Cognitive dissonance as an explanation of the genesis, evolution and persistence of Thabo Mbeki's HIV denialism

The ongoing damage that the newer forms of HIV denialism are visiting upon our country is evidenced by the recent firing of Nozizwe Madlala-Routledge, the South African Deputy Minister of Health. It is widely believed that the underlying reason for her dismissal was her support of orthodox HIV treatment and prevention strategies and her disdain for HIV denialism. This paper seeks to understand the origins, spread and metamorphosis of President Thabo Mbeki's HIV denialism in South Africa. Using the theory of cognitive dissonance, I argue that, given the structural beliefs of the African National Congress (ANC) and the pattern of emergence of HIV in the 1980s, a degree of scepticism around the putative science of HIV was probable in ANC circles. On assuming the Presidency in 1999, Mbeki tapped into this scepticism to formulate his initial biological version of HIV denialism, which claimed that ‘a virus can't cause a syndrome.' The steady erosion of support for this flagrant HIV denialism, together with the rise of neoliberal thinking in the ANC, would lead to the evolution of this biological denialism into a form of treatment denialism. This ideology argued against the widespread provision and use of antiretroviral treatment. Empirical evidence is presented to demonstrate the extent to which ongoing HIV denial in the general population is continuing to fuel the spread of HIV. Keywords: antiretrovirals, causes, HIV/AIDS, neoliberalism, policy, political aspects, South Africa, treatmentAfrican Journal of AIDS Research 2008, 7(1): 29–35