Date: Fri, 30 Jun 2000 23:42:38 +0100 From: Colin Wight <Colin.Wight-AT-aber.ac.uk> Subject: Re: BHA: Explanatory Power Yes Wallace, Spot on. A nice concrete issue that the list should be concerned with. Cheers,, At 09:31 30/06/00 -0600, you wrote: >> 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 --- > > ============================================ Dr. Colin Wight Department of International Politics University of Wales, Aberystwyth Wales SY23 3DA Tel: (01970) 621769 --- from list bhaskar-AT-lists.village.virginia.edu ---
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