Analysis of deaths on Matthias Rath illegal clinical trial
2 November 2005
- Analysis of five deaths of patients on Rath's trial
- For three of these patients Rath is at a minimum responsible
for contributing to their deaths.
- For the other two, Rath is at a minimum responsible for
misleading them and creating false hope.
- Several other deaths on Rath's trial have been reported, but we
only discuss here ones which we have investigated.
- Minister of Health has responsibility for failing to stop Rath.
- Rath's pseudo-science in conjunction with other pseudo-scientific
practices throughout South Africa is causing confusion and costing
many lives. This pseudo-science flourishes because it is perceived to
be endorsed by the Minister of Health and President Mbeki.
Matthias Rath is a pharmaceutical proprietor who claims that
micronutrients alone treat AIDS. He claims that antiretrovirals, the
treatments recognised by every competent medical authority for treating
HIV/AIDS, are toxic and make AIDS worse. He makes similar claims for
heart-disease, cancer, diabetes and other diseases.
Rath has in conjunction with his agents --which include some South
African National Civics Organisation (SANCO) branches, Anthony
Brink, David Rasnick, Sam Mhlongo and others-- conducted an
unauthorised and illegal clinical trial in Khayelitsha and other areas
in the Western Cape. This trial involves making false claims to
prospective patients that vitamins reverse the course of AIDS, taking
blood samples from patients, taking photographs of patients semi-naked
for the purpose of before and after photographs and distributing
unregistered drugs to patients. Rath's drugs, according to their
labels, consist of vitamins, amino acids, a schedule two substance
called N-acetylcysteine and other micronutrients. Based on affidavits
we have received, these drugs are prescribed in unusually high dosages.
This is in line with Rath's stated theories and past practices.
TAC has confirmed and analysed the deaths of five people who have died
on Matthias Rath's illegal clinical trial. In two of these cases, Rath
is as least responsible for having created false hope. In the other
three, Rath is partly responsible for their deaths. In at least two
further cases, patients held up by Rath as models of success on his
programme were, and are, actually taking antiretrovirals. These two
patients are alive.
TAC supports government's rollout of antiretroviral treatment. We also
support the policy of making multivitamins available to people with HIV
in the public health sector. But we take a dim view of people who claim
or imply that the risks antiretrovirals outweigh their benefits or who
make unproven claims about their own products.
Case one - the death of Marietta Ndziba
Ndziba was used --and continues to be used-- by Rath for marketing his
products. In a pamphlet distributed by Rath and his agents in
September, she was quoted as saying that her CD4 count rose from 365 to
841 due to Rath's vitamins. She implied that these vitamins treated
boils on her arm, her grey skin, diarrhoea and vomiting. She said "I
just thank God that he brings vitamins here to South Africa to help our
lives." As far as we can ascertain Ndziba never took
antiretrovirals. She died about two weeks ago. Her family continues to
be in denial about the cause of her death, with one family member
reportedly claiming that she died of a stress headache. Rath's vitamins
clearly did not help Ndziba. She should have been treated by qualified
doctors in the public health system, not Rath or his agents.
Astoundingly, a video recording of Ndziba claiming the benefits of
Rath's vitamins continues to be available on the front page of Rath's
website to this day.
Case two - the death of Ntombekhaya (we withhold her surname to
protect her family's privacy)
Ntombekhaya commenced treated for TB in 2004 at a public health clinic.
was HIV-positive and was going to start antiretroviral treatment once
her TB treatment was completed. Her CD4 count was 45 in October 2004
and she had lost weight. In early March 2005, she made contact with
Rath's agents. From that point she stopped taking medicines from the
Site B public health clinic in Khayelitsha. She was quite sick when she
started taking Rath's drugs, and she started becoming much sicker. Her
health deteriorated under the care of the Rath Foundation. It has been
alleged that they put her on a drip at one stage. Her family member
caring for her was advised by Rath's agents not to call an ambulance if
she got sicker, but to call them instead. She died on 27 March. Rath
and his agents are partly responsible for her death by taking her off
the medicines she was taking at the Site B clinic at a time that she
was critically ill and delaying her initiation of antiretroviral
treatment. We have confirmed the details of this case.
Case three - the death of Patient X
Patient X presented at Nolungile HIV clinic on 30 September 2005. He
was in such a deteriorated state due to advanced AIDS that his treating
doctor investigated his clinical history. Here it is:
He was admitted to Jooste Hospital on 12 September 2005. His baseline
CD4 count was 22 and he had a haemoglobin count of 2. He required three
blood transfusions. He was diagnosed with HIV encephalopathy and
disseminated tuberculosis. It turned out that Patient X had been
treated by a Rath clinic for two months prior to presenting at
hospital. It is during this critical period that he missed an
opportunity to be treated in the public health sector. He died on 8
October 2005. He never had an opportunity to commence antiretroviral
treatment because he had not recovered from his several opportunistic
Rath is at least partly responsible for Patient X's death by having
caused his delay in seeking assistance from the public health system.
Case four - the death of Noluthando (surname withheld at this stage
to protect family's privacy, but family is prepared to go public)
Noluthando was diagnosed with HIV in 2002. She lived openly with her
status. At some point in April or May 2005, Noluthando made contact
with Rath's agents. At this time she had stomache pains, but no other
symptoms of illness. For three days she took 20 of Rath's VitaCell
pills a day, far in excess of recommended daily allowances for many of
the substances that the VitaCell label claims are in the pills. In
these three days her condition deteriorated dramatically. She could not
walk without assistance and could not work. She therefore stopped
taking the tablets. She was admitted to Karl Bremmer Hospital and died
on 2 June 2005.
In this case, Rath is at a minimum responsible for creating false hope
by claiming that his medicines would improve Noluthando's health. We
are not sure if his tablets were responsible for Noluthando's
deterioration in health, though given the large untested doses, this
cannot be ruled out. It is unlikely that Rath delayed Noluthando
from initiating antiretroviral treatment. Her involvement with Rath and
agents appeared to be short. She was on a waiting list for
antiretroviral treatment at the time she died. She is one of the many
people who slipped through the cracks of a public health system under
strain. It is such people who are most at risk of being taken advantage
of by charlatans.
Case five - the death of Noxolo Ngalo
Noxolo Ngalo was diagnosed with HIV in January 2005. In April, she made
contact with Rath's agents. She started taking 30 Rath tablets per day.
At some point her dosage was reduced. Rath's spokesperson claimed on
ETV that she only took Rath's medicines for 9 days. But this is
contradicted by her mother who tells a coherent story of her being
involved with a Rath clinic in Du Noon until at least August and
possibly beyond, and that she continued to take Rath medications.
Rath's agents would pick her up and take her to the clinic. They were
supposed to pick her up on 5 October but did not arrive. They also
informed her that she should not take antiretrovirals. Her condition
deteriorated remarkably in the time that she was on the Rath trial. For
example she began having epileptic fits. She went to hospital and was
diagnosed with TB. She began TB treatment but her CD4 count was
extremely low (approximately 15), her condition deteriorated, she
suffered memory loss and stopped talking. She died of a combination of
liver failure and AIDS-related conditions on 5 October 2005.
We cannot know if Rath's high-dosage drugs contributed to her illness.
We also cannot ascertain if the fact that she never initiated
antiretroviral treatment --even though she was earmarked for such
treatment-- was partly a result of the false claims made to her by
Rath's agents or the slowness of the public health system. But at a
minimum Rath's claims that his vitamins would improve her health were
misleading and created false hope.
We have been alerted to several other deaths of patients on Rath's
trial but have not been able to investigate these. We also have
affidavits from two doctors working in the public health system
describing confused patients who presented to them with Rath tablets.
But the deaths caused directly by Rath's trial are few compared to the
numerous deaths caused by the pseudo-scientific confusion about HIV
that is prevalent throughout South Africa. Doctors have frequently
reported that many patients are too scared to initiate antiretroviral
treatment or that they present too late to health facilities because
they are so confused by mixed messages on the treatment of AIDS. Rath
is just one contributor (a particularly serious one) to this confusion.
Only with clear messages from our political leaders, including the
Minister of Health and President Mbeki, can this confusion be
Rath's dependence on anecdotal evidence
It might be argued that the above cases are anecdotal; they do not
prove Rath's claims are false. Surely we need to examine statistical
evidence to determine this? After all, no treatment can be 100%
successful. It could further be argued that one can present plenty of
cases of people who died on antiretroviral treatment, including
directly as a result of drug side-effects. But this misses the point.
We know that antiretrovirals effectively treat HIV and reverse the
course of AIDS by the results of numerous clinical trials and cohort
studies published in prestigious, credible, peer-reviewed scientific
journals. The results of these studies show that some people do not
benefit from antiretrovirals, but more than 80% of people with advanced
HIV disease do benefit from antiretrovirals.
Not a single peer-reviewed study confirms Rath's claims. There are no
relevant statistics from Rath's trials. There cannot be, because we
have determined in our investigations of Rath that there are no proper
protocols in place or consistent drug prescriptions: sometimes patients
are told to take 30 tablets a day, sometimes 20, sometimes just a few.
They are also given different Rath products. Instead Rath, like other
charlatans, depends on anecdotal evidence to market his theories. In
doing so, he makes a point of counting his successful cases and
ignoring his failures. We have presented the five cases above to
counter the unproven propaganda claims based on anecdotes made by Rath.
The available anecdotal evidence reinforces the unlikeliness of Rath's
claim that his micronutrients reverse the course of AIDS.
In a number of radio interviews, TAC members have been asked the
question: "But surely people are entitled to a choice?" Indeed, people
are entitled to make choices about their health. We do not dispute that
Marietta Ndziba had the right to choose not to take antiretroviral
treatment. But neither Matthias Rath nor any pharmaceutical company has
the right to make false claims that contribute to people making poor
Minister of Health has also misused the concept of choice. In a written
answer to a question in Parliament she has stated "I have never
said that traditional medicines and vitamins should be offered as
alternatives [she has unequivocally implied it on numerous
occasions - editor], which means instead of ART. What I have
that our people must be given a choice. "
But the Minister's job is to present advice to the public based on the
best available scientific evidence. It is then individuals who
can choose whether to follow or ignore this advice. The minister should
not present unproven options as valid choices.
Minister of Health's responsibility
There have been several complaints about Rath's activities lodged with
the Department of Health including by TAC, MSF, health-care workers in
the Western Cape and members of the public. We have compiled
substantial evidence of a failure to act by the relevant authorities.
We are convinced that this failure to act is a consequence of the
Minister of Health's lack of political will. The Minister of Health has
met with Rath alone and she has allowed his agents, David Rasnick and
Sam Mhlongo, to present their theories to the National Health Council.
She has made statements whose only reasonable interpretation is support
for Rath. She has also consorted with other charlatans, such
as Tine van der Maas, including voluntarily appearing in a propaganda
video produced by van der Maas (partly sponsored by Rath) and showing
this video at various forums.
The South African National Civics Organisation (SANCO) played an
important role in the anti-Apartheid struggle. But the role of some of
their branches in supporting Rath's activities has been unacceptable.
Some SANCO branches openly support Rath. They are deeply involved in
his clinical trial. They promote Rath in Khayelitsha, Hout Bay and
other places. They recruit patients for the trial and use SANCO's name
on the inadequate patient consent forms for the trial. These SANCO
branches have a reputation for using intimidatory tactics against
people they perceive to oppose them. Consequently, people with
important knowledge of deaths on Rath's trials are scared to come
forward. We have received several reports of SANCO members being paid
by Rath to carry out his agenda.
If action is not taken to stop Rath in the next few days, TAC will be
left with no choice but to proceed with litigation to seek interdicts
against Rath's activities and a declarative order against the Minister
of Health. Reluctantly, we might have to take the Minister to court yet
again, but there is no choice: too many
lives are at risk.
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