Anthony Mbewu is made director of GFHR: Is this an appropriate appointment?

Anthony Mbewu with Matthias RathAnthony Mbewu, the current President of the Medical Research Council of South Africa (MRC), has been appointed the Executive Director of the Swiss-based Global Forum for Health Research (GFHR).

The South African government under former President Mbeki and former Health Minister, Manto Tshabalala-Msimang, pursued an AIDS denialist ideology that was responsible for at least 300,000 premature deaths and tens of thousands of preventable HIV infections. [1-2] Mbeki and Tshabalala-Msimang were the main protagonists in this crime against humanity. But there were several politicians and civil servants whose actions and inactions helped extensively. Anthony Mbewu was one of them. An appointment to a top position in Geneva hardly seems appropriate for someone with his questionable track record. This included misrepresenting the relative importance of HIV as a cause of death, supporting the vitamin salesman Matthias Rath, playing down the known benefits of antiretroviral treatment, promoting absurd conspiratorialist thinking and over-promoting multi-vitamins and traditional medicine as potential responses to AIDS.

Matthias Rath, with the support of Tshabalala-Msimang, conducted unauthorised experiments on people with HIV, imported and distributed his products unlawfully and claimed multivitamins alone reversed the course of AIDS, in contrast to antiretrovirals which he claimed were toxic. Anthony Mbewu helped establish Rath's presence in South Africa.

Rath at the MRCIn 2004, Mbewu had a series of meetings with Rath that led to Rath giving a workshop and committing to pay R200,000 to the MRC, of which over R60,000 was eventually paid. The minutes of the meetings with Rath are illuminating. They include plans to run a clinical trial using multivitamins to treat cancer. At one point the minutes record Mbewu stating, “NAPWA (National Association of People with Aids) [is a] good group. TAC [Treatment Action Campaign] is paid by pharma cartel. NAPWA has an open mind and will be an great advocacy tool as a counter-balance to attack.” NAPWA was a corrupt organisation that served Manto Tshabalala-Msimang's interests by opposing antiretroviral treatment. TAC, the organisation that led the campaign for antiretrovirals, never received money from pharmaceutical companies and eventually won an interdict against Rath for propagating this claim.

The minutes are replete with pseudoscientific assertions and evince an AIDS denialist agenda. There is additional questionable behaviour: In one meeting Mbewu introduced Rath to Denova, a marketing company of which Mbewu's wife, Priscilla Reddy (also an MRC employee) was a director. [3] (This reference has links to meeting minutes, commitments to pay and photos of Rath and Mbewu.)

Mbewu presented on HIV to the Parliamentary Health Portfolio Committee on 16 March 2005 and stated:

The importance of nutrition in mitigating the impact of HIV and AIDS cannot be understated. The Tanzanian/Harvard University clinical trial by Fawzi et al published recently in the New England Journal of Medicine is a case in point. This blinded, randomised controlled clinical trial showed that amongst over 1000 HIV positive women; those assigned to receive daily multivitamin over the subsequent 5 years showed a 30% reduction in death and progression to AIDS compared to those who did not receive multivitamin. This implies that multivitamins can reduce the socioeconomic impact of HIV and AIDS by both reducing the annual death rate, as well as reducing the rate at which patients deteriorate to the point of needing active medical care. In addition, the widespread use of traditional medicines in AIDS could have direct benefit, if efficacious in reducing mortality; as well as indirect benefit in stimulating the industry of producing and distributing natural medicines.

He then stated:

Little is known about the length of survival of patients on antiretroviral therapy in resource poor settings. Data from ACTG studies in the USA, using regimens similar to those we use in South Africa suggest that median survival once started on ARVs is likely to be of the order of several years but this is very tentative.

As the TAC has explained, “these statements are misleading. He has contrasted multivitamins with antiretrovirals and in effect argued that there is more reliable evidence of the usefulness of multivitamins than antiretrovirals. This is false. The opposite is actually the case. Little is known of the effect of multivitamins on people with HIV. While Mbewu correctly identifies that a Tanzanian study found them to be beneficial, he fails to point out that these benefits were small relative to antiretrovirals. He claims little 'is known about the length of survival of patients on antiretroviral therapy in resource poor settings', while actually little is known about the survival benefits of multivitamins and a lot is known about the survival benefits of antiretrovirals in resource poor settings.” [4]

Mbewu and Rath enjoying dinnerMbewu also cast doubt on the size of the AIDS epidemic at a point when denialist scepticism was crucial to President Mbeki's resistance to introducing ARVs. He has been quoted stating, “The nation is in poor health, with just as many if not more deaths from heart disease and strokes than AIDS ... AIDS is a major problem, but heart disease and strokes are much bigger.” [5] Yet the claim that “heart disease and strokes are” a much bigger problem than AIDS had been shown to be false by a report published by the MRC. [6] (See also Professor Solly Benatar's criticisms of Mbewu's statements about AIDS mortality. [7])

The GFHR press release announcing Mbewu's appointment describes one of his achievements: “In 2003 he chaired the Task team that developed South Africa’s Comprehensive Care, Management and Treatment for HIV and AIDS programme that has enrolled 871 914 patients on antiretroviral therapy.” [8]

The statement is either cynical or callous. It shows a poor knowledge of the history of AIDS denialism in South Africa and appears designed to whitewash Mbewu's discreditable role in fostering it. This task team was appointed after a massive campaign by civil society led by the Treatment Action Campaign (TAC) to get the South African government to develop a treatment plan. It included several large marches as well as civil disobedience in which activists were beaten up, arrested and sprayed with water cannons. Finally the Cabinet relented and while Mbeki was out of the country, it ordered Tshabalala-Msimang to produce a treatment plan. Mbewu was appointed to head the task team by Tshabalala-Msimang because he was a politically reliable ally, the commissar whose job it was to ensure that the people doing the committee's real work were watched and controlled (thankfully not very successfully). To imply that Mbewu was responsible for South Africa's antiretroviral programme is a grave insult to the people who actually made the programme happen. The mealy-mouthed language and nutritional pseudoscience that made it into the report were Mbewu's doing.

GFHR describes itself as “an independent, international organization committed to demonstrating the essential role of research and innovation for health and health equity, benefiting poor and marginalized populations.” We question whether the appointment of Anthony Mbewu is consistent with that mission and call on GFHR to require Mbewu to account for his questionable and discreditable history.

References

1. Nattrass, N. 2008. AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa. African Affairs 2008 107(427):157-176. http://afraf.oxfordjournals.org/cgi/content/abstract/107/427/157 ^back^

2. Chigwedere, P. et al. 2008. Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa. JAIDS Journal of Acquired Immune Deficiency Syndromes. 49(4):410-415, December 1, 2008. http://journals.lww.com/jaids/pages/articleviewer.aspx?year=2008&issue=1... ^back^

3. TAC. 2006. Release of Documents showing collusion between some government officials, including MRC Head Anthony Mbewu, and Matthias Rath. http://www.tac.org.za/community/node/2203 ^back^

4. TAC. 2006. Submission to African Peer Review Mechanism. http://www.tac.org.za/Documents/AfricanPeerReviewMechanismReportFinal-20... ^back^

5. Pretoria News, 17/2/2005. Quoted in TAC Submission to African Peer Review Mechanism. ^back^

6. Dorrington et al. 2001. The impact of HIV/AIDS on adult mortality in South Africa. http://www.hst.org.za/publications/452 ^back^

7. SAPA. 2005. MRC Man's statement supports AIDS denial. http://70.84.171.10/~etools/newsbrief/2005/news0211.txt ^back^

8. Global Forum for Health Research. 2009. Appointment of new Executive Director: Prominent South African researcher to head Global Forum for Health Research http://www.globalforumhealth.org/Media-Publications/Archive-news/Appoint... ^back^