The country with the highest number of people living with HIV is South Africa, where an estimated 5.5 million people are HIV-positive. A close second is India, with 5.2 million people infected.

In South Africa, 18.8% of adults aged 15 – 49 years are HIV-positive, the highest prevalence rate of all the large countries [2]. Contrary to common perception in Asia, UNAIDS reported that in sub-saharan Africa, more women are infected with HIV than men.

In the first decade of the epidemic, i.e. in the 1980s, when AIDS was still strongly associated with gay Americans, no one would have predicted that South Africa would top the list of countries most badly affected. That it is so today can at least be partly attributed to Thabo Mbeki, the country's President since 1999.

In many ways, Mbeki has maintained a policy of denial. He has long refused to provide leadership to the fight against AIDS. His silence on the subject, even as the epidemic raged, has held back efforts to educate the population and combat the disease. When anti-retroviral drugs became available, he dismissed the science behind them, maintaining that they were useless in the fight against HIV. How are campaigners and medical professionals going to persuade people to take precautions and seek treatment if the government will not even acknowledge the seriousness of the disease and the available counter-measures?

To many people, it is inexplicable how a leader of the country most affected by HIV can take such a head-in-the-sand attitude. For years, I couldn't figure either.

Then about a year or two ago, I saw an article that provided an explanation. How true it is, I don't know, but it has been the only explanation that makes any sense. Unfortunately, I can't remember where I saw it; probably it was in the Economist magazine.

In a nutshell, the explanation went like this: Mbeki's thinking is trapped by his formative experiences fighting apartheid, when white South Africans treated black Africans with contempt. He is unable to get past the "dignity" issue and he tends to see any discussion about sexual behaviour and HIV as one that, once again, lends support to the view that black Africans cannot take responsibility for themselves; that they are, to a degree, subhuman.

To openly discuss the subject of HIV among his people, to admit that his country needs all the help it can get to provide treatment to the millions infected, is too demeaning to his life's work of restoring racial pride. Perhaps he sees HIV-infected black Africans as traitors to his cause -– let them die, to put it crudely. There is no way he will beg for help from white countries,nor will he even accept the idea that White science has some effective treatments in hand. He cannot stomach the racial superiority that all this represents, the article said.

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Indeed, it is not uncommon for people who have a chip on their shoulder over their race or ethnicity to get extremely defensive about it. It colours all their other interactions with people, not just with the perceived "high and mighty", but also their own people. They tend to demand that their own people should live up to certain standards so as not to give cause to the suggestion that they're an inferior group. That sense of being looked down upon by others makes them intolerant of differences within their own camp, particularly differences which they consider as stains on their community's honour.

This is a known behavioural response. The chief servant can be more heartless towards the kitchen hand than the master. The one who's spent a lifetime at the receiving end of slights finds it impossible to be either compassionate or liberal towards others of the same kind. Dignity becomes an obsession.

In the area of sexuality and sexually-transmitted diseases, I will take the liberty of calling this type of behaviour the Mbeki Syndrome.

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Even in America, one sees this. Churches that are identified with African-Americans are often reek of homophobia. It may be incredible that a minority that feels discriminated against should in turn discriminate against its own subminority -– gay and lesbian African-Americans -– but it's so darn obvious.

Original Million Man March 1995. Source: www.pbs.org

For example, last October (2005), Keith Boykin, president of the (gay) National Black Justice Coalition was refused a speaking slot at the 10th anniversary Million Man March in Washington DC, an event to celebrate African-American solidarity and to draw national attention to their clout. Boykin said that after months of feuding, he was given a place at the rally, but at the last minute, Rev. Willie F. Wilson, the march's national executive director, reneged on the agreement. Others who were present at one of the meetings between them reported Wilson making some bizarre accusations about lesbians trying to entice other women to "turn gay" with sleeping pills and g-strings.

Black gay leaders felt this was typical of the anti-gay paranoia of black leaders in general.

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In the early years of the HIV epidemic in India, one of the most frustrating things that anti-HIV campaigners faced was an attitude of denial at various levels of the government. It may be an urban myth, though it represents quite well the attitudes they encountered, but a senior Health Ministry official representing India at an International AIDS conference in Canada was reported to have told the meeting that there were no homosexuals in India.

We see something similar all across Asia. In many countries, people believe that homosexuality was introduced by the West. Traditional Asian civilisations were never so debased, they would say

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To what extent do we see the Mbeki Syndrome in operation in Singapore? It's hard to say, and I'd rather let my readers think about it and form their own conclusions. But if you read Lee Kuan Yew's biography, you'd get the sense that he felt very deracinated when he was studying in London. He was not Anglo-saxon, but he was not quite Chinese either.

Has that put him on a course for the rest of his life, to stress his Chineseness, Confucian values (also marketed as "Asian values") and speaking Mandarin? To what extent has that experience led to a national obsession about proving ourselves the equals of the West? Would that include the realm of perceived morals?

However, I want to end this essay with a wicked twist in the narrative: in gay communities everywhere, straight-acting gay men tend to hold effeminate men in contempt. Conservative-minded, coupled gay men tend to accuse their free-n-easy brethren of sullying the image of the "community". What would you call that, if not the Mbeki Syndrome too?

© Yawning Bread