By Vusi Moloi © 2009
A liberation icon, a medical doctor, former Minister of Health and an impressive linguist who boasted an impeccable command of languages of the world like Russian, Swahili, Zulu, English and more died yesterday at 2:27PM South African time at the University of Witwatersrand Donald Gordon Medical Centre and Medi-Clinic ICU in Johannesburg. Dr. Mantombazana Tshabalala-Msimang died due to complications with a liver transplant she had received back in March 2007 according to published reports attributed to her son in law who requested family privacy Martin Kingston. The African National Congress has published a tribute to Dr. Tshabalala-Msimang on their
website.
Indefatigable WarriorDr. Tshabalala-Msimang was an indefatigable fighter on behalf of her people. She consistently advanced the interests of the African natives even in the face of fearsome opposition. Faced with the HIV and AIDS crisis which clipped the wings of population growth in South Africa, Dr. Tshabalala-Msimang went against the Holy Grail when she challenged the pharmaceuticals and the pharmacists to reduce the cost of medicine in order to make medical care accessible to those who could least afford. The pharmaceutical establishment challenged her in court. The cases like
New Clicks South Africa (Pty) Ltd versus Tshabalala-Msimang and Pharmaceutical Society of South Africa and Others versus Minister of Health and Another in 2005 were soundly defeated and the state was awarded the costs. Subsequent appeal to the Supreme Court in Bloemfontein overturned the previous judgements. The unfazed Dr. Tshabalala-Msimang fought back via the Constitutional Court which ruled in her favour and settled the matter once and for all.
Traditional Health Practitioners ActBoasted by these hard won victories Dr. Tshabalala-Msimang introduced the Traditional Health Practitioners in 2007 which sought to provide a legal status of recognition to the traditional surgeons like
Inyanga, Ngaka, Sangoma, and
Lethuwela among others. This pro-African move raised the ire of the pro-Western medical establishment who regarded this move as a personal affront and launched strident attacks against Dr. Tshabalala-Msimang. She set her foot down and refused budge. Today a traditional health care worker like Sangoma enjoys a legal status like any other accredited health care worker thanks to the unbought Dr. Tshabalala-Msimang.
It’s estimated that South Africa is home to more than 200 000 Sangomas who serve millions of South Africans. South Africa commands more than 10% of world medicine plants and the know-how of the medicinal properties of these plants is controlled by 97% of the traditional surgeons.
Some of the strident critics of her new law included a highly regarded medical scientist Dr. Shadrak Mazaza of the South African Medical Association who expressed these remarks during the Traditional Health Practitioners Bill debate "My personal opinion is that adding an illiterate group of people issuing sick certificates from their shacks to the mix...well, I just can't see it happening".
It never fails how a person who has been schooled in an English institution, through no fault of their own, will almost always exhibit pejorative tendencies towards an authentic tradition like African medicine. It’s like an English establishment inculcates a sense of disdain in everything authentically African. As a corollary, the graduates of the English schools do not recognize the legitimate existence of indigenous knowledge systems. These separatist tendencies are a carry-over from colonial times when legislative instruments like the
Natal Code of Native Law of 1891, the
Black Administration Act of 1927, the
Medical, Dental and Pharmacy Act of 1928, the
Proclamation of 1932 and others were intended to criminalize, vilify and economically undermine African traditional surgeons whom the English perceived as an impressive threat to the English medical establishment. The pro-colonial and over zealous Christian churches were privy to these legislative tools designed to stymie African medicine and its practitioners.
Dr. Tshabalala-Msimang dashed those walls and worked without fail to fix the damage brought about by colonial conquest and the white establishment. Today Traditional Health Practitioners Act is the law of the land and makes it possible for a patient who consults a traditional surgeon to be issued with a medical certificate in the event of absence from work. Even the University of Witwatersrand announced plans to offer University degrees in the Sangoma profession at both Bachelors’s and Master’s of Science levels.
The AIDS Policy and ControversyWith solid victories under her belt Dr. Tshabalala-Msimang challenged the unquestionable religiosity of the pharmaceutical and medical establishment with respect to the detrimental effects of AZT as well as the issues surrounding the CD4 count which formed a basis for beginning an anti-AIDS therapy. Dr. Tshabalala-Msimang espoused a United Nations’ stage 4 AIDS-defining illness or a CD4 count of 200 cubic millimetres or less which meant that such a person qualified for an automatic public health care.
She told parliament about damage the AZT was doing to the immune system of an AIDS sufferer and her commitment to ensuring that the Government AIDS strategy had a long term outlook so that the South Africans were not left with lingering consequences that could have been avoided by a meticulous analysis of current scientific theory. In fact pregnant women had gotten killed during the AZT trials in South Africa and she didn`t want more of her people to be subjected to this highly toxic antiretroviral drug.
Her critics mistakenly charged she was denying a link between HIV and AIDS something that she never said as confirmed in an
interview with Roger Bate of the
American Enterprise Institute for Public Policy Research in October 2006. Dr. Tshabalala-Msimang put the record straight in terms of those who chose to deliberately misunderstand her simple and clear message “
We have never said that lemons or beetroot or garlic are therapeutically equivalent to ART. What we do say is that they contain micronutrients that The transmission of HIV, the rate at which people infected with the virus start to suffer from AIDS-related illness, and how well patients cope with the illness when it strikes . . . [are] affected by a number of variables, including nutrition, pre-existing health status, and lifestyle.”
Even though other scientists like the Nobel Prize winning biochemist Dr. Kary Mullis questioned the HIV and AIDS hypothesis, Dr. Tshabalala-Msimang only raised questions on the operational aspects of the theory with respect to the efficacy trials on account of toxic and death reports associated with the use of AZT. This is because the establishment scientists (the ones whose theory we all subscribe to) were not able to adequately explain the mechanisms underlying the CD4 cell loss which preceded the onset of AIDS even thought the HIV and AIDS discovery had been made since 1984. The lack of this crucial analytical understanding was casting doubt on the efficacy of treatment since the mechanisms of cause between HIV and AIDS could not be adequately accounted for.
The uncontested fact is that AZT was never designed as an AIDS drug but was rather created as a cancer chemotherapy treatment that never worked. This in itself is not new because even Prosaic of
Eli Lilly was not originally conceived for depression but was instead designed for high blood pressure treatment which subsequently got retrofitted as an antidepressant and earned billions of dollars in annual revenues for the company. Interestingly, the parent of AZT
Burroughs Wellcome & Company worked more on animal health at a certain point in their history before concentrating more exclusively on human health.
Many of the AZT trials were characterized by tragic results which impacted Dr. Tshabalala-Msimang's response in dealing with it. In their scientific paper
Effects of Zidovudine in 365 Consecutive Patients with AIDS or AIDS-Related Complex French scientists expressed their bitter disappointment from lack of efficacy and the high toxic effects of AZT which they had tested among 365 patients at the Claude Bernard Hospital, Paris in France. The human trials had to be cancelled midstream. This observation and many others vindicated Dr. Tshabalala-Msimang's cautious approach towards the antiretroviral with the unfortunate result of getting eclipsed by the marketing machines of the profit motivated pharmaceuticals and the white establishment media.
Most Contested IssueThe most contested issue was Dr. Tshabalala-Msimang’s position on the HIV and AIDS which challenged the Darwinist establishment view that HIV led to AIDS as a result of the high turnover of the CD4 and CD8 cells which left the immune system defenceless in the absence of some drug therapy like the cost-prohibitive ARVs. In simple English this meant that the T cells, like CD4 and CD8, which help fight off the foreign bodies were being produced in high numbers and also getting killed off in high numbers in a high speed cyclical process that eventually led to the collapse of the immune system. Contrary to her detractors, Dr. Tshabalala-Msimang never questioned the scientific fact that HIV virus caused AIDS but rather she expressed the challenges on the laboratory front with respect to the CD4 cell loss. In the Zimbabwe National HIV and AIDS Conference of June 2004 Dr. Tshabalala-Msimang articulated this fact "
We had many questions to be answered around how we would provide human resources, whether we had adequate laboratory support for CD4 count and viral low count."
Both CD4 and CD8 cells must cooperate in order to win the fight against infection and the main role of CD4 cells is molecular signalling which means that it works like an orchestra conductor. The immune system depends on the instructions of the CD4 to do the job. If the CD4 cells are not able to do their signalling job then the rest of the immune system is not able to respond and fight the invaders effectively. The scientific theory at the time (perhaps even today among some) was that the CD4 and the CD8 cells were being killed off by the HIV virus even as they multiplied to compensate.
New studies including the one headed by Dr. Katja C. Wolthers of the Department of Clinical Viro-Immunology of the University of Amsterdam, Netherlands disproved this establishment theory of the CD4 cells being killed off. Dr. Wolthers and colleagues showed in their scientific paper
T Cell Telomere Length in HIV-1 Infection: No Evidence for Increased CD4 + T Cell Turnover using sophisticated cell labelling techniques, that the CD4 telomeres (terminal ends of the DNA structures) were stable like those of HIV-negative persons except for the CD8 whose telomeres were shortening.
In simple English the infection fighting T cells like CD4 were not being produced and killed off as previously thought. Rather it was the source of these cells that was slowing down in terms of producing the CD4 cells. In other words if there is a tap that produces CD4 cells then that tap for some reason was declining in producing the CD4 cells. This was a fundamental shift in scientific thinking. Needless to say it vindicated Dr. Tshabalala-Msimang`s inquiring mind around this issue. The interesting thing is that a number of scientists are quietly realigning their research in the light of this new evidence.
This paradigm shift from the current scientific establishment vindicated Dr. Tshabalala-Msimang with respect to the fact that if we didn`t understand how the CD4 cell loss came about then there was no guarantee that we were solving the problem correctly. This is absolutely vital because if you have a wrong idea about a problem then you are not going to solve it correctly.
The whole HIV and AIDS issue had become politicised instead of remaining strictly scientific. President Jacob Zuma addressed this politicisation after forming the new Government “Let there be no more shame, no more blame, no more discrimination and no more stigma. Let the politicisation and endless debates about HIV and AIDS stop. Let this be the start of an era of openness, of taking personal responsibility, and of working together in unity to prevent HIV infections and to deal with its impact."
Tribute to the Great Mshengu!We want to take this opportunity to express our sympathies to the Msimang family. We love you and you will forever be cherished by us. We salute Dr. Tshabalala-Msimang! Mshengu! Donga lakaMavuso! Ngelengele! Hlubi elihle! We venerate the impressive achievements on behalf of her people whom she cared so much for. As well put by the ANC’s spokesman Mr. Jackson Mthembu we shall pick up the spear. The life and achievements of Dr. Tshabalala-Msimang will remain an inspiration to many coming after her. In her memory we shall walk in her footsteps to ensure that the Africans do not become parrots of others but rather develop their own views guided by originality, ingenuity and sincere commitment to solving the problems in the context of the material and cultural conditions that prevail in their own environment in keeping with the African proverb that says “
An African writer does not choose the topic. The topic chooses him”.
Lala kahle qhawe lama qhawe! Mshengu!About the Author
A former South African Television Journalist, Vusi Moloi is a published author of a contextual poetry book, A Goodbye To My Little Troubles, and maintains a blog, Zulumathabo on the Internet.