AIDSTruth.org - Features

Nicoli Nattrass: The Spectre of Denialism

Eduard Grebe — Mon, 12 Mar 2012 16:19:46 +0000

AIDSTruth contributor Prof Nicoli Nattrass (director of the AIDS and Society Research Unit at the University of Cape Town) has written a new book The AIDS Conspiracy: Science Fights Back, published by Columbia University Press. In the book, she explores conspiracy theories on the origins of AIDS (such as that it was manufactured by the US government), their surprising longevity, the campaigns by scientists to correct misinformation and the consequences of these myths for behaviour.

She reflects on some of the arguments in the book in a piece for The Scientist, which has also published a short extract of the book on its website.

There is a substantial body of evidence showing that HIV causes AIDS—and that antiretroviral treatment (ART) has turned the viral infection from a death sentence into a chronic disease.1 Yet a small group of AIDS denialists keeps alive the conspiratorial argument that ART is harmful and that HIV science has been corrupted by commercial interests. Unfortunately, AIDS denialists have had a disproportionate effect on efforts to stem the AIDS epidemic. In 2000, South African President Thabo Mbeki took these claims seriously, opting to debate the issue, thus delaying the introduction of ART into the South African public health sector. At least 330,000 South Africans died unnecessarily as a result.2,3

The “hero scientist” of AIDS denialism, University of California, Berkeley, virologist Peter Duesberg, argues that HIV is a harmless passenger virus and that ART is toxic, even a cause of AIDS. He has done no clinical research on HIV and ignores the many rebuttals of his claims in the scientific literature.4,5 As I describe in my new book, The AIDS Conspiracy: Science Fights Back, this has prompted further direct action against Duesberg by the pro-science community.

Read the rest of Nicoli Nattrass's article in The Scientist.

Read an extract of The AIDS Conspiracy: Science Fights Back.

What do we know about AIDS deaths in South Africa?

Eduard Grebe — Mon, 16 Jan 2012 16:07:21 +0000

By Nathan Geffen
The obscure Italian Journal of Anatomy and Embryology has published an article by AIDS denialist Peter Duesberg packed with errors. It claims that data from Uganda and South Africa shows that there is no evidence of an HIV epidemic. This journal, whose title indicates no expertise in HIV, has a track record of publishing peer-reviewed AIDS denialist nonsense.

The article will have no influence on medical science. Nor is it likely to influence the South African government; the days of state-supported AIDS denialism are gone. Nevertheless its publication and the subsequent unnecessary publicity it received in the world's leading science journal, Nature, provide a good opportunity to explain how we do know there is a massive HIV epidemic in South Africa.

The two main arguments Duesberg et al. offer are that (1) the population has increased by 20 million in the past three decades and (2) mortality reports released by Statistics South Africa (Stats SA) show relatively few AIDS deaths.

The first argument, that the population has increased, can be swiftly dealt with.

The annual number of births in South Africa over the last two decades has been between 1 and 1.2 million. By the best estimate the number of deaths rose between 1997 and 2006 from about 400,000 to about 650,000 annually. This rise in deaths, as I explain below is entirely consistent with our large HIV epidemic, but it is still far below the number of births: hence South Africa's population has risen. Source: ASSA2008 Provincial Outputs

The second argument is one that has been raised repeatedly by denialists, despite the fact that a little bit of analysis shows it is wrong.

Stats SA regularly publishes a mortality report which tabulates death statistics based on death notification forms. Every time someone dies in South Africa, a death certificate is supposed to be filled in and eventually finds its way into national statistics. A doctor is supposed to indicate the underlying cause of death and Stats SA always publishes the top 10 such causes for natural deaths. It is true that HIV as the underlying cause of death features near the bottom of the top 10 and is quite low. For example in 1997 there were just over 6,600 recorded HIV deaths and this rose to just under 18,000 in 2009.

The reason for this massive underestimate of HIV deaths is explained in an article published in 2005 by Medical Research Council researchers:

In a country such as South Africa, where the HIV status of the deceased is often unknown or the medical certifier does not have access to a full medical history, mis-classification to the immediate cause of death rather than the underlying cause often takes place. Furthermore, since 1992 it has been possible for traditional headmen to complete an abbreviated death notification form, often resulting in misclassification of the cause of death to a generalized ill-defined rubric ... in some rural areas.

In addition, some doctors are reluctant to write HIV as the underlying cause because, even though the cause of death is noted on a confidential form, they remain worried that insurance companies will access the forms and thereby deny funeral and life-insurance payouts to the families of the dead.

But the evidence for a massive increase in deaths due to AIDS is nevertheless abundant from the death data.

The number of recorded deaths in SA in 1997 was 316,505. This rose to 613,040 in 2006 and has since declined to 572,673 in 2009. Improved registration and population growth only explains this partially. I am not using false accuracy here; these are the actual counts of recorded death certificates. According to Stats SA, about 80% of deaths are recorded. Sources: Stats SA P0309.3 reports 2005 and 2011
The number of recorded deaths from opportunistic infections associated with HIV has risen dramatically. For example Tuberculosis deaths rose from 22,071 in 1997 to 77,009 in 2006. This is by far the biggest cause of recorded deaths. Influenza and Pneumonia deaths rose from 11,518 in 1997 to 52,791 in 2006 to become the second-largest cause of death after TB. Deaths due to Intestinal Infectious Diseases was not in the top 10 in 1997. In 1998 it was 9th at 8,808. In 2006 it was 3rd at 39,239. Most of the increases in these causes of death were almost definitely due to HIV.
By contrast death from Ischaemic Heart Disease rose marginally from 9,797 in 1997 to 13,025 in 2006. Diabetes deaths rose a bit more significantly, from 10,828 to 19,549 (and South Africa is indeed experiencing a diabetes epidemic). While these causes of death are not commonly associated with HIV, it's quite conceivable that their relatively small increases are at least in part explained by HIV since we know that HIV also increases the risk of death from non-AIDS causes. For example, the SMART trial found that untreated HIV causes increased risk of dying from heart disease.
With the introduction of antiretroviral treatment (ART) in the public sector in 2004, the number of people on treatment has risen to approximately 1.5 million. This correlates with a decline in recorded deaths in recent years, which is what would be predicted by an increase in the number of people taking ART. This decrease in deaths is the one silver lining of the South African epidemic.
Andrew Warlick and I prepared the graph below for the Treatment Action Campaign some years ago. It shows the changing age pattern of deaths in South Africa. It is perhaps the most compelling proof of the massive HIV epidemic in SA. It destroys AIDS denialism in one pretty picture. It shows how in 2004 the women who died in South Africa were mainly young adults, not old people. This was in contrast to 1997 as well as the situation in Brazil in 2004, a country with a comparatively tiny HIV epidemic. Only the presence of the large HIV epidemic in South Africa can explain this.

Constructed using mortality data from Statistics South Africa and Instituto Basileiro de Geografia e Estatística
In 2002, Stats SA closely analysed a 12% sample of death certificates. The death certificates often contained synonyms for deaths caused by HIV and, in contrast to the standard mortality reports that Stats SA publishes, these were counted as AIDS. It offers clear evidence of the growing epidemic. In 1997 TB and HIV were responsible for 6.5% and 4.6% of underlying causes of death respectively. This steadily rose to 9.7% and 8.7% in 2001. The only larger causes were Unspecified unnatural causes (15.3% and 8.2% in 1997 and 2001 respectively) and ill-defined causes of mortality (8.6% in 1997 and 2001). Influenza and Pneumonia deaths rose dramatically too. But deaths due to diseases not usually related to AIDS didn't show similar increases. For example, heart disease deaths declined.
In 2001, the Medical Research Council published a meticulous study based on the Department of Home Affairs Population Register. The report carefully and convincingly showed rising HIV mortality in adults.
The Actuarial Society of South Africa uses multiple sources to calibrate its models in order to come up with the best estimate of the number of annual AIDS deaths in South Africa. Their latest published model, ASSA2008, calculates that between 1997 and 2008, 2.1 million people died of AIDS in South Africa. That's an average of nearly 500 people per day. It's difficult to fathom such a catastrophe. By comparison it's almost the equivalent of the 2004 Tsunami happening in just one country every year, year after year. In 2006, the worst year of the epidemic so far, over 700 people died daily.

All of the above is of course ignored by Duesberg et al. But it is well known to experts on the South African epidemic. This raises a perplexing question: who were the peer reviewers of the Duesberg et al. article? It is very unlikely that any genuine expert in AIDS statistics would have given their paper the go-ahead.

A note from a childhood friend of Kim Bannon

Eduard Grebe — Thu, 02 Jun 2011 23:42:42 +0000

by Phillip L. Murphy

This note first appeared on a Facebook page. It is republished here with the author's permission.

After speaking with Shannon, we decided it would be beneficial to those interested in Kim's history to hear my own personal story.

I was diagnosed with HIV in the fall of 1984. It was my final year of undergraduate work at KU, and i was deciding whether to attend medical school. after receiving the news in a very seedy sedgwick county health department office, I was terrified, horrified and in shock. I had been in a monogomous relationship with a man for almost a year. He began to hear rumors that a man he had dated previously was "sick". After his test results came back positive, it was my turn. Neither of us knew what to do or where to turn. In those days there was talk of quaranteening the infected in asylums or deserted islands. We were a pariahs, angels of death. From that moment on we couldn't plan for our futures or make decisions beyond what was for dinner because we expected to drop dead at any moment. That is what was happening to those in our situation.

Randy became ill quite quickly, and had no choice but to begin the hellish drug treatments that were available at the time. I on the other hand was more fortunate in that my health remained good for more than a decade. During that time I watched as friend after friend fell from opportunistic diseases that a compromised immune system could not fight off. I felt like i had no future and just kinda twittled my life away, waiting for the end. Randy died about 4 years later, and I was alone; I thought for the rest of my short life. I saw an HIV specialist regularly. He gave me the option of going on antivirals, or waiting until i was truly sick to start. On his advice I waited and waited. In 1995 my T-cells began to plummet, and we decided it was time. New, more promising therapies were on the market, and he had every hope we could keep the virus in check. I continued with my regular check-ups and my T-cells and my overall health improved. Soon i almost forgot that i was sick. I began to have hope that maybe i could beat this, maybe I'd be the first.

After about a year of therapy, and a normal T-cell count, we decided to get off the drug therapy. They are harsh, complicated and overwhelmingly expensive. Within 6 months my T-cells were once again at an alarmingly low level and I went onto a new drug regimen that I remain on to this day, and will for the rest of my life. My T-cells remain in the normal range, I have an undetectable <0 number of virus in my blood, and remain healthy, at least physically (LOL).

I WANT EVERYONE TO READ AND UNDERSTAND. THE HIV VIRUS AND THE CONDITION CALLED AIDS IS VERY REAL, AND VERY TREATABLE.

Until i returned to Wichita in 2002 to try and save my baby sister Tricia, and re-met Kim, I had never heard of these lie-mongering denyers. Knowing Kim as a strong-willed, highly intelligent young woman, I thought it odd that Kim was so influenced by them, but I know we each have our own path. The lies they concocted, then spewed to the public is the one and only reason Kim is where she is today. PLEASE, PLEASE don't let these lies continue to hurt and kill the ones you love and care about. Stomp the lies and the people that perpetuate them into the dirt.

Today I am in a loving and healthy relationship with the love of my life and soul-mate Mando. After nearly 16 years together he is still HIV-negative and that is because of the care of great physicians and incredible advancements in HIV therapies. My life hasn't turned out exactly how i had planned, but I have played the cards I was dealt as best I could and so far I am winning the hand.

Please feel free to contact me about what I have said. If you have any questions I will be glad to answer, or find the answers for you. And again, if you can find the time to stop and say hi to Kim, you'll feel better for doing it. She is still a loving, caring, and generous spirit, even if she is trapped inside an unhealthy body.

My best love to all of you.

Phillip

P.S. Forgive the typos, Mrs. Cates really did teach me better than this.

Videos: Myths about HIV/AIDS debunked

Eduard Grebe — Fri, 10 Dec 2010 18:09:10 +0000

These two videos from AIDSVideos.org do a good job debunking some of the myths about HIV tests and about HIV/AIDS.

Kerry Cullinan: Frank Chikane’s whitewash of Mbeki is an ahistorical disgrace

Eduard Grebe — Wed, 10 Nov 2010 16:59:42 +0000

This opinion piece by Kerry Cullinan appeared on the Health-e News Service:

OPINION: Doctors call them Thabo’s children – the thousands of kids infected with HIV by their mothers at birth who still fill hospital paediatric wards, suffering from a range of debilitating infections.

When many of them were born, they did not get antiretroviral medication that could have prevented their mothers from passing HIV on to them. This was because then-president Thabo Mbeki had decided that ARVs were “toxic” and somehow less desirable than a fatal, incurable virus.

But by 2000, at the height of Mbeki’s AIDS debating society, four independent studies had shown that two ARVs, AZT and nevirapine, could cut HIV transmission from mothers to babies by up to 50%.

Also by 2000, research showed a radical change in the death patterns of South Africans with a peak in young women and men, rather than the elderly, that could only be explained by AIDS.

It is well documented that some 330,000 people died under Mbeki’s watch because his government delayed the introduction of ARVs.

What is less known is that Mbeki’s refusal to accept that AIDS was caused by a viral infection caused his government to under-fund health services at the very time that hospitals were starting to see a surge in AIDS patients. They closed nurses’ training colleges and flat-lined health budgets to save money, hastening the collapse of health services that we see today.

Yet in a series of articles published in Independent newspapers countrywide recently, Mbeki’s loyal director general, Frank Chikane, has tried to portray his former boss as a deep thinker who took a principled stance after thorough research.

Chikane’s criticisms of Mbeki are mild – painting his bizarre refusal to accept that HIV causes AIDS as a bit of a public relations blunder requiring some spin-doctoring - rather than a criminally irresponsible academic obsession that caused death, suffering and hardship for hundreds of thousands of South Africa citizens who depended on their president for leadership.

Chikane constructs his defence of Mbeki on three pillars. Firstly, that Mbeki believed that ARVs (especially AZT) were “toxic” and were being foisted on poor countries by evil pharmaceutical companies. Secondly, that he was defending “the historically disadvantaged” from “racism”. Thirdly, he was defending his own right to “think independently” of Europe and the US.

According to Chikane, “there could be no disagreement about AZT’s toxicity”.

However, he fails to spell out that four trials had shown that a four-week course of AZT and a single dose of nevirapine were safe and had been able to cut mother-to-child transmission by up to half – potentially saving 150,000 of the 300,000 babies born HIV positive annually at the time.

The first of these trials was carried out in the US as early as 1994, while two others were in Thailand and the fourth in South Africa in 2000.

In any medical treatment, risk is balanced with the seriousness of the condition. Chemotherapy is not acceptable to treat a cold but it is to treat an almost incurable disease such as cancer. Ditto ARVs: there are side-effects but the side-effect of HIV is death, so the risk is justifiable.

Chikane argues that Mbeki felt South Africa was “being asked to do what no developed countries were no developed country was doing” – namely to use AZT and nevirapine, “as monotherapy rather than as a combination of drugs”.

Chikane adds that Mbeki was disturbed that the World Health Organisation (WHO) approved of the use of single-dose nevirapine to prevent mothers from passing HIV to their babies in developing countries.

He fails to mention that, at a meeting in 1999 between then health minister Nkosazana Dlamini-Zuma and the Treatment Action Campaign (TAC) two months before Mbeki became president, Dr Zuma said that price of AZT was the major barrier to introducing it to prevent mother-to-child HIV transmission.

Chikane also fails to mention that the South African Medicines Control Council (MCC), despite all manner of political contortions to rob the body of its independence from government, found in 2000 that the benefit of using ARVs to prevent mother-to-child transmission outweighed the risks.

Time and again, Chikane raises the bogeyman of big bad Pharma – the all-powerful pharmaceutical companies – as being at the forefront of the “war” against Mbeki in a bid to safeguard their profits.

Yet at a time when Mbeki could have formed a powerful alliance with organizations like the TAC to fight for cheaper ARVs, Mbeki turned on them with viciousness, accusing TAC’s Zackie Achmat of having CIA links and the TAC of being a pawn of the pharmaceutical companies!

In addition, he fails to recall that Boehringer Ingelheim, the manufacturers of nevirapine, offered the drug free to South Africa for five years – an offer spurned by government because its president believed it was poison!

Describing the attacks on Mbeki as “ferocious” and unexpected, Chikane says “we” were forced to ensure that the Cabinet had to make compromises on HIV/AIDS and Mbeki was absolved from taking responsibility. So much for leadership!

In describing Mbeki’s inner circle’s discomfort at having to confront the then-president about his position on AIDS, Chikane inadvertently reveals Mbeki’s dictatorial manner, his narcissism and his inability to accept criticism.

He tells us few “could risk” raising Mbeki’s HIV stance with the president; that Mbeki felt those who wanted him to back down were “cowards” and that “there was no one bold enough to take on this cause” than himself.

It is hard to have sympathy for such a man, let alone such a president. Nowhere is there mention of the impact of Mbeki’s bizarre views of those living with, or affected by, HIV. Nowhere is there sympathy for the current president and health minister, who are trying valiantly to address the irresponsible legacy of the Mbeki regime. Instead, all Chikane offers is puff, paranoia and conspiracy – vintage Mbeki but wholly out of touch with current reality. – Health-e News Service.

In Defence of Science: Seven points about traditional and scientific medicine

Eduard Grebe — Sun, 05 Sep 2010 20:01:54 +0000

by Nathan Geffen, 28 August 2010

This is a corrected version of a position argued by the author at a debate that took place at the University of Cape Town in August 2010 about traditional and scientific medicine. Geffen is the treasurer of the Treatment Action Campaign, but this paper presents his personal views only. He is also author of the book Debunking Denialism (Jacana 2010)

Scientists can be elitist and patronising. In that way, they are no different to any other people with power, including some traditional healers and including people who defend science, like myself.

There are multiple knowledge systems. Cultural diversity, including African culture, is a valuable treasure. Traditional medicine is used by people across the world. African traditional medicine, in particular, is used by millions of people across Africa. It is therefore important to build relationships with traditional healers to ensure that their patients receive appropriate care. Many organisations, such as the Treatment Action Campaign (TAC), attempt to do this, with varying degrees of success.

However, In critiques of medicine and, on the other hand, efforts to accommodate traditional healing, humanities researchers sometimes stand accused of being relativist, i.e. promoting or implying multiple incompatible positions as being true or valid. They also sometimes stand accused of being less than forthright about the problems with traditional healing. With this in mind, I present seven frank points which I hope will inform this discussion.

1. For the most part what is true is independent of what we believe. Many cultural or traditional beliefs, despite being fiercely held, are false. This applies to all knowledge systems. The scientific method is the best way to ascertain true facts about the universe and correct the often dogmatic beliefs that we acquire via tradition. In contrast to untested traditional and cultural beliefs, scientific knowledge depends on carefully controlled and recorded observations and experiments, done according to continuously refined standards developed across the world by people with diverse races, languages, creeds and cultures. The scientific method sometimes elicits the wrong answers, but it generally corrects mistakes over time. It has greater explanatory power and is right more often than dogma or tradition.

2. Once the placebo effect is exhausted, what heals is independent of what is believed to heal. It is one thing to acknowledge that different people have different knowledge systems, but knowledge systems are often factually wrong about the treatment of human illness. Traditional healing, whether it be Western Judeo-Christian traditional methods, homeopathy, acupuncture, Chinese herbs or African traditional medicine often has a healing effect. But it is very seldom that these effects are found to be more effective than what we call placebo, which is admittedly a complex concept in need of much greater understanding. Traditional healers can also have a profound effect on the psychological health of people. For example in Debunking Delusions, I describe the profoundly beneficial effect of a visit by Busisiwe Maqungo, a woman with HIV who takes antiretrovirals, to her traditional healer.
But there can be dire consequences of believing that something heals when it actually does not. TAC recently held a press conference in which we criticized ETV for hosting a faith-healing advertisement of a church called Christ Embassy. TAC has subsequently received many angry letters from members of this church since that press conference. We and the letter-writers have different knowledge systems. But consider this:

a. A woman with XDR TB and HIV was doing well on TB and antiretroviral treatment at a health facility in Cape Town. Her TB had smear-converted to negative.

b. But then she attended a Christ Embassy ceremony and was led to believe that she had been faith-healed. She consequently saw no need to continue taking her medicines.

c. Over a period of about a year she became ill and developed XDR TB again. She died.

d. Before she died, she transmitted XDR TB to her family members. They are now fighting for their lives.

These sad facts are true independently of how much respect we afford the knowledge system of the adherents of Christ Embassy.
In Debunking Delusions, Andile Madondile describes his visits to traditional healers which delayed him going onto antiretroviral treatment and consequently almost led to his death. As with Christ Embassy, no matter how much respect we afford the knowledge system of traditional medicine, it should be acknowledged that Andile’s story is a familiar one played out frequently in South Africa often with deadly consequences.

3. There is very little traditional medicine that works out the box (beyond placebo). Millions of dollars are spent testing traditional and herbal medicines (read Eduard Ernst and Simon Singh’s book Trick or Treatment to see how many studies have been done on acupuncture for example). In South Africa, there are researchers testing traditional medicine at the University of the Western Cape, University of Cape Town, University of Kwazulu-Natal and the Medical Research Council. Yet I know of only one traditional medicine that has been found to be effective at treating an HIV-related opportunistic infection, herpes, and even that study, published in an obscure journal, has not to my knowledge been repeated. Some traditional medicines show promise, but there have been many failures, for example African potato in people with HIV, Hoodia to control appetite, as well as mixed results with garlic.

Nevertheless many proven medicines have their roots in what we would consider natural items: Paclitaxel, an anti-cancer drug, is derived from the Pacific Yew tree. Zidovudine, the first antiretroviral, was first made using an extract from herring sperm. There are many more. But getting an effective medicine is not as simple as scraping off the bark of a yew tree or extracting sperm from a herring. A complex technological process has to be carried out to get the final beneficial medicine.

4. It is right that patients may choose, but it is not right that healers may offer whatever they choose. Choice is often poorly understood in this debate and it is used as a mantra to justify unethical behavior. Patients should have choice. Patients can choose the healing method they wish. But healers should not have unlimited choice. In fact they do not have unlimited choice in South African law or in any reasonable ethics system. We do not accept it when we are sold a dud DVD player or a car, or when we receive unsound financial advice or even when our General Practitioner fails to treat us properly. Likewise traditional healers cannot be said to have a choice in what they offer their clients. They are obligated not to do anything to their patients that will endanger their lives.

5. The economic incentives involved in traditional medicine are immense. In this debate, the economic interests of doctors and members of the pharmaceutical industry are frequently pointed out. But if you read Andile Madondile’s story in Debunking Delusions or walk around the alternative health shops in the Waterfront Craft Market or you watch who is selling traditional medicines at the Site B train station in Khayelitsha, it is clear that there’s serious money in traditional medicine as well as alternative medicine. And yet it remains largely unregulated despite the false and dangerous claims that many of these healers make and the delays in seeking appropriate treatment that they often cause.

6. There are racial misnomers in this debate. There are many high-quality African scientists working on AIDS: Peter Mugyeni, James Hakim and Paula Munderi to name a few. Yet the worst quacks I have dealt with over the last few years, who have hidden behind the paradigm of traditional medicine, have been mostly white. All cultures have traditional medicine. My culture too has its traditional medicines. Homeopathy is decidedly European in origin and complete quackery. In fact it is the romanticisation of African traditional medicine, while other forms of traditional medicine are not so much romanticized anymore at least not by academia, that suggests a racial undercurrent.

At its worst, the romanticisation of traditional medicine has been accompanied by a dangerous distorted form of African nationalism, exemplified by Thabo Mbeki, but in more recent times by Sowetan columnist Andile Mngxitama.
Natural science is empowering and socially uplifting when correctly utilised. Science is universal and to portray it as ‘western’ and not suited to some parts of Africa is like saying African children should not be taught mathematics at school. Presenting science as un-African, even if this presentation is implicit, is in fact racist.

7. Humanities courses need to teach science better. The quality of debate about medicine in the humanities indicates that graduates are not being equipped with the skills to differentiate between good science, bad science and outright nonsense. Are humanities courses teaching students basic statistics, how to read medical abstracts and articles, how medical research is carried out and how to search pubmed? It is this frequently encountered apparent lack of knowledge that undermines respect for what emanates from the humanities.

Ends

The Cult of HIV Denialism

Eduard Grebe — Fri, 06 Aug 2010 07:18:09 +0000

By Jeanne Bergman, Ph.D.

Achieve, Spring 2010. Reprinted with permission from Achieve.

Introduction

More is known about HIV than about any other virus. Less than three decades ago, doctors were perplexed by the appearance of Kaposi's sarcoma and Pneumocystis pneumonia (PCP) in young gay men. Since then, scientists and doctors, spurred by the activism of people with AIDS, discovered the virus now called HIV and proved that it causes AIDS by crippling the immune system until the body can no longer resist life-threatening infections.

Scientists around the world have isolated HIV, photographed it with electron microscopes, and sequenced the genomes of its different subtypes. There are now highly accurate tests for HIV antibodies and the virus itself, and increasingly effective and tolerable antiretroviral drugs (ARVs) for its treatment. Science is a gradual process, and there is still much that is not fully understood about HIV, but the evidence that HIV exists, is transmissible by blood, semen, and vaginal fluids -- and that it causes AIDS -- is vast and thorough.

The Denialists and Their Cult

And yet there are thousands of people who persistently reject these facts. They believe that HIV is harmless or doesn't exist. Some argue that AIDS has other underlying causes, such as drugs, depression, "dirty" sex, stress, malnutrition, or conventional medicine. Others say that AIDS is just an artificial clustering of familiar diseases. Those who reject HIV/AIDS science call themselves "AIDS dissidents," but others usually refer them to as "HIV denialists" because they elevate personal denial into an ideology.

Most people are astonished by the existence of HIV denialism. "I had no idea there were 'AIDS deniers,' and I still don't understand why someone would believe such a thing," a blogger wrote upon reading of the deaths of denialist Christine Maggiore and her young daughter, both from AIDS. What is most baffling is the persistence of irrational beliefs, held firmly despite the evidence, despite the terrible deaths, and despite the absence of a coherent alternative theory. How can people ignore both scientific evidence and their own failing health? How could Maggiore do nothing to prevent HIV transmission to her children? How could she allow her child and herself to die needlessly? And how could her admirers, initially frightened, go on to rebuild the wall of denial?

HIV denialism can be understood if we view the movement as a kind of cult. Denialists refer to HIV medicine and science as "the orthodoxy," giving the field a religious framework, and imagine themselves in an oppositional, visionary role.

The persistence of the HIV denialism can be understood if we view the movement as a kind of cult. Denialists refer to HIV medicine and science as "the orthodoxy," giving the field a religious framework, and imagine themselves in an oppositional, visionary role. Many of the features that social scientists find typical of cults characterize the denialists. Most fundamentally, they maintain an intense "us-versus-them" worldview. Those inside belong to an exalted and secretive group -- they feel superior but persecuted for knowing a hidden truth. They believe that the pharmaceutical industry, governments, researchers, clinicians, the United Nations, AIDS activists, foundations, and HIV organizations are united in an elaborate global plot, which ex-traffic cop Clark Baker calls "the most significant criminal conspiracy I have ever imagined" to kill healthy people with toxic drugs for profit.

Doctrine and Indoctrination

Many HIV denialists adopt alternative health and spiritual beliefs, including consciousness-altering practices that are typical of cults. The use of hypnosis by HEAL-New York stands out. Members believe that simply being told that they are HIV-positive makes people sicken and die. HEAL's leader, Michael Ellner, uses hypnosis to extract people from the deadly mental "AIDS Zone" and to make them feel "at peace with testing positive."

Ellner is not alone in thinking that words kill but viruses don't. Cult scholars call this "mystical manipulation." Denialist Matt Irwin developed the theory in AIDS and the Voodoo Hex: "The severe, acute psychological stress of being diagnosed 'HIV Positive' is quickly transformed into a severe, chronic psychological stress of living with a prediction of a horrifying decline that could start at any time. This causes a suppression of the immune system, with selective depletion of CD4 T-cells. ... These factors have been studied in healthy people where they create the very same immunosuppression and immune dysregulation that may later be called 'AIDS.'"

Denialist Michael Geiger is another proponent of "dangerous" thoughts, and even accused another dissident of helping to kill Christine Maggiore by worrying about her. "Have we as yet learned nothing ... of how easy it is to plant projections of sickness and death onto our own selves, as well as our friends, acquaintances or even onto our children and thereby help to create those fears into our realities?" Ironically, Celia Farber regularly "projects" in just this way: "I feared for [Maggiore's] life, always. I feared the battle would kill her, as I have felt it could kill me, if I couldn't find enough beauty to offset the malevolence. This is a deeply occult battle, and Christine got caught in its darkest shadows." Farber also blames the "AIDS orthodoxy" for long-distance mental homicide: "This is voodoo, what they are doing to [South Africa's denialist Health Minister] Manto. It is heartbreaking. I sometimes think they killed [Maggiore's daughter] EJ with their voodoo, too. What did EJ die of? Can anybody explain it and does it look like anything anybody has ever seen?" (EJ died of PCP.)

Cults often manipulate feelings of shame and guilt to control their members. Because both AIDS and the activities associated with HIV transmission are stigmatized, the HIV-negative denialist leadership often degrades those who have HIV, even if they are dissidents themselves. Peter Duesberg has always blamed AIDS in gay men on poppers and promiscuity; he dismisses those who say they didn't engage in either behavior as liars. Clark Baker says that AIDS was invented because "a small group of promiscuous, addicted, nitrite-huffing, gonorrheal and syphilitic bath house veterans began to get sick" and "refused to accept blame for their self-destructive behavior." A poster on a denialist forum attributes AIDS to "premature aging" from "snorting poppers, doing meth, drinking heavily, smoking heavily, eating poorly, not sleeping, having unprotected sex and taking the various pathogens of hundreds of sexual partners into your body."

HIV-positive denialists who get sick are blamed for lacking commitment: "Given a choice between the opposing ideas of dying from the deadly HIV product or living a long healthy life based on the dissident belief that the HIV product is nothing more than a baseless commodity being sold by junk merchants, chosing [sic] the dissident dream is the far better choice. A pseudo dissident ... will use the dissident view as a survival coping device ... When ordinary illness strikes and they run to RX drugs and suffer the very types of health decline that the dissident model predicts, they attack the dissident message."

Denialists who die from AIDS are often posthumously smeared as liars and secret addicts. When Raphael Lombardo died, Peter Duesberg wrote, "In hindsight, I think his letter was almost too good to be true. I am afraid now, he described the man he wanted to be and his Italian family expected him to be, but not the one he really was." (Duesberg meant that Lombardo lied about drug use.) Liam Scheff rolled the reputation of Mark Griffiths down a slippery slope of innuendo into the gutter: "I knew Mark; he was cogent when I worked with him -- never anything but. Almost. Sometimes he was -- once or twice he'd been -- a bit groggy. But he told me that it was alcohol. In fact he told me that he did consume alcohol -- perhaps more than he should." Scheff said drinking, not AIDS, killed Griffiths.

Creating Pariahs

Like those leaving a cult, former denialists are treated with extraordinary hostility. Dr. Joseph Sonnabend was one of the first physicians to treat people with AIDS. He insisted on a very high threshold of evidence that HIV causes AIDS, was cautious in prescribing unproven treatments, and recognized that co-factors, such as drug use and frequent STDs, influence an individual's risk of infection upon exposure and how fast HIV disease progresses. Denialists have often claimed Sonnabend as one of their own. When clips of him were used in the denialist film "House of Numbers" to support the denialist perspective, Sonnabend responded with a scathing blog at Poz.com, repudiating the film's message and affirming that HIV causes AIDS and that ARVs save lives. He wrote: "It is hard to adequately convey the feelings of a physician who was able to finally help his patients in the mid-1990s, having lost hundreds to this disease before that time. By the time these drugs became available about 400 of my patients had succumbed to AIDS, a dreadful rate of mortality. The effect of these drugs was life saving to those with advanced disease whose survival had been limited before. The portrayal of these drugs as in effect only toxic is so unfair."

Sonnabend was immediately savaged by denialists for betraying the cult. In one forum, "Ellis" wrote: "[Y]ou're a disgusting fraud, in my opinion, having once bravely stood apart from the racket, now pointing fingers and calling names of those who still have the decency to not be bought and sold for dollars and popularity contests. Who cares if HIV causes AIDS, or ten thousand things cause AIDS? ... Are you attempting to denigrate the film because of your own outlandish, humiliating lack of composure on camera? Because you sound like the old boozy floozy you really might be, not so deep down? Because you sold out to corporate pseudo-science a long time ago, do you now pour hatred onto those who still aren't satisfied with the one-size-fits-none industrial diagnosis? Shame on you, deep, deep, deep shame. You absurd old sell-out."

Celia Farber similarly attacked Sonnabend on the Spectator's website, accusing him of personal and medical treachery: "I have countless hours of tapes from the ever shifting but consistently indignant Joe Sonnabend dating as far back at 1988 ... through 2001, if not longer. After that, he became impossibly sycophantic to the orthodoxy. ... As for me, like everybody else under Joe's Bus, I forgave him because he seemed so abashed. I even invited him to my wedding. But he is a weak, dishonest man without any integrity, who loves the sensation of throwing everybody under the bus." Sonnabend's sin was to continue to evaluate the evidence, until the proof that HIV causes AIDS and that HAART is an effective treatment was conclusive.

Controlling the Flock

Peter Duesberg has always blamed AIDS in gay men on poppers and promiscuity; he dismisses those who say they didn't engage in either behavior as liars.

Within cults, the milieu is controlled and members are isolated. For denialists, who have no ashram, this happens online and in small groups. People worried about HIV are urged not to take the antibody test, to avoid mainstream information about AIDS, and to "stay as far away from allopathic doctors as possible."

Robert Lifton, a scholar of cults, identified the "principle of doctrine over person" as a characteristic feature. This doctrine "is invoked when cult members sense a conflict between what they are experiencing and what dogma says they should experience. The internalized message ... is that one must negate that personal experience on behalf of the truth of the dogma. Contradictions become associated with guilt: doubt indicates one's own deficiency or evil." Many HIV-positive denialists struggle with the reality of failing immune systems, which undermines their belief that HIV is irrelevant. The long list of denialists who have died from AIDS (posted on AIDStruth.org) contrasts with the fact that not one of the HIV-negative denialist leaders has died young, let alone with multiple strange infections that happen to be AIDS-defining illnesses.

Some HIV-positive denialists defy the prohibition on HIV treatment when they develop AIDS; they start ARVs and experience a rapid return to health. But instead of abandoning denial, many struggle to frame an alternative explanation for the success of the meds. Noreen Martin insists that her AIDS is not viral: "My own experience with AIDS was due to a lifetime of negative health issues. When extremely sick, I took the medicines, ate healthy, took over 50 supplements a day, and had a good attitude. So, within a few months I was as good as new." She stopped ARVs for three years. "During this time," she wrote, "my fatigue slowly came back, my CD4s dipped and my viral load increased to over 3 million. Nevertheless, I never placed much stock in either of these numbers because after extensive research, I realized that neither were [sic] related to health. It was other conditions that caused the problems and the ARVs were powerful enough to keep them at bay. ... Last fall, I became extremely tired again after being anemic for almost a year and fighting lymphedema for months, I took the ARVs, as I could barely get off the couch and could not function in life." Her health again improved.

Another denialist said, "I have seen many friends get better on ARVs, but my understanding has always been that these drugs are broad spectrum in their efficacy -- that they serve to kill virtually all pathogens, but also all the 'good stuff' in our bodies." Another, a thoughtful woman struggling to reconcile her recurrent illness with dogma, wrote: "All I can say is that I'm doing what seems to be working at the time. If it stops working, I'll make a new plan. And just because they call them antiretrovirals doesn't mean that's what they are." The only way they can remain alive and in the dissident camp is to pretend that ARVs, so precisely designed to target the ways that HIV infects T-cells, are a supercharged all-purpose germicide.

Deprogramming

Some denialists with HIV are unable to ignore their own experience, and are pushing back against the cult rhetoric. One weary man, positive since 1996, wrote, "Frankly, I'm sick of the questions at this point. Some of us here are experiencing strangely similar symptoms. Some well known people have died just like the orthodoxy said they would. At what point are dissidents going to start asking the important questions, rather than repeat the words 'AIDS ZONE' over and over? I'm not in any AIDS zone, but something is happening beyond my control. I have never been closer to taking Atripla than I am today. I hate to type that ... but it's true."

The denialist movement is also deeply split by conflicting theories of AIDS causality, different schools of quackery, and the basic question of whether the virus exists or not. Their unity is only maintained by their ritual invocation of long-disproved claims and their refusal to engage with scientific evidence. The most successful denialist propaganda avoids making direct claims and persuades only by innuendo and inference, because clear and specific statements generate hostility within the movement and can be easily disproven by evidence.

Still, it is very difficult for believers to break free of HIV denialism. Dissidents build their worldviews, their sense of themselves as heroic and embattled, their careers in journalism and alternative medicine, and their webs of social relationships around their rejection of HIV science and medicine. They have a lot to lose if they acknowledge that they are simply wrong. But as HIV treatments get better and better, and people with HIV live long and healthy lives using them, the psychological impulse to refuse to accept what was once a terrible diagnosis is diminished. Perhaps soon the only AIDS denialists will be HIV-negative people far removed from the communities most affected by the epidemic, and their cult won't matter at all.

Jeanne Bergman is a veteran AIDS and human rights activist in New York City.

AIDS Denialism, Medical Hypotheses, and The University of California’s Investigation of Peter Duesberg

Eduard Grebe — Thu, 29 Apr 2010 20:36:36 +0000

AIDStruth.org, April 2010

AIDS denialist and U.C. Berkeley Professor Peter Duesberg has recently received media coverage following the withdrawal of a paper of his by the publisher, Elsevier, and an investigation into his conduct by the University. [1] Here, we provide some background and a timeline of events in the unfolding drama.

AIDS denialism, which Peter Duesberg has promoted tirelessly for the past quarter century, has claimed many victims from the ranks of HIV-positive people who believe in its tenets: that HIV is harmless or non-existent, antiretroviral drugs (ARVs) cause AIDS, and lifestyle choices and alternative therapies can prevent AIDS-related illness and death. [2] These deaths, caused by the fusion of ignorance and lies, are regrettable and tragic. They are dwarfed in scope, however, by what happened at the end of the millennium in South Africa. There, hundreds of thousands of people died when the apparatus of state was placed in service of Duesberg’s theories on HIV and AIDS.

The South African tragedy began in 2000, when Thabo Mbeki, the president from 1999-2008, was beguiled by denialist disinformation on the Internet and invited a number of denialists, as well as AIDS scientists and clinicians, to participate in a Presidential Advisory Panel on the causes and appropriate response to the AIDS epidemic. The denialists included Duesberg and his business associate David Rasnick, who was later found guilty in South African court of helping to conduct an illegal and fatal human trial to test vitamins as a “cure” for AIDS. [3] The panel was irretrievably split between the scientists and the denialists, who held that AIDS is caused by poverty and malnutrition, not a virus, and that ARVs are toxic. The denialist position had a veneer of legitimacy because of Duesberg’s position at Berkeley. Government resistance to the use of antiretrovirals for mother-to-child transmission prevention and for AIDS treatment followed, persisting even when donors were prepared to provide free or discounted drugs for these purposes. [4]

While it is impossible to quantify precisely the deaths and suffering resulting from this state-sponsored AIDS denialism, several scholars have made conservative estimates of the death toll in peer-reviewed, published studies relying on rigorous statistical methods and multiple sources of data. Nicoli Nattrass, a South African social scientist, was the first, in 2007/8. [5] In 2008, a study from Max Essex’s group at Harvard University, first-authored by Pride Chigwedere, was published in the Journal of Acquired Immune Deficiency Syndromes (JAIDS). [6] The researchers had not consulted each other, but the two studies reached remarkably similar conclusions. As a result of Mbeki’s AIDS denialist policies, between 300,000 and 400,000 South Africans died early and avoidable deaths from 2000 to 2005, and many infants were needlessly infected with the virus because their mothers were denied proper and available treatment. In addition, Nathan Geffen of the Treatment Action Campaign submitted a commentary to JAIDS that discussed the damage the Mbeki administration's policies had caused to the South African people. [7] He called for investigations into the role played by Mbeki’s various external advisors, including Duesberg. That article was peer- reviewed and published in August, 2009.

After the Chigwedere et al. JAIDS article was published in 2008, Duesberg wrote to the editor accusing Max Essex, the senior author, of having an undisclosed financial conflict of interest. In essence, Duesberg charged that Max Essex could personally benefit from promoting the use of ARVs. The complaint was forwarded to the Harvard School of Public Health, which investigated and found the complaint to be factually inaccurate and groundless.

Subsequently, Duesberg submitted a paper to JAIDS that was critical of the Chigwedere paper and that again questioned whether HIV caused AIDS and argued that ARVs were toxic. Duesberg and his co-authors also claimed that there was no statistical evidence that HIV had caused the deaths of South Africans, or even that AIDS deaths had occurred in significant numbers in South Africa. The paper was peer-reviewed and rejected. One of the reviewers warned that Duesberg could face an official investigation by his university or by the National Institutes of Health (NIH) Office of Research Integrity for two issues. First, Duesberg failed to disclose that his co-author David Rasnick had conducted illegal clinical trials for vitamin pill manufacturer and distributor Matthias Rath, who is infamous in South Africa for attacking antiretrovirals as toxic and promoting vitamins as an alternative treatment. The reviewer noted that the connection between Rath and Rasnick should have been declared as a potential conflict of interest. Duesberg was clearly aware of and sensitive to the issue of conflicts of interest, as he had leveled that very charge against Essex—his omission was not the result of ignorance.

The second issue was Duesberg’s selective citation of bits from the scientific literature while ignoring contradictory evidence, his distortion of the incomplete but still formidable knowledge of how HIV affects the immune system into the basis for his claim that it does not harm people, and his blatant misrepresentation of the contents and findings of a 2006 Lancet paper by May et al. [8] The May et al. article reported success rates of ARVs at various points in time. Duesberg misreported the results, claiming that “hundreds of American and British researchers jointly published a collaborative analysis in The Lancet in 2006 concluding that treatment of AIDS patients with anti-viral drugs has ‘not translated into a decrease in mortality.’” In fact, the article never suggests that people with HIV/AIDS who take ARVs don’t live longer than those who do not. Rather, the sentence fragment Duesberg quoted is part of a finding that, over a period of 8 years, virological response in the first 6 months after starting ARVs improved markedly, but the number of deaths from all causes within the first year of treatment did not significantly change, decreasing only a little from 2.2% to 1.3% of the participants who started HAART that year. That is, only a small number of people on ARVs died during their first year of treatment, and even that number declined, unevenly, by almost half. This conclusion in no way can be interpreted to mean that ARV treatment has not resulted in radically reduced rates of AIDS-related mortality. The paper is very clear, and it is most unlikely that Duesberg could have honestly misinterpreted the article as saying otherwise. The JAIDS editor, Bill Blattner, rejected the Duesberg et al. paper on the basis of all the peer reviews he received and his own editorial judgment.

Next, on June 9, 2009, Duesberg resubmitted the paper, addressing none of the key criticisms raised by the JAIDS reviewers, to Medical Hypotheses, where the editor, Bruce Charlton, accepted it two days later. [9] None of the papers MedHyp publishes are peer-reviewed; it is unclear if Charlton even read the Duesberg paper, considering the near-instantaneous acceptance, and even less likely that any fact checking was performed. Charlton has described himself as “agnostic” on HIV as the cause of AIDS, and his magazine had previously published other AIDS denialist articles, in addition to papers attributing chronic fatigue syndrome to aluminum in vaccinations, [10] investigating navel lint, [11] positing high heels as a cause of schizophrenia, [12] and asserting the “very particular twinning between a Down person and Asiatic people” in appearance. [13] The published version of the Duesberg paper contained a statement noting the previous rejection by JAIDS and offering copies of the JAIDS reviews to anyone who requested them. Although several people have since requested the reviews, Duesberg has not kept his promise to release them.

Various AIDS researchers and activists, including John Moore and Francoise Barré-Sinoussi, wrote to Elsevier (the publisher of Medical Hypotheses and some 2,000 other journals) requesting an investigation into why and how the Duesberg paper could have been accepted for publication. In addition, a multi-signatory letter was sent to the United States National Library of Medicine, requesting an assessment of whether Medical Hypothesis should remain listed on PubMed, the Library of Medicine’s database of peer-reviewed and legitimate articles. After an internal enquiry, Elsevier temporarily retracted the Duesberg paper, along with a second AIDS denialist article, pending the outcome of a more thorough investigation. That investigation, conducted by other Elsevier editors, commissioned five peer reviewers. All five reviewers recommended rejection, and the paper was permanently retracted. In addition, Elsevier elected to reform the publishing policies of the journal, converting it to a peer-reviewed format. The editor, Bruce Charlton, has refused to accept the publisher's instructions to date and says he will serve out his contract without changing the policy; Elsevier has indicated that in that case Charlton will be removed from his position.

Around the same time, in August 2009, two people sent formal letters of complaint to Duesberg’s institution, the University of California, Berkeley, concerning the contents of the Medical Hypotheses paper. They noted the lack of disclosure of Rasnick's potential conflict of interest and the poor quality of scholarship throughout the work. Both letters were signed. One of the writers has since publicly disclosed himself as Nathan Geffen; the other has elected to preserve the right to confidentiality.

U.C. Berkeley began an investigation into Duesberg’s conduct, led by Public Health faculty member Art Reingold, M.D., M.P.H. Duesberg chose to announce the investigation, speaking with a ScienceInsider reporter about it [14] and also probably causing the official letters of complaint to be posted on a public website, despite their being marked as confidential. The investigation is ongoing, press coverage is increasing, and more and more of the facts are becoming known.

Scientists have long known that Duesberg has not done original work with HIV, that his denialist claims have either been falsified or are not supported by evidence, and that his scholarly practices are often slipshod and perhaps even deceitful. Descriptions of Duesberg in the popular press have concentrated on the colorful or offensive aspects of his personality, and many who find his AIDS denialism offensive have nonetheless supported his academic freedom. But academic freedom is not license to breach the well-established rules of scholarship. Conflicts of interest must be declared, and deliberate misrepresentation is not acceptable conduct. Duesberg may have finally exhausted the patience of the scientific community and the University of California.

References

1. See, for example, Zoe Corbyn, “Berkeley Scholar in Dock over HIV-Aids Article,” Times Higher Education, April 24, 2010.

2. See “Denialists Who Have Died of AIDS” at http://www.aidstruth.org/denialism/dead_denialists

3. See Nicoli Nattrass’s 2007 Mortal Combat: HIV Denialism and the Struggle for Antiretrovirals in South Africa (Pietermartizburg: University of Kwazulu Press) and Nathan Geffen’s 2010 Debunking Delusions (Johannesburg: Jacana) for a discussion of Mbeki and the P residential AIDS Advisory Panel. See also the Durban Declaration that affirmed in response to the South African fiasco that HIV is the cause of AIDS, and was signed by over 5,000 people at the MD or PhD level or the equivalent: http://www.nature.com/nature/journal/v406/n6791/abs/406015a0.html.

4. Presidential spokesman Parks Mankahlana made it chillingly clear that preventing mother-to-child transmission would result in large number of AIDS orphans burdening the state when the mothers of HIV-negative children died: “Who’s going to bring the child up? It’s the state, the state. That’s resources, you see.” Geffen, op cit, p. 54.

5. Nattrass, Nicoli. 2007. Mortal Combat: AIDS Denialism and the Struggle for Antiretrovirals in South Africa, Pietermaritzburg: University of KwaZulu-Natal Press. See also Nattrass, Nicoli. 2008. “AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa.” African Affairs 107(427):157-176.

6. Chigwidere, P, Seage, G 3rd, Gruskin, S, Lee, T, Essex, M. 2008. “Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa’, in Journal of Acquired Immune Deficiency Syndrome, 49: 410-415. See also Chigwedere P, and Essex, M. 2010. “AIDS Denialism and Public Health Practice.” AIDS and Behavior 14(2):237-47.

7. Geffen, Nathan. 2009. “Justice After AIDS Denialism: Should There Be Prosecutions and Compensation?” JAIDS 51(4):454-455.

8. May MT, Sterne JA, Costagliola D, Sabin CA, Phillips AN, Justice AC, Dabis F, Gill J, Lundgren J, Hogg RS, de Wolf F, Fätkenheuer G, Staszewski S, d'Arminio Monforte A, Egger M. 2006. “Antiretroviral Therapy (ART) Cohort Collaboration. “HIV treatment response and prognosis in Europe and North America in the first decade of highly active antiretroviral therapy: a collaborative analysis.” Lancet 368(9534):451-8.

9. Duesberg PH, Nicholson, JM, Rasnick, D, Fiala, C, Bauer, H. 2009. “HIV-AIDS Hypothesis out of touch with South African AIDS – A new perspective.” Med Hypotheses (withdrawn). On what it means to have a paper withdrawn from Medical Hypotheses, see Orac’s Respectful Insolence blog post of September 15, 2009: “Pity poor Peter Duesberg: Even Medical Hypotheses has dissed him.” http://scienceblogs.com/insolence/2009/09/pity_poor_peter_duesberg_even_....

10. Exley, C., L. Swarbrick, R. Gherardi, Authier, F-J. 2008. “A Role for the Body Burden of Aluminum in Vaccine-Associated Macrophagic Myofasciitis and Chronic Fatigue Syndrome. Medical Hypotheses 72(2):135-139.

11. Steinhauser, G. 2009. “The nature of navel fluff.” Medical Hypotheses 72(6):623-625.

12. Flensmark, J. 2004. “Is there an association between the use of heeled footwear and schizophrenia?” Medical Hypotheses 63(1), 740-747.

13. Mafrica, F, and Fodale, V. 2007. “Down Subjects and Oriental Population Share Several Specific Attitudes and Characteristics” Medical Hypotheses 69(2): 438-440.

14. Miller, Greg. “AIDS Scientist Investigated for Misconduct After Complaint.” ScienceInsider April 16, 2010: http://news.sciencemag.org/scienceinsider/2010/04/exclusive-aids-scienti...

Statement by Nathan Geffen on Complaint Against Peter Duesberg

Eduard Grebe — Wed, 21 Apr 2010 16:00:13 +0000

Two media articles create the impression that I complained anonymously about Peter Duesberg to the University of California Berkeley. These are:

There was nothing anonymous about my complaint. I believe that Duesberg failed to declare a conflict of interests of one of his co-authors in an article published in a journal called Medical Hypotheses. I consequently lodged a complaint with the University. I believe high quality journals should hold the first author responsible for a failed declaration of conflict of interests by co-authors (unless the co-author hid the conflict from the first author which is definitely not the case here). Duesberg was the first author of this article. Admittedly, Medical Hypotheses is not a high quality journal.

On 9 April 2010 UCB emailed me asking if I was prepared to have my complaint given to Duesberg in full with my name on it. I unhesitatingly answered yes immediately upon receipt of the email. My complaint has never been anonymous.

The real issue here is that Medical Hypotheses published an article co-authored by David Rasnick who has been found in a court of law to have conducted an unlawful clinical trial.

People died as a consequence of this trial and Rasnick bears partial responsibility for their deaths. The company he worked for, the Rath Health Foundation owned by Matthias Rath, makes its money by selling vitamins as alternative cures for a range of diseases including AIDS. This is an unequivocal conflict of interests in an article whose implicit theme was that antiretrovirals are not an effective treatment for HIV, because Matthias Rath's business model is based on promoting such nonsense.

My complaint is copied in full below. It is self-explanatory. I intended the UCB process to run its course without me commenting to the media, but Duesberg apparently had no such qualms, leaving me with no choice but to make this statement.

I am unfamiliar with UCB's rules and therefore am not in a position to determine if Duesberg has breached their academic disciplinary code. However, to my mind a breach of ethics took place and it was therefore worthwhile lodging a complaint with Duesberg's institution. It is up to UCB to determine what if any action should be taken against Duesberg.

Here is the text of the complaint:

28 August 2009

President Mark Yudof

Office of the President University of California

1111 Franklin Street Oakland, CA 94607-5200

president@ucop.edu

Mary Croughan

Chair Universitywide Academic Senate University of California

1111 Franklin Street Oakland CA

Mary.Croughan@ucop.edu

Dear President Yudof and Chairperson Croughan

REQUEST FOR INVESTIGATION INTO PROFESSOR PETER DUESBERG

I am writing to request an investigation into the conduct of Professor Peter Duesberg. I am concerned that he has possibly breached the ethics and practices of scientific publishing in relation to a paper that recently appeared in the journal 'Medical Hypotheses', of which he is the first and corresponding author. [1]

Since publication the paper has been withdrawn by the publisher. Elsevier, states, “... 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.” [2] Since the paper is withdrawn, I have attached the article as it was originally published before withdrawal.

My concern however regards Professor Duesberg's failure to declare a relevant conflict of interest. In the paper, he states, "I and my co-authors have no commercial or other non-scientific conflicts of interest with our AIDS paper for Med. Hypotheses.”

This statement appears inaccurate to me. One of the central themes of the paper is an attack on the use of antiretroviral drugs to treat HIV infection. As an example, the abstract states, "[W]e call into question the claim that HIV antibody-positives would benefit from anti-HIV drugs, because these drugs are inevitably toxic and because there is as yet no proof that HIV causes AIDS.”

Dr. David Rasnick is a co-author of the paper by Duesberg et al. Until recently, he worked as a researcher for a company, the Dr Rath Health Foundation Africa. This organization promoted and distributed (and in terms of South African law, sold) micronutrient products as alternatives to the use of antiretroviral drugs to treat HIV infection in South Africa. The organisation, with Dr. Rasnick's direct involvement, also conducted an unauthorized clinical trial to evaluate its products as alternatives to antiretroviral drugs for treatment of people with HIV infection. The company has never published the results of this trial in a peer-reviewed medical journal, but has instead published paid advertisements purporting to report the trial's results, a practice that is considered unethical in medical research. Dr. Rasnick is described in these advertisements as one of the researchers who conducted the trial.

A case was brought by the Treatment Action Campaign and the South African Medical Association against the company's owner, Matthias Rath, the Rath Health Foundation Africa, Dr. Rasnick and others in the Cape High Court. I deposed the founding affidavit. The court was requested to interdict the unauthorized trial from continuing. The court found in favour of the plaintiffs and ruled that the defendants, including Dr. Rasnick, had indeed conducted an unauthorized clinical trial [3]. Several deaths occurred on the trial [4]. Also of note is that Dr. Rasnick has previously misrepresented his affiliation with the University of California, Berkeley [5].

In summary, the facts are that Dr. Rasnick, a co-author of the paper by Duesberg et al., has worked to boost the sales of an alternative (but ineffective) way to treat HIV infection. His employer, the Dr. Rath Health Foundation Africa, has actively attacked the use of antiretrovirals (a proven, effective way to treat HIV infection) as part of its marketing campaign for its products. Dr. Rasnick has helped to promote these products in paid advertisements. A paper co-authored by Dr. Rasnick that attacks the use of antiretroviral drugs is therefore of commercial value to his former (and possibly current) employer, Matthias Rath.

The affiliation between Dr. Rasnick and Matthias Rath is therefore a material and relevant fact that should have been disclosed in the paper by Duesberg et al. As the responsibility for making such a disclosure is the corresponding author's, it appears to me that Professor Duesberg has likely committed an ethical breach that should be investigated by the University of California, Berkeley.

Regards

Nathan Geffen

TREASURER, TREATMENT ACTION CAMPAIGN

References:

1. Duesberg, P.H., Nicholson, J.M., Rasnick, D., Fiala, C. & Bauer, H.H. HIV-AIDS hypothesis out of touch with South African AIDS - A new perspective. Med. Hypotheses (2009).doi:10.1016/j.mehy.2009.06.024 http://www.ncbi.nlm.nih.gov/pubmed/19619953

2. Duesberg, P.H., Nicholson, J.M., Rasnick, D., Fiala, C. & Bauer, H.H. WITHDRAWN: HIV-AIDS hypothesis out of touch with South African AIDS - A new perspective.

3. Zondi J. Judgment in TAC and Others v. Matthias Rath and Others. 2008.

4. TAC. Analysis of deaths on Matthias Rath illegal clinical trial. 2005.

5. TAC. The Citizen's publicity for AIDS denialists is irresponsible. 2006.

Quackery taken to task

Eduard Grebe — Thu, 25 Mar 2010 12:53:34 +0000

by Lesley Odendal

First published by health-e. This article is republished by AIDSTruth because it deals with political support for AIDS denialism.

OPINION:Nathan Geffen’s book Debunking Delusions reminds us what can go wrong when AIDS denialists are given the time of day. The book also documents clearly how we can fight denialism in a manner that saves lives and respects science. What is clear given the resurgence of AIDS denialist propaganda is that now is not the time to sit back.

As Geffen argues in his book, underlying the Treatment Action Campaign’s success in fighting denialism and quackery was the almost unsung treatment education programme. Knowledge truly is power in this case.

AIDS denialism reached its peak in the public arena in the late nineties and early 2000s when Thabo Mbeki consulted a number of AIDS denialistson his AIDS panel to advise him on AIDS policy. The public believed that the debate was over when Mbeki ‘withdrew’ from the debate, claiming that he never stated that HIV did not cause AIDS and when in 2003 antiretroviral (ARVs) began to be rolled out at a national scale to HIV-infected people. The struggle between the many players, including Mbeki, then Minister of Health Manto Tshablala-Msimang, the Treatment Action Campaign, clinicians, the international scientific community and the many denialists benefiting from, and supporting, Mbeki’s policies such as Duesberg, Anthony Brink, the Visser family and the numerous quacks in tow, received much media attention and mass mobilization.

In 2010, one may ask, what is the significance of AIDS denialism today? For most lay people, the debate is settled and the evidence is clear: HIV causes AIDS; ARVs are the best and only treatment for HIV; Mbeki’s AIDS policies caused thousands of unnecessary deaths and HIV-infections and thousands of peer-reviewed articles have been written regarding the effects of HIV on the body.

Unfortunately, the denialists are not ready to give up. Despite the numerous rebuttals against their claims and the plethora of evidence that exists against them, there has been a recent surge in denialist material that has been circulating both in the mass media in the form of the documentary House of Numbers and the infamous AIDS denialist Peter Deusberg’s (who was also on Mbeki’s panel) article in the non-peer reviewed journal Medical Hypothesis. Medical Hypothesis as not being peer reviewed and scandals around that

AIDS denialists usually support at least one of the following hypothesis:

HIV does not exist
HIV tests do not in detect the presence of HIV
Following from this, HIV prevalence is highly overestimated
HIV does exist but it is not harmless
HIV is not sexually transmitted
AIDS is caused by other factors such as poverty, malnutrition or ARVs themselves
ARVs are toxic and often fatal and cannot prevent the vertical transmission of HIV
AIDS should be treated by an extensive range of alternative remedies such as herbal concoctions, vegetables, vitamins or bizarre treatments such as ozone rectal therapy

Pride Chigwedere of the Harvard School of Public Health eloquently and passionately refutes many of these claims and the amount of words spent on deconstructing the claims of denialists is unprecedented in academia. However, what is evident and a hallmark of AIDS denialist argument is that despite any proven evidence that is thrown against them, AIDS denialists do not take this into account for developing their arguments and instead sway the debate in another direction. For them, the evidence is incorrect and they are misunderstood as the last renegades of the truth. This makes it very difficult to engage in anti-denialist debates— academics, scientists, activists and clinicians grow tired of arguing with those who do not take reason into account and who do not respect the essential tenant of science— proven evidence—and prefer to focus on their core work which is to create and disseminate more evidence to the benefit of our understanding of HIV. As Nattrass states, “the problem [of not accepting evidence] is far more than intellectual because disregarding evidence not only undermines scientific progress, but it threatens the social basis which makes such progress possible.”

More worrying, is that where the evidence suits them, AIDS denialists misrepresent data or use the incorrect data to support their arguments. In Duesberg’s article for instance, he uses the incorrect epidemiological data that misclassifies causes of death in South Africa to support his thesis that AIDS is not killing as many people as it is widely estimated by scientists across the world. Duesberg uses the Statistics South Africa Findings from Death Notification to argue that AIDS-related deaths are much lower than that postulated by Chigwedere’s 2008 article. However, it is a common fact, that due to AIDS stigma, AIDS is rarely stated as the reason for death. Up to 60% of HIV deaths are misclassified.

Duesberg also refutes the claim that ARVs are effective at preventing vertical transmission of HIV. He does not quote the numerous randomised control trials that prove that ARVs do decrease the vertical transmission down to between 3 and 5 % when properly administered, but instead examines the history of the production of AZT, one of he drugs used in this prevention strategy.

In the newly aired House of Numbers documentary, denialist views are supported by interviewing respected scientists and distorting their views in a clever concert of manipulation. The public is further shown as erratic sheep who merely carry mainstream HIV because that’s what ‘they’, the scientists said. The definition of HIV and AIDS is painted as unclear with the claim that there is confusion as to what the more than thirty-year old disease, AIDS is. The effectiveness of HIV rapid-tests are questioned in a most irresponsible manner. HIV counsellors in South Africa explain at length what the limitations of rapid testing are and why it is necessary to conduct follow-up testing. At no point is the practical or economic convenience of rapid testing explained, nor is there mention of the gold standard test PCR HIV test which instead of searching for HIV antibodies, identifies HIV DNA* in the person’s blood.

The causes of AIDS are debated at length as if the evidence has not been around for decades— HIV as being caused by ‘lifestyle’ drugs and choices such as Poppers, being homosexual, or by co-factors such as poverty and malnutrition. People living with HIV are depicted as highly-emotional sufferers who do not have an option to take life-saving medication and at no point are any people who are managing their lives well on ARVs interviewed. Instead, a baby who was clearly suffering from a very common ARV side effect, plural neuropathy, is depicted as being cured of the ailment once she is off the drug. Other patients are described as having died of hepatoxicity from Nevirapine. At no point is it explained that these side effects are well known and well documented and that every countries ARV guidelines takes these into account in the prescription of ARVs.

Just as Duesberg does, House of Numbers is another example of selective use of evidence. The consequences of this kind of conspiracy theory manipulation of evidence can be far reaching as can be witnessed in South Africa’s tragic AIDS policy of the past. House of Numbers is currently being screened at film festivals around the world. Like all other AIDS denialism, there are dire consequences to this kind of portrayal of evidence.

AIDS denialism allows for deadly consequences. Firstly, it allows people living with HIV an escape— a far too easy route into personal denial that facilitates a process of withholding treatment from oneself and taking the necessary steps to ensure a healthy future. Stemming from this, AIDS denialism allows for quackery in all forms to persist. This allows for unfounded treatments to be sold to people at high costs to cure them of their HIV, as has been tragically witnessed in so many individuals across the world. This is what resulted in the deaths of an immeasurable amount of people across the world, as ARVs are distrusted, as is the institution of scientific evidence. More than quackery, there is a current wave of religious leaders who are encouraging people to stop taking their ARVs as only their faith can heal them.

AIDS denialism, when lent a powerful policy ear, as was the case with the Mbeki administration, allows for the systematic erosion of the scientific governance of medicine. This has far reaching consequences— for example the Medical Control Council (MCC) is practically defunct due to Mbeki’s consistent disregard for scientific evidence. It can result in delaying life-saving treatment to entire nations.

Most importantly, denialism results in death. Unnecessary, painful death. It can be genocide. And it is for that reason that the activists and scientists should not stop fighting AIDS denialism. This should not only be on blogs and in academic journals—most importantly, it should be in the public. HIV Treatment Literacy (TL) is our most powerful tool in this. It is about making science accessible to the masses— even those who do not have any form of education. There are numerous groups who have shown the success of this approach. At any time one can walk into any clinic in Khayelitsha and hear TAC activists, many with no formal education, educating patients about their disease and its treatment. This is the power of TL and anti-denialists strongest weapon in essence given the fact that the denialists themselves are failing to listen.

At the book launch of Debunking Denialism, Andile Madondile, a TAC TL educator, who had indulged in quack remedies for his HIV when his CD 4 was only 9, spoke honestly of the effect that treatment literacy had on him “The comrades at TAC saved my life. They made me realise that ARVs were the only way that I was going to overcome this disease. It is the reason I am alive and well today.”

The denialists appear to be making a comeback. The sad and worrying truth is that they were never gone. The issue at stake here is that due to their easy access to money, resources, publicity, journals which are not peer reviewed and internet, their message will continue to be heard by the masses, who do not necessarily have an understanding of how science works or the myriad of AIDS data. It is this which needs to be stopped in its tracks. Even if governments are clear on the causes and treatment of HIV, at an individual level there is a different story, and this is where our efforts should be targeted. Nathan Geffen’s book Debunking Delusions comes at a time when we need to fight for truth again.

Lesley Odendal is currently completing her Masters in Public Health. She worked at the Treatment Action Campaign in 2008 and 2009.

* While some PCR tests are used to detect proviral DNA in blood cells, the author probably intended to refer to the more commonly-used RT-PCR tests that detect viral RNA in plasma.

The Price of Denial: A documentary on the legacy of AIDS denialism in South Africa

Eduard Grebe — Sat, 30 Jan 2010 12:54:36 +0000

This documentary was produced by the non-profit health news agency Health-e and was recently broadcast on an independent television channel in South Africa. View Part I:

(If you do not see the video above, your browser does not support HTML5 video playback. Download the video or visit this page in Firefox or Chrome.) Download Part I in ogg/theora or in mp4. Part II after the jump.

View Part II

Download Part II in ogg/theora or in mp4.

New myth debunked: The fact that some HIV-positive people live in good health without treatment for many years proves that HIV is harmless

Eduard Grebe — Mon, 11 Jan 2010 16:12:51 +0000

Fact: A small percentage of people infected with HIV do live for many years without developing AIDS. They are often known as long-term non-progressors. But such individuals are rare: without proper medical care, including antiretroviral drugs when needed, most HIV-positive people will eventually develop AIDS.

As putative evidence that HIV is harmless, some HIV/AIDS denialists point to examples of HIV-infected people who survive for many years, even decades, without receiving antiretroviral treatment. HIV denialists often claim that these people survived because they avoided antiretroviral therapy, and that diet, exercise, nutritional supplements or herbal therapies, stress reduction, hypnosis, and other interventions prevent progression to AIDS. These claims are untrue and dangerous.

Read the full bebunking.

In Memoriam, Lambros Papantoniou

Eduard Grebe — Wed, 02 Dec 2009 16:38:17 +0000

by George N. Pavlakis, Rockville, MD USA

What do you do about someone who claims to be an expert, serving up half-truths, twisting the facts in credible-sounding sentences and misleading a patient? There must be some rules that apply to someone who professes to be an expert and induces patients to stop their doctor-prescribed medication. These must be applied to prevent harm to more patients. And what if these actions lead to the patient’s death?

Such is the case of Lambros Papantoniou, a journalist living in Washington, a diplomatic correspondent for several Greek media institutions for more than 30 years and a man loved by all who met him. Even in the higher political echelons of Washington, he was affectionately known as “Mr Lambros”.

During a hospital stay approximately ten years ago, Lambros was diagnosed with AIDS and given anti-retroviral therapy. Following this, his interest in the AIDS problem skyrocketed, and he sought information on it. Although he was a diplomatic correspondent, he reported on AIDS issues several times.

Unfortunately, Lambros attracted the attention of Andrew Maniotis, a scientist and self-proclaimed expert on many fields, and AIDS denialist. Dr. Maniotis is not a medical doctor, nor a pathologist, as he occasionally describes himself. He is not a tenured professor, nor a tenure-track candidate for a higher academic career. At times he denies he is an “AIDS denialist,” but this term accurately describes public opinions. He does not shy away from controversy and publicizes naïve opinions that contradict the established knowledge and medical science, trying to nullify the medical gains of generations of researchers and doctors.

Maniotis claims that Lambros was like a brother to him. With such brothers, who needs enemies? The two men became friends, and Maniotis visited Lambros often in the last few years, his influence growing stronger and stronger, ultimately convincing him that HIV did not exist. Lambros stopped taking his medication and the result was devastating. After his death, Lambros’s family and friends found his medication in his refrigerator, untouched since 2007. Instead of his life-saving doctor prescribed medicine, Lambros was convinced to consume Maniotis-promoted vitamins.

During 2007, increasingly influenced by Maniotis, Lambros became more aggressive in interrogating scientists and government officials about AIDS. In his attempts to discredit Dr. Robert Gallo, Maniotis urged Lambros to seek an interview with Gallo, hoping to confront him with an AIDS denialist agenda and publish articles containing slander and misinformation.

Dr. Gallo took the bait and spoke with Lambros openly and frankly. To his credit, Lambros published a series of articles in which he reported on the issue ethically and to the best of his ability. Undaunted by this failure, Maniotis intensified his efforts to convince Lambros of his outlandish ideas on AIDS. Lambros was finally convinced and published an extensive interview, in which Maniotis disputes all scientific facts about HIV and AIDS, advising HIV positive people, like Lambros himself, to stop taking their doctor-prescribed medication and to rely on vitamins and other unproven methods.

Unfortunately, Lambros’ non-scientific background and his personal vulnerability as an HIV positive person got the best of him, and he became more and more a spokesperson of the AIDS denialists, putting his complete trust in Maniotis.

This trust eventually cost him his life. He simply stopped taking his medication. Already hospitalized once, Lambros’s health depended on blocking HIV through anti-retroviral drugs. Without this protection, the virus continues to damage the immune system, until the patient becomes vulnerable to a multitude of common infectious agents, which would ordinarily be blocked by a functioning immune system. With the medication, he likely would have lived a longer and healthier life.

Having finally succumbed to Maniotis’ 'freindship', at several White House and State Department briefings in Washington, Lambros asked hostile nonsensical questions repeating the statements of Maniotis verbatim. He asked whether anyone had actually seen the virus. He accused the medical profession of poisoning the “so-called AIDS” patients with drugs.

In retrospect, Lambros’ increasingly erratic behavior can be partially explained by his deteriorating health. HIV ultimately landed him at Howard University Hospital under unclear circumstances. The most likely scenario is that he was found confused and disoriented and was taken to the closest emergency room. He had developed encephalitis, a common outcome of end-stage HIV infection. He was later transferred to Georgetown Hospital, where he died of encephalitis. During his more lucid moments at the hospital, Lambros told his friends he was dying of AIDS.

In the meantime, Maniotis, having the trust of Lambros’s family, was calling both hospitals and arguing about prescribed treatments, accusing medical personnel of trying to kill Lambros, all while denying the existence of AIDS. The doctors found the situation highly distracting and asked that Maniotis does not contact them. The Greek Embassy had to intervene and tell Maniotis to back off.

During this last period of his life, Lambros was clearly very sick and confused, making several statements reflecting this confusion. To their shame, AIDS denialists are promoting these statements on the Internet in order to build up their own agenda, disrespecting the memory of a sick and confused man, and, of course, not acknowledging their part in his death.

"Nobody really knows why he's gone," claims Maniotis. But in the end, Lambros knew, and so do we. He died of encephalitis following the collapse of his immune system, an outcome of HIV infection. We know from millions of other cases that, had he taken his anti-retroviral medicine and prevented further damage by HIV, he could have had many more productive years.

Some of us who knew him also feel a bit guilty at times about not being able to protect him more from predators like Maniotis.

Consequently, we feel that along with celebrating his contributions, his achievements, his life of giving, of helping many people in his community, we also need to tell his true story. Lambros was a defender of our democratic ideals, a stalwart defender of the truth, a man who gave freely of himself, his time and the limited money he had, helping countless people in his neighborhood in Washington, in cities throughout the U.S. and in Greece. He is missed even by those he criticized.

We must honor him by not allowing his death to be used to hurt others. We must not be silent, as silence did not become Lambros himself.

As a generation of AIDS activists realized some time ago, Silence = Death.

Rian Malan still getting AIDS stats wrong

Eduard Grebe — Tue, 01 Dec 2009 13:09:43 +0000

by Nathan Geffen, 1 December 2009

Substantially updated by the author on 7 December 2009

In a piece published in Rapport newspaper and on politicsweb, Rian Malan claims:

[D]on't trust anything the Aids bwanas say - especially not Nathan Geffen of TAC. Earlier this week, he informed the world that Zuma's mistake "was of little consequence," because other data showed that SA's death rate has doubled since l997. Hmmm. It is true that annual death registrations rose from 316,000 in 1997 to around 600,000 in 2007, but it is absurd to claim, as Geffen did, that this was almost entirely the result of Aids.

Over the same period, completeness of registration rose from around 67 percent to 81 percent, according to Stats SA, while our population rose by close on seven million. If you adjust the raw numbers accordingly, Geffen's apparent doubling shrinks to an increase of around 15 to 20 percent.

He then published a correction:

Correction: I am informed that my mathematical skills leave much to be desired. If you run the numbers in the penultimate paragraph correctly, the real increase in SA death registrations since l997 comes out at around 30 percent - still a tragedy by any reckoning, but still way short of the doubling claimed by Geffen.

First let's deal with the numbers. Malan continues to get it wrong, even in his correction. AIDS deaths have conservatively increased 6-fold since 1997, from approximately 50,000 to well over 300,000 in 2006 as well as 2007 and maybe even over 350,000, meaning the real increase in deaths -which is way more than 30%- recorded or otherwise, was mainly due to AIDS. The ASSA2003 interventions model calculates under 150,000 AIDS deaths in 2000 and about 360,000 in 2007. Approximately 45% of deaths in 2006 and 2007 were due to AIDS. The model probably overestimates AIDS deaths but not substantially enough to give any material support to Malan's argument. But even a 30% increase in mortality, as Malan acknowledges, is a tragedy.

Far more knowledgeable people than either Malan or myself work on the ASSA model. They take into account all the available data: recorded deaths, improved registration, population growth and much else. Of course, as with any model, there is a good deal of uncertainty, but it is the best we have to go on - and far better than Malan, who admits his mathematical skills leave much to be desired.

In Malan's Rolling Stone article in 2001, his arguments were based on outright AIDS denialism, in which he confused the different types of testing algorithms needed for diagnosis of an individual patient versus epidemiological surveys. His articles in 2003 in Spectator and Noseweek continued in the same vein. But with each subsequent article he has come closer and closer to admitting the massive scale of the HIV epidemic. His latest acknowledgement that AIDS is responsible for a 30% increase in mortality is almost mainstream. Yet his writing style remains unrepentant and he brushes off as a triviality the realisation that he is not mathematically competent to do this work.

He also misrepresents me. Nowhere did I write that real deaths had doubled in my recent article that he appears to be referring to. I wrote, accurately, that recorded deaths increased over 90% in a decade. I also wrote, "Improved death registration and population growth can account for only a small portion of this increase. The vast majority of additional deaths are due to the HIV epidemic."

This was also accurate. Only a careless reading of my wording would imply that total deaths (i.e. recorded plus unrecorded) have doubled due to AIDS. This might seem a minor "He said, I said" spat, but it demonstrates a lack of integrity in public engagement. Despite our overall success, I am sure there is much fair criticism that can be directed at TAC about our actions over the last decade, but manipulating AIDS statistics is not one of them.

Without any sense of irony, Malan concludes, "we should just ignore those who try to manipulate us with numbers and support Zuma's common-sense plan to stamp out the disease." Actually, it is because of the people who Malan falsely accuses of manipulation that we finally have a common-sense AIDS plan. While we were fighting for it, Malan was supporting Mbeki on AIDS.

Some of my colleagues have been weary about me responding to Malan. They have warned me that he is being a contrarian so that he can promote his new book and that a response is exactly what he wants. But I think Malan is a talented wordsmith whose writing style convinces some people; it is them I aim my articles at. But being clever with words does not imply competence and Malan's articles on AIDS are littered with errors.

According to Wikipedia Malan stated, "I get a kick out of it when the Treatment Action Campaign attacks me; it's like sport." I do not know if he really said this, but it does appear to be sport for him.

For TAC and me, it is a waste of precious time and aggravating. Many people find AIDS statistics impersonal. But I do not; they remind me of Christopher Moraka, who testified before Parliament in 2000 that he could not get medicines to treat his systemic thrush. He died a couple of months later. Or Edward Mabunda, TAC's late firebrand poet. And Ronald Louw, a close friend and brilliant lawyer based at UKZN who died a few years ago of AIDS. No, this debate is not sport for TAC or me.

Constantine and Weiss pinpoint misrepresentations

Eduard Grebe — Thu, 26 Nov 2009 20:22:29 +0000

Statements by Professor Niel Constantine and Professor Robin Weiss about the Misrepresentation of their Interviews in “House of Numbers.”

Posted November 23, 2009, to HouseofNumbers.org

The sections on HIV antibody tests in “House of Numbers” contain fragments of interviews with a number of different people, put together in a way that confuses viewers rather than clarifying what HIV testing protocols are and how they work. The editing of the interviews to try to create doubts about the worth of HIV diagnostic assays is surely intentional. Questioning HIV diagnostics is one of the main tactics of HIV denialism.

The talking heads in these sections of the video include an eager-to-please but inexpert woman working in a temporary testing tent in a South African mall, several legitimate scientists, and HIV denialist Liam Scheff and filmmaker Brent Leung. The section jumbles together bits of speech about the use of HIV antibody testing for different purposes—for screening the blood supply, for screening individuals for HIV infection and confirmatory testing, for diagnosis and for prognosis. It also scrambles remarks about different generations of tests; about tests of different qualities—those manufactured under FDA oversight and those produced in uncontrolled conditions; about different types of HIV antibody tests—conventional and rapid tests, ELISA and Western Blot; and about the use of these tests under different countries’ government protocols—Germany, South Africa, Britain, the USA. The resulting mess of words creates confusion – as it was intended to.

The history, variety, and protocols of HIV antibody testing can be confusing to non-experts. Leung and his team have exploited this in the film. But any of the legitimate scientists or clinicians in the film, asked a clear question by an ethical interviewer who would try to present their views accurately, could easily explain how HIV antibody testing works, what protocols are used to maximize accuracy in different places and at different times, the distinctions between screening and diagnostic assays, the differences between ELISAs and Western Blots, and so on. But Brent Leung sought to confuse, not clarify. He wanted to make it seem like the tests are unreliable and that the scientists he interviewed didn’t know disagreed with each other about HIV tests. The reality is very different. HIV antibody tests are extremely accurate, and various confirming protocols (two or three different types of tests) are used in different places.

Two scientists who were interviewed by Leung, then edited to appear as if they held antagonistic views, are Niel Constantine, Professor of Pathology at the University of Maryland, and Robin Weiss, Professor of Viral Oncology in the Division of Infection and Immunity at University College, London. Professors Constantine and Weiss both say that their interview footage as edited misrepresented what they know and what they said. In fact, contrary to the impression created in “House of Numbers”, they agree with one another about the nature, value, and accuracy of HIV antibody tests. Here are their statements.

Dr. Constantine's Statement

“What Mr. Leung has done is take our statements completely out of context. For example, he and I were discussing the use of rapid HIV tests and their accuracy. I explained that the tests were excellent, but that some individuals were assembling rapid HIV tests from individually purchased components and making these tests in their garages for sale. Such tests, that had not been subjected to the quality assurance measures required by organizations such as the FDA, were inferior and should not be used. That is, only tests that were approved by expert organizations should be used. Hence, my statement in the film "Now if I tell you that the test you took was lousy and didn't mean a thing." Mr. Leung used this to imply that I was stating that HIV tests were useless.”

-- Niel T. Constantine, Ph.D., Professor of Pathology, University of Maryland School of Medicine

Dr. Weiss's Statement

“The sound bites were extracted out of quite a long interview with me and presented out of context. In my recollection (I don't have a tape of the interview) Leung was pressing me about HIV antibody tests in reference to screening blood donations. When I said ‘I don't think the Western Blot is a useful diagnostic test; I don't think it's worth doing’, I was referring to relatively high throughput screening for blood banks, and in the mid 1980s we did not yet have commercial dip stick Western Blot kits available. In retrospect, it would have been better for me to say: ‘I don't think the Western Blot was a useful primary screening test’.

“I also cited what I regarded as a dogma that a Western Blot test was essential as a confirmatory test; ELISA tests made by two different manufacturers can also provide a confirmed result. For instance, in some UK labs the Wellcozyme ELISA using a competition format was used for primary screening and was then followed up with a confirmatory assay using the Abbott standard direct-binding ELISA instead of a Western Blot.

“It strikes me that similar false contrast and out of context quotes have been crafted together throughout the programme. Furthermore, Leung doesn't seem to understand or acknowledge that doubts about the precision or reliability of tests that were devised as research tools in 1984 (the first year in which we could grow HIV in reasonable amounts in the lab) really have little relevance to the reliability of subsequent mass produced commercial tests, which had to go through extensive quality control before they were marketed or used in clinics and blood banks. It's rather like saying that Roentgen's original fuzzy X-ray pictures are a valid reason for debunking today's radiological imaging systems for hospital diagnosis.”

-- Robin A Weiss, Ph.D., Professor of Viral Oncology, Division of Infection and Immunity, University College London

The following text is an annotated transcript of the sections of the video about HIV antibody testing, to provide a context for Professor Constantine’s and Professor Weiss’ statements. Annotations in italics.

Scene: Brent Leung is getting an HIV test in a South African mall.

African woman tester: “We always say to our clients: even if you have tested here, you can go to other centers and go and verify your test. We cannot say you’re 100%. Because you find clients going from area to area doing these tests, and they come with stories that I was negative at a certain area and positive with you.” She seems to be talking about people who are HIV+ testing repeatedly at different sites in hopes of getting negative results.

Leung: “And how do they decide if they are positive or negative?”

Tester: “We cannot tell, because we are using a rapid test.” This answer doesn’t mean the rapid test is useless, but that it requires confirmation.

Audio: Sinister background music.

Leung, narrating to impose a particular interpretation on the interview snippets: “It occurred to me that perhaps the HIV epidemic is reported to be so widespread in South Africa and other poor nations simply because they use these inaccurate tests.”

Image: flooded African shantytown.

James Chin, MD, MPH- Chief of Global HIV Surveillance World Health Organization 1987-92: “There’s the saying that if you knew how sausages, what sausages are made of, most people would hesitate to sort of eat them because they wouldn’t like what’s in it; and if you knew how HIV numbers are cooked, uh.. or made up, you would use them with extreme caution.”

This is a completely different topic—how HIV statistics are estimated—but the insertion of this sentence here makes it seem that Chin is discussing HIV tests.

Caption: London, England. View of London, Thames from above.

Leung: “I decided to investigate HIV testing protocols used throughout the developed world.”

Harold Jaffe MD, Director, CDC AIDS Division 1992-95 Head of Public Health Dept. Oxford 2004- Present: “When we are testing people for HIV, the first thing we do is a screening test and it’s usually a test called the “ELISA” Jaffe’s sentence is cut off here.

Niel T. Constantine PhD- Director, Clinical Immunology Institute of Human Virology: “But there are also now available rapid assays that can be used as screening methods.”

Liam Scheff, HIV denialist: “Because they’re faster, and we all know, faster and cheaper is more efficient.”

And people don’t need to wait two weeks for highly accurate results. Is this bad?

Claudia Kücherer, MD, Molecular Biologist, Robert Koch Institute, Germany: “If an ELISA is positive, it does not mean that the patient is HIV positive. So that’s a problem.” But what did she then go on to say as an explanation of this statement? We are not shown, as Leung only manipulates sound bites.

Robin Weiss PhD- Professor of Viral Oncology University College London: “If we’re using antibodies as a screening test to tell who is infected or not, uh, very occasionally you can get false positives.”

Niel T. Constantine: “So screening tests by themselves should not be used as a definitive measure of infection; that’s why we use a screening test to pick up all the cases, but we use a confirmatory test to eliminate any false positives.

Back to the South African testing booth:

Tester: “Take it easy… I’ll pierce at the site.” She pricks Leung’s finger.

*Leung [voice over]: “It should be emphasized that most of the developing world uses only screening tests to confirm an HIV diagnosis; there are not confirmatory tests.” Leung is presumably referring to the use a second ELISA test from a different manufacturer, in contrast to a Western Blot, for confirmation. This is a highly accurate protocol and necessary where resources are limited.

Robert C. Gallo: “This has a margin of error done properly that’s extremely low. In other words, it’s one of medicine’s better tests.”

Robin Weiss: “I don’t think the Western Blot is a useful diagnostic test; I don’t think it’s worth doing.” See Dr. Weiss’s explanation of this sentence.

Niel T. Constantine: “Did he give a reason? You know anybody can say anything, I think it’s stupid to drive a car. But come on you gotta give a reason!”

In the background, Leung starts to say, “He said…”

Robin Weiss: “It’s a useful prognostic test. Once you know that someone is infected, then you can follow their antibody responses well with Western Blots.” This is a true, accurate statement.

Niel T. Constantine: “I’d say he’s absolutely wrong, it has a complete usefulness.” With what statement is Professor Constantine disagreeing here? The film doesn’t show

Footage pans backs and forth between the two men in a blurred, swinging motion, juxtaposing them to impose a sense of concurrency and argument.

Robin Weiss: “You don’t need a Western Blot! And it’s become a dogma in HIV research that you need one ELISA followed by a western; you don’t. You need two different kinds of ELISAs made in two different formats.” Professor Weiss here emphasizes the need for using two independent tests to obtain confirmation of HIV status. Most countries still use an ELISA followed by a Western Blot, a long established and highly reliable procedure. Professor Weiss simply says that there is an alternative method that could now be used and expresses his opinion that using two ELISAs is the better option.

Leung: “Would you ever want to confirm somebody is positive using just ELISAs? “

Claudia Koshered: “No. Never. It’s not…It’s against the rules, it’s against the recommendations.” In Germany, that is true, but not everywhere. Different nations make different decisions on many aspects of health care all the time.

Liam Scheff: “It’s a turbulent sea of argument about how can we use this test, when can we use this test, why does this test have no standard?” Tests made by different manufacturers are slightly different, and are read differently. However, all approved tests are very accurate. It is a profound logical error to say that if screening or measuring tests vary, the thing they screen for or measure does not exist

Niel T. Constantine: “Now if I tell you that the test you took was lousy and didn’t mean a thing, would that make any difference for everybody to hear?” See Dr. Constantine’s statement about the proper context for this comment: he is referring to bootleg tests that are not reliable.

Leung: “It’ll make a difference for me.”

Niel T. Constantine: “Yeah I know.”

Science, pseudoscience and professional responsibility

Eduard Grebe — Thu, 26 Nov 2009 15:05:04 +0000

by Dr John Moore, PhD (Originally published by health-e)

Surveys have consistently shown that over 40% of Americans do not believe in evolution. It is not surprising, then, that our society is vulnerable to being fooled by people who misrepresent scientific or historical facts.

We are now all too familiar with the crazed activities of the 'Birthers', an ad hoc, right wing political group refusing to accept President Obama was born in the United States. Earlier this year, we saw media coverage of the insane views of a clique that refuses to accept American astronauts walked on the moon 40 years ago. The "9/11 Truth Movement" flourishes on the internet, arguing that the World Trade Center and the Pentagon were not hit by hijacked jetliners, but were blown up by the CIA at the behest of Israeli intelligence. Conspiracy groups like these usually do little real damage to society, although the activities of the "9/11 Truth Movement" foster anti-Semitism and insult the memories of the nearly 3000 Americans who died on 9/11. Unfortunately, other equally bizarre and factually unfounded, internet-based conspiracy groups can, and do, harm, even kill, significant numbers of people. This is not just an American problem, as the ripple effects of conspiracy theories spread worldwide via the internet. Indeed, the most serious consequences of one such group’s actions have been felt in Africa.

A small group of misguided and, in some cases malicious, individuals have long promoted the view that HIV does not cause AIDS or, in an even more bizarre twist of the truth, that HIV does not even exist. An even nastier variation of the theme is that HIV was created by the US government as a device to kill "undesirables", such as people with black skins or who are gay. None of these opinions is true, and there is not a shred of credible scientific or historic evidence to support them. Unfortunately, the Mbeki administration in South Africa put in place policies based around the premises that HIV is harmless but anti-retroviral drugs are dangerous. This decision caused over 330,000 unnecessary deaths during the first half of this decade. And yet the "AIDS Denialists" even question this death toll, a tactic no different from Holocaust Deniers asking "Did six million really die". Many Americans and Europeans have also died, persuaded by the "AIDS Denialists" that they did not need to take anti-retroviral drugs to treat their HIV infections. Distrust of the federal government and the medical establishment among African American communities has adversely affected AIDS prevention and treatment programs in the USA, in no small measure due to the crazy belief that HIV was created as a weapon of selective genocide. Indeed, this particular rumor even re-surfaced in the last Presidential election campaign. Real people die real deaths as a direct result of the pseudo-science promoted by the "AIDS Denialists".

In a similar vein, groups that claim vaccination is harmful have harmed global immunization programs, and thereby caused avoidable deaths worldwide. A conspiracy theory group often called "The Mercuries" has been particularly vociferous in its argument that a mercury-containing preservative found in some vaccines causes autism. There is less mercury in a vaccine shot than in a tuna fish sandwich, and the mercury present in the fish is in a more dangerous chemical form. Overall, a now vast body of solid scientific evidence has proven that autism has no connection whatsoever to any vaccine or vaccine component. This is now settled science within the professional community, which understands that the cause of autism is based in human genetics. But despite the facts, the distrust of vaccines that has been created by “The Mercuries” and other anti-vaccine conspiracy groups is now damaging efforts to counter swine flu by vaccination, both in America and, increasingly, elsewhere. The polio vaccine eradication campaign has been harmed, notably in Nigeria, by rumors that the vaccine is contaminated with dangerous chemicals, or even with HIV, or that it was designed by “white people to sterilize black people”. As a result, this dangerous infection has still not been eradicated from Africa, where it lingers on, killing and paralyzing yet more people.

The mindsets of the "AIDS Denialists" and "The Mercuries" are similar to each other. Both groups are irrational on the science, twisting the facts to a perverse extent and stubbornly ignoring and rejecting all the evidence that speaks against their views. Each group is bolstered by a very small number of scientists whose paper qualifications provide them with a superficial, wafer-thin veneer of academic credibility. The two conspiracy groups contain individuals who will resort to threats of violence and who harass those who dare to speak up against them. A common tactic of both groups is to smear scientists and physicians who recommend AIDS drugs or the use of vaccines as being nothing more than paid tools of the pharmaceutical industry. Yet both the "AIDS Denialists" and "The Mercuries" are supported by promoters of “alternative (i.e., quack) therapies" who have a financial interest in damning approved anti-HIV drugs or licensed vaccines. “Ambulance-chasing” lawyers have also been heavily involved with the anti-vaccine groups, fostering the hopes of grieving parents that they (and the lawyers) might receive a payout from a scientifically ill-informed jury.

The conspiracy theory groups also receive the support of a small, but noisy, subset of media professionals who seem attracted to the personalities involved, smelling stories in the controversies. This has been particularly problematic recently in the anti-vaccine arena, where some American chat shows and right wing news programs have given undue attention to “The Mercuries”. Bizarre as it may seem, the views of medically unqualified Hollywood celebrities are given equal, or even greater, weight on these shows than those of expert physicians and scientists. Science and pseudoscience should never be “balanced” in this way. To make an analogy: if a film star claimed that we should not fly on a jetliner because mercury contamination could make the wings fall off, we would simply laugh, preferring to listen to the views of qualified aeronautical engineers and metallurgists (and to our own experience as travelers). Yet, nowadays, film stars’ views on vaccine composition are given huge weight by some chat show hosts.

The "AIDS Denialists" and "The Mercuries" are no different from the "Birthers", the moon-landing hoaxers, the "9/11 Truth" members and the Holocaust Deniers in the irrationality of their views and their belief in government conspiracies and cover-ups. Indeed, some members of the various groups flit from one conspiracy-themed web site to another, seeking and finding solace in a variant form of irrationality. One of the very few academic supporters of the" AIDS Denialism" movement also investigates the Loch Ness Monster, Alien Crop Circles and other such fringe or paranormal themes. It would be funny if it were not so tragic.

What can be done about dispelling this kind of damaging nonsense? America has a strong tradition of free speech, so dangerous views will continue to be promoted, however harmful they are to public health and the best interests of society. The internet is the territory of the conspiracist, and it is likely to remain so. But media professionals should not be so unquestioning of the science when they provide airtime or column inches to those with fringe views. Controversy may help sell advertising, but at what cost?

A particular concern is that the ideas that HIV is harmless and that vaccines cause autism have been underpinned by a very few academics or physicians working in American or European universities or hospitals. These “thought leaders” for the conspiracy groups should now be made to face the professional consequences of their scientifically unsupportable actions. Is academic freedom such a precious concept that scientists can hide behind it while betraying the public so blatantly? When the facts are so solidly against views that kill people, there must be a price to pay. Post-tenure review of the progress of academic careers is something the university system could put in place if it chose to. How can bona fide universities justify their employees teaching students, even medical students, that HIV is harmless? How can academic and medical institutions still employ people whose views lead to the deaths of over 330,000 South Africans? Shielding the proponents of pseudoscience by doing nothing is a dereliction of a duty to the public. It is also moral cowardice. It is now time for Africa to speak out and demand action against those who have been responsible for so many deaths on this continent.

The Shameless Rian Malan

Eduard Grebe — Thu, 19 Nov 2009 14:17:00 +0000

by Nathan Geffen, 19 November 2009

In 2001, Rian Malan wrote an article in Rolling Stone questioning the accuracy of HIV tests in order to disparage the evidence of a growing HIV epidemic in South Africa. In 2003 he published similar articles in the Spectator and Noseweek. All these articles were replete with errors. I subsequently debunked the latter two in a January 2004 article.

One of Malan's errors was particularly serious. He presented miscalculated, massively understated estimates of AIDS deaths which he falsely attributed to Stats South Africa. As I wrote then, the mistake was so serious and obvious that it raised questions about Malan's basic competence as a research journalist -or more disturbingly- about his motives and integrity.

In Mbeki's 2004 State of the Nation speech he quoted from Malan and spoke warmly about him. It was not explicitly about HIV, but to anyone following the debate at the time, it was clear that Mbeki was grateful for Malan's support on AIDS.

In the last year and especially the last few weeks, following the speeches of President Jacob Zuma and Minister of Health Aaron Motsoaledi, state-supported AIDS denialism has been destroyed. If Malan had any shame, he would have stayed out of the public light after supporting an ideology responsible for the deaths of hundreds of thousands of people. But he is shameless and his denialist scribblings have continued (see this rebuttal of Malan by Eduard Grebe in 2007).

His latest appeared on Politicsweb on Friday 13 November. Malan pointed out, correctly, that Zuma and Motsoaledi quoted a wrong and over-stated estimate for the 2008 deaths. The mistake, based on Home Affairs data, was an honest one. In contrast to the untruths in Malan's articles, it was not in service of a deadly ideology. On the contrary, Zuma's speech and Motsoaledi's dense-with-statistics 47-slide presentation, were for the most part superb and demonstrated renewed political will to combat the epidemic.

Yet Malan wrote this jaundiced rant, “This country is full of HIV consultants and researchers and specialist HIV hacks who are paid a lots of money on account of their supposed expertise. The state president says that the Aids equivalent of an atom bomb has detonated among our people AND THERE'S NO REACTION AT ALL FROM ANY OF THEM. They all knew, like I did, that Zuma's number was bullshit, but they were perfectly happy to let it stand, cos big Aids numbers are good for business, innit? NOT ONE OF THOSE MOTHERS SAID ANYTHING! They think you are stupid and want to keep you that way.”

He also confirmed his AIDS denialism, “In other words, there is no apocalypse. No massive Aids related death surge. If anything, death registrations are stable.”

Actually, as I explained in an article on Politicsweb, there has undoubtedly been a massive AIDS-related death surge; we have simply reached the crest of that surge thanks to the ARV programme. And if the programme falters AIDS deaths will grow again. Only a shameless denialist like Malan could tell such an obvious lie – again. He is also guilty of exactly what he accuses others of: distortion of statistics to promote his career. If there is to be a commission of inquiry into AIDS denialism, Malan should be questioned about his motives and actions.

AIDS and mortality in South Africa

AIDSTruth — Wed, 18 Nov 2009 08:59:17 +0000

By Nathan Geffen, 16 November 2009

On 2 November 2009, Statistics South Africa released the latest mortality data, which goes up to 2007 (Stats SA, 2009). This table gives the number of recorded deaths per year:

Year	Number of recorded deaths by Stats SA
1997	317,131
1998	365,852
1999	381,820
2000	415,983
2001	454,847
2002	502,031
2003	556,769
2004	576,700
2005	598,054
2006	612,462
2007	601,033

You do not need to be a statistician to be astounded by this. Recorded deaths have increased over 90% in a decade. Improved death registration and population growth can account for only a small portion of this increase. The vast majority of additional deaths are due to the HIV epidemic. A huge body of evidence shows this. For example, there has been a three-fold increase in TB deaths over the same period and TB is the leading cause of death in people with HIV. Also the age pattern of the deaths --younger instead of older adults comprise the bulk of them-- and the drop in the median age of death from 51 in 1997 to 44 in 2007 are consistent with the way AIDS works. (For more detailed evidence see Dorrington et al. 2006, Dorrington et al. 2001 and Stats SA, 2002).

Also noticeable is that the number of deaths appears to have stabilised from 2005 to 2007 and perhaps has even begun to decrease slightly. This is most likely due to the state's antiretroviral (ARV) treatment programme.
Unfortunately because the public sector programme has not been well monitored and there are numerous treatment providers in the private sector, there is not accurate data on the number of people on treatment. But by using several sources of data, including figures published by the Department of Health, medical aid data and public sector ARV procurement data it is possible to make reasonable estimates. Muhammad Aarif Adam of Sanlam and Leigh Johnson of the Centre for Actuarial Research have made plausible calculations of the number of people on treatment in the middle of each year up until mid-2008, shown in the next table (Adam and Johnson, 2009).

Year	No people on treatment
2001	6,000
2002	15,000
2003	26,000
2004	47,000
2005	109000
2006	229,000
2007	371,000
2008	568,000

The programme began in earnest in 2004 and the stabilisation of the death rate has coincided with it. If you consider that many, perhaps most, of the people on the programme would be dead by now that would easily account for stemming rising deaths. Make no mistake; there has been a massive surge in deaths in South Africa for more than a decade and AIDS deaths continue to be very high; deaths might have stabilised but at a very high number. Life-expectancy declined to the low-50s. At least though, we are implementing the most effective known scientific medical intervention to mitigate the effects of the disease and it now appears that life-expectancy is increasing again.

But many unnecessary deaths occurred because of the delayed rollout of the ARV treatment programme. Two studies have conservatively estimated that former President Thabo Mbeki's AIDS denialist policies cost well over 300,000 lives (Nattrass, 2008; Chigwedere, 2008). Mbeki did not pursue this deadly policy without help though. Officials in government, civil servants and even some journalists supported his policy, tried to give it legitimacy and for a time succeeded in quashing the demand for a treatment rollout from health workers and AIDS activist organisations, like the Treatment Action Campaign (TAC). Thankfully, we have moved beyond this awful era of South African history.

PS: The last two weeks have seen what I believe is the final death-knell of state-supported AIDS denialism. Both President Zuma and Minister of Health Motsoaledi have delivered important speeches showing their intention to fight the epidemic. On page 35 of his presentation Motsoaledi quoted mortality data for 2008 from Home Affairs which appears to be far too large. I am unaware of how this number was derived and it appears to be an error. In other respects Motsoaledi's speech was excellent and his mistake is of no great importance.

References

Adam M and Johnson L. 2009. Estimation of adult antiretroviral treatment coverage in South Africa. September 2009, Vol. 99, No. 9 SAMJ

Chigwedere P. 2008. Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa. JAIDS Journal of Acquired Immune Deficiency Syndromes. 49(4):410-415, December 1, 2008.

Dorrington R et al. 2001. The impact of HIV/AIDS on adult mortality in South Africa.

Dorrington R et al. 2006. The Demographic Impact of HIV/AIDS in South Africa.

Nattrass N. 2008. AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa. African Affairs 2008 107(427):157-176.

Statistics South Africa. 2002. Causes of death in South Africa 1997-2001 : Advance release of recorded causes of death.

Statistics South Africa. 2009. Mortality and causes of death in South Africa, 2007: Findings from death notification.

How to spot an AIDS denialist

Eduard Grebe — Fri, 13 Nov 2009 13:00:00 +0000

by Seth Kalichman (Originally published in the New Humanist)

Imagine that you or someone you love just received an HIV positive test result. The news is devastating. After a short time you begin to face the diagnosis. You turn to the Internet for answers. Searching the words “AIDS diagnosis” brings up thousands of websites. A whirlwind of information spins your mind. One credible-looking website, Aids.org, reads: “There is no cure for AIDS. There are drugs that can slow down the HIV virus and slow down the damage to your immune system. There is no way to ‘clear’ HIV from the body. Other drugs can prevent or treat opportunistic infections (OIs). In most cases, these drugs work very well. The newer, stronger ARVs have also helped reduce the rates of most OIs. A few OIs, however, are still very difficult to treat.”

With a click of the mouse, an equally credible-looking site, Aliveandwell.org, asks: “Did you know … Many experts contend that AIDS is not a fatal, incurable condition caused by HIV? That most of the AIDS information we receive is based on unsubstantiated assumptions, unfounded estimates and improbable predictions? That the symptoms associated with AIDS are treatable using non-toxic, immune-enhancing therapies that have restored the health of people diagnosed with AIDS and that have enabled those truly at risk to remain well?”

Which do you trust? Which do you believe? Which would you want to believe? Would you choose to believe there may be hope offered by medical treatments or would you prefer to believe that HIV is harmless? This simple example illustrates the lure of AIDS denialism.

AIDS denialism tells us what anyone would want to hear – that HIV does not cause AIDS and that if you live a “healthy lifestyle” (whatever that is) you won’t get AIDS. None of which is true. In fact, there are an estimated 33 million people in the world living with HIV infection. In 2007 there were nearly three million new HIV infections and two million people died of AIDS. People are living longer and healthier lives with HIV infection as a result of earlier detection through HIV antibody testing and the remarkable success of HIV treatments. Indeed, countries that launched aggressive testing and treatment programs, such as Brazil and Botswana, have reduced suffering and prolonged life. In contrast, South Africa delayed testing and treatment programs as a result of former President Thabo Mbeki’s AIDS denialism, policies that resulted in over 300,000 unnecessary deaths and over 35,000 infants senselessly infected with HIV. There is no rational basis for disputing these established facts, and yet rejecting the reality of AIDS is the mission of AIDS denialists.

AIDS denialism is one of several incarnations of denialism. All denialism is defined by rhetorical tactics designed to give the impression of a legitimate debate among experts when in fact there is none. Holocaust deniers claim that historians disagree about the evidence for Nazi mass gassings and systematic murder of Jews. Global warming denialists say that climatologists are torn by the evidence about climate change. 9/11 “Truth Seekers”, as clever a piece of branding as “pro-life”, say the collapse of the Twin Towers resulted from controlled demolition. Vaccine hysterics tell us that the science is split on whether vaccinations cause autism. And AIDS denialists say that scientists are in disagreement about whether HIV causes AIDS.

It is easy to be fooled by AIDS denialists. Not only do they tell us what we want to hear, they use methods of persuasion to create the illusion of debate. Just as HIV attacks our immune defences that would otherwise destroy it, AIDS denialists appeal to our sense of scepticism. Indeed, AIDS denialists refer to themselves as dissident scientists and sceptics. Denialists misuse science and rely on pseudoscience to call established fact into question. Denialists also exploit what is not known about how HIV causes AIDS to suggest that HIV may not cause AIDS at all. The more sophisticated efforts of AIDS denialism, like the “documentary” House of Numbers, are most disturbing because they use every trick in the denialist playbook to juxtapose pseudoscience with established science. The best way to recognise AIDS denialism is to know their common tricks of persuasion.

There are two sides to every debate. But just asserting there is a debate does not mean there is one. AIDS denialists rely on a small band of fake experts, mostly retired academics who proclaim that HIV does not cause AIDS. There is not a single instance of an “expert” offered by AIDS denialism that has ever actually done research on AIDS. In rare examples, denialist experts have a history of credible science only to have later gone off the deep end. The most credentialled AIDS denialists are Nobel Laureate Kari Mullis, who developed the PCR technology for sequencing the genetic code, and Peter Duesberg, Professor of Biochemistry and Molecular Biology at the University of California-Berkeley and member of the National Academy of Science. Although credentialled, neither is credible. Aside from saying HIV cannot cause AIDS, though he has done no research on AIDS, Mullis has shared his experiences on LSD and encounters with an alien fluorescent raccoon, and Duesberg, who did important work on cancer in his early career, now claims that there is no genetic basis for any cancer. Both have demonstrated an outright disregard for scientific evidence.

But beyond these two high-profile mavericks most of the “experts” in AIDS denialism are out-and-out pseudoscientists. My favourite is Henry Bauer, Emeritus Professor of Chemistry and Science Studies at Virginia Tech University, who claims to have proven that HIV cannot cause AIDS. Professor Bauer is also a self-proclaimed international expert on the existence of the Loch Ness Monster. Detecting fake experts requires looking beyond college degrees and achievements from decades gone by. Do not confuse credentials with credibility. Saying that there is no genetic basis for any cancer, describing extraterrestrial experiences, and searching for big green monsters in Scottish waters should matter when examining the credibility of someone making important claims about the causes of a devastating disease.

In the 1980s legitimate scientists disagreed about AIDS. For AIDS deniers, everything old is new again. AIDS denialists rely on selected research findings from the days when not much was known about AIDS. The first tests for HIV antibodies were less reliable than current testing technologies. There were early debates about what caused AIDS and good ideas that turned out to be dead ends. The drug AZT was prescribed in massive and often toxic doses. But none of this is true any more. Though there remain many debates in medical science about how HIV causes AIDS, there is no longer a debate about whether HIV causes AIDS. Unfortunately, outdated scientific literature is not purged when new knowledge emerges. AIDS deniers use this information to create the illusion of a live debate. Denialists select old findings that support their flawed logic because they have no evidence of their own. Cherrypicking is another favourite rhetorical technique of denialists. This involves selecting a lone scientific finding, presenting the results out of context, and deploying it as evidence for their own conclusions.

Another popular denialist manoeuvre is to call for a definitive single study, analogous to the creationist demand for a definitive transitional fossil to prove evolution. Peter Duesberg for example, asserts that “There is not a single controlled epidemiological study to confirm the postulated viral etiology of AIDS.” He is right about this. No one scientific study ever “proves” anything. Scientists are cautious to draw conclusions from even a series of experiments. To establish that HIV causes AIDS required countless laboratory, clinical, and epidemiological studies, all converging to a definitive conclusion. There is no single scientific paper proving that HIV causes AIDS, just as there is also no single physics experiment proving that a man could land on the moon, no single study that proves excessive exposure to the sun causes skin cancer or one study that proves smoking causes lung cancer. Rather there are tens of thousands of studies containing a wide range of evidence that, taken together, make an overwhelming case.

AIDS denialists will also demand even more specific evidence, only to change the demand once the evidence is produced. One example of this “pushing back the goalpost” technique was the former Sunday Times journalist and prominent AIDS denier Neville Hodgkinson’s claim that HIV tests are invalid because HIV has never been isolated. When scientists provided evidence that HIV has been isolated, the demand changed; Hodgkinson argued that the isolated virus was “impure”. Denialists now demand that the virus be isolated in “pure form”, that is uncontaminated by proteins. The demand for a pure virus devoid of cellular proteins is impossible to meet as it defies the biological nature of viruses. Such shifting of the grounds of debate allows denialists to claim that they are the ones following the evidence, and it is the AIDS establishment – an alliance of careerist researchers and greedy drugs companies – who are propagating pseudoscience.

All denialism is entrenched in conspiracy thinking. A spectrum of such thinking motivates AIDS denialism, covering everything from a government conspiracy to invent HIV for genocide against Africans and gays to a pharmaceutical industry conspiracy to sell toxic drugs. One of my favourites is the flamboyant conspiracy thinking of vitamin entrepreneur Matthias Rath, who said “The people and the governments of the world have to decide whether they are ready to stop being manipulated by the pharmaceutical industry and embrace instead the scientific knowledge that is now available to fight the global HIV/AIDS epidemic with effective, safe and affordable natural means.” The “natural means” Rath is referring to, of course, are the useless vitamins that he peddles to the poor. Though Rath has now been prevented from marketing his phony cure in Africa, and famously lost his libel suit against Ben Goldacre when he exposed his fraudulent practices, great damage was done and he continues to agitate for AIDS denialism through his spurious Health Foundation.

But while some denialists are clearly charlatans out to make a quick buck out of other people’s misery, many are perfectly genuine, which is what makes them especially dangerous. They can be persuasive because they actually believe what they say. Evidence means nothing to them. Their thought process resembles what psychiatrists call an “encapsulated delusion”, where despite what appears to be otherwise rational thinking there is an intractable maladaptive belief system that is impermeable to contrary evidence. Many of these people have themselves been diagnosed with HIV, and cling to the hope that this is not a death sentence. This adds a particular poignancy to their claims. A potent irony also hangs over denialism; year on year AIDS deniers who have tested positive for HIV succumb to AIDS-related illnesses. The most visible of such cases was Christine Maggiore, the founder of the Alive and Well movement that claims there is no causal link between HIV and AIDS. Maggiore believed that HIV does not cause AIDS even after the AIDS-related death of her three-year-old daughter and right up until her own death of AIDS in 2008. AIDS denialists are therefore a mixed bag of rogue scientists, pseudoscientists, conspiracy theorists, and snake-oil salesmen. There are also vocal AIDS denialist activists, primarily HIV positive people who are in deep denial of their diagnosis and seek the insulating bubble offered by AIDS denialism.

So, what can we do about AIDS denialism? There will always be crazy people who say crazy things. AIDS denialists only do harm when people listen to them. The best defence against AIDS denialism is improved public understanding of science and medicine. We all need to know how to recognise cranks and crackpots and their sinister rhetorical devices. When searching for reliable information make sure it does not rely on old, most likely outdated, sources. Find credible sources of current information and trust them, but keep pressing them with questions. Familiarise yourself with the basic facts of HIV and AIDS and be sceptical of far-fetched conspiracies. Be informed and think critically, but don’t fall for global conspiracy hysteria or accept pseudoscience because that is what you want to hear. We know that drugs companies make huge profits, and that scientists rely on research grants and can be fallible. This does not mean there is a global conspiracy to misrepresent the science. AIDS researchers and the pharmaceutical industry, believe it or not, are in it to save lives.

And finally, hard as it might be for believers in free speech and open debate, if you encounter AIDS denialism, do not enter into a debate. AIDS denialists want to create the impression that there is a debate regarding HIV causing AIDS and debating feeds the illusion. This debate was exhausted years ago. Now it merely serves as a distraction from the ongoing struggle to explain how and why HIV causes AIDS and trying to prevent it. In the words of The Who, and the title of Richard Wilson’s excellent book on scepticism, “Don’t Get Fooled Again”.

To see the AIDS Denialist Hall of Fame, visit the article at New Humanist.

Seth Kalichman's book Denying AIDS: Conspiracy Theories, Pseudoscience, and Human Tragedy is published by Springer/Copernicus - all royalties from the book are donated to buy HIV treatments in Africa.

Warning about pseudo-scientific review of alternative AIDS medicines

Eduard Grebe — Thu, 12 Nov 2009 17:10:44 +0000

A website that is advertised via Google ads, is promoting alternative, unproven and untested medicines for the treatment of HIV. The website is http://www.hivsecrets.com. Upon registering with it, a report titled HIV Alternative Therapies Report is made freely available for download. This report is written by a Ms Shirley Wyand. Ms Wyand has no known expertise in the science of HIV/AIDS.

The report is replete with misconceptions. For example, it states, "Since Western medical science offers no cure and few treatments for AIDS, people living with HIV are open to other options, and a tradition of gathering and sharing treatment information already exists." On the contrary, antiretroviral treatment is a very effective chronic treatment for HIV. There are also many effective medicines that treat AIDS-related opportunistic infections. There are no alternative treatments for HIV that have been shown to be effective. Indeed, once a medicine is shown to be effective it is no longer an alternative one.

Another example of the report's misconceptions is that it promotes an untested product called Revivo tea. This products advertisements touting its efficacy for the treatment of HIV have recently been banned in South Africa by that country's Advertising Standards Authority.

We urge people with HIV to be extremely cautious about following any of Ms Wyand's advice.

Anthony Mbewu is made director of GFHR: Is this an appropriate appointment?

Eduard Grebe — Wed, 04 Nov 2009 12:55:35 +0000

Anthony Mbewu with Matthias RathAnthony Mbewu, the current President of the Medical Research Council of South Africa (MRC), has been appointed the Executive Director of the Swiss-based Global Forum for Health Research (GFHR).

The South African government under former President Mbeki and former Health Minister, Manto Tshabalala-Msimang, pursued an AIDS denialist ideology that was responsible for at least 300,000 premature deaths and tens of thousands of preventable HIV infections. [1-2] Mbeki and Tshabalala-Msimang were the main protagonists in this crime against humanity. But there were several politicians and civil servants whose actions and inactions helped extensively. Anthony Mbewu was one of them. An appointment to a top position in Geneva hardly seems appropriate for someone with his questionable track record. This included misrepresenting the relative importance of HIV as a cause of death, supporting the vitamin salesman Matthias Rath, playing down the known benefits of antiretroviral treatment, promoting absurd conspiratorialist thinking and over-promoting multi-vitamins and traditional medicine as potential responses to AIDS.

Matthias Rath, with the support of Tshabalala-Msimang, conducted unauthorised experiments on people with HIV, imported and distributed his products unlawfully and claimed multivitamins alone reversed the course of AIDS, in contrast to antiretrovirals which he claimed were toxic. Anthony Mbewu helped establish Rath's presence in South Africa.

Rath at the MRCIn 2004, Mbewu had a series of meetings with Rath that led to Rath giving a workshop and committing to pay R200,000 to the MRC, of which over R60,000 was eventually paid. The minutes of the meetings with Rath are illuminating. They include plans to run a clinical trial using multivitamins to treat cancer. At one point the minutes record Mbewu stating, “NAPWA (National Association of People with Aids) [is a] good group. TAC [Treatment Action Campaign] is paid by pharma cartel. NAPWA has an open mind and will be an great advocacy tool as a counter-balance to attack.” NAPWA was a corrupt organisation that served Manto Tshabalala-Msimang's interests by opposing antiretroviral treatment. TAC, the organisation that led the campaign for antiretrovirals, never received money from pharmaceutical companies and eventually won an interdict against Rath for propagating this claim.

The minutes are replete with pseudoscientific assertions and evince an AIDS denialist agenda. There is additional questionable behaviour: In one meeting Mbewu introduced Rath to Denova, a marketing company of which Mbewu's wife, Priscilla Reddy (also an MRC employee) was a director. [3] (This reference has links to meeting minutes, commitments to pay and photos of Rath and Mbewu.)

Mbewu presented on HIV to the Parliamentary Health Portfolio Committee on 16 March 2005 and stated:

The importance of nutrition in mitigating the impact of HIV and AIDS cannot be understated. The Tanzanian/Harvard University clinical trial by Fawzi et al published recently in the New England Journal of Medicine is a case in point. This blinded, randomised controlled clinical trial showed that amongst over 1000 HIV positive women; those assigned to receive daily multivitamin over the subsequent 5 years showed a 30% reduction in death and progression to AIDS compared to those who did not receive multivitamin. This implies that multivitamins can reduce the socioeconomic impact of HIV and AIDS by both reducing the annual death rate, as well as reducing the rate at which patients deteriorate to the point of needing active medical care. In addition, the widespread use of traditional medicines in AIDS could have direct benefit, if efficacious in reducing mortality; as well as indirect benefit in stimulating the industry of producing and distributing natural medicines.

He then stated:

Little is known about the length of survival of patients on antiretroviral therapy in resource poor settings. Data from ACTG studies in the USA, using regimens similar to those we use in South Africa suggest that median survival once started on ARVs is likely to be of the order of several years but this is very tentative.

As the TAC has explained, “these statements are misleading. He has contrasted multivitamins with antiretrovirals and in effect argued that there is more reliable evidence of the usefulness of multivitamins than antiretrovirals. This is false. The opposite is actually the case. Little is known of the effect of multivitamins on people with HIV. While Mbewu correctly identifies that a Tanzanian study found them to be beneficial, he fails to point out that these benefits were small relative to antiretrovirals. He claims little 'is known about the length of survival of patients on antiretroviral therapy in resource poor settings', while actually little is known about the survival benefits of multivitamins and a lot is known about the survival benefits of antiretrovirals in resource poor settings.” [4]

Mbewu and Rath enjoying dinnerMbewu also cast doubt on the size of the AIDS epidemic at a point when denialist scepticism was crucial to President Mbeki's resistance to introducing ARVs. He has been quoted stating, “The nation is in poor health, with just as many if not more deaths from heart disease and strokes than AIDS ... AIDS is a major problem, but heart disease and strokes are much bigger.” [5] Yet the claim that “heart disease and strokes are” a much bigger problem than AIDS had been shown to be false by a report published by the MRC. [6] (See also Professor Solly Benatar's criticisms of Mbewu's statements about AIDS mortality. [7])

The GFHR press release announcing Mbewu's appointment describes one of his achievements: “In 2003 he chaired the Task team that developed South Africa’s Comprehensive Care, Management and Treatment for HIV and AIDS programme that has enrolled 871 914 patients on antiretroviral therapy.” [8]

The statement is either cynical or callous. It shows a poor knowledge of the history of AIDS denialism in South Africa and appears designed to whitewash Mbewu's discreditable role in fostering it. This task team was appointed after a massive campaign by civil society led by the Treatment Action Campaign (TAC) to get the South African government to develop a treatment plan. It included several large marches as well as civil disobedience in which activists were beaten up, arrested and sprayed with water cannons. Finally the Cabinet relented and while Mbeki was out of the country, it ordered Tshabalala-Msimang to produce a treatment plan. Mbewu was appointed to head the task team by Tshabalala-Msimang because he was a politically reliable ally, the commissar whose job it was to ensure that the people doing the committee's real work were watched and controlled (thankfully not very successfully). To imply that Mbewu was responsible for South Africa's antiretroviral programme is a grave insult to the people who actually made the programme happen. The mealy-mouthed language and nutritional pseudoscience that made it into the report were Mbewu's doing.

GFHR describes itself as “an independent, international organization committed to demonstrating the essential role of research and innovation for health and health equity, benefiting poor and marginalized populations.” We question whether the appointment of Anthony Mbewu is consistent with that mission and call on GFHR to require Mbewu to account for his questionable and discreditable history.

References

1. Nattrass, N. 2008. AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa. African Affairs 2008 107(427):157-176. http://afraf.oxfordjournals.org/cgi/content/abstract/107/427/157 ^back^

2. Chigwedere, P. et al. 2008. Estimating the Lost Benefits of Antiretroviral Drug Use in South Africa. JAIDS Journal of Acquired Immune Deficiency Syndromes. 49(4):410-415, December 1, 2008. http://journals.lww.com/jaids/pages/articleviewer.aspx?year=2008&issue=1... ^back^

3. TAC. 2006. Release of Documents showing collusion between some government officials, including MRC Head Anthony Mbewu, and Matthias Rath. http://www.tac.org.za/community/node/2203 ^back^

4. TAC. 2006. Submission to African Peer Review Mechanism. http://www.tac.org.za/Documents/AfricanPeerReviewMechanismReportFinal-20... ^back^

5. Pretoria News, 17/2/2005. Quoted in TAC Submission to African Peer Review Mechanism. ^back^

6. Dorrington et al. 2001. The impact of HIV/AIDS on adult mortality in South Africa. http://www.hst.org.za/publications/452 ^back^

7. SAPA. 2005. MRC Man's statement supports AIDS denial. http://70.84.171.10/~etools/newsbrief/2005/news0211.txt ^back^

8. Global Forum for Health Research. 2009. Appointment of new Executive Director: Prominent South African researcher to head Global Forum for Health Research http://www.globalforumhealth.org/Media-Publications/Archive-news/Appoint... ^back^

"House of Numbers" Lies about Research Findings on T Cells Destruction and AIDS

Eduard Grebe — Mon, 02 Nov 2009 12:39:48 +0000

by Jeanne Bergman

The lynchpin of Brent Leung’s argument in “House of Numbers” that HIV does not cause AIDS is the headline of a 2007 article on ScienceDaily.com that read, “Sudden Loss Of T Cells Is Not Trigger For AIDS, New Study Suggests.” [1] The screen shows the article’s headline and first paragraphs for 12 seconds (a very long time in “House of Numbers”), while Leung, in a voice-over, intones, “In late 2007, ScienceDaily reported that three prominent research teams had published papers in the Journal of Immunology, challenging the theory that the sudden loss of T-cells triggers disease and AIDS.” Since T cell destruction is understood to be the primary mechanism by which HIV destroys the immune system, this seems to seriously challenge the HIV/AIDS paradigm.

The film then cuts to a clip of researcher John P. Moore saying, “The details of HIV pathogenesis, how HIV kills people, are still being worked out.” The placement of this interview fragment implies that Moore would agree that T cell destruction does not lead to AIDS and death (though, of course, he does not agree: JPM – personal communication). Next, Leung is shown in a lab, theorizing that, “If the sudden loss of T-cells in HIV positive individuals can’t explain why people get disease, then there must be co-factors that cause people to get sick and die. Or, factors that have absolutely nothing to do with HIV.” And the film goes on to propose other causes for AIDS—poverty, poppers, AZT.

But the research Leung cites to claim that T cell loss does not cause AIDS does not say what Leung says it did. On the contrary, it affirms that in humans T cell destruction leads to AIDS and death. The document on the screen was indeed from ScienceDaily, a popular science news website. However, the headline and first paragraph of that article, which was itself based on a press release from Tulane University, did not accurately represent the research: notably, it failed to mention that the research was done with non-human primates. Leung and his crew disregarded the rest of the ScienceDaily article, which clearly recorded that non-human primates were used and stated that the particular strain of SIV infecting these particular simian species behaves differently from HIV in humans. (Some other strains of SIV do cause AIDS in other simian species, notably in macaques) In the simian species used in this particular study, the animals rebound from the T cell destruction caused by the infecting virus, whereas humans generally don’t when they are infected with HIV. Leung also ignored the actual Journal of Immunology articles that ScienceDaily linked to—which is remarkable since his entire case against HIV’s causality rests on them. [2]

The articles misrepresented by Leung said that three teams of researchers studied SIV-infected sooty mangabeys, rhesus macaques, and African green monkeys, respectively, and found that soory mangabeys and African greens have non-pathogenic infections: they can recover from T cell depletion, which is why they do not get AIDS. (Rhesus do progress rapidly to AIDS.) The researchers explicitly contrasted non-human primate T cell recovery with the disease progress in HIV-infected human beings, who cannot recover from T cell depletion without treatment, and who therefore progress to AIDS and death. The three research teams suggest that while some non-human primates have evolved to adapt to the virus over many centuries, it is still new in humans: we have not yet evolved to recover from T cell destruction. The researchers see their findings as suggestive for therapies to control immune system activation and promote recovery from HIV-related T cell destruction.

We contacted ScienceDaily and they have corrected the misleading headline and paragraph. The headline now reads, “Progression Of SIV Infection In Monkeys Points To Differences Between Human And Simian Forms Of AIDS.” [3] The summary of the research clarifies the distinction between the virus in humans and simians:

Another major question raised by the study is why monkeys with SIV, unlike HIV-positive humans, are generally resistant to progression to AIDS after infection with the virus.

The answer, the authors propose, is that thousands of years of host/virus co- adaptation has enabled monkeys, the natural hosts of SIV, to effectively limit T cell immune activation and apoptosis, a mechanism that leads to progression of the disease. By contrast, humans, who were introduced to the virus fairly recently, have not had the opportunity to develop such protective adaptations.

ScienceDaily has also added an Editor's Note:

This story has been modified from its original version, which can be accessed here:http://web.archive.org/web/*/http://www.sciencedaily.com/releases/2007/09/070923193631.htm (via the Internet Archive's Wayback Machine). This version clarifies that the research described in the story examined the differences in how the simian and human forms of AIDS progress. The purpose of the story was NOT meant to suggest that the sudden loss of T cells is not the trigger of AIDS in humans, nor was there any intent to support the erroneous belief that HIV somehow does not cause AIDS. We regret any confusion that this may have caused. Links to the abstracts of the journal papers referred to above are provided below.

There is very little actual research cited in “House of Numbers.” It is shocking that Leung so radically misrepresented the only legitimate “evidence” for his HIV denialist theory, and that his source in fact affirms that HIV destroys T cells in humans, causing AIDS.

November 1, 2009

Notes

1. Tulane University (2007, September 26). Sudden Loss Of T Cells Is Not Trigger For AIDS, New Study Suggests. ScienceDaily. ^back^

2. Ivona V. Pandrea, Rajeev Gautam, Ruy M. Ribeiro, Jason M. Brenchley, Isolde F. Butler, Melissa Pattison, Terri Rasmussen, Preston A. Marx, Guido Silvestri, Andrew A. Lackner, Alan S. Perelson, Daniel C. Douek, Ronald S. Veazey, and Cristian Apetrei. Acute Loss of Intestinal CD4+ T Cells Is Not Predictive of Simian Immunodeficiency Virus Virulence. Journal of Immunology, 2007; 179: 3035-3046.

Shari N. Gordon, Nichole R. Klatt, Steven E. Bosinger, Jason M. Brenchley, Jeffrey M. Milush, Jessica C. Engram, Richard M. Dunham, Mirko Paiardini, Sara Klucking, Ali Danesh, Elizabeth A. Strobert, Cristian Apetrei, Ivona V. Pandrea, David Kelvin, Daniel C. Douek, Silvija I. Staprans, Donald L. Sodora, and Guido Silvestri. Severe Depletion of Mucosal CD4+ T Cells in AIDS-Free Simian Immunodeficiency Virus-Infected Sooty Mangabeys. Journal of Immunology, 2007; 179: 3026-3034.

Jeffrey M. Milush, Jacqueline D. Reeves, Shari N. Gordon, Dejiang Zhou, Alagar Muthukumar, David A. Kosub, Elizabeth Chacko, Luis D. Giavedoni, Chris C. Ibegbu, Kelly S. Cole, John L. Miamidian, Mirko Paiardini, Ashley P. Barry, Silvija I. Staprans, Guido Silvestri, and Donald L. Sodora. Virally Induced CD4+ T Cell Depletion Is Not Sufficient to Induce AIDS in a Natural Host. Journal of Immunology, 2007; 179: 3047-3056. ^back^

3. Tulane University (2007, September 26). Progression Of SIV Infection In Monkeys Points To Differences Between Human And Simian Forms Of AIDS. ScienceDaily. ^back^

Maggiore's labs

Eduard Grebe — Sun, 01 Nov 2009 07:00:00 +0000

"House of Numbers" offers new information about the late Christine Maggiore's experience with HIV testing. In the movie, her oral narrative and the dated lab reports on screen simply don't line up. What the film clearly shows by including the lab work is that Maggiore was HIV infected, and the reports suggest that her immune system controlled the virus well for some time. Commentary are placed in the blocks.

Christine Maggiore: “In 1992, I was encouraged by a doctor to take what’s called an HIV test as a mater of social responsibility, and I was shocked and devastated and horrified when the results came back positive. It was one of those moments that everyone fears their whole life. A week later, I take the same test to an AIDS specialist. He looks and says, this isn’t a positive test. I don’t know what this test means.”

The screen shows a lab report from Patricia O’Connell, NP, for Christine Maggiore, dated 02/24/92. Resolution is not good, but it looks like two bands—P24 and P120/160—of a Western Blot were reactive, the rest non-reactive. This VERY clearly is a positive test. The test interpretation instructions are below and she has a positive WB according to this test’s criteria (p24 and gp120).

Maggiore: “So I take the test again, and this time my results come back from the lab marked “’indeterminate.”

The screen shows part of a lab report in, with “Western blot” and “indeterminate” highlighted in yellow—bands from only 2 (GAG, ENV) of 3 groups positive. But it appears to have been a pretty thorough set of tests, include T-4 count etc. Interesting how shot is edited: column headings missing, no date, etc. NB: The second WB has different criteria – the same two bands are present but without a POL band this test will not be listed as positive. CD4 count (1040) and CD4/CD8 ratio (1.28) are comparable to an uninfected person and typical of someone who is controlling the virus very well immunologically. No date though.

Some denialists claim Maggiore refused treatment at this time, but with this CD4 count it would never have been offered. Indeed, Maggiore herself characterized the advice of her doctor at the time as 'wait 'til you get sick, and then we'll give you AZT.' This quote also contradicts another denialist myth, that asymptomatic people with HIV were routinely offered antiretroviral treatment.

Maggiore: “I’m faced with a decision: do I want to wait six weeks to test again, or do it right away? I opted for right away. My results that time come back positive.”

The screen shows another lab report, dated 9/23/93—nineteen months later. This is hardly “right away.” It is REACTIVE on every line—8 of 8 bands positive.

Maggiore: “Took it again, came back negative.”

The screen shows a lab report dated 08/09/93-six weeks BEFORE the test shown above. So the sequence of events she is narrating is not supported by the paperwork shown. The name on this report is Christina Maggiore, not Christine. Only a fragment is visible. NB: can’t tell if this one is an ELISA screen or a WB. It looks like an ELISA.

Maggiore: “I took it again—positive”

On screen, another lab report dated Sept. 29, 1993. This seems to be the one she took “right away”—six days after the solidly positive test. Sept 29, 93: HIV-1 EcG Confirmation [can’t read] Positive HIV-1 Ab 3g (?0 EIA 9.9 ]

Maggiore: "I’m very much opposed to the concept of mandatory testing of any population, because the tests are scientifically shown to be unreliable and inaccurate."

South Africa needs an HIV/AIDS truth commission

Eduard Grebe — Tue, 27 Oct 2009 22:44:17 +0000

Salim Abdool Karim with his wife and collaborator Quarraisha Abdool Karim
Photo credit: CAPRISAIn this article prominent South African AIDS researcher, Prof Salim S. Abdool Karim, calls for a truth commission to account for South Africa's past HIV/AIDS denialist policies and rebuild trust:

The HIV/AIDS epidemic is one of the greatest challenges facing post-democracy South Africa. In 2007, the country, which is home to less than one per cent of the world's population, carried 17 per cent of the global burden of HIV infection — and the virus continues to spread relentlessly.

The government's response to the epidemic during the last decade has contributed to this disproportionate burden. It not only questioned the reliability of HIV testing, the safety and efficacy of antiretroviral drugs and the accuracy of statistics on AIDS-related morbidity and mortality, but also the very premise that HIV causes AIDS.

Deliberate attempts were made to undermine scientific evidence as the basis for action and to place politics at odds with science. President Thabo Mbeki's AIDS Advisory Panel, set up in 2000, marked a low point in the government's relationship with scientists when he asked AIDS scientists to engage AIDS 'denialists' in a debate for political adjudication.

Preventable deaths

The impact of these policies was very damaging. The government delayed the implementation of nevirapine — an antiretroviral drug proven to prevent mother-to-child transmission of HIV — which resulted in hundreds of thousands of newborns becoming infected unnecessarily. Researchers at Harvard University estimate that between 2000 and 2005, 330,000 lives were lost to HIV/AIDS and 35,000 babies were born with the virus because of government inaction and failure to provide lifesaving drugs.

AIDS activists have repeatedly had to challenge health service providers, government and pharmaceutical companies. Through petitions, marches, mobilising communities and legal action they have sought to bring more treatment to poor people.

But the change in government leadership last year has created new hope that the country will rise to the challenges posed by HIV/AIDS. President Jacob Zuma's 2009 State of the Nation Address boldly stated: "We must work together to improve the implementation of the Comprehensive Plan for the Treatment, Management and Care of HIV and AIDS so as to reduce the rate of new HIV infections by 50 per cent by the year 2011. We want to reach 80 per cent of those in need of ARV [antiretroviral] treatment also by 2011."

Yet, while these statements are welcome, should we simply forget the past and accept that it was unfortunate — but there is nothing we can do about it now? To simply ignore the actions that led to hundreds of thousands of avoidable deaths would be to condone them and lay South Africa open to history repeating itself.

Call for a commission

South Africa needs an HIV/AIDS truth commission as a vital step towards establishing what happened and why, including detailed estimates of how many people died.

It is particularly important to hear directly from the decision-makers and to gather personal testimonies from all parties involved on how the damaging policies took hold in a democracy, where government should be accountable to the public for its actions.

The commission would also help us understand how to prevent the situation from happening again and would give the many people who lost loved ones to AIDS an explanation for why they died unnecessarily.

It is also needed to rebuild trust among people working against HIV/AIDS in South Africa, including those in research, government, health and local communities.

Simply establishing the truth is an important step. But for real reconciliation, the truth must also be made public and open to scrutiny before we can move on.

As South Africa starts building a new era in its response to the HIV/AIDS epidemic, we must work together — government, scientists, civil society and community organisations. It will take all our efforts — unimpaired by any ill-feeling or hurt from the past — to build a constructive foundation for tackling this devastating enemy.

Salim S. Abdool Karim is director of the Centre for the AIDS Programme of Research in South Africa at the University of KwaZulu-Natal. He was a member of Thabo Mbeki's AIDS Advisory Panel.

This article originally appeared on SciDev.net. It is republished in accordance with the Creative Commons Attribution 2.0 licence.

Reviled, Yes. Genius? Not So Much.

Eduard Grebe — Mon, 19 Oct 2009 15:06:58 +0000

Newsweek Exposes Duesberg’s Psychopathology

by Jeanne Bergman for AIDStruth.org

Peter Duesberg:
Photo by Seth Kalichman

"The whole dissident idea attracts a lot of crazies. And then all of a sudden, without realizing it, you've become one of them."

—Peter Duesberg

Newsweek this week published a strange and very revealing profile of the HIV über-denialist Peter Duesberg by Jeneen Interlandi (“The World’s Most Reviled Genius: Can the Scientist Who Denies the Cause of AIDS Be Trusted to Cure Cancer?” Oct. 19, 2009, pp. 44-48). The article asks if Duesberg’s aneuploidy theory of cancer may have some real promise that is being ignored because he has completely destroyed any scientific credibility he ever had by refusing to acknowledge that he was wrong about HIV and AIDS. (The short answer to this question is simply: no. Aneuploidy isn’t being ignored, much better scientists than Duesberg are working on it, and it is unlikely to be the key to the cause or cure of cancers. [1]) More significantly, the piece reveals a lot about the character and pathology of the man behind the denialist movement.

Interlandi describes how Duesberg has “toiled in scientific purgatory” at Berkeley. An embarrassment to the University, he has been relegated to a crummy little lab in a shabby building, with no grant funding, no promising graduate students, and no respect from anyone—including other cancer researchers working on aneuploidy. He is no longer allowed to teach. Duesberg clearly understands that this follows from his failed theory that HIV is harmless. Interlandi identifies in him a core conflict between two equally disturbing character traits: “he craves a return to respectability, [and] he refuses to cede any ground to his adversaries.” (See AIDStruth’s article about his malignant narcissism.) But Duesberg seems unable to grasp that the contempt is the result of his refusal to accept the conclusive scientific evidence that HIV is the cause of AIDS, and of his persistent proselytizing of his disproven claims about HIV, AIDS and antiretrovirals, which has caused hundreds of thousands of unnecessary deaths, particularly in South Africa.

The Newsweek profile touches on the formative impact of Nazism on Duesberg, who grew up a privileged Catholic in fascist Germany, and the resulting attitudes he holds toward people who aren’t heterosexual white men. He degrades women and developmentally disabled people (both lack “all the IQ genes,” he told Interlandi, “half joking”). He calls black people Schwartzes (the German N-word) and gays “homos,” and describes both as evolutionary failures. [2] His assistant calls these “gaffes,” and says of Duesberg: “He’s just from a different era, when people actually talked like that.” Actually, only Nazis and other racists, homophobes and eugenicists talked like that. Decent people of any age didn’t, and don’t.

In an extraordinary instance of projective inversion, Duesberg likens himself to the victims of Nazism rather than to the perpetrators of the Holocaust. Paraphrasing his reflection on his professional marginalization, Interlandi writes that for Duesberg “Being cast out of the mainstream… is like being herded onto a train by the Gestapo, never to be seen again.” Duesberg said this while relaxing at Caffe Strada, across the street from the great university that has tolerated both his professional failures and his hate speech. It’s appalling that the University of California allows this bigot to occupy space and draw a salary at the taxpayers’ expense.

Duesberg illustrated both his delusional feeling of victimization and his lack of ethics and judgment with a story about conducting secret tumor experiments on mice that he and his assistant bought in local pet shops. The article notes that this violated University policy concerning the pre-approval, housing, and treatment of lab animals. It might have also mentioned how stupid it is: results from those experiments would never be meaningful or publishable since they came from a small number of out-bred mice. U.C. learned of the project and, Interlandi writes, “Despite Duesberg's pleas to let them finish up, the mice were confiscated and killed. The data were lost. ‘We are the pauper scientists,’ he says, recalling the incident. ‘Always begging on our knees. Ever since HIV.’" Again, Duesberg can only see his imagined persecution, and not his abject failure as a scientist.

Newsweek did its best to find legitimate defenders of Duesberg. Interlandi writes: “Even some scientists who don't agree with Duesberg say that he has been treated unfairly,” and she quotes Lancet editor Richard Horton: "The ideological assassinations that he has undergone will remain an embarrassing testament to the reactionary tendencies of modern science.” But Horton wrote this in 1996, thirteen years ago, when antiretroviral drugs were just coming on the market. With their success, and in light of the unnecessary infections and deaths for which Duesberg is responsible, any illusions that criticism of Duesberg is based on ideology rather that evidence can no longer be sustained.

Peter Duesberg is shunned by his fellow scientists not because he is stubborn or obnoxious. He is shunned because he has been the driving force behind the AIDS denialist movement. He influenced the South African government, under former President Thabo Mbeki, to adopt an AIDS denialist position and delay the implementation of antiretroviral treatment access. This resulted in over 350,000 avoidable deaths. There is no possibility of professional reprieve for a  scientist so consciously involved in such a grotesque outcome.

Endnotes

1. Is there any validity to the notion that Duesberg’s infamy has hindered exploration of a promising domain of cancer research? Not according to cancer research George Klein:

In some of the comments around the Newsweek article, and in similar Duesberg-contexts previously, I have noticed a slight hesitation by the virologists about the cancer-aneuploidy story, leaving open the possibility that this was a real contribution by Duesberg. It is not. Aneuploidy as an important factor in causing cancer was proposed 1910 by Boveri, as Duesberg correctly states. Later, it was not forgotten or ignored, as he claims, but was continuously on and off in the discourse. When he now proposes it as a major insight, reached by him, he is using exactly the same technique of distorting the facts and inflating himself, as he always does.

This is not a question of either oncogene mutations, or aneuploidy. Aneuploidy contributes to the malignization of the cells, by influencing the oncogenes and the suppressor genes. More variability is generated, and the cancer cell evolves more readily towards greater autonomy. But the rearrangement of the chromosomes does not alter the fact that it is the oncogenes and the suppressor genes that are the key players.

A correlation between the degree of aneuploidy and prognosis has been noticed by the German-Swedish pathologist Gert Auer and Duesberg may well have picked up the idea from him. Another German (German-American) cytogeneticist, Thomas Reed has similar ideas. In view of the fact that he invited Duesberg to speak at the NCI (according to him) he may be in support for Duesberg’s argument. But please notice that Duesberg’s input contributed is nothing but dialectics. I cannot see the slightest originality in his work or in his reasoning. The fact that he manages to make this appear as a new way of thinking that may advance the cancer problem, or, indeed, is more ingenious new thought contributed by a pariah (as Scientific American put it) or by a genius (Newsweek) is nothing but more Duesbergiana. It is amazing how well he plays this game and how he can find new consumers who have not yet realized that they are being misled.

George Klein MD, PhD, Professor Emeritus, Research Group Leader, Microbiology and Tumor Biology Center (MTC) Karolinska Institutet, Stockholm, Sweden. Personal communication, Oct. 12, 2009.

2. Duesberg frequently makes racist and sexism comments. In Nashville, TN, in April 2009, he referred to the impact of AIDS on “the populations of Africa, which”— snickering sarcastically—“we love so dearly,” It was clear that the prospect of millions of Africans dying didn’t bother him.

Real Answers to the Fake Questions in “House of Numbers”

Eduard Grebe — Fri, 11 Sep 2009 00:48:52 +0000

by Jeanne Bergman

“House of Numbers” is a film with a hidden agenda: it tries to make viewers doubt the reality that the virus called HIV exists and causes AIDS. It conceals this agenda behind a false veneer of honest inquiry. The filmmaker, Brent Leung, told a Huffington Post blogger: “I am not a denialist. Posing questions is very different than denying something. … I traveled the globe speaking with scientists, activists, clinicians, journalists and patients asking questions. My main goal? To educate myself and others, and to generate discussion on important questions that have not yet been answered.” But Leung is an HIV denialist—he has said he is “neutral” on the issue of HIV/AIDS, which means he rejects the evidence-based science that has conclusively proved the existence of HIV and its causative role in AIDS, a fatal disease syndrome. His film is supported and promoted only by denialists. And Leung in fact got the information he sought from the legitimate scientists, doctors, and advocates he interviewed, but he then edited it out of the film to deceive and confuse viewers. The audience is manipulated to reach the wrong answers to the questions he ask. Since Leung leaves his own positions unstated, he dodges accountability for the film’s potential impact—namely, that people might decide that they don’t need to protect themselves or others from being infected with HIV, or that people living with HIV might reject medical care and the medications that could keep them healthy.

Here we summarize the fake “questions” Leung raises in the film, and provide real, evidence-based answers.

“House of Numbers” asks if there is really a scientific consensus about HIV/AIDS.

The real answer is: YES. There is an overwhelming scientific consensus, based on incontrovertible evidence, that HIV exists and is the cause of AIDS. The scientific evidence has shown conclusively that HIV exists, is transmitted by the blood and sexual fluids of infected people, and gradually destroys the human immune system, resulting in AIDS, a syndrome manifesting in various diseases that healthy people fight off but that cause illness and ultimately death in people with advanced HIV disease. Before the advent of antiviral medications, people with advanced HIV disease had multiple, devastating infections and symptoms that would not seriously harm a person with a healthy immune system. Since 1981, over 25 million people worldwide have died from HIV/AIDS.

The makers of “House of Numbers” deceived legitimate HIV researchers, infectious disease doctors, and AIDS activists and philanthropists to get interviews with them, and they edited the footage to make it seem that there is disagreement that HIV exists and is the necessary cause of AIDS. These facts have been established in laboratories, clinically, and by epidemiology, and published in tens of thousands of peer-reviewed publications. We have much still to learn about HIV and AIDS, and some scientists don’t like each other, but no legitimate, qualified scientist or doctor questions the existence or consequences of the virus.

“House of Numbers” questions the reliability of the HIV test. Does the HIV antibody test actually tell us anything at all?

The real answer is: YES. HIV tests are extremely reliable, sensitive and specific. What is usually referred to as the “HIV test” is just one step in HIV screening and diagnosis. The ELISA or EIA test screens for the presence of HIV antibodies in blood or oral fluids. In any diagnostic tests, there is a balance between sensitivity (recognizing everyone who is a true positive, who has the virus or whatever is tested for) and specificity (recognizing everyone who is a true negative, who doesn’t have the virus or whatever is tested for). Greater sensitivity always means more false positives, because very sensitive test will react to some things that are not the virus as if it were. Although rare, HIV false positives can happen: they are caused by the ELISA test reacting to antibodies produced in pregnancy or from some autoimmune diseases. (It is not true, as denialists claim, that 70 different conditions can cause false positives. And false positives are a feature of all screening tests, not just those for HIV. For example, some men will test positive for pregnancy. It doesn’t mean they are pregnant, or that pregnancy tests are totally useless, or that pregnancy doesn’t exist: it only means that the test is calibrated to capture all pregnancies when used correctly because a false negative is a bigger problem than a false positive.)

The ELISA test for HIV is very sensitive, because it is used to screen the blood supply and any false negatives could result in the HIV infection of hundreds of people. A positive ELISA test is 99.5% sensitive after the “window period” following infection, before HIV antibodies have developed. Because there is a small risk of a false positive, every HIV test is then confirmed with a Western Blot test. The two-test protocol is over 99.9% accurate, and clinical monitoring of a patient’s viral load and immune system by a physician further confirms the diagnosis. Misdiagnoses of HIV infection resulting in inappropriate treatment with antiretroviral drugs are extremely rare and are considered malpractice. (In 2007, an HIV-negative Massachusetts woman, Audrey Serrano, sued and won $2.5 million in damages against the doctor who treated her for AIDS without confirming that she was HIV infected. The HIV testing technology is so good that there is simply no excuse for the mistake that her doctor made.)

“House of Numbers” questions the practice of asking about risk factors in testing and diagnosis. Don’t doctors just want to know if you are gay or a drug user, and isn’t the diagnosis really bogus?

The real answer is: NO. Questions about risk factors are part of good screening, diagnosis and care. One step in many HIV testing protocols is an interview to assess the individual’s risk of infection. This has value as for prevention education; in addition, knowledge about risk helps frame the accuracy of a screening test. For straightforward statistical reasons, the likelihood of a false positive is higher where there are no risk factors and low prevalence than where risk factors and prevalence are high. But every positive ELISA test is still confirmed by a Western Blot or other test. The HIV tester in the movie who says that an AIDS diagnosis would be dependent on risks being acknowledged in an interview was simply wrong. It seems likely that she was asked misleading questions by the interviewers.

“House of Numbers” questions why some people who are exposed to HIV are not infected. Maybe HIV isn’t communicable? Maybe it doesn’t exist?

The real answers are NO and NO. There is no virus for which exposure always leads to infection. It should be obvious that not everyone exposed to a pathogen gets sick. Everyone knows that when someone in an office has a cold, some co-workers will catch it, and others won’t: how many do get sick depends in part on what steps people take to reduce the possibility of transmission. In the film, denialist Liam Scheff says that scientists say that HIV is so infectious it “leaps off penises into vaginas.” That’s a lie—people knowledgeable about HIV are clear that HIV is a hard virus to get—but the consequences of infection are serious, so prevention is crucial. The likelihood that a virus, including HIV, will be transmitted depends on many factors, including the nature of the contact, the innate transmissibility of the particular virus, the nature of the exposure or contact, how long the virus survives outside the body, and the viral load of the person who has it (people recently infected have very high levels of virus, while people on antiretroviral HIV medications have low, sometimes undetectable levels). This may be complicated, but it isn’t unusual at all. (And be aware that many HIV denialists reject the existence not only of HIV but of ALL viruses, and even of the role of germs in disease!)

“House of Numbers” questions how one disease varies so much in different people. Could it be that there’s no such disease as AIDS?

The real answer is: No. HIV infection will, over time, destroy the immune system in almost all infected people. The immune system is then unable to fight off opportunistic infections that are present in the environment, and they will get sick and die. Different strains of the virus and different regionally endemic diseases that affect immune-compromised people account for geographic variation in HIV disease patterns. Once a person is infected, the rate of disease progression is affected by many factors—the strain of the virus and the person’s age, overall health, environment, nutrition.

Causality does not require uniformity to be demonstrated. While there is a period averaging ten years when an HIV-positive person is clinically asymptomatic (that is, has no major symptoms), there is great variation between people’s HIV disease progression, even within the same region or even household. For example, Christine Maggiore, an HIV-infected denialist, said she first tested positive in 1992: she survived without HIV treatment for fifteen years until her death from AIDS last December. Her daughter, to whom she transmitted the virus perinatally, survived only 3 ½ years without treatment: she died, tragically and unnecessarily, of AIDS in 2005.

“House of Numbers” asks if a disease that is diagnosed differently on different continents is really only one disease.

The real answer is: YES. It is all HIV disease, and how the doctors and public health officials in different countries decide to mark the point at which it becomes full-blown “AIDS” doesn’t alter the reality of the virus and its effects. The virus doesn’t care what you call it, and the progression of the untreated disease is not driven by, but only expressed in, diagnostic language. Differences in diagnostic criteria by region reflect lack of access to HIV testing technologies and different clinical approaches: specifically, most African countries’ health systems cannot afford HIV testing. That doesn’t mean that HIV doesn’t exist or that poverty causes AIDS. Where HIV tests are not available, an AIDS diagnosis obviously cannot include HIV status as an element of an AIDS diagnosis, so the diagnosis is based on the presence of opportunistic infections that would only afflict a person with a compromised immune system.

“House of Numbers” asks if the profits that pharmaceutical companies make from HIV drugs might in fact be the reason for the invention of HIV/AIDS.

The real answer is: NO. The fact that the pharmaceutical industry does make money from HIV drugs does not mean that there is no such thing as HIV or AIDS. From the earliest days of the epidemic, AIDS activists have demanded the pharmaceutical industry and the government do smarter, more ethical, and expanded research. Activists have fought for the rapid development of better, more effective, more tolerable, and more affordable treatments for HIV, and the current generation of antiretroviral drugs for HIV are effective and easily tolerated by most people living with the virus. But that can lead to complacency and even the HIV denialism showcased by “House of Numbers. ” We must continue to fight to make HIV treatment accessible and affordable to everyone who needs it, including through the production of generics and international trade strategies like compulsory licensing that cut into the drug companies’ profits. We need to fight for prevention strategies that are science-based and really work, like needle-exchange and condoms, and more fundamentally address the structural injustices that render some populations much more vulnerable to HIV, as well as to other diseases. And we must press for the development of vaccines, other prevention technologies like microbicides and post-exposure prophylaxis, and ultimately for a cure.

David Rasnick fails to declare conflict of interests

Eduard Grebe — Fri, 31 Jul 2009 18:47:51 +0000

David Rasnick is a co-author with Peter Duesberg and others of an article in Medical Hypothesis which claims that HIV is not the cause of AIDS. The abstract of the article states, "we call into question the claim that HIV antibody-positives would benefit from anti-HIV drugs, because these drugs are inevitably toxic and because there is as yet no proof that HIV causes AIDS." [1]

We note an undeclared conflict of interests in this article by David Rasnick. Rasnick was a researcher for a company called the Rath Health Health Foundation Africa. This organisation promoted and distributed (and in terms of South African law, sold) micronutrient products as alternatives to antiretroviral treatment in South Africa. It also conducted an unauthorised clinical trial using these products as alternatives to antiretrovirals on people with HIV. The company never published the results of this trial in a peer-reviewed medical journal, but instead published adverts purporting to report the trial's results, a practice that is considered unethical in medical research. Rasnick is described in these adverts as one of the researchers on the trial.

A case was brought by the Treatment Action Campaign and South African Medical Association against the company's owner, Matthias Rath, the Rath Health Foundation Africa, Rasnick and others in the Cape High Court in which the court was requested to interdict the unauthorised trial from continuing. The court found in favour of the plaintiffs and ruled that the defendants, including Rasnick, had indeed conducted an unauthorised clinical trial. [2] Several deaths occurred on the trial which have been documented by the TAC and others. [3] This is not the first time Rasnick has been involved in academic misconduct. He has previously misrepresented his affiliation with the University of California Berkley. [4]

The Nuremberg code was established partly in response to Nazi experimentation on human subjects during World War II. It establishes the minimum standards experiments involving humans should adhere to. It states:

...

2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.

3. The experiment should be so designed and based on the results of animal experimentation and a knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment.

4. The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.

5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur ... [5]

The unauthorised trial in which Rasnick was involved breaches nearly every clause of the Nurember code, particularly those above. Proper informed consent from the trial participants was also not obtained. There can be few crimes by a medical researchers as heinous as running an unauthorised experiment on human beings. While the court ruling in South Africa was a civil one, there can be little doubt that Rasnick is guilty of a grievous crime for which he should be prosecuted.

References:

1. Duesberg, P.H., Nicholson, J.M., Rasnick, D., Fiala, C. & Bauer, H.H. HIV-AIDS hypothesis out of touch with South African AIDS - A new perspective. Med. Hypotheses (2009). doi:10.1016/j.mehy.2009.06.024 http://www.ncbi.nlm.nih.gov/pubmed/19619953

2. Zondi J. Judgment in TAC and Others v. Matthias Rath and Others. 2008. http://www.tac.org.za/community/files/file/TACAndSAMAVersusRathAndGovernmentJudgment.pdf
3. TAC. Analysis of deaths on Matthias Rath illegal clinical trial. 2005. http://www.tac.org.za/Documents/ns02_11_2005.htm
4. TAC. The Citizen's publicity for AIDS denialists is irresponsible. 2006. http://www.tac.org.za/community/node/2214
5. Nuremberg Code. Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10, Vol. 2, pp. 181-182.. Washington, D.C.: U.S. Government Printing Office, 1949. http://ohsr.od.nih.gov/guidelines/nuremberg.html

New myth debunked: HIV is an endogenous retrovirus

Eduard Grebe — Wed, 08 Jul 2009 21:14:43 +0000

Fact: HIV has been shown to be exogenous throughout 20+ years of research.

An endogenous retrovirus is one whose genetic material has been incorporated into that of the host. This happens when the genome of the virus incorporates itself into the chromosome of the host's sex cell (sperm or egg) – or its progenitor – and thus, upon fertilization becomes part of the normal genome found in every cell in the body of the host. Over time, the endogenous retroviral genome usually accumulates deleterious mutations rendering it incapable of productive infection. One myth used by denialists is that HIV is one of these endogenous retroviruses. However, several lines of evidence from the published scientific literature refute this claim, and prove that it is an exogenous virus, found only in CD4+ T-cells and a few other CD4+ cell types (such as macrophages) and not found in most other host cells.

Early evidence:

In the very first publication regarding the identification of HIV, Dr. Luc Montagnier described several experiments showing that HIV was exogenous. The controls used in his co-culture experiments, for example, did not produce a reverse transcriptase signal, only those cells exposed to infected patient lymphocytes. This indicates that the signal did not originate from the genome of the uninfected donor cells. The RT signal (and thus the virus) was able to be passed on to other uninfected lymphocyte cultures and resulted in a similar RT signal pattern. This passing on of the virus is another line of evidence that HIV is unlikely to be endogenous [1].

Southern Blots:

The southern blot is a method for probing for the presence of a specific DNA sequence within a DNA sample. In southern blot hybridization, a small segment of single-stranded DNA is hybridized to genomic DNA. There is nothing in the human genome that hybridizes at reasonable stringency levels (i.e. the specificity of the test) to probes made from HIV-1 or HIV-2 proviral genomes[2]. One study did find two very short sequences (192bp and ~30bp) with some similarity (<60% and 95% respectively) to parts of the HIV genome. However, these two sequences were detected only under very low stringency (low specificity) and no other sequences with similarity to HIV were found [3].

PCR:

In experiments using PCR (another method for detecting specific genetic sequences) in infected patients’ lymphocytes, PCR detects HIV in only a fraction of the infected donor’s T-Cells [4]. This alone is enough to demonstrate that HIV cannot be endogenous. An endogenous virus, by virtue of its past integration in host germ cells, would be detectable in all nucleated cells of the host. In other experiments, HIV DNA was found in the lymphocytes of patients but only very rarely in sperm cells [5]. The absence of HIV DNA from certain cell types in patients again refutes the idea that HIV is endogenous.

The Genome Projects:

The genome projects have been a valuable tool in the field of genetics and also refute the idea that HIV is endogenous. At the time this article was being written, only two examples existed in the scientific literature of endogenous lentiviruses in mammals: one in rabbits and one in lemurs [6][7]. All sequenced primate genomes (including several human genomes) show no endogenous lentiviral genomes.

Common Sense:

Some common sense combined with a brief look at infections would likewise indicate that HIV is not endogenous. If it were endogenous, sequences would be most similar between family members and most different between distantly related individuals. However, this is not the case. Europeans of non-West African descent have been identified with HIV-2 infection, despite HIV-2 being predominantly found in West Africa [8]. Conversely, many Africans have been infected by HIV-1. If one claims that HIV is endogenous, one therefore also claims that West Africans with HIV-2 infections are more closely related to non-West African Europeans with HIV-2 infection than they are to their HIV-1 infected countrymen. This is simply absurd.

References

1. Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vézinet-Brun F, Rouzioux C, Rozenbaum W, Montagnier L. Science. 1983 May 20;220(4599):868-71. PMID: 6189183

2. Characterization of a continuous T-cell line susceptible to the cytopathic effects of the acquired immunodeficiency syndrome (AIDS)-associated retrovirus. Folks T, Benn S, Rabson A, Theodore T, Hoggan MD, Martin M, Lightfoote M, Sell K. Proc Natl Acad Sci U S A. 1985 Jul;82(13):4539-43. PMID: 2989831

3. Novel human endogenous sequences related to human immunodeficiency virus type 1. Horwitz MS, Boyce-Jacino MT, Faras AJ. J Virol. 1992 Apr;66(4):2170-9. PMID: 1548756

4. Sensitive detection of HIV DNA in T4 lymphocytes of infected individuals by polymerase chain reaction.

Hsia K, Spector SA; International Conference on AIDS. Int Conf AIDS. 1990 Jun 20-23; 6: 160

5. HIV-particles in spermatozoa of patients with AIDS and their transfer into the oocyte. Baccetti B, Benedetto A, Burrini AG, Collodel G, Ceccarini EC, Crisà N, Di Caro A, Estenoz M, Garbuglia AR, Massacesi A, et al. J Cell Biol. 1994 Nov;127(4):903-14. PMID: 7962075

6. Discovery and analysis of the first endogenous lentivirus. Aris Katzourakis, Michael Tristem, Oliver G. Pybus, and Robert J. Gifford Proc Natl Acad Sci U S A. 2007 April 10; 104(15): 6261–6265. PMCID: PMC1851024

7. Parallel Germline Infiltration of a Lentivirus in Two Malagasy Lemurs. Gilbert C, Maxfield DG, Goodman SM, Feschotte C, 2009 PLoS Genet 5(3): e1000425. doi:10.1371/journal.pgen.1000425

8. HIV-2 infection in 12 European residents : virus characteristics and disease progression. Van Der Ende M. E.; Schutten M.; Thaoi Duong LY; Gruters R. A.; Osterhaus A. D. M. E. AIDS ISSN 0269-9370 1996, vol. 10, no14, pp. 1649-1655 (23 ref.)

Justice After AIDS Denialism: Should There Be Prosecutions and Compensation?

Eduard Grebe — Wed, 01 Jul 2009 22:28:55 +0000

AIDSTruth member and Treatment Action Campaign treasurer Nathan Geffen writes in the Journal of Acquired Immune Deficiency Syndromes:

Edward Mabunda

Edward Mabunda died on April 9, 2003. At least another 600 people died of AIDS in South Africa that day.(1) Edward was just 36 years old. He left behind a wife and 3 children. He was also a leader in the Treatment Action Campaign (TAC). He became an icon of the movement because of the fiery poetry that he recited to thousands of people. His poems urged former President Thabo Mbeki to make antiretrovirals (ARVs) available in South Africa’s public health system. He died because he could not obtain these life-saving medicines in time.(2)

From 1999 to 2007, Mbeki and his Minister of Health Manto Tshabalala-Msimang obstructed and then undermined the implementation of highly active ARV treatment (HAART) and prevention of mother-to-child transmission of HIV in the public health system. Two studies, conducted independently of each other, conservatively calculated that over 300,000 people died because of Mbeki’s AIDS denialist policies.(3–5) Edward Mabunda was one of them.

These studies could not account for additional deaths due to the promotion of quackery, often with the health minister’s support. They also did not consider the number of infections that occurred because of the confusion generated by the insipid state-funded prevention campaign and the messages by some outspoken Mbeki supporters dismissing the link between sex and HIV infection.(6) The Mbeki era also fostered a profound mistrust of scientific medicine, the consequences of which also cannot be quantified.

Read the full article in JAIDS.

Or, if you don't have a subscription, read it at Denying AIDS and other odditites.

Reference: JAIDS Journal of Acquired Immune Deficiency Syndromes: June 30, 2009 - Volume Publish Ahead of Print. doi: 10.1097/QAI.0b013e3181ab6da2

Clarification on false claims made in emails circulating on the Internet

Eduard Grebe — Mon, 22 Jun 2009 13:32:54 +0000

We have learnt that Dr Jim Murtagh has made false claims about his relationship with some members of aidstruth.org in email correspondence with AIDS denialists. We do not wish to be drawn into the squabbles of people not associated with us. Nevertheless, we print the following clarification to rectify confusion generated by Dr Murtagh's emails:

Dr Murtagh is not a member of aidstruth.org. We are not affiliated with him. The members of aidstruth.org can be found on our About page.
This website receives no funding other than the personal contributions of some of its members to cover hosting costs.
Contrary to Dr Murtagh's claims, neither the Treatment Action Campaign (TAC) nor any other organisation in which members of aidstruth.org have a leadership role support Dr Murtagh financially or materially.
No members of aidstruth.org were aware that Dr Murtagh would make false claims in emails. We find such behaviour repugnant.
No leaders of the TAC are involved with Dr Murtagh or his dealings.
Contrary to suggestions in Dr Murtagh's emails, a judgment of the Cape High Court has found no evidence that the TAC has any financial relationship with the pharmaceutical industry. On the contrary, the court found it unlikely that the TAC would have such a relationship. The same court interdicted an individual and two organisations for falsely claiming the organisation was funded by the pharmaceutical industry.