Should Thabo Mbeki be blamed for the early deaths of 365,000 people from Aids? Yes. The charge against the former South African President, based on calculations by a Harvard research group, appears to be a conservative estimate of the impact of a lethally perverse exercise in denying science, by a leader who was sophisticated, and in many areas, respected.

Mbeki’s refusal to support the supply of antiretroviral drugs or to launch a proper prevention scheme led to the premature deaths of 330,000 adults and 35,000 babies born infected, the team from the Harvard School of Public Health concludes. There is obvious room for debate over the figures – for example, over comparisons with nearby countries, as well as estimates of the further infection that might have been caused had sufferers not died early. But scientists who have examined the study (published online, and on Monday, in print in the Journal of Acquired Immune Deficiency Syndromes), say that the assumptions are cautious.

You might want to throw into the blame game at the same time the Bush Administration’s dogged insistence that US-backed family planning in Africa should encourage abstinence and not promote the use of condoms. That position, equally perverse, did much to cancel out the reputation the US would otherwise have deserved for its development efforts in the past eight years. But still, there is a big difference between US aid programmes holding back gifts of contraceptives and Mbeki denying life-prolonging treatment to his country’s citizens who already had the infection. Mbeki’s denial that the virus was the prime cause of Aids (he avoided a complete denial of any link at all) was the oddest feature of his otherwise too-cerebral presidency. Along with his refusal to condemn Robert Mugabe for plunging Zimbabwe into destitution, it is his most destructive decision.

Mbeki argued to his biographer, Mark Gevisser, that Western countries maintained that HIV infection caused Aids only because of their racist, colonial beliefs about African sexual promiscuity. He claimed that retrovirals were toxic and part of a commercial plan to render Africa dependent, and persisted despite protests by Nelson Mandela and his Cabinet.

Since he was ousted by his party in September, the South African Government has been trying to extract itself from this poisonous legacy.

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