Aids and Poverty: Doctors in Africa Appear to Have Forgotten That Many of the Sick They Encounter Have Always Satisfied the Bangui Definition of Aids. (Medical/Aids)

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That tuberculosis (TB) is a disease largely associated with destitution and poverty is beyond dispute. Its prevalence diminishes as social and economic conditions improve.

Sub-standard housing, shacks and overcrowding favour the risk of massive infection or re-infection. Eighty per cent of South Africa can still be described in this way today since the inequalities of the imperialist and apartheid eras still define the country.

When one looks at the history of South Africa, it is difficult, if not impossible, not to conclude that the current debate on HIV/Aids is dominated by medicalisation of diseases of poverty. Doctors and most other health professionals find it difficult, if not impossible, to deal with health-related issues without medicalising them.

The HIV/Aids orthodoxy claims with little substantiation that what we are seeing in Africa since 1983 is new. Regrettably, insidiously and tragically, this helps all the guilty to forget the history of apartheid and three centuries of colonial conquest and imperialism. I shall confine myself to South Africa.

In a recent polemical review, Prof Peter Duesberg and Dr David Rasnick (both members of the Mbeki Aids Panel) returned to the now discarded drug hypothesis -- that the use of recreational drugs is the common denominator of Aids in America and Europe.

They reminded us that before the popularisation of the virus -- HIV/Aids hypothesis -- many American and some European investigators had postulated that the epidemic was a collection of drug and lifestyle diseases.

The correlation between immunodeficieney and poverty, malnutrition, poor sanitation, urban squalor and rural and urban unemployment cannot be denied. We have now had almost 20 years of HIV/Aids, and because of the almost exclusive biomedical approach, other questions are not being asked as frequently as they should.

Doctors in Africa appear to have forgotten that many of the sick they encounter have always satisfied the Bangui definition of AIDS (ie, chronic cough, diarrhoea, fever, TB and weight loss) even long before HIV.

Indeed undergraduate medical students and qualified health professionals read from their recommended manuals that immunodeficieney may be caused by malnutrition.

In Africa, the problem may even be worse than malnutrition -- ie, "chill penury" (destitution and poverty). Nutritionally Acquired Immune Dysfunction Syndrome (NAIDS) is well recognised in many medical textbooks.

The syndrome includes several other known conditions, which lead to immunodeficiency. It is known that starving and malnourished children mostly exposed to poor environmental conditions are particularly susceptible to respiratory and gastro intestinal infections and septicaemia.

With regard to the medical history of South Africa long before Luc Montagnier's HIV/Aids 'discovery", Prof John Reid of the Durban Medical School noted that 50% of black children in rural areas of South Africa died before the age of five. …