The Capes of Rath

He's a bastard, in't he?

By Calum Nelson, MPharm

In South Africa there’s a popular comedian called Matthias Rath. Here’s one of his jokes:

“Patient: Doctor Doctor, I’m worried about transmitting HIV to my unborn baby.

Doctor: Don’t worry, just have some potatoes. Whatever you do, don’t take any poisonous anti-viral medicine which will actually cause AIDS.”

It’s a screamer eh? Ok, I lied. Matthias Rath is actually a doctor from Germany, not a comedian, and some might also say he’s a serial killer. Not a serial killer in the Harold Shipman way, but his practices have almost certainly led to the deaths of thousands of South Africans.

South Africa is a nation with a massive HIV/AIDS crisis. It is currently estimated that 11% of South Africans are HIV-positive. This means that if you walk down a busy street in South Africa, chances are 1 in every 10 people you see has HIV. This changes by province; in KwaZulu-Natal the rate goes up to 26%. With a disease this widespread, anyone able to market a treatment might end up very rich very quickly and it appears that Matthias Rath also knew this.

Having studied medicine in his native Germany, Rath went into research in California. It was here that he started making claims about the use of high dose vitamins in treatment of cardiovascular disease. He began suggesting that conventional cancer treatments should not be used as they kill patients and that they should instead take Rath’s vitamin supplements. His books developed an impressive readership throughout Europe and he sold lots of interestingly priced vitamins. Despite being criticised and fined throughout Europe for claiming his pills could cure cancer, he developed an impressive following and an impressive bank balance, allowing him to try and break South Africa. Well he broke it alright.

With all guns blazing he filled newspaper pages with his claims. “Antivirals are a conspiracy by the pharmaceutical industry to poison you. Vitamins are the true solution to AIDS. Stop taking your antivirals right now…RIGHT NOW. STOP IT. STOP TAKING THEM. SPIT IT OUT. Now don’t let me catch you doing it again.” Ok, so those weren’t his exact words, but they might as well have been. Soon he was conducting trials, recruiting poor black township residents with promises of money or food. The patients were told to stop taking their antivirals and were instead given high doses of vitamins. Guess what happened. Guess. Everyone was actually fine and they all lived happily ever after. Sorry, typo, what I meant to say was that a considerable number of the study participants quickly deteriorated and died. The South African High Court eventually found that Rath’s trial was illegal. This could have ended up being an unfortunate isolated incident in which a doctor with crazy ideas performed an unethical trial. Thousands of lives may have been saved if one of Rath’s supporters didn’t just happen to be the President of the Republic of South Africa.

And so it came to pass that thanks to Matthias Rath, a country with one of the highest HIV rates in the world was telling people to take African potatoes and garlic instead of antivirals. The country refused to roll out antiviral treatment programmes; they turned down grant money intended for the purchase of HIV medication and even turned down donations of drugs. Presidential advisors recommended banning HIV tests and denied any knowledge of an AIDS epidemic in Africa. President Thabo Mbeki himself repeatedly denied that HIV is the sole cause of AIDS and his health minister Manto Tshabalala-Msimang repeatedly praised Rath’s work and publicly decried antiviral therapy as being dangerous and counterproductive. Overall it’s estimated that around 330,000 people died unnecessarily in the space of 5 years thanks to the government’s policy on antivirals.

Naturally these policies encountered opposition; the Western Cape province ignored governmental advice and continued to supply antiretrovirals. Groups such as Treatment Action Campaign (TAC) did their utmost to get HIV medication to those in need. This resulted in Anthony Brink, a colleague of Rath, taking TAC to the International Criminal Court in The Hague, accusing them of genocide. In his indictment Brink set out what he believed to be an appropriate punishment for Zachie Achmat, the founder of TAC:

“APPROPRIATE CRIMINAL SANCTION

In view of the scale and gravity of Achmat’s crime and his direct personal criminal culpability for ‘the deaths of thousands of people’, to quote his own words, it is respectfully submitted that the International Criminal Court ought to impose on him the highest sentence provided by Article 77.1(b) of the Rome Statute, namely to permanent confinement in a small white steel and concrete cage, bright fluorescent light on all the time to keep an eye on him, his warders putting him out only to work every day in the prison garden to cultivate nutrient-rich vegetables, including when it’s raining. In order for him to repay his debt to society, with the ARVs he claims to take administered daily under close medical watch at the full prescribed dose, morning noon and night, without interruption, to prevent him faking that he’s being treatment compliant, pushed if necessary down his forced-open gullet with a finger, or, if he bites, kicks and screams too much, dripped into his arm after he’s been restrained on a gurney with cable ties around his ankles, wrists and neck, until he gives up the ghost on them, so as to eradicate this foulest, most loathsome, unscrupulous and malevolent blight on the human race, who has plagued and poisoned the people of South Africa, mostly black, mostly poor, for nearly a decade now, since the day he and his TAC first hit the scene.

Signed at Cape Town, South Africa, on 1 January 2007

Anthony Brink”

Fortunately Rath’s heyday is over in South Africa. Manto Tshabalala-Msimang was replaced as health minister and Mbeki was replaced as president by Kgalema Motlanthe, who stated that “the era of AIDS denialism in South Africa is over.” Despite this, a massive amount of damage was done by Rath and the other AIDS dissidents in South Africa. The lack of HIV medication is estimated to have caused 35,000 babies to have been unnecessarily born with HIV and 171,000 preventable HIV infections. Antiviral medication is difficult enough for the poorest to afford at the best of times thanks to prohibitive pricing by the pharmaceutical industry and so extra restrictions are likely to have a devastating effect. Purely for the sake of money and advancing his own career, Rath destroyed thousands of lives and thousands of families across South Africa. In a similar fashion to our own MMR scare, irresponsible claims made with a lack of evidence proved dangerous and the importance of examining evidence is once again demonstrated.