"Comrades, we won!" shouted Zackie Achmat, long-time HIV/AIDS activist and founder of South Africa's AIDS lobby group, Treatment Action Campaign (TAC), outside the Cape High Court in Cape Town on Friday.
In a landmark judgment, the Court ruled that clinical trials of multivitamins in the treatment of HIV/AIDS by controversial vitamin salesman Matthias Rath were unlawful, and banned them from continuing.
The judgment also forbids Rath from publishing any more advertisements claiming that his product, VitaCell cures AIDS, pending further review by the Medicines Control Council (MCC), South Africa's drugs regulatory authority.
Judge Dumisani Zoni ordered Health Minister Manto Tshabalala-Msimang and her director general to take "reasonable measures" to prevent Rath from engaging in such activities and instructed the health department to thoroughly investigate Rath's vitamin trials, and "in light of the facts revealed by such investigation, take further reasonable action in accordance with their duty".
"This judgment is a victory for the rule of law and the scientific governance of medicine. Over the last decade in this country that rule of law has been contested by our minister of health and the president, and a culture of impunity has been created such that charlatans like Matthias Rath can get away with deceiving vulnerable people such that those people end up progressing to AIDS and dying," said TAC spokesperson Nathan Geffen, at a media briefing shortly after the ruling.
Geffen cited testimonies from two families whose relatives had died after participating in Rath's trials. "Although this is a great victory, let's not forget that there were real human lives lost as a consequence of the actions of Matthias Rath, and more importantly, by the failure of Tshabalala-Msimang and the president to stop this sort of quackery," said Geffen.
In a press release, the TAC underlined the government's role in supporting Rath, and called for Tshabalala-Msimang's dismissal.
The TAC has recorded five deaths as directly linked to Rath's trials, but suggested the real mortality figure may be closer to 12.
Geffen stressed the significance of Friday's judgment in emphasising the government's duty to "enforce the scientific governance of medicines as defined in the Medicines and Related Substances Act".
|The minister of health has fostered this situation by creating the illusion that people with HIV have a choice between ARVs versus alternative remedies|
"Charlatans and quacks abound. In Cape Town and other cities, numerous unproven remedies are sold as cures for AIDS. The minister of health has fostered this situation by creating the illusion that people with HIV have a reasonable choice to make between ARVs [antiretroviral drugs] versus alternative remedies," stated the press release.
The TAC put "all purveyors of untested and unregistered medicines, especially those selling so-called 'cures' for HIV/AIDS" on notice that they would be using Zoni's judgment to close them down. Zeblon Gwala, the inventor of the alleged AIDS-remedy Ubhejane, was singled out, as was Tine van der Maas and her "Africa's Solution" remedy.
Operating in South Africa since about 2004, pharmaceutical entrepreneur Matthias Rath claimed that his multivitamins treated AIDS, heart-disease, cancer, diabetes, bird flu and numerous other diseases. In early 2005, Rath and his associates opened facilities in the Western Cape township of Khayelitsha, where they ran unauthorised clinical trials of a variety of vitamin "cures" for HIV/AIDS, including VitaCell.
"People took the Rath medications because they didn't know any better. And also because of the food parcels and stipends," Thembisa Mkhosana, a community health advocate in Khayelitsha told IRIN/PlusNews. According to Mkhosana, the monthly stipends of R750 (US$92) and parcels containing "vegetables, tinned foods ... everything" were given to trial participants.
Rath ran numerous advertisements aimed at convincing HIV-positive people to take his high-dose multivitamins rather than ARVs, available free-of-charge through the public health system, which he claimed were "toxic".
One of those who responded to Rath's marketing was Mkhosana's cousin. "She was taking the Rath pills, and now she's sick," said Mkhonsana. "She started losing weight, vomiting, and having diarrhoea. But now she's going for ARVs. Some people are still doing Rath's work by the back door [in Khayelitsha], but I hope with this ruling, it will stop."
In February 2005, the TAC and the South African Medical Association (SAMA) lodged a complaint against Rath with the Medicines Control Council. After repeated requests by the TAC that the health department investigate Rath's activities were ignored, they subsequently added the department to the complaint.
Rath responded by claiming that the TAC was working as an agent of pharmaceutical companies, and in 2007 published a book called "End AIDS!" on the topic of "pharmaceutical colonialism and its genocidal consequences for people in the developing world".
"We hope people will get the message that there still isn't a cure for AIDS," TAC researcher Noisa Mhlathi said at the close of Friday's press conference, reiterating a message that many health officials worried was lost during the course of the long and acrimonious legal battle.