Stop pseudo-science and AIDS denialism

Advertising Standards Authority of South Africa orders Matthias Rath to withdraw his adverts

14 March 2005

Editorial

For more than a year, the wealthy vitamin salesman Matthias Rath has run a high-profile media campaign attacking scientific medicine and the Medicines Control Council by placing adverts in national newspapers. He does this in order to promote his own over-priced vitamins which he prescribes in dangerously high quantities. The Medicines Control Council and the Department of Health failed to take action against him. This has emboldened him to take his campaign further, by attacking the science of HIV, antiretroviral medicines and making false defamatory allegations against the TAC and the Advertising Standards Authority of South Africa (ASASA). In recent weeks, Rath's agents have distributed pamphlets and posters in Cape Town city centre, Nyanga and Khayelitsha which contain lies about vitamins and antiretrovirals and make false allegations against TAC.

According to government over 5.6 million South Africans live with HIV and about 500 000 need antiretroviral treatment. The Department of Health has just announced that it will spend more than R3 billion on purchasing antiretroviral medicines. It is government policy to make antiretrovirals available and to encourage people who have AIDS to enroll in the programme. Rath's campaign undermines this policy, causes public confusion and endangers lives. We therefore ask President Mbeki, Minister of Health Tshabalala-Msimang and the ANC why they have not condemned Rath? Any reason why SANCO-Khayelitsha, which considers itself a government ally, has joined Rath's campaign?

Rath's adverts have been run in some of South Africa's most widely read and respected newspapers, including Business Day, City Press, the Mail & Guardian and The Sowetan. He also published in Cape Town community based newspapers, City Vision and Vukani. Of these newspapers, only the Mail & Guardian took a stand and publicly refused to continue publishing Rath without awaiting the outcome of a complaint against Rath at ASASA. It has been brought to our attention that the Sunday Times refused to publish his adverts as well and we commend them for this. We know that City Vision and Business Day do not support Rath's positions. We hope that City Press also does not support him. Rath is not the only charlatan who gets undeserved positive media coverage. A few weeks ago, Kaapse Son ran a profile of a person claiming to be able to cure AIDS using ozone; this type of nonsense is not unusual.

Litigation against The Sowetan

The Sowetan regularly publishes Rath's adverts without indicating that they are adverts or criticising them in editorial comment. Furthermore it published a highly defamatory Rath advert on Friday 11 March despite a ruling by ASASA on 10 March that Rath's adverts must be withdrawn, in response to a complaint laid by the TAC and George Stacey. The content of the advert, which also contains hate-speech against ASASA and TAC, could have left the Sowetan in no doubt that it was in breach of the ASASA code. The Sowetan has on a number of occasions runs op-ed pieces, profiles and letters by AIDS denialists - often making false defamatory accusations against TAC and frequently without reply. Therefore, we have consulted lawyers and intend to sue the The Sowetan for defaming TAC. ASASA has asked us to indicate what sanctions against Rath we believe are appropriate. We are also considering other litigation to put an end to Rath's distribution of quack remedies as well as libelous pamphlets and posters in the Western Cape.

We appeal to South Africa's newspapers: The Sowetan has ignored the ASASA ruling and published adverts that endanger public health and contain hate-speech. Newspapers that do this risk unravelling the self-regulatory framework that maintains ethical behaviour in the industry. Stop giving Rath and other charlatans media-space.

TAC calls on

organisations around the world with knowledge of Rath's activities to please contact us (email: info@tac.org.za and put "RATH INFORMATION" in the subject line);

WHO, UNAIDS and UNICEF to issue a statement condemning Rath, who has misused their recommendations in his adverts;

US-based activists to urge newspapers, such as the New York Times, to stop publishing Rath's adverts;

the South African government to issue an unequivocal condemnation of Rath and

the Medicines Control Council to take action against Rath immediately.

TAC thanks George Stacey for laying a complaint with ASASA against Matthias Rath.

 

Please find the following below:

ASASA ruling in the matter between TAC and George Stacey versus Matthias Rath.

Article by COSATU's Neva Makgetla in Business Day, 11 March 2005, calling for an end to denialism.

Also please note the following article on the TAC website:

The Price of Denial by Mark Heywood (a history of political denial about the HIV epidemic)

 

ASASA Ruling

Please note that the ruling below is a typed copy, by TAC, of the ASASA ruling. We have done our best to ensure it is correctly typed but cannot guarantee this. We hope ASASA will place the ruling on their website.

Ruling of the ASA Directorate

In the matter between

TREATMENT ACTION CAMPAIGN (TAC) FIRST COMPLAINANT

GEORGE STACEY SECOND COMPLAINANT

and

DR RATH HEALTH FOUNDATION AFRICA RESPONDENT

9 March 2005

DR RATH HEALTH FOUNDATION/TAC & ANOTHER/1861

Consumer complaints were lodged against a Dr. Rath Health Foundation Africa print advertisement in the Mail & Guardian on 26 November 2004.

The advertisement is headed "Why should South Africans continue to be poisoned with AZT?

THERE’S A NATURAL ANSWER TO AIDS’ and contains a number of claims regarding this topic.

COMPLAINTS

In essence, the complainants submit that the advertisement breaches the Code in the following respects:

It exaggerates the efficacy of multivitamins in "treating" AIDS.

It deliberately misleads consumers about zidovudine (AZT).

It deliberately misleads consumers about nevirapine (NVP).

It deliberately misleads the public about the MCC.

The first complainant requested sanctions.

RELEVANT CLAUSES OF THE CODE OF ADVERTISING PRACTICE

The first complainant identified the following clauses of the Code as relevant

Section II, Clause 2 – Honesty

Section II, Clause 4.1 – Substantiatian

Section II, Clause 4.2.1 - Misleading claims

Section II, Clause 4.2.2 – Puffery

Section II, Clause 4.2.3 – Hyperbole

Section II, Clause 4.2.4 – Expert opinion

Section II, Clause 4..2.5 – Statistics and scientific information

Section II, Clause 4.2.6 – Headlines

Section II, Clause 6 – Disparagement

Section II , Clause 7 – Comparative advertising

Section II, Clause 13 – Safety

Appendix H – Advertising for over-the-counter medicines

In addition, in light of the second complainant’s submissions, the following further clauses of the

Code were taken into account:

Section 1, Clause 12 – Responsibility to the consumer

Appendix A – Medicinal and related products and advertisements containing health claims

Appendix F – Reference to diseases in advertising

RESPONSE

The respondent addressed the ASA Directorate at length on the merits of the matter, and denied that

The advertisement is in breach of the Code.

ASA DIRECTORATE RULING

At a meeting held on 9 February 2005 the Directorate considered the relevant documentation

Submitted by the respective parties.

Controversy

The treatment of HIV/AIDS is a highly controversial subject by its nature, and especially in light of the types of claims made in the advertisement.

Clauses 2.4 of Section 1 states:

"To the extent that any advertisement:

Expresses an opinion of a matter of which is the subject of controversy; and

That controversy involves issues within the area, broadly defined of public policy and practice, then that opinion shall not be subject to the provisions of the Code relating to misleading claims except that -

All advertisements which contain such controversial statements should:

be ready recognizable as advertisements;

cause no confusion as to the identity or status of advertiser;

Whenever such information is not readily available state the advertiser’s address and telephone number."

This clause creates certain requirements for a claim to amount to "controversial statement". Once it has been established that the statement is controversial, the Directorate may not consider whether or not the claim is misleading. In other words, the claim can no longer be evaluated in terms of clause 4.2.1 of Section II but can be considered in terms of the remaining clauses of the Code.

For this reason the Directorate will first consider whether or not each claim is acceptable in terms of the named clauses of the Code other than Clause 4.2.1 of Section II. Only if the claim is acceptable in terms of the other clauses, will it become necessary for the Directorate to determine whether or not the claim in question falls within the ambit of Clause 2.4 of Section I, in order to determine whether or not Clause 4.2.1 of Section II can be considered.

Substantiation

The respondent has lodged a bulky set of research in substantiation of its claims. The respondent’s attention is drawn to Clause 4.1.4 of Section II which requires that "Documentary evidence … shall emanate from or be evaluated by a person/entity which is independent, credible and an expert in the particular field to which the claims relate and be acceptable to the ASA". The substantiation submitted is in the form of various research articles, extracts from websites and articles by the respondent’s representatives. These have not been evaluated by an independent expert or entity as required by Clause 4.1 of Section II.

However, in so far as the advertisement refers to particular outcomes of particular studies, the ASA will have regard to the accuracy of same.

The ASA wishes to clarify its role in this matter before proceeding on the merits:

1. The ASA does not have the jurisdiction or ability to decide on the efficacy or safety of either of the treatments debated. This is the role of the Medicines Control Council (MCC).

2. The ASA’s role is essentially to determine whether the information conveyed to the consumer is substantiated and conveyed within the restrictions imposed by the Code.

Pharmaceutical Manufacturers Association of South Africa

Finally the ASA wishes to address a concern raised by the respondent that the Pharmaceutical Manufacturers Association of South Africa is a member of the ASA, and the influence that this will have on the ASA’s decision. The respondent should note that member bodies of the ASA are not involved in the decision making process at Directorate level, and the alleged bias can therefore not arise in the current decision.

Turning to the advertisement:

Headline: "Why should South Africans continue to be poisoned with AZT"

The respondent has submitted that this is the only part of the advertisement that falls within the ambit of Clause 2.4 of Section I, and therefore should not be considered by the ASA. The restriction imposed by Clause 2.4 of Section 1, however, only extends to misleading claims, as previously indicated.

The Directorate is therefore called upon to first consider the other clauses of the Code. The claim in question relies on a factual assumption that "South Africans continue to be poisoned by AZT". The toxicity of AZT must therefore be substantiated.

As noted above, the respondent has submitted bulky substantiation, most of which appears to relate to potential toxicity of various treatments. However Clause 4.1 of Section II calls upon the respondent to submit verification from an independent, credible expert in the relevant field.

As the respondent has failed to submit such verification of the claim, "South Africans continue to be poisoned with AZT", the claim is in breach of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt or ruling.

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

This claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "On 1 July 2004, a landmark study by Harvard University was published in one of the world’s leading medical journals, the New England Journal of Medicine, summed up the same day b y the world’s most influential and respected newspaper, the New York Times. The study found that: daily doses of multivitamins slow down the disease and cut the risk of developing AIDS in half."

On careful reading of this statement in its entirety, one notes that the claim is not that the study found that "doses of multivitamins slow down the disease and cut the risk of developing AIDS in half" but that the New York Times summarized the study in this way.

The Directorate notes that the respondent has not provided a copy of the relevant article.

This aside, the overall impression of this claim is that the study has indeed made these findings. The hypothetical reasonable person would not understand that the New York Times may have misinterpreted or misquoted the study. The impact of the claim is therefore that the study in question made the cited findings.

The study in question ex facie found that "Multivitamin supplements delay the progression of HIV disease and provide an effective low-cost means of delaying the initiation of antiretroviral therapy in HIV infected women." This appears to be different from implying that the study found that "daily doses of multivitamins slow down the disease and cut the risk of developing AIDS in half".

The claim as communicated to the consumer, is therefore not supported by the documentation submitted, and is not substantiated in terms of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "The question is why the people of South Africa have not been told about this. For actively promoting natural health approaches to AIDS, the South African government has continually been attacked by pharmaceutical interest groups and received no support at all from the medical establishment. The reason for this lack of support is obvious. Non-patentable natural therapies have very low profit margins, whereas patented synthetic pharmaceutical AIDS drugs are a multi-billion dollar business".

The paragraph in the advertisement states the opinion of the advertiser and as a whole does not rely on any objectively substantiable statements of fact or figures. For this reason, the bulk of the paragraph does not fall within the ambit of Clause 2.4.1 or 4.2.5 of Section II.

The exception to this is the statement that "Non-patentable natural therapies have very low profit margins". This is an objectively substantiable fact. The respondent has not put anything before the Directorate to illustrate the comparative costs of different therapies, and the Directorate is therefore unable to consider whether the statement correctly reflects the facts.

The statement, "Non-patentable natural therapies have very low profit margins" is therefore unsubstantiated in terms of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on

receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Turning to the remainder of the paragraph, the Directorate notes as follows:

Clauses 4.2.2 and 4.2.3 of Section II refer to potential defences rather than breaches; no expert opinion is expressed in terms of Clause 4.2.4 of Section II; the statement is not a headline in terms of Clauses 4.2.6 of Section II; The statement does not refer to another product specifically and Clauses 6 and 7 of Section II therefore does not apply; and the statement does not directly advocate any potentially unsafe behaviour in terms of Clause 13 of Section II. Appendices A, H and F do not apply as the statement does not refer to any medicinal product or treatment that the respondent sells.

The statement therefore does not appear to breach any clauses of the Code, with the possible exception of Clause 4.2.1 of Section II and Clause 1.2 of Section I. The question of whether the statement is responsible and therefore in breach of Clause 1.2 of Section I is inherently tied to the question of whether or not the statement is misleading and the Directorate is unable to consider this clause in isolation from Clause 4.2.1 of Section II.

As the question is now whether or not the statement is misleading in terms of Clause 4.2.1 of Section II, the Directorate firstly has to consider whether or not the claim falls within the ambit of Clause 2.4 of Section 1.

The first requirement of the clause is that the claim expresses an opinion on a subject of controversy. The Directorate is in no doubt that the treatment of Aids and in particular the role of the South African government therein, is controversial. As indicated above, the statement is also the opinion of the advertiser.

The second requirement is that the controversy concerns issues of public policy and practice. The respondent has in this opinion, highlighted the ongoing public debate regarding the government’s Aids policy. This clearly falls within the ambit of public policy and practice.

The claim therefore falls within the ambit of Clause 2.4 Section 1, and the Directorate is therefore unable to consider whether or not the opinion is misleading .

Claim: The Harvard study, conducted in Tanzania over a period of eight years, involved more than a thousand HIV-positive pregnant women. It was a placebo controlled and double blind trial conforming to the highest standards. The study showed that inexpensive multitvitamin treatment is more effective in staying off disease among HIV-positive women than any toxic AIDS drug. (NEMJ 2004 Jul 1;351(1):23-32)"

In considering whether or not this is substantiated the ASA had regard to the contents of the actual study cited:

It is correct that the study was in Tanzania

It is correct that the period of study was "eight years". The study states, "…starting in April

1995… until the end of the study in August 2003".

It is correct that the study involved "more than a thousand HIV positive women". The exact figure is 1078.

It is correct that the test was "placebo controlled and double blind."

While the report on the test does not say that it conformed to the "highest standards", it appears to be a reasonable conclusion given the abovementioned and the respectability of the journal in question.

The claim in the advertisement concludes that: "The study showed that inexpensive multivitamin treatment is more effective than any toxic AIDS drug."

The study, in fact, reached no conclusion in relation to the relative efficacy of various treatments, and the study did not use a drug using control group. The study also reached no conclusion relating to or made any reference to any "toxic AIDS drug".

While the advertiser may have drawn this conclusion from comparisons with other research it is incorrect to say that the "study showed" this.

The claim is therefore unsubstantiated and in breach of Clause 4.1 of Section II.

Given the above finding:

The claim be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "More than a decade ago, a study co-authored by two-time Nobel Peace winner Linus Pauling, published in another leading scientific journal, found that an optimal dose of vitamin C alone can block the replication of HIV by 99% (Proceedings of the National Academy of Sciences of the United States of America 1990 Sep:87 (18):7245-9)"

The study in question states, "in chronically infected cells expressing HIV at peak levels, ascorbate reduced the levels of extracellular reverse transcriptase activity (by<99%)".

The communication of the advertisement is that Vitamin C has a 99% block on the replication of HIV in all cells. From the study it appears ex facie that this is only true, at best, for "chronically infected cells".

As blocking the HIV replication by 99% in a chronically infected cell has ex facie significantly different impact from blocking the replication of HIV by 99% in all cells, the communication is not substantiated.

The claim is therefore unsubstantiated and in breach of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling

The withdrawal of the advertising material must be completed within the deadline stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "Every textbook of biochemistry recognizes that vitamins and other micronutrients are the most decisive factor determining the optimum function of the immune system".

The respondent has submitted inter alia, extracts from a few relevant textbooks. The advertisement appears to draw conclusions from the material that the respondent has submitted. The ASA is not in a position to analyse and verify that the textbooks submitted support this conclusion. The ASA is also not in a position to accept that the submitted textbooks are "every text book", although the Directorate notes that it is extremely doubtful that this is the case.

As noted above, the respondent has submitted bulky substantiation, much of which appears to relate to the potential toxicity of various treatments. However, Clause 4.1 of Section II calls upon the respondent to submit verification from an independent credible expert in the relevant field.

As the respondent has failed to submit such verification of the claim, it is in breach of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertisisng material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "Hundreds of studies have found that AZT is profoundly toxic to all cells of the human body, and particularly to the blood cells of our immune system".

The respondent has submitted and referred to studies allegedly showing that AZT is toxic. However, the ASA notes that:

The ASA does not have "hundreds" of such studies, or references thereto, before it.

The ASA is not in a position to determine whether these studies support the statement "profoundly toxic".

As noted above, the respondent has submitted bulky substantiation, much of which appears to relate to potential toxicity of various treatments. However, Clause 4.1 of Section II calls upon the respondent to admit verification from an independent, credible expert in the relevant field.

As the respondent has failed to submit such verification of the claim, it is in breach of Clause 4.1 of Section II.

To this end, the ASA requests that should the respondent wish to submit further substantiation, it must have the hundreds of studies analysed by an independent expert in terms of Clause 4.1 of Section II, and have that expert verify that there are indeed at least over two hundred studies and that these studies all support the claim.

Given the above finding

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "Numerous studies have found that children exposed to AZT in the womb suffer brain damage, neurological disorders, paralysis, spasticity, mental retardation, epilepsy, other serious diseases and early death."

As noted above, the ASA is not in a position to evaluate whether these studies submitted by the respondent in support of this claim actually support the statement.

The respondent has submitted bulky substantiation, much of which appears to relate to potential toxicity of various treatments, However, Clause 4.1 of Section II calls upon the respondent to submit verification from an independent, credible expert in the relevant field.

As the respondent has failed to submit such verification of the claim, it is in breach of Clause 4.1 Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Clause; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "Incredibly, two weeks after the publication of the Harvard study, the Medicine Control Council proposed new regulations that will effectively prevent free access to life-saving vitamin therapy and information about it, and recommended that HIV-positive women take AZT during their pregnancies".

While much of this statement is conjecture and opinion, it is based on an assumption that the MCC "proposed regulations will prevent access to life-saving vitamin therapy and information about it, and recommend that HIV positive women take AZT during their pregnancies". The Directorate notes that neither these proposed regulations nor any independent expert interpretation thereof are before it and the claim is therefore not substantiated in this respect.

The claim is therefore in breach of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed when the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in the current format until adequate substantiation is submitted, evaluated and a new ruling is made.

Claim: "ON WORLD AIDS DAY the Treatment Information Group and the Dr. Rath Health foundation ask the medical community and the people of South Africa:

Do you want to continue being misled by the pharmaceutical industry and its front organizations to believe that exorbitantly expensive and highly toxic drugs like AZT and nevirapine are the answer to AIDS?

Don’t you think it’s time to support the South African government and the traditional healers of South Africa and join our nationwide public information campaign based on natural science and medical truth?"

Again the Directorate notes that the phrasing of this section of the advertisement takes the form of conjecture and opinion. However, the respondent has relied on certain substantiable statements as the basis for this opinion.

"exorbitantly expensive and highly toxic drugs like AZT and nevirapine"

"support the South African government and traditional healers"

As noted above, the respondent has submitted bulky substantiation, much of which appears to relate to potential toxicity of various treatments. However Clause 4.1 of Section II calls upon the respondent to submit verification from an independent, credible expert in the relevant field. Such verification has not been submitted.

The claim "exorbitantly expensive and highly toxic drugs like AZT and nevirapine" is therefore unsubstantiated and in breach of Clause 4.1 of Section II.

The respondent has, in making those claims, created the impression that its campaign and philosophy is backed by the South African government and by the traditional healers of South Africa. There is nothing before the ASA to support this impression.

The claim "support the South African government and traditional healers" is therefore also in breach of Clause 4.1 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising materials must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current format until adequate substantiation is submitted, evaluated and a new ruling is made.

The picture of an AZT bottle and the claim, "This is a 25mg bottle of AZT supplied by Sigma-Aldrich for use in research laboratories. The label speaks for itself, GlaxoSmithKline recommends between 500 and 1500mg of AZT daily – twenty and sixty times the quantity that Sigma-Aldrich warns research workers could kill or severely injure them – alleging that AZT has extended and improved the quality of life of millions of people living with HIV/AIDS around the globe. Also that Glaxo Welcome (now GSK) are a reputable company. We do not lie to people."

 

Clause 6.1 of Section II states that, "Advertisements shall not attack, discredit or disparage other products, services, advertisers and advertisements directly or indirectly". Clause 6.2 recognises that "Comparisons highlighting a weakness in an industry or product will not necessarily be regarded as disparaging when the information is factual and in the public interest".

The respondent has not addressed this issue head on in its submissions. The paragraph refers directly to AZT and GlaxoSmithKing. The implication is that AZT is toxic and that GlaxoSmithKing is in fact not "reputable" and are recommending doses of AZT that could "kill or severely injure" people.

The Directorate is therefore in no doubt that the claims in this paragraph in particular, and the claims regarding the toxicity of AZT in general, disparage other AZT and GlaxoSmithKline.

As stated in Clause 6.2 of Section II, these claims would be arguably be allowed if proven to be factual in that matter at hand. However, as stated repeatedly above, insufficient substantiation has been submitted in respect of the claims. There is therefore no need for the Directorate to consider the implications of Clause 6.2 of Section II further at this stage.

The respondent’s attention is also drawn to the provisions of Clause 7 of Section II for its own guidance.

The claim is therefore in breach of Clauses 4.1 and 6 of Section II.

Given the above finding:

The claim must be withdrawn;

The process to withdraw the advertising material must be actioned with immediate effect on receipt of ruling;

The withdrawal of the advertising material must be completed within the deadlines stipulated by Clause 15.3 of the Procedural Guide; and

The claim may not be used again in its current form until adequate substantiation is submitted, evaluated and a new ruling made.

In light of the above findings, the Directorate finds it unnecessary to consider the remaining clauses at this point.

The Directorate wishes to specifically clarify the following:

In Nampak/Kimberly-Clark/1400- the Advertising Industry Tribunal noted that, "The ASA has always held that principle requires offending advertising to be withdrawn from every medium in which it appears, notwithstanding that the complaint did not refer to that particular medium." Similarly, in this matter any ruling made in respect of the medium considered applies, in so far as the principle is relevant, to other mediums.

Clause 3.1 of Section I states, "This Code is to be applied in the spirit, as well as the latter." The principle applies equally well to the reading of a ruling. Where the Directorate has ruled against a principle as stated in a particular claim, the principle as well as the specific claim may not be used again in future advertising .

The complaint is upheld.

The first complainant has requested sanctions in this matter. The complainants are therefore requested to comment on sanctions in light of this ruling and in terms of Clause 14 of the Procedural Guide, within 10 (ten) days of receipt of this ruling. Thereafter, the respondent will be given an opportunity to comment. The Directorate will then consider the matter in terms of Clause 8.5 of the Procedural Guide.

[END OF ASASA RULING]

Beware the deadly denialism of profiteers

By Neva Makgetla (printed in Business Day, 11 March 2005)

LIKE most South Africans, I have a close family member with HIV, and consequently a visceral interest in the debate on antiretrovirals. In my relative’s case, there is no question: she would have died 10 years ago had she not been on the early trials for antiretrovirals.

In 1997, she had been positive for more than 10 years. Her T-cell count was below 150, meaning she had almost no immune system left. Today, thanks to antiretrovirals, the virus is virtually undetectable in her blood and she is in excellent health.

Because of this kind of success, antiretroviral treatment is standard throughout the world, backed by all major medical organisations and most governments, including ours.

So why is antiretroviral treatment continually under attack?

Most recently, the Matthias Rath Foundation ran advertisements attacking the Treatment Action Campaign (TAC) after a campaign in Khayelitsha to discourage people from using antiretrovirals. The press periodically publishes commentary or letters with claims that are entirely untrue. These claims include:

Myth — There is no evidence that antiretrovirals work. This claim is ludicrous. In virtually every country, introduction of antiretrovirals on a mass scale has cut deaths by more than 70%.

Myth — Antiretrovirals have extraordinary side effects, making them intolerable for users. Again, this is simply untrue. Some people get severe side effects, but most do not.

Myth — Drug firms just want to make profits. This is odd coming from the foundation, which made its money selling vitamins as a cure-all, even for cancer.

Its advertising has been banned in the UK, and Germany outlawed some of its products. So who is profiteering from disease?

Unlike its treatments, antiretrovirals have been tested and used with success. The main activists in support of antiretrovirals in SA are doctors, the TAC and the Congress of South African Trade Unions (Cosatu).

The TAC and Cosatu do not get any funding from pharmaceutical companies. Both have engaged in legal processes to cut medicine prices.

The underlying rationale for attacks on antiretrovirals is that nutritional supplements such as vitamins can and should replace medication because they are somehow less intrusive and more natural — although most are made synthetically.

Certainly, good overall health helps with any disease. Still, no sensible person tries to treat tuberculosis or pneumonia with vitamins alone.

The same is true for HIV. A healthy lifestyle is critical for people with the virus. But when HIV makes an immune system deteriorate, the only proven treatment is antiretroviral treatment. Why does the denialism persist?

Why does the media publish adverts and commentary against antiretrovirals without counter-comment? Surely the persistence of denialism should be investigated? Is it not newsworthy that the foundation would profit directly if it pushed out antiretrovirals?

As a minimum, the press should point out where inputs, including letters, misrepresent known facts. It is not enough to publish articles supporting anti-retrovirals in a different issue or on another page.

If anyone with HIV stops treatment because the media propagate propaganda against antiretrovirals, it has a hand in hastening their death. Surely advertising revenues and sensational headlines are not worth that price?

Irresponsible vendors of alternative drugs and treatments have economic interest in the debate.

Yet there should be no competition between nutritional supplements and antiretroviral treatment. People with HIV need both.

Supporters of antiretrovirals are perhaps too fond of noting that the drugs are a treatment — not a cure. We do not hear that emphasis around medication for cancer or diabetes, even though the diseases also have no cure.

As with cancer and diabetes, with treatment people with HIV can live for decades. In the west, where people easily get treatment, AIDS is treated as a chronic condition, not a fatal disease.

That means it is less stigmatised; people have more incentive to get tested, so they will not spread HIV unknowingly; and the burden of fear and pain is less for all those infected and affected. The same should be true of SA.

- Makgetla is a Congress of South African Trade Unions economist.

[END OF ARTICLE BY MAKGETLA]

[END OF NEWSLETTER]