[CAPE TOWN] A Namibian legal activist has expressed dismay that controversy raging in South Africa over the efficacy of vitamins as a treatment for HIV/AIDS has reached his country.
Delme Cupido, coordinator for the AIDS Law Unit of Legal Assistance Centre — a Namibian public interest law centre — wrote a letter published today (20 May) in The Namibian in response to an advertisement placed in the newspaper last Friday (13 May).
The advertisement, which Cupido says was portrayed as a reprint of an article in the New York Times, promoted the views of German-born doctor Matthias Rath that vitamins are a more effective treatment for HIV/AIDS than antiretroviral (ARV) drugs are.
"It is simply irresponsible and unethical to tell people who require ARVs in order to stay alive, that they should abandon treatment and use vitamins alone to fight HIV," writes Cupido.
"Not only does this harm individual patients, but it also sows a dangerous confusion in the minds of people living with HIV, [and] decision makers and the general public," says the letter. "This is something that we cannot afford, and will not countenance."
Rath has for been lobbying for the past year against the use of anti-retroviral medicines in South Africa, maintaining that the drugs are toxic and that people calling for greater access to them are the paid lackeys of pharmaceutical companies.
He argues that HIV-positive people should instead take vitamins, which he claims can also cure cancer, heart disease, and diabetes.
Rath's activities are alarming the South African medical profession, which has struggled to increase the availability of AIDS drugs.
Although it is now government policy to provide free anti-retroviral drugs at clinics and hospitals, the latest official figures show that only a small proportion of the people who need the drugs are getting them.
An estimated five million South Africans have HIV. About 500,000 need AIDS drugs, according to the Actuarial Society of South Africa, yet only 42,000 get the medicines at state facilities.
Rath has published full-page advertisements in South African newspapers, the New York Times and the International Herald Tribune, highlighting the results of research he says he has carried out in Cape Town's Khayelitsha township.
The advertisements say his vitamins boosted the immune systems of 18 AIDS patients who had never taken anti-retroviral medicines.
Rath has not published his results in a peer-reviewed journal. He said last week that he believed the results were so important that they could not wait for the lengthy peer review process, and it was in the public interest for him to take his results straight to the press.
The Treatment Action Campaign, an AIDS activist group, alleges that Rath has been conducting an unregistered, and therefore illegal, clinical trial in Khayelitsha. Rath counters that his research is on vitamins, which are not classed as medicines, and so he does not need to register a clinical trial.
The South African Medicines Control Council and the Department of Health are investigating Rath's activities but are not prepared to comment on the matter until their probe is complete.
Rath is not registered as a doctor with the Health Professions Council. Both the South African Medical Association and the Southern African HIV Clinicians Society have denounced him, but government officials and regulatory bodies such as the Medicines Control Council have remained silent.
Health minister Manto Tshabalala Msimang has defended Rath, saying his advocacy of vitamins supports the government's view that they are integral to combating HIV.
But Rath has been condemned by researchers from the Harvard School of Public Health in the United States, who say he has distorted the findings of their research into the benefits of vitamins for HIV-positive people in Tanzania to advocate his position.
The World Health Organisation, UNICEF and UNAIDS have also criticised Rath, saying his advertisements are misleading, and distancing themselves from his claims that they supported his nutritional approach.
The South African health minister has generated renewed controversy as well, over her advocacy of garlic, olive oil, and lemon juice as tools for fighting HIV. She has not provided any details of scientific studies to back up her claims about the benefits of these products.
She recently appeared in a video produced by local nutrition therapist Tina van der Maas, which shows sick patients making apparently miraculous recoveries after receiving various nutritional mixtures. Van der Maas says she has no plans to publish the results of her work, as "she does not have [an academic] title, and you need a title to publish".