Drug wars: South African groups are clashing over whether AIDS medicines are harmful. Credit: Rodger Bosch/AFP/Getty Images

Doctors and AIDS activists in South Africa have filed a joint lawsuit against the country's health minister and controversial vitamin supplierMatthias Rath as concerns mount over the government's lack of leadership amidst the country's worsening AIDS crisis.

The South African Medical Association (SAMA) and the prominent activist group Treatment Action Campaign (TAC), which together filed the lawsuit, say they aim to end the climate of what the TAC calls “politically-supported denialism” afflicting the country's fight against AIDS.

A key element of the lawsuit is the allegation that in at least two townships, Rath is running illegal medical trials for his multivitamins, which he markets to AIDS sufferers as an alternative to 'poisonous' antiretroviral drugs.

We want the court to put an end to government-supported charlatanism. Nathan Geffen, Treatment Action Campaign

Rath has promoted these trials through several newspaper advertisements, claiming that a combination of micronutrients alone can reverse the course of AIDS, even in its advanced stage. But the TAC says five or more patients have died during these trials.

“There are reports of up to 12 deaths, but it's hard to say,” says TAC spokesman Nathan Geffen. “We hold [Rath] partially accountable for two to three of them. In the other cases, we feel they created false hopes,” he says.

Two patients from the trial, still alive and held up by Rath as models of success, were found to actually be taking antiretroviral drugs, according to the TAC.

Separately, health minister Manto Tshabalala-Msimang has long provoked outrage with her public support of garlic, lemon and beetroot as defenses against AIDS, as well as her ongoing affiliations with denialists like Rath. “We want the court to put an end to government-supported charlatanism,” says Geffen.

SAMA spokesman Mark Sonderup says the legal process is an attempt to get various agencies under the health minister's control, such as the Medicines Control Council, to properly investigate Rath's activities. “As the representative body of doctors in South Africa we have a principled duty to respond to what is going on,” Sonderup says.

A spokesman for Rath declined to speak to Nature Medicine about the case, saying he is convinced the journal is “funded to the hilt with drug money.”

Although the lawsuit is not expected to reach the court for some months, the TAC and SAMA have already gained public backing from several prominent groups, including the country's largest trade union, a major church council and various non-governmental organizations.

South Africa hosts an estimated 5.3 million HIV-infected individuals, the most for any country. A UNAIDS report released on 21 November says the country's epidemic has evolved at an astonishing speed, from a prevalence of less than 1% in 1990 to 25% by 2000.

The country's budget for AIDS has more than tripled since 2001 to R1.5 billion (about $235 million). In March the government spent R3.4 billion (about $533 million) to acquire a three-year stock of antiretroviral drugs. Experts estimate these drugs are provided to about 140,000 people, a significant increase from a year earlier—but still far behind the government's own rollout targets.