South African AIDS activist dies as a result of quackery

The Economist:

AT THE dinner held last June to celebrate the budget speech of the health minister of KwaZulu-Natal, one guest stood out. Among the politicians crammed into the premier's house in Parkside, Pietermaritzburg, celebrating the first increase in health funding for seven years, was a young woman in a stunning red dress and two rows of black and white beads. Her straightened hair had been streaked with blonde highlights, and her skin glowed.

This picture of health was Nozipho Bhengu, and she had full-blown AIDS. For the past two years she had been campaigning round the townships and clinics of the region, hoping to remove the stigma from the disease and to assure victims they could get help. The help she meant, however, was not better distribution of antiretroviral drugs (ARVs) but a different, homelier treatment. As a young, scared AIDS patient herself, she had been influenced by Manto Tshabalala-Msimang, South Africa's health minister, to think that ARVs were toxic and not particularly useful. A better way to deal with HIV (if it caused AIDS at all, and was not just some invention of racist Western minds) was with supplements and proper food.

The secret of Miss Bhengu's success was a strange, pinkish mush that she made up each day in a liquidiser. First garlic, two cloves of it, and ginger, to treat infections. Then lemon juice and peel, to detoxify the body and fortify the liver. Beetroot for the blood. A cup of Pronutro cereal, for selenium. Paw-paw and watermelon for vitamins and to improve the taste. Occasionally carrots, spinach and yogurt. And then a good shot of Africa's Solution, a brew of plant extracts that came in a bottle with a green, black and yellow label, the colours of the ruling African National Congress, and promised “a positive life”. This concoction, she believed, had made her well.

Miss Bhengu's efforts to treat her illness had been public property since 2001, when her mother, an ANC legislator, had talked about her in a speech to Parliament. Nozipho was that rare thing, a young middle-class woman whose illness had been openly admitted. (How much worse it would have been for her, her mother said, if she had been in some “informal settlement”, without a warm blanket to cover her, or soap to wash her clothes and body.) She became a symbol of the universality of a disease that affects 6.5m South Africans, one in five adults, and kills around 900 a day. But, even more so, she became a symbol of the confusion over how AIDS ought to be treated.

She had been diagnosed HIV-positive in 1998 and taken to hospital in 2003, by that time with galloping AIDS. Her liver was inflamed, and there was a growth on her spleen; her CD4 count, a measure of immunity, was 55, against the normal measure of 600. It seemed she would die, but she was almost as terrified of the drugs the doctors wanted her to take. She dreaded the side-effects of ARVs, the headache and nausea and skin rashes; for a week she tried them, but her body could not cope. At that point, “Manto” came to see her and recommended — as she had done for several other politicians' relations — a change of course. As she put it, reassuringly, “I do not know of any side effects of eating proper food.”

The new diet was provided by a former colleague of the health minister's, Tine van der Maas, who had briefly been a nurse and had then become a self-taught nutritionist. Her presence, too, reassured Miss Bhengu: a big middle-aged Dutch woman, flopping about barefoot in casual shirts and trousers, confident that her diet could cure diabetes, arthritis and cancer, as well as AIDS. Miss van der Maas insisted that her patients should do exercises, crying “Up! Up!” in her strong Dutch accent as they weakly raised their arms; but the medicine she brought was no more scary than bulging bags of vegetables. After three months, Miss Bhengu's CD4 count was up to 135. Delightedly, she told interviewers she was “the scientific proof” that the diet worked.

She knew that the Treatment Action Campaign (TAC), the main pressure group for a proper antiretroviral programme, dismissed the diet as quackery. For a while, before she was ill, she had attended their meetings. But her illness, combined with political pressure, changed her mind. She entered the realm of hope and anecdotes, where AIDS sufferers trusted to live longer by swigging from bottles of Ubhejane, or African potato extract, the recipe for which had been imparted to a truck-driver in a dream; or where Jacob Zuma, former deputy president of the ANC, hoped after sex with an HIV-positive woman to wash off infection in the shower.

At Miss Bhengu's funeral on May 24th the arguments raged on. Manto was invited, but had another engagement. Her stand-in was booed off the podium for mocking Mr Zuma's shower. The TAC announced that had Miss Bhengu taken drugs, she would have lived longer. Her parents defended her “democratic right” to opt for lemons and garlic. Not long before, the head of health for KwaZulu-Natal announced that he might start trials of the diet in the region's hospitals.

When she died, Miss Bhengu was writing a book called “From Victim to Victor”. She had just two chapters to go.

TAC statement on the death of Nozipho Bhengu

Garlic 'cure' rekindles AIDS row