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Elsevier issues ultimatum to Medical Hypotheses editor

Eduard Grebe — Thu, 11 Mar 2010 08:22:00 +0000

In a stunning indictment of the pseudoscience published in Medical Hypotheses, the journal's publisher has issued an ultimatum to the editor: implement peer review or resign. This comes after the retraction of two AIDS denialist papers that the journal published, which were unanimously rejected by five reviewers in a process managed by The Lancet. The papers, “HIV-AIDS hypothesis out of touch with South African AIDS: A new perspective” by Peter Duesberg and “AIDS denialism at the ministry of health” by Marco Ruggiero, caused great concern in the scientific community and several prominent AIDS researchers wrote to the publisher expressing their concern. The retractions and Elsevier's decision to implement peer review at the journal will no doubt be held up by denialists as evidence of "censorship," but in fact illustrates that "dissident science" does not stand up to the scrutiny of peer review. Medical Hypotheses does not conduct peer review and had under the leadership of its present editor, Bruce Charlton, become a haven for pseudoscience of various kinds, including AIDS denialism.

Below are two reports on the publisher's steps to reform Medical Hypotheses.

Zoë Corbyn writes in Times Higher Education:

The editor of the journal Medical Hypotheses has been given until 15 March either to implement changes to adopt a traditional peer-review system, or to resign.

He has also been told that even if he stays with the journal, his contract will not be renewed at the end of the year.

As Times Higher Education reported in January, publisher Elsevier is attempting to rein in its unorthodox journal, which publishes papers on the basis of how interesting or radical they are rather than using peer review, after it published a paper last July that denied the link between HIV and Aids.

The article prompted an outcry from Aids researchers, leading Elsevier to propose changes to both introduce peer review and exclude papers on certain controversial topics.

But Elsevier’s plans have been vehemently opposed by the journal’s editor, Bruce Charlton, its editorial advisory board and a large number of Medical Hypotheses’ authors, who have mounted a campaign to save the journal, believing it offers an important outlet for radical ideas.

Professor Charlton said: “Elsevier is asking me either to resign immediately, or else immediately to begin implementing changes that it has unilaterally and irrationally demanded. But my conscience will not allow me… I cannot do either of these things.”

The news comes as two controversial papers on the Aids virus that had been retracted from the journal following the outcry are “permanently withdrawn” after they failed to pass the test of peer review.

The papers in question are “HIV-AIDS hypothesis out of touch with South African AIDS: A new perspective” by Peter Duesberg, professor of molecular and cell biology at the University of California, Berkeley, and a paper published the same month, “AIDS denialism at the ministry of health” by Marco Ruggiero, professor of molecular biology at the University of Florence.

Both papers are being permanently withdrawn from the scientific record, even though the Ruggiero paper does not deny the link between HIV and Aids, but argues that the Italian Ministry of Health seemed not to believe that HIV is the “sole cause” of the Aids virus.

The papers were both rejected unanimously by five anonymous reviewers in a process managed by The Lancet, another Elsevier journal.

But Professor Charlton said he rejected both the process and outcome of this assessment, and accused Elsevier of running a “show trial” and making a “gross mistake”.

Read the full article.

ScienceInsider reports:

The editor of the journal Medical Hypotheses—an oddity in the world of scientific publishing because it does not practice peer review—is about to lose his job over the publication last summer of a paper that says HIV does not cause AIDS. Publishing powerhouse Elsevier today told editor Bruce Charlton that it won't renew his contract, which expires at the end of 2010, and it asked that Charlton resign immediately or implement a series of changes in his editorial policy, including putting a system of peer review in place. Charlton, who teaches evolutionary psychology at the University of Newcastle upon Tyne in the United Kingdom, says he will do neither, and some on the editorial advisory board say they may resign in protest if he is fired.

Elsevier's move is the latest in an 8-month battle over the journal; it comes after an anonymous panel convened by Elsevier recommended drastic changes to the journal's course, and five scientists reviewed the controversial paper and unanimously panned it.

Medical Hypotheses, which says it "will consider radical, speculative and non-mainstream scientific ideas provided they are coherently expressed," is the only Elsevier journal not to practice peer review. Scientist, entrepreneur, and author David Horrobin, who founded the journal in 1975, believed reviewers tend to dislike what lies outside the scientific mainstream and thus are reluctant to embrace new ideas, however promising. Charlton, who succeeded Horrobin in 2003, takes the same view: He decides what gets published himself—although he occasionally will consult another scientist—and manuscripts are edited only very lightly. As thejournal's Web site explains, "the editor sees his role as a 'chooser', not a 'changer.' "

It's a policy that leads to the occasional wild and wacky paper—a 2009 article for which the author studied his own navel lint became an instant classic—but the journal is also a "unique and excellent" venue for airing new and valuable ideas, says neuroscientist Vilayanur Ramachandran of the University of California (UC), San Diego, who published in the journal 15 times himself and sits on its editorial advisory board. "There are ideas that may seem implausible but which are very important if true," Ramachandran says. "This is the only place you can get them published."

...

Duesberg—who has not published anything on HIV the past decade except for one paper in a journal published by the Indian Academy of Sciences—says Elsevier's measures are the latest example of "censorship" imposed by the "AIDS establishment." But Medical Hypotheses' critics applaud the publisher’s latest step. "It seems clear that Elsevier has come to realize that there is a problem with Medical Hypotheses and that they are doing what they can to rectify it," says Moore.

Read the full article.

Debunking Delusions - New book by Nathan Geffen

Eduard Grebe — Wed, 10 Mar 2010 13:27:38 +0000

AidsTruth contributor and a leader of the Treatment Action Campaign, Nathan Geffen, has published a new book documenting AIDS denialism and the related quackery in South Africa titled Debunking Delusions: The Inside Story of the Treatment Action Campaign. We will publish a full review soon. More information can be found at the book's website. Below is the publisher's summary of the book.

Summary

One of the great, iconic struggles for social justice in the 21st century has been the campaign of the TAC against state-supported Aids denialism in South Africa. This struggle between activists, scientists and health workers, on the one hand, and a strange alliance of dissidents, quacks and political leaders, on the other, is here recounted in absorbing and dramatic detail for the first time by an insider. In his book Nathan Geffen, one of the TAC leaders, describes how early on in its life the organisation discovered that the greatest obstacle to AIDS treatment was in fact the South African government’s denialism. Not only did this extend to a reluctance to provide antiretroviral treatment to AIDS patients but also to support of a host of quacks and denialists who operated freely in the country to sow suspicion and confusion about the efficacy of standard medical treatment of AIDS. The most notorious of these were the German vitamin seller, Dr Matthias Rath, who along the way sued The Guardian of London and lost his case, and the Dutch nurse Tine van der Maas. It was the TAC that, as a result of a court case it brought against Rath, managed to stop his operations in South Africa; and it was the TAC, once again through legal means, that put pressure on the South African government to roll out an antiretroviral programme throughout the country. Geffen describes not only the TAC’s response to the puzzling intransigence of government and the spellbinding nonsense of dissidents, but the thought, strategy and discussion that lay behind the organisation’s major decisions. The story of the TAC’s campaign is one of the great triumphs of citizen activism for social justice and human rights.

About the Author

Nathan Geffen has been one of the leaders of TAC since 2000. His work has involved confronting the AIDS denialist policies of Thabo Mbeki and Manto Tshabalala-Msimang. He was also the editor of TAC’s magazine Equal Treatment. He has written extensively on AIDS and human rights. He previously co-authored two chapters in Edwin Cameron’s book Witness to Aids, winner of the Sunday Times Alan Paton Award. This is Geffen’s first full book.

“Between these covers you will find all the passion and intelligence Nathan Geffen devoted to the fight against quackery in South Africa. The Mbeki government’s march of folly is fully exposed here. One hopes that this book will serve, not only as a record, but as a lesson.” – Jonny Steinberg

“An intellectually incisive, engagingly written history of a policy calamity – and the courageous activism it unleashed – that has important implications for our country's understanding of its past, as well as its future course.” – Edwin Cameron

Junk Science Kills

Eduard Grebe — Tue, 09 Feb 2010 17:45:03 +0000

Elizabeth M. Whelan writes in the New York Post:

The media gave big headlines to this week's stories on a prestigious British medical publication's retraction of an article that had claimed to show a causal link between standard childhood vaccinations (measles, mumps and rubella) and autism.

Yet the coverage of the Lancet affair didn't truly convey the outrageousness of the original publication or the gravity of its consequences -- consequences long festering, since the paper was published not last week but 12 years ago.

Many of us in the scientific community recognized the "study" as junk when it appeared in 1998. Even before we learned of then-unknown ethical failings by its lead author, we knew the study was based on a tiny population of only 12 children. More, it relied on a novel methodology that assumed some bizarre, previously unheard of, association between children's autism and their manifestation of intestinal problems.

Nonetheless, the media back then seized on this story from a prestigious medical source -- and the scare picked up steam when TV appearances by actress Jenny McCarthy and a Rolling Stone article by Robert Kennedy Jr. blared word of the putative dangers of vaccines.

When criticism of the paper intensified in the days after publication, Lancet editor-in-chief Dr. Richard Horton defended his decision to publish what he acknowledged as an inferior study by claiming it would generate debate on the autism/vaccine issue. Even when 10 of the original 13 authors withdrew their names from the article, Horton still refused to withdraw the study.

Read the full piece in the New York Post.

Salon.com: The autism-vaccine lie that won't die

Eduard Grebe — Mon, 08 Feb 2010 15:42:12 +0000

Rahul K. Parikh, M.D. writes on Salon.com:

The media trumpeted an irresponsible study, ensuring that its nasty legacy thrives

Feb. 05, 2010

This week, Dr. Andrew Wakefield's now infamous study linking the MMR vaccine to autism was finally retracted by the prestigious Lancet medical journal. The move came days after medical officials in the United Kingdom found the doctor guilty of multiple ethics violations. For doctors, this is a victory -- but a bittersweet one.

As a pediatrician, I grapple daily with what Wakefield wrought: parents who are twisted in knots -- to the point of tears -- about whether to immunize their child. In the 12 years since the publication of Wakefield's study, 10 of his fellow co-authors have denounced him, and an unremitting series of revelations have exposed just how corrupt his motives and methods were. Most important, multiple studies verified there is no link between the MMR (or any other) vaccine and autism. Meanwhile, infectious diseases once confined to medical history have broken out in our communities. To say the retraction is criminally overdue is an understatement.

Further, even as Wakefield's research is expunged from the scientific record, what he spawned -- a well-funded, vocal, even rabid movement -- will remain. Without him, poster girl Jenny McCarthy would have been abandoned in the MTV archives instead of smugly crowing to Time magazine, "I do believe sadly it's going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it's their f___ing fault that the diseases are coming back. They're making a product that's s___ ." And anti-vaccine darling David Kirby would split his time between running a P.R. firm and writing pithy articles about art and aircraft instead of turning speculation and rumor into a Kennedy-esque vaccine-autism conspiracy theory. Finally, Wakefield himself stands to be completely unaffected by both the U.K. medical community (which could revoke his license to practice there) and the Lancet's decision. He long ago settled here in the U.S. and successfully peddles his views through his Thoughtful House autism center in Texas.Still, while the media busily finger-wagged, blogged and tweeted about the damnation of Andrew Wakefield, I wondered whether it considered its own complicity in the whole sordid affair.

The anti-vaccine hysteria, after all, began like so many other big stories: with a press conference. That's where Andrew Wakefield first staked his claim that the MMR vaccine caused autism, according to Paul Offit's book, "Autism's False Prophets." Wakefield wasn't flanked by doctors or hospital officials but by P.R. folks he had hired himself. "One case of [autism] is too many," he said. "It's a moral issue for me, and I can't support the continued use of [the MMR vaccine] until this issue has been resolved."

The problem, of course, is that a news conference loads a gun that the media usually pulls the trigger on: Headlines like "Ban Three-in-One Jab, Doctors Urge" started rolling off the presses. While measles made a tragic resurgence, few reporters attempted to scrutinize Wakefield or his audacious claim. (Even Salon has its own history of bad reporting on the topic, in a controversial and inaccurate 2005 piece by Robert F. Kennedy Jr.)

Read the full article on Salon.com.

Wakefield, who linked MMR vaccine to autism, found to have shown "callous disregard" for children

Eduard Grebe — Thu, 28 Jan 2010 22:56:30 +0000

The anti-vaccine movement, which shares characteristics with AIDS denialism (both like to blame pharmaceutical conspiracies) and which was originally based on claims by British surgeon Andrew Wakefield, has been dealt a decisive blow by a finding against Wakefield by the General Medical Council. Caims that the MMR vaccine was linked to autism have since been shown to be baseless, but are still promoted by some, including by groups linked to AIDS denialism. The Guardian reports:

Dr Andrew Wakefield, the expert at the centre of the MMR controversy, "failed in his duties as a responsible consultant" and showed a "callous disregard" for the suffering of children involved in his research, the General Medical Council (GMC) has ruled.

Wakefield also acted dishonestly and was misleading and irresponsible in the way he described research that was later published in the Lancet medical journal, the GMC said. He had gone against the interests of children in his care, and his conduct brought the medical profession "into disrepute" after he took blood samples from youngsters at his son's birthday party in return for payments of £5.

The doctor, who was absent from today's GMC hearing, faces being struck off the medical register. The panel decided the allegations against him could amount to serious professional misconduct, an issue to be decided at a later date.

Continue reading at The Guardian.

Also see "From the Lancet to the GMC: how Dr Andrew Wakefield fell from grace".

The Lancet: a new South Africa takes responsibility

Eduard Grebe — Mon, 07 Dec 2009 14:56:40 +0000

The Lancet has hailed the new approach evident in South Africa in which the government has decisively turned away from the AIDS denialism associated with former President Thabo Mbeki.

The Lancet, Volume 374, Issue 9705, Page 1867, 5 December 2009

HIV/AIDS: a new South Africa takes responsibility

On Dec 1 the usual activities surrounding World AIDS Day will take on a special significance for South Africans. In a high-profile event in Pretoria, the South African National AIDS Council (SANAC) is bringing together people who work in HIV/AIDS, those who have been affected by HIV, and government officials, including President Jacob Zuma, Deputy President and SANAC Chair Kgalema Motlanthe, and the Minister of Health Aaron Motsoaledi. Zuma will give a televised address on HIV/AIDS to the nation. Under the motto “I am responsible, we are responsible, South Africa is taking responsibility”, a new era in the country's response to HIV/AIDS is being publicly heralded. In a key-messages booklet, SANAC calls on everyone to know their HIV status by frequent testing; on communities to stop stigma and discrimination against people living with HIV; and on itself to ensure that the government is taking responsibility for people to receive counselling, provide condoms, and give access to treatment for tuberculosis and HIV.

Already on Oct 29, in what has been widely praised as a landmark speech, Zuma left no doubt about the decisive departure from the previous government's stance of denialism and indifference: “South Africa must work harder to implement the national strategy to tackle HIV/AIDS…all South Africans need to know their HIV status and be informed of the treatment options available to them…there should be no shame, no discriminations, and no recriminations”. The non-governmental organisation Treatment Action Campaign called Zuma's speech, which came almost 10 years after Thabo Mbeki made his HIV/AIDS denial clear before the same National Council of Provinces, as “one of the most important speeches in the history of AIDS in South Africa”.

This extremely welcome and long-awaited change in attitude, and its appropriate urgency, is accompanied by a burst of behind-the-scene activities at the Department of Health and SANAC. In a press conference last month, Motsoaledi explained that there are moves ahead to integrate health facilities for tuberculosis and HIV/AIDS, that antiretroviral treatment (ART) guidelines are being revised to initiate treatment for those with a CD4-cell count below 350 cells per μL, and that there are plans for comprehensive integrated antenatal care, which include prevention of mother-to-child transmission—all actions that were called for in The Lancet's recent South Africa Series. The revised ART treatment discussions even came ahead of new WHO recommendations, published on Nov 30. South Africa's National Strategic Plan for HIV/AIDS and sexually transmitted diseases aims to reduce the rate of infections by 50% and cover 80% of the people who need ART by 2011. In October, Cabinet committed to accelerate the response to meet these targets by 2011.

Additionally, Motsoaledi and others in his department are busy identifying and rectifying managerial and attitudinal deficiencies in district-level health-care facilities and have created an expert group to advance the National Health Insurance agenda.

This integrated multilevel approach to tackle the long-neglected burden of HIV/AIDS—based on, and emboldened by, scientific assessment—is a refreshing and brave shake up by a politician. It raises hope and excitement, especially among scientists, academics, and clinicians, who have been ignored and alienated for far too long. However, the task is enormous. South Africa remains the country with the largest HIV-positive population, 5·7 million, according to 2008 UNAIDS figures. Average antenatal prevalence is 29·3% but four districts record a prevalence above 40%, and 79% of maternal deaths tested for HIV were HIV-positive. What is needed to make these ambitious plans a reality is adequate resources, both financial and human, and buy-in by all involved. The South African World AIDS Day motto rightly asks for everyone to take responsibility and play his or her part.

When we asked for serious discussions and decisive actions in a Comment accompanying the launch of The Lancet Series, we could not have hoped for a swifter indication of serious engagement. And although the ultimate test will be in the actual delivery of preventive efforts and treatment for all, and evidence of an effect on new infections and mortality, a first very important and encouraging step towards these goals has been made. South Africa has shown how science and policy working together make the best advocates for change—change for a healthier future.

Article reproduced by permission of Elsevier.

doi:10.1016/S0140-6736(09)62065-1

Killer syndrome: The Aids denialists

Eduard Grebe — Tue, 01 Dec 2009 12:48:40 +0000

Rob Sharp reports in The Independent on the presistence of AIDS denialism

A middle-aged man walks into an East London café and apologises for being late. With his clipped hair and bus-driver's uniform of thick overcoat, shirt, and branded tie, he looks like any other public service employee. But soon he delivers a speech of startling ferocity against the medical establishment.

Mike explains that he runs a London-based health website on which he posts articles and links to information that questions whether HIV causes Aids, disputes the existence of HIV, and denies the fact that unprotected sex helps to spread it. He offers support for those who, he says, are "negotiating with medical authorities over taking a different approach to dealing with their circumstances." He claims to get thousands of hits on his site and has helped advise several people who have been diagnosed with HIV and are launching legal action against their local health authorities, in the belief that they have been unfairly treated by the doctors who are trying to help them.

Mike is an Aids denialist. He shares the view of a global network of academics and campaigners that follow the proclamations of Peter Duesberg, a cell biologist at the University of California, Berkeley, who believes HIV does not cause Aids. And, alarmingly, 2009 has been a good year for the denialist community.

In the first week of November, a record number of Aids denialists from 28 countries, including Britain, attended the Rethinking Aids conference in Oakland, California. One of the main draws of the conference was a screening of a controversial new documentary by Canadian-born director Brent Leung, House of Numbers, which gives a platform to denialist theories.

Over the last two months it has been screened at the Cambridge and Raindance Film Festivals - decisions that provoked a storm of criticism online. The Spectator was forced to cancel a debate and screening of the film on 28 October after some of the participating speakers pulled out. And yet despite widespread outrage, the film has undoubtedly encouraged those who espouse denialist theories in the UK.

So who are the Aids deniers and what do they believe? According to Seth Kalichman, a psychologist at the University of Connecticut, whose exposé of the movement, Denying Aids, was published in March, denialists anywhere in the world generally share several common beliefs. They say that the "myth" that HIV causes Aids is the product of conspiracies between governments and the pharmaceutical industry; that antiretroviral medication is toxic; and that one day the orthodox medical theories on HIV will crumble.

So far, so typically crackpot. But the movement has gained some damaging traction - and the propagation of denialist theories can have deadly repercussions. Aids charities warn that reading material which argues that HIV does not cause Aids can dissuade potential sufferers from getting tested for HIV, and even lead HIV-infected people to ignore HIV-positive results and cause them to reject antiretroviral therapies.

"Denying the link between HIV and Aids is scientific illiteracy," says Yusef Azad, director of policy and campaigns at the National Aids Trust, Britain's leading HIV/Aids charity. "But worse than that, it is profoundly dangerous and has caused countless unnecessary deaths. Just because something is on the internet does not mean it is even remotely true. More than two decades of peer-reviewed scientific research demonstrates in some detail how HIV attacks the immune system and causes Aids if left untreated."

Read the full article on The Independent's website.

McGill Daily on the dangers of denialism

Eduard Grebe — Fri, 27 Nov 2009 00:14:33 +0000

Stephanie Law writes in the McGill Daily:

Christina Maggiore died of an AIDS-related illness on December 27, 2008. She was a successful businesswoman who started a multimillion-dollar import/export clothing company, and a freelance consultant for U.S. government export programs. Maggiore is most notorious for her role as an HIV-positive activist who promoted the idea that HIV is not the real cause of AIDS. She was an HIV-denialist.

Maggiore was diagnosed with HIV in 1992. In 1994, she met Peter Duesberg, a molecular biology professor at the University of California at Berkley. Duesberg convinced Maggiore that HIV does not lead to AIDS. A year later, Maggiore started one of the largest networks of HIV-denialists and skeptics, called Alive & Well AIDS Alternatives.

Maggiore refused antiretroviral treatment for HIV because she did not think HIV would lead to AIDS and AIDS-related illnesses. She did not take the recommended treatment for pregnant HIV-positive women to prevent mother-to-child transmission. Her child died at the age of three from Pneumocystis jirovecii pneumonia. The Los Angeles County coroner and various other independent pathology experts concluded that the death was a direct result of her untreated HIV that had progressed into AIDS.

W hen asked about Maggiore, Mark Wainberg, director of the McGill University AIDS Centre, becomes enraged: “Christina Maggiore and her daughter died because they didn’t get treated…. Their story is tragic, but the reality is, Christina Maggiore was so misguided in believing this concoction of bullshit, that it cost not only her life, which is her business, but also the life of her three-year-old kid, and that is everybody’s business.”

Maggiore and her daughter’s deaths are only two of many that result from denying the causal link between HIV and AIDS.

Read the full article.

The Lancet reviews AIDS denialist film "House of Numbers"

Eduard Grebe — Tue, 17 Nov 2009 19:32:10 +0000

Talha Burki writes in The Lancet Infectious Diseases:

Strange, perhaps, for The Lancet Infectious Diseases to review House of Numbers. It is a threadbare documentary that claims there is no connection between HIV and AIDS. It arrives at this conclusion through a toxic combination of misrepresentation and sophistry. At best, it is a misguided and misbegotten film; at worst, it is downright malevolent.

All of which makes a fine case for ignoring it. HIV/AIDS denialism is an ideology in disgrace; the ravings of what Stephen Lewis—former UN Special Envoy for AIDS in Africa—describes as a “lunatic fringe”. To debate House of Numbers is to attend the film with an honesty and dignity that is entirely alien to its nature. Far better to leave it mouldering in the clutches of cranks and conspiracy theorists.

Only, denialism kills. A study published in the Journal of Acquired Immune Deficiency Syndromes found that South Africa's former reluctance to roll-out antiretroviral-drug programmes—a consequence of former President Thabo Mbeki falling under the sway of the denialist movement—cost more than 330 000 lives. Today, South African policy is very different; “the era of denialism in South Africa is completely over”, stated Barbara Hogan upon her appointment as Health Minister after Mbeki's removal. But it is not inconceivable that the denialist movement might gain ground elsewhere, with similarly catastrophic results.

House of Numbers purports to be an investigative piece by Brent Leung, a filmmaker with “unanswered questions” about the AIDS pandemic. But the disreputable credo of denialism is easy to recognise. The belief system can be summarised as follows: AIDS is not caused by HIV. It is instead a disease related to poverty, malnutrition, and homosexual lifestyles. Antiretroviral drugs are poisonous—“AIDS by prescription” claims Peter Duesberg, spearhead of the denialist movement, and a prominent figure in this film—the pharmaceutical industry is in on the conspiracy, as are the major health organisations. “Could it be that the real epidemic is extreme poverty not HIV?”, Leung disingenuously asks.

If you have a subscription to The Lancet, read the full article here.

The Lancet Infectious Diseases, Volume 9, Issue 12, Page 735, December 2009

doi:10.1016/S1473-3099(09)70316-0

HIV/AIDS is leading cause of death of women of reproductive age: UN report

Eduard Grebe — Thu, 12 Nov 2009 16:48:14 +0000

The World Health Organization's report Women and health: today's evidence, tomorrow's agenda identifies HIV/AIDS as the leading cause of death among women of reproductive age: "Globally, the leading cause of death among women of reproductive age is HIV/ AIDS. Girls and women are particularly vulnerable to HIV infection due to a combination of biological factors and gender-based inequalities, particularly in cultures that limit women’s knowledge about HIV and their ability to protect themselves and negotiate safer sex."

Here is an extract from the report:

This section is copied without footnotes or graphs. To download the full report, see below.

Women and HIV/AIDS

Globally, HIV is the leading cause of death and disease in women of reproductive age. Of the 30.8 million adults living with HIV in 2007,a 15.5 million were women. The prevalence of HIV infection in women has increased since the early 1990s and is most marked in sub-Saharan Africa.

Total number of people living with HIV/AIDS in 2007 was 33 million, including two million children younger than 15 years.

Southern Africa is most affected; in 2005–2006, median HIV prevalence among pregnant women attending antenatal care was above 15% in eight Southern African countries. Infection was acquired primarily through heterosexual transmission.

In all regions, HIV disproportionately affects female sex workers and injecting drug users, as well as the female partners of infected males.

Women’s particular vulnerability to HIV infection stems from a combination of biological factors and gender inequality. Some studies show that women are more likely than men to acquire HIV from an infected partner during unprotected heterosexual intercourse. The risk posed by this biological difference is compounded in cultures that limit women’s knowledge about HIV and their ability to negotiate safer sex. Stigma, violence by intimate partners, and sexual violence further increase women’s vulnerability. Fewer young women than young men know that condoms can protect against HIV. Furthermore, while women generally report increased condom use during high-risk sex, they are generally less likely to protect themselves than men are.

The youngest women are the most vulnerable. They not only face barriers to information about HIV – and in particular how they can protect themselves from infection – but in many settings they often engage in sexual activity with older men who are more sexually experienced and more likely to be infected.

Female drug users and sex workers are particularly vulnerable; stigma, discrimination and punitive policies only increase their vulnerability. The rate of HIV infection among female sex workers is high in many parts of the world, and a large proportion of women who use drugs also engage in sex work. In prisons, the proportion of drug users among females is higher than among males. The use of contaminated injection equipment is particularly prevalent among women, resulting in higher rates of HIV infection.

Economic vulnerability is another key factor driving HIV infection among women. Economic vulnerability is sometimes associated with migration, which increases high-risk behaviours among women who may be driven into sex work by economic necessity. On a more positive note, in recent years women have benefited from increased access to HIV prevention, treatment and care. Data from 90 low- and middle-income countries suggest that, overall, women are slightly advantaged in terms of access to antiretroviral therapy: at the end of 2008, 45% of women in need and only 37% of men in need received antiretroviral therapy. In 2008, 45% of pregnant women living with HIV received antiretrovirals to prevent mother-to-child transmission of HIV, up from 10% in 2004. Nonetheless, challenges remain: only 21% of pregnant women received HIV testing and counselling, and only one third of those identified as HIV-positive during antenatal care were subsequently assessed for their eligibility to receive antiretroviral therapy for their own health.

To download the full report or executive summary, visit this page: http://www.who.int/gender/documents/9789241563857/en/index.html

South African health minister reveals "shocking" AIDS figures; blames Mbeki denialism for worsening the crisis

Eduard Grebe — Wed, 11 Nov 2009 12:58:05 +0000

South Africa's Mail & Guardian newspaper reports:

"In 11 years -- from 1997 to 2008 -- the rate of death has doubled in South Africa. That is obviously something that cannot but worry a person," Health Minister Aaron Motsoaledi told reporters at Parliament in Cape Town.

He said that in 1997 the total number of deaths stood about 300 000. Last year the figure was 756 000.

Motsoaledi said the figures called for a "massive change in behaviour and attitude" toward Aids among South Africans.

"On the figures, it's shocking. As to whether it has been affected by what we did in the past 10 years, to me that's obvious," he said, according to the South African Press Association.

Read the full article.

Landmark speech by South African President Jacob Zuma

Eduard Grebe — Fri, 30 Oct 2009 12:09:20 +0000

The Treatment Action Campaign's statement on the South African president's unequivocal repudiation of AIDS denialism in a speech to the upper house of the country's parliament:

Yesterday, President Jacob Zuma made one of the most important speeches in the history of AIDS in South Africa. In front of the National Council of Provinces (NCOP), he unequivocally acknowledged the devastation of AIDS on our country. With this speech state-supported AIDS denialism has been banished. The Treatment Action Campaign welcomes the ushering in of this new era, almost exactly ten years since former President Mbeki made a speech that began the era of state-supported denial in front of the NCOP.

President Zuma acknowledged that government’s efforts so far have been insufficient to curb the devastation of the epidemic. The reality of this has been declining health outcomes and increasing mortality. We have a crippled health system and a ballooning epidemic from the years of AIDS denialism and inaction by former President Thabo Mbeki and former Health Minister Manto Tshablala-Msimang. However, today’s speech puts that behind us and provides hope that President Zuma will urgently tackle the epidemic with renewed commitment to meet the treatment and prevention targets of the HIV & AIDS and STIs National Strategic Plan 2007-2011 (NSP).

In his speech, President Zuma acknowledged that the fear and shame that have surrounded the epidemic must be overcome. The spread of the epidemic is intimately connected to government’s ability to safeguard our human rights. All South Africans must feel secure to know their status and access and adhere to treatment without fear of discrimination.

President Zuma emphasized the need for behaviour change to reduce new infections by 50% from 2007 to 2011, the NSP prevention target. Changing behaviour must be facilitated by increased access to prevention services and by reducing the vulnerabilities to HIV infection in our society. Converting knowledge to behaviour change will be directly linked to these interventions.

A theme of the speech was that to turn the tide of the epidemic political will is needed not only by government but also by the citizens of South Africa. TAC and other civil societies have developed an active cadre of HIV activists in South Africa but this commitment to tackling the epidemic needs to be adopted throughout our society. As South African citizens we must actively engage with our own health and the health of each other. As active citizens we can overcome the stigma and discrimination that have driven the epidemic.

Key challenges remain to meeting the ambitious targets of the National Strategic Plan (2007 - 2011) for the treatment and prevention of HIV. But with the renewed political will demonstrated by President Zuma demonstrated by President Zuma and the leadership of Minister of Health, Aaron Motsoaledi, we believe these targets are achievable.

Joseph Sonnabend: House of Numbers is an AIDS denialist film

Eduard Grebe — Fri, 30 Oct 2009 11:52:58 +0000

Joe Sonnabend writes in his POZ blog:

House of Numbers is the title of a documentary film which according to its promotional material will "rock the foundations on which all conventional wisdom on HIV/AIDS is based"

I have seen the film. It is completely unable to achieve this grandiose objective. It is in fact an AIDS denialist film, despite the contention to the contrary by Brent Leung who made it.

The denialists are a disparate group who remarkably continue to believe that HIV cannot be the causative agent of AIDS either because it is harmless or because it does not exist. There are even those who believe that AIDS itself does not exist as a distinct disease entity. Of course there is no shortage of people with strange views that fly in the face of solid evidence. We can mostly just ignore them. But sometimes these views can be dangerous, and then we really do have to confront and challenge fallacious assertions that can lead to harm.

The Spectator is a weekly UK publication that had arranged a showing of the House of Numbers to be followed by a panel discussion of the film with audience participation. I had agreed to be one of the four panel members together with the filmmaker. Several people asked me not to participate in this event, probably with the thought that it was wrong to associate in any capacity with individuals who hold such outrageous views. There was also much activity on UK blogs, generally denouncing the Spectator event. It seems that a lot of people just did not want it to happen.

Two of the panel members withdrew so the event has now been cancelled. This is a pity. The film is as I said, dangerous. It is dangerous specifically because it presents antiviral treatments as only toxic with no mention of their benefits. Therefore it is justified to be very concerned that some people who need treatment may be dissuaded from receiving it after seeing the film.

I do accept that it is right to not prohibit individuals from expressing their views, no matter how distasteful. But when these views carry danger it is particularly important that they be challenged with valid information. It is absolutely wrong to ignore the film and allow it a free hand in spreading misinformation. As I have experienced when I was a member of President Mbeki's panel in S. Africa, it is impossible to argue with those who hold such denialist views. They are impervious to reason. It is therefore pointless to engage them in discussion. However, when their position is presented to the public, then it is right to try to expose the fallacy of their views to those who might be influenced by them and thus may come to harm as noted above regarding HIV infected people in need of treatment.

I should explain why this is definitely a denialist film despite the protestations of its director that it is not.

In providing a more or less equal, uncritical and essentially neutral platform to those holding denialist views together with those who do not, the filmmaker, presenting himself as an unbiased observer merely asking questions, puts forward the impression that the issue of HIV's role in causation remains unsettled. Although the film does not explicitly reject HIV as playing a causative role in AIDS, it most certainly leaves one with the impression that this, and even the existence of the virus, is merely conjecture. This is a misleading presentation of the well established causative link between HIV and AIDS as something that is just a theory, on a par with the theories of Dr Duesberg or of those who claim that HIV does not exist.

This is absurd and as I explained, also dangerous.

Read the full post.

Death by denial: Symposium explores HIV denial, conspiracy theories

Eduard Grebe — Tue, 27 Oct 2009 22:08:19 +0000

AIDSTruth contributor Nicoli Nattrass and Seth Kalichmann, author of Denying AIDS were among the scientists and activists who participated in Harvard University's symposium on AIDS Denial. The Harvard Gazette reports:

People who deny that the HIV virus causes AIDS continue to persist in their beliefs despite overwhelming scientific evidence to the contrary, nurtured by the broad reach of the Internet and cherry-picked scientific claims, AIDS authorities said Monday (Oct. 19).

Researchers from Harvard, elsewhere in the United States, and South Africa convened at the Carpenter Center for the Visual Arts to decry HIV “denialism,” saying that the continued questioning of HIV’s role in AIDS harms those infected with the virus by discouraging both testing and treatment.

According to the speakers, denialism takes two major forms. Some skeptics deny that HIV plays a role in AIDS, or that it even exists, while others believe in AIDS conspiracies, acknowledging that HIV causes AIDS but questioning HIV’s origins, saying it results from a government conspiracy, is intended as a genocide campaign against blacks, that it was created in CIA labs, or is of other sinister origin or purpose.

The event, sponsored by the Harvard University Center for AIDS Research, was presented in conjunction with the Carpenter Center’s exhibit “ACT UP New York: Activism, Art, and the AIDS Crisis, 1987-1993.” The exhibit contains posters, T-shirts, fliers, and pamphlets from ACT UP’s AIDS activism campaigns which, through sometimes graphic and jarring messages, pushed government action against AIDS. The campaign argued that the government dragged its feet because of homophobia and racism aimed at two groups prone to the ailment: gay men and intravenous drug users, who are often minorities.

Read the full article.

The Spectator dabbles in denialism

Eduard Grebe — Sat, 24 Oct 2009 21:53:00 +0000

The Spectator's editor, who has in the past questioned climate change, has now started "Questioning the AIDS consensus", inspired by the denialist film House of Numbers.

Update: Now Neville Hodgkinson writes in The Spectator "on a new film that challenges the tenets of the Aids religion and exposes the dangerous confusion at the heart of the industry".

New Statesman's Mehdi Hassan writes:

I have blogged before on the new Spectator editor Fraser Nelson's crude denialism of climate change and his failure to engage with the peer-reviewed scientific literature. I see he has now turned his attention to questioning the link between HIV and Aids, in his Coffee House blog post "Questioning the Aids consensus". Here is how he puts it:

Is it legitimate to discuss the strength of the link between HIV and Aids? It's one of these hugely emotive subjects, with a fairly strong and vociferous lobby saying that any open discussion is deplorable and tantamount to Aids denialism. Whenever any debate hits this level, I get deeply suspicious.

Which is why the below clip -- from a documentary which the Spectator Events division is screening next week, called House of Numbers -- aroused my interest. The film picked up awards at various American film festivals, but has since been denounced as backing Aids denialism. Yet the footage shows Luc Montagnier -- who won a Nobel prize last year for his work on Aids -- saying that many HIV infections can be shrugged off by a healthy immune system.

If Nelson had done his research, he would know that 18 angry doctors and scientists interviewed in the film have since issued a public statement claiming that the film-maker Brent Leung "acted deceitfully and unethically" when recruiting them and that House of Numbers "perpetuates pseudoscience and myths".

Read Mehdi's full post.

HIV and Aids: debate or denial?

Eduard Grebe — Sat, 24 Oct 2009 19:26:11 +0000

Ben Goldacre writes in The Guardian:

A lot of strange stuff can fly in under the claim that you are "simply starting a debate". You may remember the Aids denialist documentary House of Numbers from three weeks ago. Since then, it has received many glowing outings. The London Raindance film festival explained that they were proud to show it, and a senior programmer appeared on YouTube saying they had gone through the film at 15-second intervals, finding no inaccuracies at all.

This is pretty good for a film which suggests that HIV doesn't cause Aids, but antiretroviral drugs, or poverty, or drug use do, or HIV probably doesn't exist, diagnostic tools don't work, and Aids is simply a spurious basket diagnosis invented to sell antiretroviral medication for a wide range of unrelated problems, and the treatments don't work either.

But now the film has received an even more prominent platform. Here is Fraser Nelson, political editor of the Spectator, promoting the Spectator event next Wednesday at which they will be screening this film: "Is it legitimate to discuss the strength of the link between HIV and Aids? It's one of these hugely emotive subjects, with a fairly strong and vociferous lobby saying that any open discussion is deplorable and tantamount to Aids denialism. Whenever any debate hits this level, I get deeply suspicious."

Of course people will have some concerns. Despite international outcry, from 2000 to 2005 South Africa implemented policies based on the belief that HIV does not cause Aids, and declined to roll out adequate antiretroviral therapy. It has been estimated in two separate studies that around 350,000 people died unnecessarily in South African during this period.

Read the full article.

Swine Flu Shots Revive a Debate About Vaccines

Eduard Grebe — Mon, 19 Oct 2009 13:04:58 +0000

Jennifer Steinhauer writes in the New York Times:

People who do not believe in vaccinating children have never had much sway over Leslie Wygant Arndt. She has studied the vaccine debate, she said, and came out in favor of having her 10-month-old daughter inoculated against childhood diseases. But there is something different about the vaccine for the H1N1 flu, she said.

“I have looked at the people who are against it, and I find myself taking their side,” said Ms. Wygant Arndt, who lives in Portland, Ore. “But then again I go back and forth on this every day. It’s an emotional topic.”

Anti-vaccinators, as they are often referred to by scientists and doctors, have toiled for years on the margins of medicine. But an assemblage of factors around the swine flu vaccine — including confusion over how it was made, widespread speculation about whether it might be more dangerous than the virus itself, and complaints among some health care workers in New York about a requirement that they be vaccinated — is giving the anti-vaccine movement a fresh airing, according to health experts.

“Nationally right now there is a tremendous amount of attention on this vaccine,” said Dr. Thomas Farley, the New York City health commissioner. That focus has given vaccine opponents “an opportunity to speak out publicly and get their message amplified that they didn’t have at other times,” he said.

Barbara Loe Fisher, president of the National Vaccine Information Center, an advocacy group that questions the safety of vaccines, said the swine flu has “breathed new life” into the cause. “People who have never asked questions before about vaccines are looking at this one,” Ms. Fisher said.

The increased interest is frustrating to health officials, who are struggling to persuade an already wary public to line up for shots and prevent the spread of the pandemic. According to a CBS News poll conducted last week, only 46 percent said they were likely to get the vaccine. The nationwide poll, which has a margin of sampling error of plus or minus three percentage points, found that while 6 in 10 parents were likely to have their children vaccinated, less than half said they were “very likely to.”

Read the full article.

The Lancet Infectious Diseases reviews Denying AIDS

Eduard Grebe — Tue, 29 Sep 2009 11:14:57 +0000

Seth Kalichman's Denying AIDS is reviewed by Talha Burki in the latest issue of The Lancet Infectious Diseases.

Denying AIDS

Talha Burki

The Lancet Infectious Diseases. Volume 9, Issue 10, October 2009, Page 600

Seth Kalichman, Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy, Copernicus Books (2009) ISBN 978-0-387-79475-4 Pp 205. £13.99..

The Guardian: Pernicious film of Aids denialist propaganda

Eduard Grebe — Sun, 27 Sep 2009 10:30:55 +0000

Ben Goldacre writes in his Bad Science column for The Guardian:

This week, listening to the Guardian science podcast, I had a treat. Caspar Melville, editor of New Humanist magazine, leader of something called the Rationalist Association, had been to see two films at the Cambridge film festival. One was a dreary creationist movie that famously misrepresented the biologists interviewed for it. This was obvious bad science, he explained. But the other was different: House of Numbers, a new film about Aids, really had something in it.

I have now seen this film. It presents itself as a naive journey by one young film-maker to discover the science behind HIV. In reality, it's a dreary and pernicious piece of Aids denialist propaganda.

All the usual ideas are there. It's antiretroviral drugs themselves that are the cause of symptoms called Aids. Or it's poverty. Or it's drug use. HIV doesn't cause Aids. Diagnostic tools don't work, Aids is simply a spurious basket diagnosis invented to sell antiretroviral medication for a wide range of unrelated problems – and the drugs don't work either.

It would take two months of columns to address all the bogus claims of this film, and that blizzard, perhaps, is the point of making it, with all the classic rhetorical devices that have been honed by Aids denialists and creationists over decades. It engages, for example, in repeated overstatement of marginal internal disagreements about the details of HIV research, to the extent that 18 doctors and scientists interviewed for the film have issued a statement saying that the director was "deceptive" in his interactions with them, that it perpetuates pseudoscience and myths, and that they were selectively quoted to make it seem as if they are in disagreement and disarray, when in fact they agree on all the important facts.

Read the full article at The Guardian.

Thami Mseleku removed as head of South African health department

Eduard Grebe — Sat, 19 Sep 2009 23:57:32 +0000

The last holdover of the Mbeki/Tshabalala-Msimang era of state-supported AIDS denialism in South Africa, Director-General of Health Thami Mseleku, has been dismissed.

Health-e reports:

Mseleku axed

18.09.2009 Anso Thom

text Health department Director General Thami Mseleku, a destructive leftover from former health minister Dr Manto Tshabalala-Msimang’s reign, will leave the end of the month, with the Western Cape’s Director-General for Health Professor Craig Househam set to step in.

Unconfirmed reports of Mseleku’s departure and Househam’s appointment have been doing the rounds for several days and have been confirmed by several sources, some within the national health department.

Fidel Hadebe, spokesperson for health minister Dr Aaron Motsoaledi, has declined to comment while Househam denied, via his spokesperson Faiza Steyn, that he had been approached.

Dr Francois Venter, president of the Southern African HIV Clincians Society said he had also heard the rumours that Mseleku was on his way out.

“He, with Tshabalala-Msimang, grossly mismanaged our health system and cost hundreds of thousands of South African lives. In a just world, they would both go to jail. The HIV world is just pleased to see the back of him,” said Venter.

Mseleku, referred to in the corridors as “Manto’s bodyguard”, has not endeared himself to any of the stakeholders in the health sector.

He left his post as Education Director General and was appointed Health DG in January 2005. He shied away from involvement in health policy issues, opting to plunge head first into the political controversies involving the health department – most notably those involving HIV/AIDS.

He took a personal interest in controversial vitamin seller Dr Matthias Rath, exonerating him from any wrongdoing, asking a New Yorker journalist during an interview: “What, exactly, was Rath’s crime?”

Court papers later revealed that Mseleku’s claims that his department had investigated Rath, involved two telephone calls, both to Rath employees.

Later Mseleku refused to take action against uBhejane, a concoction sold as an AIDS cure by former truck driver Zeblon Gwala, and described criticism of uBhejane as “colonialist”.

Mseleku was also instrumental in getting the Treatment Action Campaign and AIDS Law Project excluded from a United Nations General Assembly Special Session on AIDS.

He had told unhappy AIDS activists in a meeting about the matter: “We are government. We have been given a mandate to govern. All of you must just shut up.”

In 2006, Mseleku ordered all provincial heads of department to refuse media interviews on HIV/AIDS in the wake of the health minister’s humiliation at the Toronto AIDS conference and a possible visit to the country by UN AIDS envoy Stephen Lewis.

In the same year, he forbade departmental officials to attend a meeting convened by the Nelson Mandela Foundation aimed at encouraging dialogue between government and HIV/AIDS scientists.

Last year, 19 of the world’s foremost health and human rights experts condemned Mseleku’s comment at a TB conference that “human rights are not relevant to the considerations of health policy in a developmental state”.

More recently, there have been calls for Mseleku’s head to roll over the poor handling of the occupational specific dispensation (OSD) for doctors, dentists, pharmacists and emergency medical personnel – which led to a widespread strike by doctors.

The implementation of OSD for nurses happened without anybody at the National Health Department, specifically Mseleku, fulfilling a proper and meaningful oversight role.

It is also widely accepted that Mseleku was the main instigator behind the firing of Deputy Health Minister Nozizwe Madala-Routledge in 2007. Described by many working in HIV/AIDS as their darkest time, Madlala-Routledge has spoken about how she had been sidelined, bullied, ignored and been made to feel like a “handbag, that can be picked up when they needed me or not” during her more than three years in the health department.

She revealed how she had been barred from getting access to any information from health department officials as Mseleku had instructed senior management to not liaise with her. “Instead I had to make a submission to the health minister and she would decide whether I could see it or not.”

Househam, DG in the province since 2002, will inherit a department low on morale and with a huge vacancy rate. Househam has been lauded for his achievements in the Western Cape, but has not endeared himself to academics at the Universities of Cape Town and Stellenbosch.

The former University of Free State professsor has not hesitated in diverting funds from academic hospitals to secondary and primary health care sites, placing massive pressure on the institutions and eliciting a backlash from senior specialists.

Medical Editors Push for Ghostwriting Crackdown

Eduard Grebe — Sat, 19 Sep 2009 23:43:29 +0000

Failure to disclose conflicts of interest, substandard peer review and the involvement of some scientists in pharma profiteering weakens the public's trust in legitimate science and creates an environment in which denialism and pseudoscience flourish. We welcome the policy changes that some journals are implementing.

The New York Times reports:

The scientific integrity of medical research has been clouded in recent years by articles that were drafted by drug company-sponsored ghostwriters and then passed off as the work of independent academic authors.

Yet the leading medical journals have continued to rely largely on an honor system of disclosure to detect such potential bias, asking authors to voluntarily report any industry ties or contributors to their manuscripts.

But now, in light of recently released evidence that some drug makers have gone to great lengths to turn scientific articles into marketing vehicles for their products, some influential medical editors are cracking down on industry-financed ghostwriting. And they are getting help from some members of Congress.

These editors are demanding that journals impose tougher disclosure policies for academic authors and that the journals enforce their own rules by actively investigating the provenance of manuscripts and by punishing authors who play down extensive contributions by ghostwriters.

Read the full article.

Elsevier retracts Duesberg’s AIDS Denialist article

Eduard Grebe — Wed, 09 Sep 2009 22:51:51 +0000

There can be few greater embarrassments for scientists than for a publisher to retract their papers forcibly. This is exactly what has happened to two AIDS denialist articles, one of them co-authored by Peter Duesberg and David Rasnick. Here is what happened.

In 2008, the Journal of AIDS (JAIDS) published an article by Pride Chigwedere [1] and colleagues of Harvard University, who estimated that delays in providing antiretroviral drugs in South Africa due to state-supported AIDS denialism had caused over 300,000 deaths. This publication confirmed the results of a previous study by South African professor and aidstruth.org member Nicoli Nattrass. [2] AIDS denialist Peter Duesberg, whose influence on the disastrous South African government policies was mentioned in Chigwedere’s article, submitted a response to JAIDS that was co-authored by four others including Rasnick. After this article was rejected because of its poor academic quality, Duesberg et al. submitted it to a different journal, Medical Hypotheses. Two days later, the editor accepted the paper. Medical Hypotheses does not practice peer review, a process in which several scientists check a submitted academic paper for quality and suggest needed improvements over a period of weeks or months. The Duesberg et al. paper was accepted without such a review process, after inspection only by the editor of Medical Hypotheses.

That Duesberg’s paper was not properly reviewed by experts is painfully obvious, as neither facts nor logic are allowed to temper the authors’ denialist speculations and opinions. For example, they argue that AIDS is not a problem in Africa because the total population of Africa has increased during the AIDS era. One could as easily conclude that cancers are never fatal, since the population of California has increased despite the presence of these diseases. Duesberg et al. also say antiretroviral medicines have not reduced AIDS mortality, an obvious lie since these drugs have drastically lowered mortality. Worse, Duesberg et al. say they derived this idea from a scientific article. [3] In fact, the article they cite states nothing of the sort; it actually shows that a newer combination of antiretroviral drugs is not substantially better than an older combination. Of course, both these combinations are better than Duesberg’s favored treatment option – nothing. Doing nothing in the face of HIV infection is, however, very often a death sentence, as it was to over 300,000 South Africans. [1,2]

Duesberg’s article was the latest in a string of low-quality and in some cases offensive publications in Medical Hypotheses, including at least one apparently racist article and the other now-retracted denialist paper, entitled “Aids denialism at the ministry of health” by Ruggiero et al. (2009 Jul 6). [4,5]

How were these papers accepted in the first place? Medical Hypotheses is published by the prestigious publishing company Elsevier and, more importantly, indexed on PubMed, the definitive source of medical literature run by the National Library of Medicine (NLM) in the United States. Journals indexed in PubMed must meet certain standards. The NLM explains, “Scientific merit of a journal's content is the primary consideration in selecting journals for indexing. The validity, importance, originality, and contribution to the coverage of the field of the overall contents of each title are the key factors considered in recommending a title for indexing, whatever the intended purpose and audience.” [6] Because the Duesberg et al. and Ruggiero et al. papers so obviously lack scientific merit, several scientists became concerned that Medical Hypotheses does not satisfy the NLM’s requirements. By giving space to lies about HIV and AIDS, and by “legitimizing” AIDS denialists via inclusion of their names on PubMed, the journal has also become a potential threat to public health.

Aidstruth.org members therefore drafted a letter to the NLM outlining these concerns. It was signed by 20 scientists and activists and stated, “We, the undersigned, respectfully request that the journal Medical Hypotheses be reviewed for MEDLINE deselection at the earliest convenience of the Literature Selection Technical Review Committee. Medical Hypotheses does not appear to meet the standards for MEDLINE listing as established by the National Library of Medicine, and recent publications in the journal are inconsistent with the stated missions of the National Library of Medicine and the National Institutes of Health.” [7] The NLM responded that it would review the journal in October of 2009.

Separately, Elsevier was made aware of the problems. John Moore, an HIV scientist at Weill Cornell Medical College and a former, founding member of aidstruth.org, and Françoise Barré-Sinoussi, Nobel Prize Laureate and co-discoverer of HIV, each wrote to Elsevier objecting to the Ruggiero et al. and Duesberg et al. articles. To Elsevier's credit, Executive Vice President of Global Medical Research Journals, Glen Campbell, responded by stating that he shared the concerns expressed. In his letter to Dr. Barré-Sinoussi, Dr. Campbell referred to the Duesberg et al. article and the “implications of its wider dissemination for global health care.” [8] Campbell also stated that Elsevier had retracted both the Duesberg et al. and Ruggiero et al. articles with immediate effect, and had begun an internal review of the processes “by which these two articles were accepted.” Elsevier also committed to “reviewing the polices and practices of Medical Hypotheses.” We applaud Elsevier and Dr. Campbell for responding so constructively and effectively.

An additional area of concern is that Duesberg et al. declared in the Medical Hypotheses paper that the authors had no conflict of interests, a statement that is made by the corresponding author, Duesberg, on behalf of all the authors. This statement was inaccurate: Co-author David Rasnick was until recently employed in South Africa by vitamin salesman Matthias Rath, whose company's marketing strategy is based on undermining public confidence in antiretroviral drugs. [9] The attack by Duesberg et al. on the use of anti-retroviral drugs in South Africa could therefore be of considerable commercial value to Rasnick’s ex-employer, a conflict of interest that should have been declared in the paper. Complaints about this ethical issue have now been sent to both the University of California, Berkeley (where Duesberg has tenure) and Elsevier.

Aidstruth.org will give further updates on this matter as it develops. Meanwhile, where there was once the abstract of Peter Duesberg's latest AIDS denialist article, the following statement can now be found on PubMed:

This Article-in-Press has been withdrawn pending the results of an investigation. The editorial policy of Medical Hypotheses makes it clear that the journal considers "radical, speculative, and non-mainstream scientific ideas", and articles will only be acceptable if they are "coherent and clearly expressed." However, we have received serious expressions of concern about the quality of this article, which contains highly controversial opinions about the causes of AIDS, opinions that could potentially be damaging to global public health. Concern has also been expressed that the article contains potentially libelous material. Given these important signals of concern, we judge it correct to investigate the circumstances in which this article came to be published online. When the investigation and review have been completed we will issue a further statement. Until that time, the article has been removed from all Elsevier databases. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy. [10]

[1] Chigwedere P, Seage G, Gruskin S, et al. Estimating the lost benefits of antiretroviral drug use in South Africa [Internet]. J Acquir Immune Defic Syndr. 2008. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18931626

[2] Nattrass, N. AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa. African Affairs, 2008. Available at: http://afraf.oxfordjournals.org/cgi/content/abstract/107/427/157

[3] May MT, Sterne JA, Costagliola D, et al. HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis. Lancet, 2006. Available through: http://www.ncbi.nlm.nih.gov/pubmed/16890831

[4] The article is retracted on PubMed with a suitable notice. See http://www.ncbi.nlm.nih.gov/pubmed/19586724

[5] For examples of other poor-quality articles, as well as the racist one, published by Medical Hypotheses, see http://docs.google.com/Doc?docid=0AS7SzpS3zHZBZGQ2cWZjeGNfMjhobXYyaDcydA...

[6] NLM. Medline Journal Selection. http://www.nlm.nih.gov/pubs/factsheets/jsel.html

[7] The complete letter is here.

[8] The response from Elsevier to Barré-Sinoussi can be read here.

[9] See http://www.aidstruth.org/features/2009/david-rasnick-fails-declare-confl...

[10] See http://www.ncbi.nlm.nih.gov/pubmed/19619953

New York Times reviews "House of Numbers"

Eduard Grebe — Fri, 04 Sep 2009 13:59:57 +0000

From the New York Times:

Couched as a “personal journey” through the history of H.I.V. and AIDS, “House of Numbers” is actually a weaselly support pamphlet for AIDS denialists. Trafficking in irresponsible inferences and unsupported conclusions, the filmmaker Brent Leung offers himself as suave docent through a globe-trotting pseudo-investigation that should raise the hackles of anyone with even a glancing knowledge of the basic rules of reasoning.

Assembled from interview fragments with doctors, scientists, journalists and others, the film cobbles together an insinuating argument against the existence of H.I.V. as a virus and AIDS as the resulting disease. Among the many inflammatory claims is that diagnosis is a pharmaceutical-industry ruse to sell complex drug therapies (which the film then presents as the real cause of the syndrome we identify as AIDS). Evidence to support this and other highly dangerous contentions is found not in verifiable statistics (house of numbers, my foot) but in the impassioned anecdotes of individuals who have outlived the expectations of an H.I.V.-positive diagnosis.

Read the full review.

New York Times: Hope in South Africa

Eduard Grebe — Wed, 02 Sep 2009 21:10:35 +0000

The New York Times writes in an editorial titled Hope in South Africa:

For years, South Africa was an international laughing stock for its tragically absurd approach to the deadly AIDS epidemic. Now, that nationalnightmare may be ending.

The new government of President Jacob Zuma seems to have a clearer-eyed view of the problem, its remedies and the need to improve the overall health care system than its predecessor did. Fixing what’s broken will not be easy, but we are encouraged by signs of a commitment to do so.

To see how far South African leaders have come, one needs to recall where the country was.

The former president, Thabo Mbeki, compiled a record that is still hard to fathom: he embraced crackpot theories that disputed the demonstrable fact that AIDS was transmitted by a treatable virus. He insisted that antiretroviral drugs were toxic and encouraged useless herbal folk remedies instead. He even claimed he knew nobody with the disease, although nearly 20 percent of the adult population is said to be living with H.I.V.

Thousands of Africans were needlessly sickened and died. And the most influential country in sub-Saharan Africa squandered the opportunity to contain the AIDS epidemic. Although it has less than 1 percent of the world’s population, South Africa now accounts for 17 percent of the world’s burden of H.I.V. infection.

A saner approach began to take shape last year after Mr. Mbeki was forced out of office and Barbara Hogan was named health minister. Last week, the new health minister, Dr. Aaron Motsoaledi, went further.

He accepted a withering critique by South African scientists, who said the governing African National Congress party’s record on AIDS and health care was deeply flawed, and promised remedial action. “We do take responsibility for what has happened and responsibility for how we move forward,” Dr. Motsoaledi said in an article by The Times’s Celia Dugger.

South Africa’s leaders must espouse sensible, scientifically based advice about AIDS and put in place programs that seek to both treat and prevent the disease. That means expanding efforts to prevent mothers from infecting their babies, discouraging people from having multiple sex partners and offering circumcision to men, a relatively simple surgical procedure proved to have greatly reduced the risk of infection in South Africa.

The problem is bigger than AIDS. Even though South Africa spends more on health than any other African country, tuberculosis is rampant and child mortality rates are rising. The government must work to improve the quality of health care, ensure that all South Africans have access to the system and fire incompetent staff.

None of this will reverse the damage and deaths of Mr. Mbeki’s disastrous legacy, but it can offer the people of South Africa a better future.

AIDS denial: A lethal delusion

Eduard Grebe — Mon, 22 Jun 2009 23:51:30 +0000

Jonny Steinberg writes in New Scientist:

ON 27 December 2008, a well-heeled 52-year-old woman died in a Los Angeles hospital. Her death certificate describes a body riddled with opportunistic infections typical of the late stages of AIDS. Christine Maggiore had tested HIV positive 16 years earlier, but she had shunned ART, the antiretroviral therapy that stops HIV replicating and prevents AIDS.

This was not the first time a death in Maggiore's family had made headlines: five years earlier her 3-year-old daughter Eliza Jane had died. The autopsy described a chronically ill little girl who was underweight, under-height, and had encephalitis and pneumonia - all AIDS-related. When pregnant, Maggiore had again rejected ART and she had breastfed Eliza Jane, another way of transmitting the virus.

Why, in 21st-century California, would a middle-class woman and her young daughter die like this when there is tried-and-tested treatment for their illness? The answer lies in a bizarre medical conspiracy theory that says AIDS is not caused by HIV infection (see Five myths about HIV and AIDS).

It is tempting to dismiss the so-called AIDS denialism movement out of hand, but it has a strong internet presence, with a plethora of websites and blogs that can mislead the unwary. While the movement has lately suffered some significant blows to its credibility, it has in the recent past wielded extraordinary influence, especially in southern Africa, the centre of the world's AIDS epidemic. "Denialism has been relegated to the fringes of the internet, but it isn't of no consequence," says John Moore, an immunologist at Weill Cornell Medical College, Ithaca, New York, and one of the world's foremost AIDS researchers. "It can still cost the lives of unsuspecting people."

Read the full article

Five myths about HIV and AIDS

Eduard Grebe — Mon, 22 Jun 2009 23:48:35 +0000

Jonny Steinberg writes in New Scientist:

Despite the overwhelming evidence that HIV causes AIDS, a hardcore group still denies it (see AIDS denial: A lethal delusion). We explore five of the most common myths about AIDS.

MYTH: AIDS is not caused by HIV

DEBUNKING: This is the biggie, of course. As long ago as 1983, researchers first isolated HIV from people with AIDS. By 1985, they had developed a test showing that the overwhelming majority of people with AIDS have antibodies to HIV in their blood. They also showed that people who test HIV-positive and initially appear healthy go on to develop AIDS the vast majority of the time unless they are treated.

Read the full article

British Chiropractors try to silence science writer who called their claims "bogus"

Eduard Grebe — Mon, 01 Jun 2009 13:36:23 +0000

Complainant-friendly British libel laws are increasingly being used to silence the critics of alternative medicine. The British Chiropractic Association (BCA) has won an initial judgement against Simon Singh, a prominent science writer, after he called their fantastical claims, wholly unsupported by the scientific evidence, for chiropractic (e.g. that it can treat otitis media in children) "bogus". The court held that Singh had to show the BCA knew their claims to be false. This judgement is dangerous for free speech and the public interest, since if it is allowed to stand, it would seem to encourage anyone who makes bogus claims - but who sincerely believe themselves - to sue for libel when they are called out. The Guardian writes:

The consequences of letting the libel law loose on scientific debate are horrendous. Science proceeds by peer review. A researcher's colleagues must submit his or her ideas to scrutiny without fear of the consequences. If they think they could lose their homes and savings in the libel courts, however, they will back off.

For alternative therapists are not the only ones answering their critics with lawyers. NMT, an American health giant, is suing a British doctor for questioning one of its treatments.

After the Singh ruling, the Sense About Science lobby group fears the commercial pressure to rush out new treatments will lead companies to quash doubters with writs in London courts and put public health at risk.

Watching recent libel cases has been like hearing rumours about parliamentary expenses. For years, I have wondered what it will take to turn a neglected scandal into a public outrage. After Eady ordered the censorship of a New York author's book on terrorism, which had not even been published in Britain, the US Congress began drafting a law which will guarantee that English libel judgments have no validity in America. The United Nations has condemned the judges' practice of welcoming rich libel tourists from across the world to their hospitable courts and urged Britain to allow free speech on matters of public interest.

In the Commons, MPs have railed against the absurdity of a legal system which forced a Danish newspaper to pay £100,000 for criticising the shady financial practices of the Icelandic bank Kaupthing, which duly collapsed six months later along with the rest of the Icelandic economy.

None of their despairing pleas has moved the government or persuaded the judiciary to reform itself. Maybe the Singh case will.

If he goes ahead with an appeal this week, bloggers, academics and the massed ranks of the scientific great and good are ready to join him. They have grasped what too many still fail to realise: the greatest threat to freedom of speech in Britain is not the state or the security services or the press barons, but a fusty and illiberal legal system, which has become a public menace.

Read Nick Cohen's full article.

Mark Hoofnagle reviews Denying AIDS in Denialism Blog

Eduard Grebe — Tue, 26 May 2009 17:00:24 +0000

Mark Hoofnagle reviews Seth Kalichman's Denying AIDS for the Denialism Blog. He writes,

Seth Kalichman is a better man than I. Kalichman is a clinical psychologist, editor of the journal Aids and Behavior and director of the Southeast HIV/AIDS Research and Evaluation (SHARE) product, and he has devoted his life to the treatment and prevention of HIV. Despite a clear passion for reducing the harm done by HIV/AIDS, to research this book he actually met, and interviewed, prominent HIV/AIDS denialists. I confess I simply lack the temperament to have done this. To this day, when I read about HIV/AIDS denialists, and the the 330,000 people who have died as a result of HIV/AIDS denialism, I see red. I think violent, bloody thoughts.

Read the rest of the review

POZ Magazine reviews Denying AIDS

Eduard Grebe — Mon, 25 May 2009 15:05:57 +0000

From POZ.
(Un)deniable Evidence
by James Wortman

A college professor takes on AIDS naysayers in his latest book.

Despite overwhelming scientific findings, some people remain convinced that HIV doesn’t cause AIDS and that antiretrovirals are toxic poisons. Led by vocal skeptics such as former South African President Thabo Mbeki and the late Christine Maggiore, AIDS denialism continues to flourish, especially with the help of the Internet.

To counter this strengthening movement, Seth Kalichman, PhD, a social psychology professor at the University of Connecticut, wrote Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy ($25, Copernicus Books), which examines AIDS denialism’s origin, agendas and potentially damaging influence on HIV prevention and treatment.

Kalichman believes that the scientific community’s decision to stay quiet over the years has only fueled the denialists’ power. “[For too long] scientists have believed that if you ignore the denialists, they will go away,” he told POZ. “The HIV community really has a role in combating this misinformation.”

All royalties will help the Family Treatment Fund provide AIDS meds for people living with HIV/AIDS in Africa.

Scientists distance themselves from AIDS denialist film

Eduard Grebe — Thu, 23 Apr 2009 23:37:23 +0000

Update: Read an account of the film 'House of Numbers' by a member of the AIDSTruth team.

Scientists who appear in a new film 'House of Numbers' have distanced themselves from the film after it transpired that the filmmaker is an AIDS denialist, and that he manipulated the final product in order to mislead viewers and promote denialist myths. The director, Brent Leung, deceived a number of prominent scientists into granting him interviews, pretending that the film would be a history of AIDS research. However, Leung also interviewed a number of prominent AIDS denialists and edited the film in such a way as to create the false impression that uncertainty exists about AIDS science and that AIDS denialism is a credible position.

The scientists have released a statement raising strong objections to the film.

The film has been screened at two film fesitvals (in Nashville and Boston), with AIDS denialists attending the screenings, and at times behaving abusively towards members of panels convened by the film festivals as a community response. See this article in Bay Windows for a report on the screening in Boston, where denialists stormed the stage during the panel discussion. Scientists were invited to "debate" the film with Leung and/or other denialists, but have refused to do so. See this article on why AIDSTruth opposes debating denialists. Also see this article in the Tenessean and this blog post by Seth Kalichman for further background.

Although the film is unlikely to gain much attention outside these film festivals, it is dangerous and has the potential to mislead people with HIV into disregarding their doctors' advice.

A statement about the film, ‘House of Numbers', by people who appear in it

We are writing to state our strong objections to 'House of Numbers' and the agendas it promotes. We consider the film as being harmful to the best interests of the general public and, in particular, people with HIV infection or at risk for acquiring it.

We all appear in the film, having granted interviews to its Director, Mr. Brent Leung, during the period 2006-2008. Mr. Leung was deceptive in his interactions with us. He informed us that his film was intended to present the true history of AIDS research, and an accurate summary of the science of HIV infection. He also told several of us that he intended the film would expose and counter many of the myths about HIV and AIDS that have been promoted by a small clique of individuals we refer to as "AIDS denialists".

The reality is that his film does none of those things. Instead, it presents the AIDS denialist agenda as being a legitimate scientific perspective on HIV/AIDS, when it is no such thing. His film perpetuates pseudo-science and myths.

AIDS denialists individually or collectively promote several notions that have no basis in science or the facts. Among these views are that HIV either does not exist or is harmless; that therapies for HIV infection are themselves the cause of AIDS; that drug abuse causes AIDS; that HIV was created by the US government to kill Africans and African-Americans as an act of genocide; that diagnostic tests for HIV infection do not work. None of these beliefs is true. AIDS denialism has caused the deaths of hundreds of thousands of South Africans, and many more individuals in the USA and other countries. For more information on the dangers of AIDS denialism and the damage it has caused, we encourage you to review material posted at http://www.aidstruth.org .

The scientific facts are: HIV is a natural virus that entered the human population from chimpanzees many years ago. HIV diagnostic assays are highly accurate and reliable. Untreated HIV infection eventually kills most of the people who acquire it, by causing AIDS, but anti-retroviral therapy dramatically prolongs the lives of those who have access to it. While good nutrition is important for general health and well being, it is not sufficient to prevent or treat HIV infection and it cannot cure AIDS. For accurate sources of information on these central points, please refer to material posted at the following sites:

http://en.wikipedia.org/wiki/Origin_of_AIDS

http://www.sciencemag.org/cgi/content/abstract/1126531

http://www.cdc.gov/hiv/resources/factsheets/

http://www.nlm.nih.gov/medlineplus/ency/article/003538.htm

http://www.aidsfactsheet.com/facts.htm

We have viewed the film's trailer, and we are aware of reports about the film's contents that are circulating on the internet after Mr. Leung gave an advance showing to AIDS denialists (a courtesy he did not extend to us). We believe that 'House of Numbers' presents some of our views out of their proper context. By editing our interviews to suit his preconceived agenda, Mr. Leung attempts to portray AIDS scientists as divided and disorganized, and he seeks to present legitimate differences of scientific opinion on various aspects of HIV/AIDS in a way that disguises the wider and more substantive points on which we all agree and which we have stated strongly, here and elsewhere (http://www.nature.com/nature/journal/v406/n6791/full/406015a0.html).

'House of Numbers' is an inaccurate portrayal of the truth about HIV and AIDS. Mr. Leung persuaded us to take part in it by acting deceitfully and unethically. None of us would have agreed to be interviewed for the film had we known it would promote the AIDS denialist agenda, and include members of that small clique as participants of supposedly equivalent credibility.

We register our protest about 'House of Numbers' out of respect for the millions of people who have already died from AIDS. This film could cause more unnecessary deaths, if any of those who watch it are persuaded that it is not necessary to reduce their risks for acquiring HIV infection, or take the appropriate therapies if they do become infected.

Donald Abrams, MD - Professor, University of California San Francisco

Francoise Barre-Sinoussi, PhD - Professor, Institut Pasteur, Paris, France

David Baltimore, PhD - Professor, California Institute of Technology

Niel T. Constantine, PhD - Professor, University of Maryland School of Medicine, Baltimore

Robert C. Gallo, MD - Professor, University of Maryland School of Medicine, Baltimore

Hans R. Gelderblom, PhD - Professor, Robert Koch-Institut, Berlin, Germany

Harold Jaffe, MD - Professor, University of Oxford, UK

Claudia Kücherer, PhD - Robert Koch - Institute, Berlin, Germany

Daniel R. Kuritzkes, MD - Professor, Harvard University, Boston

Reinhard Kurth, MD - Professor, Robert Koch - Institute, Berlin, Germany

Jay Levy, MD - Professor, University of California San Francisco

Joseph B. McCormick, MD - Professor, University of Texas School of Public Health

John P. Moore, PhD - Professor, Weill Medical College of Cornell University, New York

Nancy Padian, PhD - Professor, University of California Berkeley

Peter Piot, MD - Professor, Imperial College of Science, Technology and Medicine, London, UK

Robert R. Redfield, MD - Professor, University of Maryland School of Medicine, Baltimore

Robin A. Weiss, PhD - Professor, University College London, UK