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Social History of Medicine Advance Access published online on October 31, 2006
Social History of Medicine, doi:10.1093/shm/hkl077
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© The Author 2006. Published by Oxford University Press on the behalf of the Society for the Social History of Medicine. All rights reserved

Article

The Politics of Uncertainty: The AIDS Debate, Thabo Mbeki and the South African Government Response

Kiran van Rijn


  Abstract

Shortly after becoming President of South Africa in 1999, Thabo Mbeki began to seek non-mainstream advice about his nation's AIDS epidemic; a number of those consulted were outspoken in denying the causal link between HIV and AIDS. In response to Mbeki's actions, over 5,000 scientists signed the ‘Durban Declaration’, which declared HIV to be the cause of AIDS, and which appeared in Nature shortly before the thirteenth AIDS conference, held in Durban, South Africa, in July 2000. The government position and strategy were not completely resolved until July 2002, when the Constitutional Court effectively compelled the government to provide anti-retroviral medication to all HIV-infected pregnant women. Mbeki's public remarks, in essence, can be interpreted as seeking to promote an understanding of AIDS in Africa in terms of epidemiology, rather than virology. Throughout this episode, different interpretations of AIDS served to advance different moral and political courses of action. The ability of medical science to compel political action depended on whether that science was understood to be conclusive or uncertain, objective or value-laden, disinterested or tied to vested interests. Mbeki (along with AIDS sceptics) tested conventional AIDS science for these qualities. By examining the politics of uncertainty, we learn about the politics that sustain certainty.

Keywords: HIV-AIDS; Thabo Mbeki; South Africa; Durban Declaration; politics; uncertainty; dissident; epidemiology; virus; science.
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