An opinion piece in the British Medical Journal on disease denialism in the US.
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In the early 2000s, I worked, and for part of that time lived, in South Africa. Those were the years of AIDS denialism, when the President of the Republic, Thabo Mbeki, rejected mainstream views about HIV/AIDS, denying that the human immunodeficiency virus caused the disease and that antiretroviral therapy, saving lives around the rest of the world, was akin to poison. The entire state apparatus was overhauled to ensure that the President’s views became national policy, with his health minister Manto Tshabalala-Msimang, following Mbeki’s lead on HIV and suggesting that beetroot, garlic, lemons, and African potatoes were better than AIDS drugs for the disease, while quack cures like Virodene got championed by President Mbeki and his Deputy President Nkosazana Dlamini-Zuma. Most of the provincial leaders followed suit, except in the Western Cape where activists from the Treatment Action Campaign, doctors and nurses from Médecins Sans Frontières, and the provincial health department started a programme to get antiretroviral drugs to the people who needed them. After Thabo Mbeki resigned in 2008 after almost ten years in office, a Harvard University study estimated that over 350,000 deaths were attributable to the refusal of his government to provide AIDS treatment to his citizens. South Africa rebooted its AIDS response quickly after his departure and now has the largest AIDS treatment programme in the world.
If Thabo Mbeki had his Manto Tshabalala-Msimang, Donald Trump has found something of an equivalent in the shape of Scott Atlas, from Stanford’s Hoover Institution. Atlas was the subject of a scathing piece in the Washington Post in late August, which reported that he has championed the idea of sequestering the elderly and letting the coronavirus rip through the rest of the nation, akin to the Swedish “herd immunity” model which was tried unsuccessfully earlier this year, and in which deaths mounted and the economy suffered, even though this laissez-faire approach was supposed to ameliorate both. After the Washington Post story, Atlas claimed he was being misrepresented and that there was no White House policy to achieve herd immunity. But, there seems to be no question that he has pushed for decreasing testing of asymptomatic people even if they have been exposed to someone with covid-19, and has repeatedly pushed for schools and colleges to reopen and for lockdown orders to be lifted. If Sweden’s approach to “herd immunity” was a failure, trying anything like it in the US, with its patchwork of a healthcare system, and with millions of people without healthcare insurance and living with underlying conditions which predisposes them to serious complications from covid-19, is likely just to pile disaster upon disaster.
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