UNIVERSITY OF PENNSYLVANIA - AFRICAN STUDIES CENTER
AFRICA ACTION 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" http://www.unaids.org/hivaidsinfo/faq/myths.html
Dr. Malegepuru William Makgoba, President of the Medical Research Council, South Africa Preface to AIDS Mortality Report, 2001 http://www.africaaction.org/docs01/mrc0110.htm
National Institute of Allergy and Infectious Diseases, National Institute of Health NIAID Fact Sheet, The Evidence that HIV Causes AIDS http://www.niaid.nih.gov/factsheets/evidhiv.htm or http://www.aegis.com/factshts/niaid/2000/ niaid2000_fact_sheet_evidhiv.html [type URL on one line]
Treatment Action Campaign page with links on "Debunking Denialists" http://www.tac.org.za/debunking.htm
The dead hand of denialism
by Edwin Cameron
Edwin Cameron is a judge of the Supreme Court of Appeal in South Africa.
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 http://ww2.aegis.org/news/dmg/2003/MG030410.html http://www.mg.co.za
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 know.
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 scientific truth.
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 life-saving centrality.
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 and evasion.
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 deliberately targets.
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 momentous consequences.
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 denialists.
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 it.
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+
Message-Id: <200305091654.h49Gsuq00511@marduk.africapolicy.org> From: "Africa Action" <email@example.com> Date: Fri, 9 May 2003 12:55:16 -0500 Subject: South Africa: AIDS Denialism Speech
Editor: Ali B. Ali-Dinar
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