PO Box 13287, Vincent, 5217, South Africa.
In a time of epidemiological crisis, political leaders do not always listen to the scientific analysis and recommended action from the experts. Such experts are then turned into whistle-blowers and agitators who have a profound political agenda that challenges the prevalent ideology.
In Sidney Karks day it was apartheid that would not heed such voices of reason based on analysis. He was a pioneer in the field of primary health care, but had to leave the country when his ideas were ignored and his achievements dismantled by the apartheid regime.
The present South African government has unfortunately taken on the mantle of its predecessor in this regard. It is faced with an epidemic of a sexually transmitted disease that is even deadlier than syphilis, but has chosen to pursue other concerns. Human immunodeficiency virus (HIV)/AIDS is not regarded as a priority, despite the high death rate and the massive morbidity that it causes.
Kark and his colleagues were pioneers in the study of a disease that was decimating Africans and clarified the connection between syphilis and the socio-political climate of the day. The migrant labour system was established to provide workers for the diamond and gold mines. It tore families apart and allowed syphilis to spread. This barbaric system has not yet been replaced and has become a major contributory factor in the spread of HIV.
What a pity that history is repeating itself and that the best science is being ignored in order to pursue another narrow political and economic agenda. Instead of the colour of a mans skin being the determinant of deprivation, it has become the thickness of his wallet. A wealth of scientific evidence is challenged and top scientists are criticized or silenced if they challenge the prevailing Presidential view that HIV/AIDS is not important and may even be a mirage.
The lesson is clear. The pursuit of truth is in the best interests of public health epidemiologists, but it is demanding of high standards and a thick skin. Wanting to expose the truth is in the best interests of the patientsthe communitybut once again pandering to wayward politicians and bureaucrats has become entrenched on the question of curbing the HIV/AIDS epidemic in South Africa.
Reprinting this work will be a salutary lesson to those public health doctors who do not take up their social obligations and prefer to hide behind the parapet of self-interest. Kark was a pioneer in the delicate balance of being allowed to survive and exposing iniquity at the same time. His research was meticulous but still managed to tread on many toes. It is 50 years later but the use of science must still be protected from being abused by any political agenda and turned on its head.