minister two weeks ago after Mbeki was turned out of office by his party.
“It was imperative to get ahead of the curve of this epidemic 10 years ago,” she said. “We all have lost ground. It’s even more imperative now that we make HIV prevention work; we desperately need an effective HIV vaccine.”
She was applauded and praised at the opening ceremony of an international AIDS vaccine conference by international scientists and public health officials who were frequently spurned by the former health minister.
“A breath of fresh air,” said Alan Bernstein, executive director of the Global HIV Vaccine Enterprise.
Tshabalala-Msimang’s views earned her the nicknames “Dr Garlic” and “Dr Beetroot” and made her a favorite target for cartoonists.
South Africa now has the world’s highest number of people with HIV, counting some 5.4 million people as infected with the virus that causes AIDS.
Unlike Tshabalala-Msimang, Hogan was frank about the cost of the epidemic which kills nearly 1,000 South Africans a day and infects about the same number.
She said that more than half of all South African public hospital admissions are AIDS-related and more than one-quarter of the national health budget goes to fighting the disease.
She said although South Africa now boasted the world’s largest anti-retroviral program, with 550,000 people on treatment, more needed to be done. She said it needed to be more community-based, with treatment administered by nurses — a long-standing demand of AIDS activists that the former health minister resisted.
“I want to emphasize that we will scale up mother-to-child prevention programs,” she said, referring to therapy to keep HIV-positive pregnant women from passing on the disease.
Tshabalala-Msimang only agreed to roll out UN recommended therapy for pregnant women earlier this year.
Hogan, a veteran anti-apartheid activist, was one of the few African National Congress lawmakers who publicly criticized Mbeki’s AIDS stance and his government’s reluctance to provide therapy.
Malegapuru Makgoba, vice chancellor and principal of the University of KwaZulu-Natal, said that for the first time in years, South African academics are free to “state that HIV causes AIDS without getting threats.”
“It is a liberating experience,” Makgoba said at the conference, winning applause. “You don’t know how long we suffered in bondage.”
Hogan told the conference that countries such as South Africa — where life expectancy has fallen to 52 years — desperately need scientists to come up with a vaccine against HIV.
“I’m told that it could take anything from 15 years to a century to get an effective vaccine and that it’s at least 25 years since the scientific community started looking for an HIV vaccine,” Hogan said. “I challenge you to look harder and faster.”
More than 6,500 new HIV infections occur daily worldwide, and about 1,000 of these in South Africa.
It is the first time the AIDS vaccine conference has been held in Africa, which is at the epicenter of the epidemic.
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