File spoon-archives/bhaskar.archive/bhaskar_2000/bhaskar.0006, message 250


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 


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