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Foreword by Zackie Achmat viii
Acknowledgements x
Abbreviations xi
Chapter 1 Ideas Matter 1
Origins 2
Key themes 10
Chapter 2 AIDS Science and the Problem of AIDS Denialism 15
The science of HIV and ARV treatment 18
AIDS denialism 22
The Mbeki connection 33
Chapter 3 AIDS Policy prior to the Mbeki Presidency 38
AIDS policy during the transition to democracy 39
AIDS policy during the Mandela presidency 40
The Treatment Action Campaign (TAC) 45
Mbeki's early contacts with AIDS denialists 47
Ambiguities of AIDS policy during the Mandela presidency 50
Chapter 4 Mbeki's Questioning of AIDS Science 54
Opposing AIDS science 55
Growing opposition to Mbeki's stance 67
Governance and AIDS: TAC takes on the pharmaceutical companies 78
Some reflections on Mbeki's stance on AIDS 80
Chapter 5 The Fight for Antiretrovirals: 2001-2003 91
Cause-of-death statistics 92
Legal action over MTCTP 95
Growing political resistance to Mbeki and the Health Minister 100
TAC continues the struggle for lower drug prices 104
Civil disobedience 108
The cabinet revolt 118
When ARVs are rejected, what then? 120
Chapter 6 Rolling out HAART: 2004-2006 128
HAART coverage in South Africa 131
The rollout of HAART in the public sector 133
Budgeting for the public-sector rollout 134
Have there been 'sufficient' public-sector resources for the rollout? 135
Achievements and missed opportunities during the Mbeki presidency: Costs and benefits paid in human lives 136
Continuing pressure 138
Chapter 7 Treatment Anarchy 142
The confusing discourse of 'choice' 143
Support for purveyors of scientifically untested alternatives to ARVs147
Undermining the scientific regulation of medicine 155
Of culture and neutrality 164
TAC treatment literacy 166
Chapter 8 The Last Front: Defending the Scientific Regulation of Medicine 169
The political context: Challenges to Mbeki's authority 169
The Madlala-Routledge factor 172
Mobilising international opinion 174
Where to now? 180
Appendix 1 AIDS Policy Timeline 185
Appendix 2 Letter to Mbeki from HIV Scientists 197
Notes 204
References 233
Index 252
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Martin Pelletier
reviewed Mortal Combat: AIDS Denialism and the Struggle for Antiretrovirals in South Africa on April 13, 2008 Mortal Combat
I read this book hoping for a general overview of what bioethics is all about. This book is not that. However, it is an interesting and exceptionally well thought out series of essays on several contemporary ethical issues within the scientific community. At heart, the author is a lawyer, so I believe much of the language could have been simplified and condensed, but aside from that and some unnecessary swipes at a former President, this is an excellent book which will definitely challenge your thinking, and may even change your points of view.
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