From: "Wallace Polsom" <wallace-AT-raggedclaws.com>
Subject: Re: BHA: Explanatory Power
Date: Fri, 30 Jun 2000 09:31:38 -0600


> Incidentally Mervyn, given that I know you are a Guardian reader
> (occasionally?) have a look at today's G2 re AIDS in Africa for a good
> account of why the empirical cannot be determinant in the last instance.

Is this the article you're referring to, Colin?

----------

http://www.guardianunlimited.co.uk/Archive/Article/0,4273,4035196,00.html

A fight for life

More than 23 million sub-Saharan Africans are infected with HIV. The
scientific establishment says this virus causes Aids. But Thabo Mbeki, South
Africa's president, is not convinced and has experts seeking other
explanations. Sarah Boseley on a bitter row that could decide the fate of a
continent

Sarah Boseley

Friday June 30, 2000


Seldom can a scientific row have been played out for higher stakes. Around a
table in Johannesburg last month sat a collection of professors and doctors
whose collective brain wattage should be enough to floodlight the most
impenetrable corners of academic darkness. Not on this issue. What they were
debating was the cause of Aids - an argument that goes back a decade and was
near extinguished in the United States. Now, however, it has crossed
continents to be reignited in South Africa. The lives of millions hang in
the balance.

This is Thabo Mbeki's expert international panel, called together by him in
advance of the international Aids conference in Durban next month. All
around them is human evidence of the problem. In the streets of sub-Saharan
African cities, orphaned children sleep out, stigmatised and shunned by
their communities, debarred from school and in danger of death from
malnutrition and sickness or a life of vagrancy and crime. Their parents
died of Aids, as did 2.6m worldwide last year, mostly under the age of 35.
Sub-Saharan Africa is now bearing the brunt of this latter-day plague.

In the west, it is largely accepted that the HIV virus is the cause of the
epidemic. UNAIDS - the United Nations organisation which released a chilling
report released this week - says a colossal 23.3m Africans living south of
the Sahara are infected with HIV - 70% of the total infected worldwide - and
facing an early death without medical treatment.

The scale of the problem for governments such as President Mbeki's in South
Africa is terrifying. The antiretroviral drugs that have succeeded in
halting the death toll in the west are beyond their means. It isn't hard to
see why Mbeki has balked at the implications and is looking for another way.
In the face of a scandalised Aids establishment, he declared he was not
convinced that HIV caused Aids. Africa, he said, must look for her own
solutions.

He is tempted by the dissident ideas of Peter Duesberg, professor of
biochemistry and molecular biology at the University of California,
Berkeley, which caused controversy in the US 10 years ago. The attraction of
Duesberg's theory is clear. Break the link between HIV and Aids and there is
hope for millions who, without medical treatment on a scale that would
bankrupt the country, face death within 10 years. And hope for future
millions, because he says Aids is not infectious. His argument faded out in
the west as the infection rate dropped because of changes in behaviour among
at-risk groups and death sentences were commuted by new drugs. But in Africa
it has blossomed again, bolstered by the assertion that Aids in Africa is a
different disease because it exists in the heterosexual community. The
clinics are full of sick babies, not gay men.

The Mbeki government is looking for miracles. Two years ago, it rushed to
back a cheap purported Aids remedy called virodene, invented by Olga Visser,
a technician previously involved in cryopreservation - attempts to
deep-freeze people until scientists have found ways to keep them alive
forever. Virodene's active ingredient was an industrial solvent which was
banned from use on humans in South Africa. When the Medicines Control
Council in South Africa blew the whistle on virodene, declaring it unsafe,
the Mbeki government closed the MCC down.

This was followed by pronouncements that poverty and malnutrition were the
cause of Aids and a refusal to give mothers western drugs to stop them
transmitting HIV infection to their babies. Under pressure to conform from
the West, with the 13th International Aids Conference about to descend on
Durban and threats from some scientists of a boycott, Mbeki has set up his
international panel to go back to basics and tell him what to think about
Aids. Duesberg is on it. So is Professor Luc Montaignier, the French
scientist who discovered the HIV virus and Dr Ann Duerr of the highly
orthodox Centres for Disease Control in Atlanta, Georgia. So is Professor
Eleni Papadopulos-Eleopulos, a biophysicist from the Royal Perth Hospital in
Australia who doubts that HIV even exists.

Mbeki has been accused of inviting only the dissidents on to his panel, but
there is a mixture of true believers and heretics, and others were
approached. Some will have chosen not to get involved, for the argument has
all the ferocity of a religious schism.

Gordon Stewart, emeritus professor of public health at the University of
Glasgow and a former World Health Organisation adviser on Aids, is one of
two British members, both dissidents to a degree. He says the medical
establishment is very good at turning on those who refuse to accept the
mainstream thesis. "It is a matter of extensive and quite incredible
demonisation - not just ostracism and censorship but also demonisation."

Mbeki, in his own defence and theirs, claimed there was "an orchestrated
campaign of condemnation" against certain scientists considered "dangerous
and discredited", with whom nobody should communicate. "In an early period
in human history, these would be heretics burned at the stake!" he wrote in
a letter to heads of state, in which he compared the silencing of the
scientists to apartheid.

Andrew Herxheimer, the other British member of the panel, who is known for
his role in the respected Cochrane collaboration - a database which
assembles and compares all the evidence for the efficacy of medicines from
international clinical trials - says he has been warned. "Various of my
friends say 'you are a dissident. With all the good work you have done, that
will be the end of you'," he says.

Herxheimer's abiding interest is in the systematic compilation of evidence
from trials and reviews and on the cause of Aids, on transmission through
blood and from mother to child, it is murky, he says. "They may be right,
but I'm an agnostic. I want to see the evidence for some of these
statements."

Aids is diagnosed from an accumulation of general symptoms, including weight
loss, diarrhoea and fever in the absence of malnutrition or cancer. It has
no typical symptoms. Tuberculosis is rife in sub-Saharan Africa. Are people
dying of TB or Aids? Sometimes it is hard to tell. "Many are dying of
opportunistic infections," says Herxheimer. "TB and sexually transmitted
diseases are the big, big problem, and poverty and malnutrition.

"The way that Aids is diagnosed is very unsatisfactory. I once came across a
French epigram which I love: Un idiot pauvre est un idiot; un idiot riche
est un riche . In Africa, a person with TB who is HIV negative has TB; a
person with TB who is HIV positive has Aids. That is not acceptable as a
logic, or as a basis for policy."

Tests detect only antibodies made in response to contact with the virus, the
dissidents say. That does not mean, they argue, that any virus remains in
the body, yet that person is told they are likely to develop AIDS in years
to come. "I think that what is so terrible about the whole thing is that
people equate HIV with a death sentence, which is rubbish," said Herxheimer.

Passions are high on both sides. Angry scientists who say there is no other
explanation for mass deaths which follow wherever HIV spreads denigrate the
heretics. The dissidents talk of censorship and cover-up. "It really is a
terrible scandal," exclaims Professor Stewart. "It has been hyped up by the
media and politicians and Hollywood and all kinds of activist groups."

Aids in the UK is now a very rare disease, Stewart argues. As far as he is
concerned, the sickness afflicting Africa is not the same, and we should not
be looking to failed UK solutions. "In the UK we have been unsuccessful.
After 20 years we have no cure or vaccine and the spread is continuing among
at-risk groups.

"We have been criminally irresponsible - we have told people they have Aids
when they are HIV positive and that's not true. We have told them there is
no cure and no vaccine and they are going to die. We have caused endless
stress and even suicide. Families have worried about whether their children
are going to be infected. That's why it is such a panic disease. The medical
establishment has made the panic."

Robin Weiss, a viral oncologist at the Institute of Cancer Research in
London and a leading authority on HIV, thought the Duesberg hypothesis had
died out 10 years ago, when he and his scientific colleague, the American
Harold Jaffe, wrote a merciless dissection of its failings in Nature
magazine. He is appalled to find he was wrong.

"We'd all forgotten about him, but it has come up again," he said.

Aids came out of nowhere in 1980, says Weiss, and by 1985 was the major
cause of death in both sexes in the west between the ages of 25 and 45,
overtaking accidents, cancer and everything else. Then came the powerful
drug combinations which hit the HIV virus. Mortality dropped by 80%.
Duesberg had been telling people not to take the drug AZT. "The gay men in
San Francisco who had lionised him went away sheepishly and got their drugs
because they didn't want to die," says Weiss. "He lost his constituency. Now
he is going to South Africa, where mortality isn't dropping by 80%."

He understands the lure for Mbeki, confronted by the desperate fact that 25%
of his country's young people are HIV positive. "It is a siren voice. It's
like Odysseus and his sailors hearing the sirens. Odysseus strapped himself
to the mast. Mbeki hasn't done that yet. How terribly seductive - how beauti
ful it must sound. Africa is bewildered, as we must have been 650 years ago
when the plague came along. This could have the same demographic and
economic impact."

But the unbelievers are wrong, says Weiss, as they were a decade ago in San
Francisco. He would not change a word of his 1990 attack on Duesberg's
theories in Nature. "HIV is the singular common factor that is shared
between AIDS cases in gay men in San Francisco, well nourished young women
in Uganda, haemophiliacs in Japan and children in Romanian orphanages," he
and Jaffe wrote. "To deny the role of HIV in Aids is deceptive."

Nothing, Weiss says, has changed. "Everything that has happened in the past
10 years strengthens the evidence that HIV causes Aids. It is a complicated
disease, but that is it."

He, too, was invited to join Mbeki's panel, but could not make the dates.
But he, like every other doctor and scientist involved in Aids, is watching
what is going on with acute and nervous interest. The bitter argument taking
place cannot be dismissed, because the issues are too important. The lives
of too many are at stake.

If Mbeki continues to embrace the dissidents, the basic public health
messages about condom use and safe sex will be lost, as well as any chance
of getting drugs to women in childbirth to prevent them infecting their
babies with HIV, a relatively cheap and effective option. This is not ivory
tower stuff. In Johannesburg and Durban, hypothesis meets the real world of
life - and death.




     --- from list bhaskar-AT-lists.village.virginia.edu ---