Understanding AIDS is South Africa
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It was in 1998 that South Africa's then Deputy President Thabo Mbeki took the bizarre stance that HIV, the virus, does not cause AIDS, but that AIDS, like hunger, is instead purely the result of poverty. By focusing debate on the disease—whether HIV is the cause of AIDS—Mbeki focused it away from implementation policy: whether the state should pay for the roll out of anti-retroviral medications to pregnant mothers, rape victims, and the population as a whole. Why should Mbeki have chosen to turn the debate from implementation policy to the nature of scientific explanation per se? What was behind his adamant claims that western science is in danger of imposing its findings upon Africa in some neo-colonial gesture? Mbeki had consulted so-called AIDS dissidents in the U.S., including Charles Geshekter, a professor of African history at California State University, Chico, about the relationship between scientific practice, scientific truth, African history, and colonialism. The result was Mbeki's belief that since science has deeply perpetrated itself into the history of colonialism, therefore scientific practice and scientific truth are nothing other than cultural constructions—at the same level as other representations and signs of western history. Africa, he came to think, would have to find its own scientific cures, since its diseases were different (distinctively African in symptomatic configuration) and its knowledge systems were unique.
By discovering specific forms of African symptomatology, Mbeki would have shown, he believed, that HIV is caused by poverty, thus assimilating science to development theory. For those symptoms of what would be classified as a specifically African form of AIDS would be the classic symptoms of the poor—tuberculosis, sexually transmitted diseases, etc. What Mbeki seemed to want was a reduction of theory acceptance to cultural values and communities, a regionalization of science both in terms of specifically African disease types and specifically African solutions. Since theory acceptance was a cultural matter, it would become possible for the state to broker an "agreement" between disputing theories and practitioners, which is exactly what it tried to do when it invited the dissidents and the scientific community to Pretoria to "work things out." Naturally, these groups had nothing to say to each other. But the presumption was that the state could assert negotiation power over knowledge production which would then be called "African."
It may well be that the knowledge issue has been a disguise for a more insidious agenda. Rolling out anti-retroviral medications to pregnant mothers cuts fetal transmission dramatically. Doing that means the mothers die and the children live...live to become orphans with miserable lives. The choice is therefore horrible in its starkness: either one denies anti-retrovirals to pregnant mothers, guaranteeing an early death to their children, or one floods the society with motherless children for whom nobody can care. If this is the choice—millions of orphans living degraded, suffering lives and causing social havoc or their quicker deaths—and if you choose the latter, you had better never say that in public. Transparent debate about the Malthusian issue is impossible in a post-apartheid state genuinely committed to human rights because the choices are so stark. So what you do is create a smokescreen. Instead of facing the terrible social issue, you create havoc in the halls of science by denying that HIV causes AIDs.
I am not saying this has been the government's position; I am saying I suspect it has been. Meanwhile, the government was successfully sued in the Constitutional Court by the Treatment Action Campaign on the grounds that its failure to roll out anti-retrovirals constituted a massive human rights violation against its own citizens. Still, the government is stalling.
The question of epistemology—who is entitled to what knowledge claim on what basis—is everywhere apparent in the AIDS debate, and with the gravest possible results. Mbeki has gone too far in applying the postcolonial, development theory he learned in his M.A. class at Sussex University and in turning the rhetoric of leftist development economics and postcolonial theory into rhetoric reducing knowledge to colonial politics. But what are the terms by which one criticizes this? The implications are vast. Those postmodernists in the philosophy of science who believe that the results of science cannot be justified on the basis of some rigorous procedure or another, and who also believe that science is finally a matter of social practice—nothing more and nothing less—open the door to a Mbeki who agrees. His stance is that science is just social convention, and he doesn't want to depend on the social conventions of former colonizers, the European community. He wants an African consensus about scientific truth which reflects their needs. There is a lot to be said for the postmodernist position that scientific truth has no ultimate justification beyond social practice. Given that, how do you refute Mbeki? By forcing the consensus of scientists down his throat? But he has come up with other scientists who do not agree with the consensus position, scientists at respected universities. Mbeki might very well say live and let live. You have your scientists; I have mine. This is my continent; don't force western values onto it any longer. I'm sick and tired of you. Happily, huge numbers of people on his continent do not accept his position, and the fights rage on in South Africa.
Mbeki's hubris reflects the desire of a post-colonial country to refuse global knowledge systems—those of science—in the name of articulating its own independent project. New nations bred out of massive historical lacerations and long periods of injustice often claim new identities through radical rejection of global norms, disdaining global norms as colonial subjugation. Frantz Fanon, post-colonial activist and writer, said it many years ago when he spoke of the dialectical swing between slavish identification and excessive rejection new nations often exhibit. No one knew better than Fanon how the global south has been placed in the position of passive recipient.
Many people have spoken out strongly against the Mbeki position, most significantly Nelson Mandela. The government has reneged on its position in light of the Treatment Action Campaign's successful lawsuit, but still waffles about the roll out of anti-retrovirals.
Scholarship at South African universities has the challenge of renegotiating its out-of-date Marxist/liberal epistemologies and learning to speak against the state from within a human rights partnership. This critique requires the invention of new concepts and activist stances. Many interesting things are happening in the social sciences and the humanities within South African universities. However, both also remain pressed by the same forces that motivate Mbeki: neo-colonial dependency on the north, a desire to assert independence from the north through the setting forth of exaggerated ideas, and lack of capacity which forces dependency on theory and methodology from the north that often doesn't fit well with southern realities. Such dependency, combined with the exaggerated assertion of independence, obtains within the state, university, and policy sectors, and prevents the achievement of full independence of mind for South African universities and society at this critical juncture in the transition to democracy.
Daniel Herwitz is director of the Institute for the Humanities, Mary Fair Croushore Professor of Humanities, and professor in the School of Art and Design at U-M. From 1996-2002 he was chair in philosophy at the University of Natal, Durban, South Africa. Parts of this article are adapted from his book Race and Reconciliation (Minnesota, 2003).