Damned Heretics

Condemned by the established, but very often right

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Qualified outsiders and maverick insiders are often right about the need to replace received wisdom in science and society, as the history of the Nobel prize shows. This blog exists to back the best of them in their uphill assault on the massively entrenched edifice of resistance to and prejudice against reviewing, let alone revising, ruling ideas. In support of such qualified dissenters and courageous heretics we search for scientific paradigms and other established beliefs which may be maintained only by the power and politics of the status quo, comparing them with academic research and the published experimental and investigative record.

We especially defend and support the funding of honest, accomplished, independent minded and often heroic scientists, inventors and other original thinkers and their right to free speech and publication against the censorship, mudslinging, false arguments, ad hominem propaganda, overwhelming crowd prejudice and internal science politics of the paradigm wars of cancer, AIDS, evolution, global warming, cosmology, particle physics, macroeconomics, health and medicine, diet and nutrition.

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Many people would die rather than think – in fact, they do so. – Bertrand Russell.

Skepticism is dangerous. That’s exactly its function, in my view. It is the business of skepticism to be dangerous. And that’s why there is a great reluctance to teach it in schools. That’s why you don’t find a general fluency in skepticism in the media. On the other hand, how will we negotiate a very perilous future if we don’t have the elementary intellectual tools to ask searching questions of those nominally in charge, especially in a democracy? – Carl Sagan (The Burden of Skepticism, keynote address to CSICOP Annual Conference, Pasadena, April 3/4, 1982).

It is really important to underscore that everything we’re talking about tonight could be utter nonsense. – Brian Greene (NYU panel on Hidden Dimensions June 5 2010, World Science Festival)

I am Albert Einstein, and I heartily approve of this blog, insofar as it seems to believe both in science and the importance of intellectual imagination, uncompromised by out of date emotions such as the impulse toward conventional religious beliefs, national aggression as a part of patriotism, and so on.   As I once remarked, the further the spiritual evolution of mankind advances, the more certain it seems to me that the path to genuine religiosity does not lie through the fear of life, and the fear of death, and blind faith, but through striving after rational knowledge.   Certainly the application of the impulse toward blind faith in science whereby authority is treated as some kind of church is to be deplored.  As I have also said, the only thing ever interfered with my learning was my education. My name as you already perceive without a doubt is George Bernard Shaw, and I certainly approve of this blog, in that its guiding spirit appears to be blasphemous in regard to the High Church doctrines of science, and it flouts the censorship of the powers that be, and as I have famously remarked, all great truths begin as blasphemy, and the first duty of the truthteller is to fight censorship, and while I notice that its seriousness of purpose is often alleviated by a satirical irony which sometimes borders on the facetious, this is all to the good, for as I have also famously remarked, if you wish to be a dissenter, make certain that you frame your ideas in jest, otherwise they will seek to kill you.  My own method was always to take the utmost trouble to find the right thing to say, and then to say it with the utmost levity. (Photo by Alfred Eisenstaedt for Life magazine) One should as a rule respect public opinion in so far as is necessary to avoid starvation and to keep out of prison, but anything that goes beyond this is voluntary submission to an unnecessary tyranny, and is likely to interfere with happiness in all kinds of ways. – Bertrand Russell, Conquest of Happiness (1930) ch. 9

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Times falls short on Bird Flu, unaware of scientific literature

March 28th, 2006

16 million PubMed papers unknown to Times reporters

The New York Times science reporters and editors are operating under a severe handicap. These stalwarts are clearly unaware of the existence of PubMed, a database available courtesy of the NIH for more than a decade even on a simple home computer, which provides immediate access to the world’s stock of medical papers published in peer reviewed journals.

The database access is provided by the NIH, and will yield abstracts of the papers in a list for free to anybody interested who cares to fire up a browser and type in the word “PubMed” into a search engine. PubMed will list the papers and provide abstracts for any topic you care to ask about. If you belong to an organization like a university library you get the whole paper, not just an abstract.

This miracle is apparently as yet unknown to the New York Times, however. Their Bird Flu squad, assigned to produce a special section on Bird Flu today, evidently failed to consult this modern marvel of information in preparing their pieces. Neither the cause of this flu’s deadliness nor the ready cure for it are covered in their roundup, even though solutions to both of these puzzles are provided in the literature and have been for some time, as noted in our earlier posts on the topic.

Bird flu’s deadly power is to cause the immune system to overreact and produce Tumor Necrosis Factor or TNF in the lungs, which handicaps breathing so severely that nearly half of the unfortunate Asians who have caught it have, like the soldiers of the first World War, turned blue and died in short order.

The cure for such a cytokine storm is none other than our friendly nutritional factor, Vitamin A, in the form of carrots, fish oil and similar. Two studies showing this are out and easily found in PubMed by anyone who can get past the semi-illiterate jargon of the titles and abstracts of medical literature.

But the Times Bird Flu squad shows no sign of performing any better than the celebrated AIDS reporters and commentators of that august journal, including the hard working Larry Altman and the elegantly professorial Nicholas Wade, who despite their combined forty two years experience in the field, have not yet cottoned on the fact that HIV as a candidate for causing AIDS is about as likely as using a bicycle to get to the moon, according to the many as yet unrefuted papers of a certain Berkeley professor, as well as plain common sense.

Possibly their neglect of the scientific literature in both fields has to do with the pain of wading through the jargon which is the stock in trade of professionals in these fields, which is only really interesting when you realize that it conceals ignorance and illogic, almost as often as it conveys good information, in these two fields.

Surely it is distasteful to men whose main role in life is writing elegantly clear exposition for the readers of the Times to have to chew on literary concrete any more than they have to. With both of them evidently unaware that the theory of HIV was scuttled by unanswerable objections almost as soon as it left the launch ramp and splashed into the sea of ignorance and dutiful stenography that allows almost any claim by scientists to win immediate acceptance in the media, they lack the motivation to read any more of the standard literature than they have to in AIDS, and presumably are similarly disinclined to tackle any more of the bird flu papers than they have to, also.

Well, we don’t necessarily blame them. It is hard for middle aged men to catch up with the new toys of the new era. We doubt if either of them own an iPod, or do much text messaging. The PubMed data base is probably equally alien and incomprehensible to these traditional literary folk.

And after all, the officials of the NIH don’t appear to be setting any better example. Although we tipped him off four months ago NIAID director Anthony Fauci and his cohorts still seem unaware that they could save $7 billion by simply asking one of their secretaries to point a browser at the very data base which their own institution has bestowed upon the American people, miraculously transforming every kid or blogger with a keyboard into a medical authority more informed than the combined staff of Cornell and the Mayo Clinic.

PubMed is Easy to Use

Simply enter your search topics – one or more terms – and click Go. PubMed can be searched using MeSH terms, author names, title words, text words or phrases, journal names, or any combination of these. Retrieved citations are displayed and their associated abstracts can be selected for viewing. A unique feature of PubMed is the ability to instantly find related articles for any citation.

Additional search modes offer the ability to perform more complex searches by specifying data fields, age groups, gender, or human or animal studies. A special clinical queries page provides customized searches for studies based on etiology, diagnosis, prognosis, or treatment of a particular disease. Systematic reviews of a topic and medical genetics can also be searched here. Search results can be viewed or downloaded in various formats, including a format suitable for bibliographic management software.

PubMed’s LinkOut feature provides access to a wide variety of relevant web-accessible online resources, including full-text publications, biological databases, consumer health information, research tools, and more. Currently citations from more than 4,600 journals are linked to the full-text on publishers’ web sites. Users may have to register, or there may be a fee or subscription required to access the full-text.

Here is the overall Times guide to Avian Influenza, pages which contain all the articles in the Science section today.

The CDC has plenty of relevant articles on its own web site, if that is easier for Tony Fauci or Nicholas Wade to deal with. Just type “cytokine” into the CDC search slot, gentlemen, and you’ll find papers such as this one, the fifth listed. Not that the CDC has been very alert in its own use of PubMed. The paper was written in July last year, but according to the dating the CDC finally found it and listed it little more than a week ago, on March 21, 2006. Evidently the staff of the CD are almost as PubMed challenged as the NIH or the Times.

The paper (as we noted in our original November 20 post here nearly five months ago) explains that bird flu’s A-H5N1 virus occupies the lungs and intestines primarily and creates Tumor Necrosis Factor-α (TNF-α) in the lungs in a cytokine storm produced by an overreaction of the immune system.

It’s title is
“>Uiprasertkul M, Puthavathana P, Sangsiriwut K, Pooruk P, Srisook K, Peiris M, et al. Influenza A H5N1 replication sites in humans. Emerg Infect Dis [serial on the Internet]. 2005 Jul [date cited].

Here is the entire text.

Past Issue

Vol. 11, No. 7

July 2005

Influenza A H5N1 Replication Sites in Humans

Mongkol Uiprasertkul,* Pilaipan Puthavathana,* Kantima Sangsiriwut,* Phisanu Pooruk,* Kanittar Srisook,* Malik Peiris,† John M. Nicholls,† Kulkanya Chokephaibulkit,* Nirun Vanprapar,* and Prasert Auewarakul*

*Mahidol University, Bangkok, Thailand; and †University of Hong Kong, Hong Kong Special Administrative Region, People’s Republic of China

Suggested citation for this article

Tissue tropism and pathogenesis of influenza A virus subtype H5N1 disease in humans is not well defined. In mammalian experimental models, H5N1 influenza is a disseminated disease. However, limited previous data from human autopsies have not shown evidence of virus dissemination beyond the lung. We investigated a patient with fatal H5N1 influenza. Viral RNA was detected by reverse transcription–polymerase chain reaction in lung, intestine, and spleen tissues, but positive-stranded viral RNA indicating virus replication was confined to the lung and intestine. Viral antigen was detected in pneumocytes by immunohistochemical tests. Tumor necrosis factor-α mRNA was seen in lung tissue. In contrast to disseminated infection documented in other mammals and birds, H5N1 viral replication in humans may be restricted to the lung and intestine, and the major site of H5N1 viral replication in the lung is the pneumocyte.

Highly pathogenic avian influenza virus H5N1 is the first avian influenza virus that was documented to cause respiratory disease and death in humans (1–3). In 2004, it caused widespread disease in poultry in Asia (4) and led to human disease in Thailand and Vietnam, with reported fatality rates of 66% and 80%, respectively (5,6). With the emergence of a second wave of disease outbreaks in poultry in Thailand, Vietnam, and Indonesia, this disease poses a global threat to human health (4). Additional human cases have been reported since August 2004. The high pathogenicity of this virus in avian species is associated with readily cleavable hemagglutinin (HA), but other amino acid residues in HA and neuraminidase have been recently reported to be involved in avian pathogenicity (7). In mice, some H5N1 virus strains cause a disseminated infection and death, and this phenotype was associated with specific amino acid substitutions in PB2 and the multibasic cleavage site in HA (8). Natural infection of felines with H5N1 viruses also resulted in disseminated infection (9). However, the pathogenesis of H5N1 disease in humans is more obscure. Despite severe and generalized clinical manifestations, the result of multiple organ dysfunction, previous limited autopsy data failed to show evidence of viral replication beyond the respiratory tract (10,11). The tissue tropism of the virus in humans has also not been clearly established by immunohistochemical analyses (10,11). The absence of detectable viral antigen–positive cells in previous reports may relate to the fact that the patients died during the late phase of the disease after intensive treatment with antiviral drugs. In this report, we investigated a case of fatal H5N1 disease in a child for tissue tropism caused by the virus in the lungs and other organs.

Methods

Patient and Virologic Diagnosis

Detailed clinical description of the patient is reported elsewhere (12). The patient was a 6-year-old boy who had a progressive viral pneumonia that led to acute respiratory distress syndrome and death 17 days after onset of illness. He was initially treated with multiple broad-spectrum antimicrobial agents. Virologic diagnosis of H5N1 infection was made on day 7 of illness. After oseltamivir became available in Thailand, he was treated on day 15 of his illness with this agent until he died. He was also treated with methylprednisolone on day 15 until death and with granulocyte colony-stimulating factor for leukopenia from day 5 to day 10 of illness.

Virologic diagnosis was made by antigen detection, viral culture, and reverse transcription–polymerase chain reaction (RT-PCR) on a nasopharyngeal wash specimen as described (12) and was confirmed by seroconversion of neutralizing antibody against H5N1 virus. The virus was identified as avian influenza virus (H5N1) by whole genome sequencing. The virus was an avian virus with no evidence of genetic reassortment with human influenza viruses. Phylogenetic analysis showed that the viral genomic sequence formed a distinct cluster with other H5N1 viruses isolated from humans and poultry in Thailand and Vietnam, but it was still related to the previously described H5N1 viruses circulating in southern China. As with other viruses isolated from poultry in Vietnam, Thailand, and Indonesia, this virus was also a genotype Z virus (4).

Pathologic Examination

Autopsy was carried out by standard techniques, and precautions were taken to minimize risk of transmission of infection. The tissue obtained was prepared for routine histologic analysis, and a portion was stored at –70°C for further study. For RT-PCR, fresh unfixed specimens were minced into small pieces in lysis buffer of an RNA extraction kit (RNA Wizard, Ambion, Austin TX, USA). Total RNA was then extracted according to the manufacturer’s protocol. RNA was also extracted from paraffin-embedded tissues by sequential extraction with TriZol reagent (Invitrogen, Carlsbad, CA, USA) and the RNAEasy kit (Qiagen, Valencia, CA, USA) after digestion with proteinase K. RT-PCR for H5 was then conducted on extracted RNA by using One Step RT-PCR kit (Qiagen) with the H5 specific primer pairs H5F (5´-ACTCCAATGGGGGCGATAAAC-3´) and H5R (5´-CAACGGCCTCAAACTGAGTGT-3´) (13). An RT-PCR for glyceraldehyde-3-phosphate dehydrogenase (GAPDH) mRNA was done in parallel to control for the amount and quality of RNA as described (14). Strand-specific RT-PCR was carried out by a method similar to RT-PCR for viral RNA detection, except that only 1 primer was added at the reverse transcription step.

For immunohistochemical analysis, sections were deparaffinized and rehydrated. Antigenic site retrieval was accomplished by heating each slide in a microwave oven at 700 W for 15 min in 0.05 mol/L citric acid buffer, pH 6.0, and cooling for 20 min at room temperature. Endogenous peroxidase activity was blocked by incubating the slides in 0.3% H2O2 for 30 min at room temperature. Sections were incubated with 20% normal goat serum (Dako, Glostrup, Denmark) for 20 min at room temperature and then with an anti-influenza A nucleoprotein monoclonal antibody at a 1:100 dilution (B.V. European Veterinary Laboratory, Woerden, the Netherlands) for 1 h at room temperature. Slides were rinsed 3 times in 0.05 mol/L Tris-buffer, pH 7.6, 0.1% Tween 20 and incubated with horseradish peroxidase–conjugated goat anti-mouse immunoglobulin at a 1:400 dilution (Dako) for 30 min at room temperature. The slides were washed as above, developed with diaminobenzidine (Dako), and counterstained with hematoxylin. Some slides of lung tissue were double-stained with a monoclonal antibody (1:50 dilution) against surfactant (Dako).

Cytokine Expression

Tumor necrosis factor-α (TNF-α), interferon- (IFN-γ), and interleukin-6 (IL-6) mRNA were detected in the extracted RNA by an RT-PCR with previously described primer pairs (15–17). Plasma levels of TNF-α and IFN-γ were measured by enzyme-linked immunosorbent assay (Pierce Endogen, Rockford, IL, USA) and compared with samples from 3 H3 influenza–infected patients and 5 healthy persons.

Results

Figure 1

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Figure 1. Microscopic shape of the lung showing proliferative phase of diffuse alveolar damage and interstitial pneumonia…

Figure 2

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Figure 2. A) Detection of H5 influenza viral RNA in lungs, intestines, and spleen by reverse transcription–polymerase chain reaction…

Figure 3

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Figure 3. Immunohistochemical analysis showing influenza A antigen-specific staining in nuclei of cells lining the alveoli (A)…

The autopsy showed proliferative phase of diffuse alveolar damage, interstitial pneumonia, focal hemorrhage, and bronchiolitis. The pneumocytes showed reactive hyperplasia without virus-associated cytopathic changes (Figure 1). Superimposed infection by fungus, morphologically consistent with aspergillosis, was seen in some areas of the lung. The lymph nodes, spleen, and bone marrow showed slight histiocytic hyperplasia. No evidence of hemophagocytic activity was seen. The liver had mild fatty changes, activated Kupffer cells, and slight lymphoid infiltration in the portal areas. The brain was edematous, and small foci of necrosis were found. Intestines, kidneys, heart, and other organs showed no remarkable changes.

H5-specific RNA was detected in the lung, spleen, and small and large intestines by RT-PCR (Figure 2A). Control reactions without the reverse transcription step were negative, confirming that the PCR amplicon was not contaminated. The successful extractions of RNA from all organs were confirmed by the amplification of GAPDH mRNA (data not shown). We also tested whether the RNA was genomic RNA from virion or replicating RNA and mRNA from productively infected cells. To determine this, we conducted strand-specific RT-PCRs. Positive- and negative-stranded viral RNA was found in the lung, small intestines, and large intestines, but only negative-stranded RNA was detected in the spleen (Figure 2B). Because of the absence of positive-stranded RNA, which would serve as mRNA and the template for genome replication, we concluded that viral replication was absent or very low in the spleen and that the viral RNA detected in the spleen was probably nonreplicating virion RNA. No evidence of viral RNA was seen in the adrenal glands, brain, bone marrow, kidneys, liver, or pancreas. Results of the RT-PCR for viral RNA in plasma were also negative.

Immunohistochemical analysis detected influenza A virus antigen-positive cells in lung tissue. The staining was localized in nuclei of alveoli-lining cells. Positive cells were found in 4 of 9 blocks of lung tissue. The shape and location of the antigen-positive cells indicated that they were type II pneumocytes. To confirm this, we used surfactant as a marker of type II pneumocyte (18). We double-stained slides from adjacent cuts with anti-influenza A and anti-surfactant monoclonal antibodies and showed that all influenza virus antigen–positive cells with nuclear staining showed intracytoplasmic staining of surfactant (Figure 3). Slides stained only with antibodies to surfactant showed intracytoplasmic, not intranuclear, staining. This finding confirmed that viral antigen–positive cells were type II pneumocytes. Although viral mRNA was present in the intestines, viral antigen was not detected in 4 blocks of tissue from the small and large intestines. In accordance with the absence of viral mRNA in other organs, viral antigen was not detected in those tissues. We also tested 2 blocks of tissue from the trachea. We did not detect any positive staining in columnar epithelium, which is the usual target for influenza virus infection in humans (19), which suggests that the virus targeted primarily lung tissue and not airway epithelium. Similarly, we did not find viral antigen in bronchiolar epithelium in the lung sections. Columnar epithelium in both the trachea and bronchiole was intact, thus providing adequate columnar epithelial cells for evaluation. The lack of pathologic changes is consistent with the absence of viral infection in these tissues.

The high pathogenicity of the H5N1 avian influenza virus has been proposed to be caused by induction of proinflammatory cytokines (20). Cytokine dysregulation could be the major cause of tissue damage in humans, especially in organs in which productive infection does not take place and cell damage cannot be accounted for by cytolytic viral infection. To investigate this aspect of viral pathogenesis, we tested for the presence of cytokine mRNA in tissues from various organs. We detected TNF-α mRNA in lung tissue, but not in other organs (intestines, stomach, spleen, brain, bone marrow, kidneys, liver, and pancreas) of this patient, or in lung tissue of patients who died of other causes (Figure 2C). We did not find any increase in levels of IFN-α, IFN-γ, and IL-6 mRNA in organs of this patient when compared with control tissues from healthy persons.

In accordance with previous reports showing the increased levels of serum cytokines, we found high levels of interferon-induced protein 10 in serum samples collected on day 5 (37,000 pg/mL) and day 10 (4,300 pg/mL) of illness. These levels are comparable to those reported in H5N1-infected cases (10). However, we could not detect any significant levels of TNF-α and IFN-γ in these samples.

Discussion

Detailed autopsy data on patients with H5N1 disease are limited, and our data provide an insight into the pathogenesis of H5N1 virus in humans. We provide evidence that H5N1 viral replication is not confined to the respiratory tract but may also occur in the gastrointestinal tract. However, a fecal sample was not available for detection of virus. Although viral RNA was detected in the spleen, no evidence of viral replication was seen in this organ. The patient was treated with an antiviral agent for 2 days before death, which could have lowered the level of viral replication in the examined tissues. However, we still found viral mRNA in lungs and intestines, indicating that the viral replication was still ongoing. Viral replication in lungs and intestines was greater than in other sites. Our data agree with previous reports of human cases and cases in experimentally infected macaques, which also suggest that H5N1 influenza virus replication takes place predominantly in the lungs (10,11,21). We also show that type II pneumocytes, not columnar tracheal epithelial cells, are the major site of H5N1 viral replication in humans. Type II pneumocytes are surfactant-producing, alveolar epithelial cells and progenitor cells of both type I and type II cells. This cell type has been shown to contain sialic acid in newborn human lung (22). Whether the availability of the receptor alone determined the site of H5N1 infection needs further investigation.

Infection of the gastrointestinal tract by avian influenza virus, including H5N1, is common in avian species (23,24). However, involvement of the gastrointestinal tract in H1 and H3 influenza infection is rare in humans (25). A patient with H5N1 influenza virus infection was reported to have diarrhea as the initial symptom, which raises the question of whether the gastrointestinal tract may is another site of viral replication and shedding, similar to its function in avian species (26). In another recent report of a patient with a fatal H5N1 infection and severe diarrhea and encephalitis in Vietnam, the virus was found in a rectal swab (27). Our data confirm that H5N1 influenza virus replication can occur in the gastrointestinal tract even in the absence of diarrhea. However, we do not know the extent of viral shedding in stool in this patient. The absence of pathologic changes in the intestine, despite the viral replication, is intriguing.

The absence of viral antigen in the trachea indicated that the upper airway is probably not an active site of the viral replication. This finding is in marked contrast to the circumstances with human influenza, in which the upper respiratory tract and the tracheal and bronchial epithelium are primarily targeted (19). The predilection of H5N1 influenza virus for the lower airways may explain why detecting virus in upper airway specimens for diagnosis of H5N1 infection in humans is difficult (1). This finding also implies that specimens from the lower respiratory tract, such as sputum or bronchoalveolar lavage, would have a higher sensitivity for viral detection than an upper respiratory specimen, such as nasopharyngeal aspirates or throat swab specimens. Our data showing the absence of viral antigen in columnar epithelial cells contrast with a recently published report that H5N1 viral replication took place selectively in ciliated bronchial epithelial cells in an in vitro culture model (28). Whether this result was due to properties of specific viral strains or a difference attributable to the in vitro model needs further clarification.

In contrast to previous reports (10,11), we did not find prominent hemophagocytosis in any of the organs. The presence of hemophagocytosis in these reports supports the cytokine dysregulation model of pathogenesis. Whether the young age of our patient or prior treatment with immunosuppressive corticosteroids affected this manifestation in this patient is unclear.

TNF-α mRNA was detectable in the lungs but not in other tissues. This finding is in agreement with previous observations that H5N1 viruses isolated from human disease hyperinduce production of cytokines, most prominently TNF-α, in cultured human macrophages in vitro (20,29). The simultaneous presence of viral mRNA and cytokine mRNA in the same organ suggests a direct induction of cytokine in productively infected cells. In accordance with this finding, we also found that the viral isolate from this patient induced a high level of TNF-α production from primary human macrophages, which is comparable to the previously described strains (M. Peiris, unpub. data). However, we could not rule out the possibility that the superimposed fungal infection might have played a role in the induction of TNF-α in this patient. The hemagglutinin of the 1918 pandemic H1N1 influenza virus also appears to hyperinduce production of cytokines and chemokines in a mouse model of disease (30).

In conclusion, we have documented that H5N1 disease in humans is one in which viral replication is restricted to the respiratory and gastrointestinal tracts. The multiorgan dysfunction observed in human H5N1 disease, despite the apparent confinement of infection to the lungs, has remained an enigma. The hypothesis that cytokine dysregulation may contribute to the pathogenesis of severe H5N1 disease (20) remains a possibility. An understanding of the pathogenesis of human H5N1 disease is important in preparing for a pandemic.

Acknowledgments

We thank Kobporn Bunnak and Raweewan Khanyok for expert technical assistance.

This study was supported by a research grant from the National Center for Genetic Engineering and Biotechnology of Thailand.

Dr. Uiprasertkul is a pathologist at the Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok. His primary research interest is the pathogenesis of viral diseases.

References

Yuen KY, Chan PK, Peiris M, Tsang DN, Que TL, Shortridge KF, et al. Clinical features and rapid viral diagnosis of human disease associated with avian influenza A H5N1 virus. Lancet. 1998;351:467–71.

Subbarao K, Klimov A, Katz J, Regnery H, Lim W, Hall H, et al. Characterization of an avian influenza A (H5N1) virus isolated from a child with a fatal respiratory illness. Science. 1998;279:393–6.

Claas EC, Osterhaus AD, van Beek R, De Jong JC, Rimmelzwaan GF, Senne DA, et al. Human influenza A H5N1 virus related to a highly pathogenic avian influenza virus. Lancet. 1998;351:472–7.

Li KS, Guan Y, Wang J, Smith GJ, Xu KM, Duan L, et al. Genesis of a highly pathogenic and potentially pandemic H5N1 influenza virus in eastern Asia. Nature. 2004;430:209–13.

Grose C, Chokephaibulkit K. Avian influenza virus infection of children in Vietnam and Thailand. Pediatr Infect Dis J. 2004;23:793–4.

Tran TH, Nguyen TL, Nguyen TD, Luong TS, Pham PM, Nguyen VC, et al. Avian influenza A (H5N1) in 10 patients in Vietnam. N Engl J Med. 2004;350:1179–88.

Hulse DJ, Webster RG, Russell RJ, Perez DR. Molecular determinants within the surface proteins involved in the pathogenicity of H5N1 influenza viruses in chickens. J Virol. 2004;78:9954–64.

Hatta M, Gao P, Halfmann P, Kawaoka Y. Molecular basis for high virulence of Hong Kong H5N1 influenza A viruses. Science. 2001;293:1840–2.

Kuiken T, Rimmelzwaan G, van Riel D, van Amerongen G, Baars M, Fouchier R, et al. Avian H5N1 influenza in cats. Science. 2004;306:241.

Peiris JS, Yu WC, Leung CW, Cheung CY, Ng WF, Nicholls JM, et al. Re-emergence of fatal human influenza A subtype H5N1 disease. Lancet. 2004;363:617–9.

To KF, Chan PK, Chan KF, Lee WK, Lam WY, Wong KF, et al. Pathology of fatal human infection associated with avian influenza A H5N1 virus. J Med Virol. 2001;63:242–6.

Chokephaibulkit K, Uiprasertkul M, Puthavathana P, Chearskul P, Auewarakul P, Dowell SF, et al. A child with avian influenza A (H5N1) infection. Pediatr Infect Dis J. 2005;24:162–6.

Poddar SK. Influenza virus types and subtypes detection by single step single tube multiplex reverse transcription-polymerase chain reaction (RT-PCR) and agarose gel electrophoresis. J Virol Methods. 2002;99:63–70.

Nishimori H, Shiratsuchi T, Urano T, Kimura Y, Kiyono K, Tatsumi K, et al. A novel brain-specific p53-target gene, BAI1, containing thrombospondin type 1 repeats inhibits experimental angiogenesis. Oncogene. 1997;15:2145–50.

Richtsteiger R, Henke-Gendo C, Schmidtke M, Harste G, Heim A. Quantitative multiplex real-time PCR for the sensitive detection of interferon beta gene induction and viral suppression of interferon beta expression. Cytokine. 2003;24:190–200.

Blaschke V, Reich K, Blaschke S, Zipprich S, Neumann C. Rapid quantitation of proinflammatory and chemoattractant cytokine expression in small tissue samples and monocyte-derived dendritic cells: validation of a new real-time RT-PCR technology. J Immunol Methods. 2000;246:79–90.

Yamaji H, Iizasa T, Koh E, Suzuki M, Otsuji M, Chang H, et al. Correlation between interleukin 6 production and tumor proliferation in non-small cell lung cancer. Cancer Immunol Immunother. 2004;53:786–92.

van Golde LM, de Vries AC, Batenburg JJ. Aspects of metabolism and storage of pulmonary surfactant: experiments with isolated type II pneumocytes and lamellar bodies. Eur J Respir Dis. 1987;153:182–8.

Hers JF. Disturbances of the ciliated epithelium due to influenza virus. Am Rev Respir Dis. 1966;93(Suppl):162–77.

Cheung CY, Poon LL, Lau AS, Luk W, Lau YL, Shortridge KF, et al. Induction of proinflammatory cytokines in human macrophages by influenza A (H5N1) viruses: a mechanism for the unusual severity of human disease? Lancet. 2002;360:1831–7.

Kuiken T, Rimmelzwaan GF, van Amerongen G, Osterhaus AD. Pathology of human influenza A (H5N1) virus infection in cynomolgus macaques (Macaca fascicularis). Vet Pathol. 2003;40:304–10.

Cerna A, Janega P, Martanovic P, Lisy M, Babal P. Changes in sialic acid expression in the lung during intrauterine development of the human fetus. Acta Histochem. 2002;104:339–42.

Webster RG, Yakhno M, Hinshaw VS, Bean WJ, Murti KG. Intestinal influenza: replication and characterization of influenza viruses in ducks. Virology. 1978;84: 268–78.

Shortridge KF, Zhou NN, Guan Y, Gao P, Ito T, Kawaoka Y, et al. Characterization of avian H5N1 influenza viruses from poultry in Hong Kong. Virology. 1998;252:331–42.

Zinserling AV, Aksenov OA, Melnikova VF, Zinserling VA. Extrapulmonary lesions in influenza. Tohoku J Exp Med. 1983;140:259–72.

Apisarnthanarak A, Kitphati R, Thongphubeth K, Patoomanunt P, Anthanont P, Auwanit W, et al. Atypical avian influenza (H5N1). Emerg Infect Dis. 2004;10:1321–4.

de Jong MD, Bach VC, Phan TQ, Vo MH, Tran TT, Nguyen BH, et al. Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma. N Engl J Med. 2005;352:686–91.

Matrosovich MN, Matrosovich TY, Gray T, Roberts NA, Klenk HD. Human and avian influenza viruses target different cell types in cultures of human airway epithelium. Proc Natl Acad Sci U S A. 2004;101:4620–4.

Guan Y, Poon LL, Cheung CY, Ellis TM, Lim W, Lipatov AS, et al. H5N1 influenza: a protean pandemic threat. Proc Natl Acad Sci U S A. 2004;101:8156–61.

Kobasa D, Takada A, Shinya K, Hatta M, Halfmann P, Theriault S, et al. Enhanced virulence of influenza A viruses with the haemagglutinin of the 1918 pandemic virus. Nature. 2004;431:703–7.

Suggested citation for this article:

Uiprasertkul M, Puthavathana P, Sangsiriwut K, Pooruk P, Srisook K, Peiris M, et al. Influenza A H5N1 replication sites in humans. Emerg Infect Dis [serial on the Internet]. 2005 Jul [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol11no07/04-1313.htm

Comments to the Authors

Please use the form below to submit correspondence to the authors or contact them at the following address:

Prasert Auewarakul, Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Rd, Bangkok 10700, Thailand; fax: 66-2-418-4148; email: sipaw@mahidol.ac.th

If this paper, which is intelligible to any layman as far as we can judge, is too difficult for a Times editor or reporter to understand, they can always contact the author for further explanation – Prasert Auewarakul, Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Rd, Bangkok 10700, Thailand; fax: 66-2-418-4148; email: sipaw@mahidol.ac.th

Seems to us that even a Times reporter, even one of Wade’s baffling inability to handle a theoretical challenge to HIV over two decades, should be able to understand this sentence, at least:

TNF-α mRNA was detectable in the lungs but not in other tissues. This finding is in agreement with previous observations that H5N1 viruses isolated from human disease hyperinduce production of cytokines, most prominently TNF-α, in cultured human macrophages in vitro.

Of course, then the question becomes, what is the antidote for a cytokine storm of TNF in the lungs? According to the CDC easy guide to Avian Influenza, their staff have no idea, since the advice about treatment is no different than for regular flu:

How is avian influenza in humans treated?

Studies done in laboratories suggest that the prescription medicines approved for human influenza viruses should work in treating avian influenza infection in humans. However, influenza viruses can become resistant to these drugs, so these medications may not always work. Additional studies are needed to determine the effectiveness of these medicines.

In other words, they haven’t a clue that in the last year not one but two studies have been published confirming what other papers have already established, which is that a little Vitamin A does very nicely in knocking out this rather unpleasant phenomenon which otherwise would result in termination of the patient’s breathing ability.

This may be because nutritional factors do not interest the CDC or the Times since they have not much to do with the great engine that drives the bulk of disease research these days, the enduring hope that a profit making drug will be the answer. We have no idea, of course, whether this scurrilous speculation has any truth to it.

However, we should point out that as we have mentioned before the nutritional approach in this case is respectable to a degree that even the Times and CDC cannot argue with, namely, the Harvard School of Public Health.

The paper to refer to is Effects of Vitamin A Supplemnentation on Immune Responses and Correlation with Clinical Outcomes, from Clinical Microbiology Reviews, July 2005, pages 446-464, by the estimable Eduardo Villamor and Wafaie W. Fawzi.

If any of the staff of the Times or the CDC, or for that matter Tony Fauci or his secretary, wish to phone up Eduardo and get the gen from the horse’s mouth, his telephone is 617-432-1238. His email is evillano@hsph.harvard.edu.

Since the cost of a phone call these days is a few cents, and the potential saving to the US and the governments of the rest of the world would probably approach $10 billion, not even counting the economic loss from bird flu panic if the flu is detected in the US, let alone the lives of birds around the world currently threatened with execution though suffocation or being burned alive, and not to mention the dispiriting prospect of chicken off the menu of all but the most expensive restaurants, we hope that it will be made.

Of course, if Anthony Fauci wishes to send even a fraction of this saving our way, we will not be embarrassed.

South Park comments on the HIV?AIDS debate

March 27th, 2006

Religion and pseudo religion as enemies of free speech

Curiously appropos, HIV debunkers will surely think, when they see the November episode lampooning Scientology, in which Stan is informed by the leader of Scientology about how things really work inside the church.

This is the exchange between the leader of Scientology and the kid Stan, after Stan falls into the hands of Scientologists with their E meters, who persuade him that his reading indicates he is depressed though he didn’t know it, but then when they give him a bigger test, his score is so high that they decide he is L. Ron Hubbard reborn:

Stan: It’s not about the money, it’s about the message, right?
Leader: Wait a minute, Whoah, whoah. You don’t actually believe that crap do you? Dummy! Brainwashed alien souls! E meter and theta levels! Those people out there buy that crap but I thought you were smart enough to see what was really going on. What’s better than telling people a stupid story and havng them believe you? Having them pay you for it stupid?
Stan: But why me? Why do you need me to write something or lead you?
Leader: Because if these people all think you are the reincarnation of L Ron Hubbard, then they they’ll buy your new writings and you and I together will make $3 million.
Stan: $3 million?
Leader: That’s how a scam works! But this is a scam on a global scale! Do you f-ing get me now?
Stan: Yeah, yeah, I get you.
Leader: Then keep writing L. Ron, your people are waiting…..

(Later) Leader: Fellow scientologists, our prophet has finished his writing and he will now read it to you before making it available to you at a nominal fee..
Stan (unable to get started):…I… I… Look, I can’t do this. You know, we all want to know who we are and where we cam from. Sometimes we want to know so badly we will believe anything. I am not L. Ron Hubbard. Scientology is just a big fat global scam!
Leader: Oh. Oh. We are gonna sue you!
Stan: What?
Leader: Yes you think you can say our religion is a lie?! We are gonna sue you, buddy!
Stan: But you told me it was a lie!
Leader: Oh now you are putting words in my mouth. You are so sued! You can’t make fun of Scientology. Kid we are gonna sue your a*s and your b**ls. How dare you mock our founder you little punk! You’ll be hearing from our lawyers tomorrow.
Stan: OK sue me! Go ahead. I’m not scared of you. Sue me!

This may seem a reassuring example of free speech in action in comedy, but in digging around to try and find the entire script, we discovered that on the contrary, it seems to be an example of free speech that was soon restricted by pseudo-religion.

First the episode, Trapped In The Closet (a technically first class youtube.com feed if you have broadband), was reported by CNN and others to have triggered the resignation of Isaac Hayes last week from providing the voice of the Chef, since Hayes is a scientologist, as are Tom Cruise and John Travolta. According to the BBC Hayes objected to the ridicule of religion, a status now claimed by Scientology:

Tuesday, 21 March 2006, 14:06 GMT

South Park backs Chef for series

The 10th season of South Park will open in the US on Wednesday with a new episode featuring Chef, days after the departure of soul singer Isaac Hayes.

It will dispel speculation that the Chef character, which Hayes voiced, was to be axed after Hayes left over the show’s satirising of religion.

A recent episode parodied the Church of Scientology, to which Hayes belongs.

It is not yet clear who is providing Chef’s voice, said a spokesman for US TV channel Comedy Central.

The series, which has been running since 1997, tells the story of four boys in the dysfunctional Colorado town and regularly deals with sensitive subjects and satirises famous figures.

A synopsis of the new episode titled The Return of Chef states that the boys notice “something about Chef that seems different. When Chef’s strange behaviour starts getting him in trouble, the boys pull out all the stops to save him.”

Hayes left South Park last week, saying the show was insensitive to “personal spiritual beliefs”.

“There is a place in this world for satire but there is a time when satire ends and intolerance and bigotry toward religious beliefs begins,” he said.

Co-creator Matt Stone said Hayes would be released from his contract and had the best wishes of the South Park team.

Stone said: “In 10 years and over 150 episodes of South Park, Isaac never had a problem with the show making fun of Christians, Muslims, Mormons or Jews.

“He got a sudden case of religious sensitivity when it was his religion featured on the show.”

In a recent episode, one of the gang, Stan, did so well in a Scientology test that church followers thought he was the next L Ron Hubbard, the late science-fiction writer who founded Scientology.

Hayes did not take part in that episode, Trapped in the Closet, which was first broadcast in the autumn.

A planned repeat scheduled for last week was cancelled at the last minute in favour of two repeats featuring Isaac Hayes as Chef.

But all this may be just a prime example of the unreliability of the media these days, for this report was later corrected by Roger Friedman on Fox411 at FoxNews which reported that Isaac Hayes had not been particularly offended, and had not resigned, but that it had been done for him by some other scientologist, a woman who had issued the statement. According to FoxNews via MediaGab Hayes had a stroke three months ago and is recovering at home, which is why he has not been able to appear in South Park recently.

Friday, March 24, 2006 at 12:00 PM

From MediaGab

Actors and Actresses

Isaac Hayes may not have quit “South Park” at all – or at least not willingly. Turns out Hayes has been away from Comedy Central’s hit show for the past three months because he had a stroke.

According to foxnews.com, he’s at home recuperating and did not issue the press release which said he was quitting because the show made fun of his faith.

That release was put out by fellow Scientologist Christina “Kumi” Kimball, a fashion executive for designer Craig Taylor.

According to foxnews.com, “Hayes loves ‘South Park’ and needs it for income. He has a new wife and a baby on the way.”

In other words, someone issued a statement on behalf of Isaac Hayes which he didn’t subscribe to, and Matt Stone replied (possibly knowingly, since it would generate publicity anyway) without checking with Hayes, and other news stories were written on the basis of the first news stories, followed by a mass of comment.

Then the repeat really was pulled, courtesy of Tom Cruise.

Meantime, Tom Cruise may have gotten Comedy Central to pull its repeat of “South Park”‘s Scientology spoof last week, but the result is that episode is all over the Web. You can see it for free at youtube.com.

Not only that, the Comedy Central Web site has four clips from the 21-minute show. And it also says that “Trapped in the Closet” will air this Wednesday at 10 p.m.

So whether or not Cruise actually did use influence at Viacom/Paramount to get the show pulled from last week’s schedule, here it is, bigger and better than ever. Of course, no one would have cared one way or another if “Trapped” simply had aired on schedule.

Of course, no one could blame Cruise, John Travolta or even R&B singer R. Kelly for being upset about the episode. They are poked fun at mercilessly.

In the episode, Stan, one of the “South Park” characters, is solicited into Scientology. He gives them $240 and takes an EMeter test. This convinces the higher-ups that Stan is the reincarnation of the group’s founder, L. Ron Hubbard.

That would be bad enough, wouldn’t it? But Cruise visits Stan in his bedroom and winds up hiding in his closet when Stan tells him he’s not the greatest actor. Thus is born the line “Tom Cruise won’t come out of the closet.”

It’s repeated dozens of times. Travolta soon joins Cruise in Stan’s closet. He won’t come out, either. And when they do, there is the ecstatic announcement that they’ve “come out of the closet.”

You get the picture. But nothing in “Trapped in the Closet” is any worse than anything “South Park” creators Stone and Parker have done before. Just rent “Team America” and see what I mean.

So the pulling of the episode was apparently not even due to Hayes, but to Tom Cruise, according to Reuters. Given that the episode said quite plainly that Scientology was a scam with a stupid story, one can imagine that the entire organization was frantic to prevent a repeat:

Two days later, Comedy Central abruptly pulled a scheduled repeat of that episode, titled “Trapped in the Closet.” Sources close to the show said the rerun was canceled after Cruise threatened to boycott promotion of his upcoming film, “Mission: Impossible III,” for sister studio Paramount Pictures.

Whatever the truth of the matter, it seems clear that Scientology now has influence on US entertainment media, even as large an outfit as Viacom, through the membership of Cruise and other celebrity members. We are watching with interest to see if the scientologists take up the challenge and sue South Park for what was a straightforward depiction of their church operation as a scam.

Meanwhile the creators of South Park are digging in. So, Scientology, you may have won THIS battle, but the million-year war for earth has just begun!

‘South Park’ Battle ‘Has Just Begun’

March 18, 2006

(AP)

Quote

“So, Scientology, you may have won THIS battle, but the million-year war for earth has just begun!”

“South Park” creators Trey Parker and Matt Stone

(AP) “South Park” has declared war on Scientology.

Matt Stone and Trey Parker, creators of the animated satire, are digging in against the celebrity-endorsed religion after a controversial episode mocking outspoken Scientologist Tom Cruise was yanked abruptly from the schedule Wednesday, with an Internet report saying it was covert warfare by Cruise that led to its departure.

“So, Scientology, you may have won THIS battle, but the million-year war for earth has just begun!” the “South Park” creators said in a statement Friday in Daily Variety. “Temporarily anozinizing our episode will NOT stop us from keeping Thetans forever trapped in your pitiful man-bodies… You have obstructed us for now, but your feeble bid to save humanity will fail!”

The Internet blogger hollywoodinterrupted.com said Thursday that Cruise threatened to not promote “Mission: Impossible 3,” a surefire summer blockbuster, if the offending episode ran. Comedy Central is owned by Viacom, as is Paramount, which is putting out the film.

But Cruise’s representative, Arnold Robinson, told The Associated Press Friday that the mega-star made no such demands.

“Not true,” Robinson said. “I can tell you that he never said that.”

A call by The Associated Press to a Paramount representative was not returned Friday.

The episode in question, “Trapped in the Closet,” which first aired last November, shows Scientology leaders hailing Stan, one of the show’s four devilish fourth-graders, as a savior. A cartoon Cruise locks himself in a closet and won’t come out. An animated John Travolta, another famous Scientologist, enters the closet to try to get him out.

The battle began in earnest earlier this week when Isaac Hayes, another celebrity Scientologist and longtime show member, voicing the ladies’ man Chef, quit the show, saying he could no longer tolerate its religious “intolerance and bigotry.”

“There is a place in this world for satire, but there is a time when satire ends and intolerance and bigotry towards religious beliefs of others begins,” the 63-year-old soul singer and outspoken Scientologist said.

“Religious beliefs are sacred to people, and at all times should be respected and honored,” he continued. “As a civil rights activist of the past 40 years, I cannot support a show that disrespects those beliefs and practices.”

Stone and Parker didn’t buy that either.

On Monday, Stone told The Associated Press, “This is 100 percent having to do with his faith in Scientology…He has no problem, and he’s cashed plenty of checks, with our show making fun of Christians.”

A Comedy Central spokesman said Friday that the network pulled the controversial episode to make room for two shows featuring Hayes.

“In light of the events of earlier this week, we wanted to give Chef an appropriate tribute by airing two episodes he is most known for,” the spokesman said.

©MMVI, The Associated Press.

Abdul at least has Condoleeza and W on his side


Put this together with the latest outrage in Afghanistan where the unfortunate Abdul Rahman’s very life is in danger even though the latest report is that he is to be freed, since at least one cleric has called for him to be torn limb from limb if he is let go, and one begins to realize the roots of belief even in science may be the religious impulse.

A religious attitude where if you convert to another religion you are threatened with death, as in the case of Abdul, is not much different except in degree from the behavior of the HIV faithful when they are confronted with skepticism. Whether their behavior is appropriately described by the South Park script is another question.

Given the almost childish weakness of the HIV?AIDS paradigm in every major respect it is hard not to think it is. But since they seem to combine the insecurity of the religious when they face sharp analysis with the bullying attitude of the Scientologists, a combination of religious feeling and scam motivation is strongly suggested.

However, as we have often said, we agree with Lang that discussions of motivation are always impure speculation and that the science has to be decided on its own merits.

Hundreds protest reports Afghan convert to be freed

Hundreds protest reports Afghan convert to be freed

Monday, March 27, 2006 Posted: 1009 GMT (1809 HKT)

A source close to the case says that Christian convert Abdul Rahman “could be released soo

KABUL, Afghanistan (CNN) — Hundreds of people protested in a northern Afghan city following reports that a man who faced a possible death penalty for converting to Christianity would be released, officials said.

About 700 Muslim clerics and others chanted “Death to Bush” and other anti-Western slogans in Mazar-e-Sharif on Monday, officials told The Associated Press.

Clerics have called for protests across Afghanistan against both the government and the West, which had pressured President Hamid Karzai’s administration to drop the case against Abdul Rahman.

On Sunday, a Western diplomat and Afghan officials close to Karzai told CNN that Rahman would be released soon.

Other sources in the Afghan judiciary said the case against Rahman had been thrown out on technical grounds and sent back to prosecutors to gather more evidence.

Those same sources said Rahman may not be released.

Karzai has been under growing international pressure to find a way to free Rahman without angering Muslim clerics who have called for him to be killed.

The Afghan Cabinet discussed the case Saturday, but results of that meeting were unknown. A government source familiar with his case said on Friday he would be released in the coming days.

On Sunday, The Associated Press quoted an official as saying an Afghan court had dismissed the case against Rahman because of a lack of evidence. (Watch Washington’s view of the case — 2:05)

The official told AP the case had been returned to prosecutors for more investigation and that Rahman would be released in the meantime.

“The court dismissed today the case against Abdul Rahman for a lack of information and a lot of legal gaps in the case,” the official said, speaking on condition of anonymity because he was not authorized to speak publicly on the matter. AP said the official has been closely involved with the matter.

“The decision about his release will be taken possibly tomorrow,” AP quoted the official as saying. “They don’t have to keep him in jail while the attorney general is looking into the case.”

Abdul Wakil Omeri, a spokesman for the Supreme Court, confirmed to AP that the case had been dismissed because of “problems with the prosecutors’ evidence.”

He said several family members of Rahman have testified that he has mental problems.

“It is the job of the attorney general’s office to decide if he is mentally fit to stand trial,” he told AP.

A Western diplomat, speaking on condition of anonymity, said questions were now being raised as to whether Rahman would stay in Afghanistan or go into foreign exile, AP reported.

The judge presiding over Rahman’s case told Reuters the case had flaws and had been referred back to prosecutors. But he declined to elaborate on the flaws or say if the review would delay the trial, which had been due to begin in coming days.

“The case, because of some technical as well as legal flaws and shortcomings, has been referred back to the prosecutor’s office,” the judge, Ansarullah Mawlavizada, told Reuters.

Earlier Sunday, AP quoted prosecutor Sarinwal Zamari as saying that doctors would examine Rahman on Monday to determine whether he was mentally fit to stand trial.

“It has been said that he has mental problems,” the prosecutor said. “Doctors will examine him tomorrow and will then report to us.”

According to an interview published Sunday in an Italian newspaper, Rahman said he is fully aware of his choice and is ready to die for it.

“I am serene. I have full awareness of what I have chosen. If I must die, I will die,” AP quoted Rahman as telling the Rome daily La Repubblica.

“Somebody, a long time ago, did it for all of us,” he added in a clear reference to Jesus.

The newspaper did not interview Rahman directly but sent him questions through a human rights worker who visited him at a Kabul detention facility. Authorities have barred journalists from seeing Rahman.

U.S. Secretary of State Condoleezza Rice said she could not confirm that an Afghan court had dismissed the case and stressed the U.S. needs to respect the sovereignty of Afghanistan, which she called a “young democracy.”

“Unlike the Taliban, it actually has a constitution to which one can appeal,” she told CNN’s “Late Edition.” “We as Americans know in democracy, as it evolves, there are difficult issues about state and church — or, in this case, state and mosque.

“We expect that, given our own history, that we would know Afghans have to go through this evolution.”

Asked if U.S. Christian missionaries should be encouraged to go to Afghanistan, Rice told NBC: “I think that Afghans are pleased to get the help that they can get” but added “we need to be respectful of Afghan sovereignty.”

Rahman, 41, faces trial on charges of converting to Christianity — a death-penalty offense under Afghanistan’s constitution, which is based on Islamic law.

Rahman reportedly converted 16 years ago while he was a medical aid worker for an international nongovernmental organization (NGO).

The case reflects a gulf between Afghanistan’s conservative and clerical judiciary and the fledgling Western-backed democracy led by Karzai.

“We’ve been very clear with the Afghan government that it has to understand the vital importance of religious freedom to democracy,” Rice said.

U.S. troops overthrew Afghanistan’s ruling Taliban, which had harbored al Qaeda, following the September 11, 2001 terrorist attacks on New York and Washington.

U.S. troops are still battling Taliban and al Qaeda remnants in parts of the country.

Also on Sunday, AP quoted officials as saying Rahman had been moved to a notorious maximum-security prison outside Kabul that is also home to hundreds of Taliban and al Qaeda militants.

Rahman was moved to Policharki Prison last week after detainees threatened his life at an overcrowded police holding facility in central Kabul, a court official said on condition of anonymity, AP reported.

Gen. Shahmir Amirpur, who is in charge of Policharki, confirmed the move and said Rahman had been begging his guards to give him a Bible, according to AP. (Full story)

Journalist Tom Coghlan contributed to this report.

Copyright 2006 CNN.

Rebecca keeps her poise amid Web storm

March 22nd, 2006

Canadian trained, principled and lucid


The estimable Rebecca Culshaw has written a follow up piece on Why I Quit HIV: The Aftermath.

A seasoned academic analyst and mathematician, Rebecca is a strong character who is not at all thrown by the whirl of email she received, which was often supportive as well as including the usual idiocies. The latter annoyance included the suggestion she take a shot of blood from an advanced HIV?AIDS patient to show she has the courage of her convictions. That would prove nothing, as she points out.

A few individuals kindly suggested that I inject myself with the blood of a late-stage AIDS patient. While such an act might sensationalize my viewpoint, there are a number of problems with such an “experiment.” First, I can only imagine the non-HIV contaminants that might be found in such blood. Second, the data and results contained in the literature are sufficient to cast doubt on HIV. But most importantly, such an “experiment” would hardly settle anything, given the “latency period” of 10-15 years for progression to “AIDS.”

There is something reassuring as well as admirable in the way Rebecca dispenses with the plethora of misunderstanding and misinformation that greeted her perfectly straightforward statement (see earlier post Culshaw, yet another beauty with scientific sense, speaks out). So there are people who keep their heads when all around them are losing theirs! Rudyard Kipling would be proud.

If you can keep your head when all about you

Are losing theirs and blaming it on you;

If you can trust yourself when all men doubt you,

But make allowance for their doubting too;

If you can wait and not be tired by waiting,

Or, being lied about, don’t deal in lies,

Or, being hated, don’t give way to hating,

And yet don’t look too good, nor talk too wise;

(Here is the full poem, “If”, in which Kipling continued what looks like very pertinent advice to all wavering between loyalty to their HIV dependent labs across America and the new view they may have developed recently.

If

If you can keep your head when all about you

Are losing theirs and blaming it on you;

If you can trust yourself when all men doubt you,

But make allowance for their doubting too;

If you can wait and not be tired by waiting,

Or, being lied about, don’t deal in lies,

Or, being hated, don’t give way to hating,

And yet don’t look too good, nor talk too wise;

If you can dream – and not make dreams your master;

If you can think – and not make thoughts your aim;

If you can meet with triumph and disaster

And treat those two imposters just the same;

If you can bear to hear the truth you’ve spoken

Twisted by knaves to make a trap for fools,

Or watch the things you gave your life to broken,

And stoop and build ’em up with wornout tools;

If you can make one heap of all your winnings

And risk it on one turn of pitch-and-toss,

And lose, and start again at your beginnings

And never breath a word about your loss;

If you can force your heart and nerve and sinew

To serve your turn long after they are gone,

And so hold on when there is nothing in you

Except the Will which says to them: “Hold on”;

If you can talk with crowds and keep your virtue,

Or walk with kings – nor lose the common touch;

If neither foes nor loving friends can hurt you;

If all men count with you, but none too much;

If you can fill the unforgiving minute

With sixty seconds’ worth of distance run –

Yours is the Earth and everything that’s in it,

And – which is more – you’ll be a Man my son!

In this decisive spirit Rebecca writes:

Many people insisted that I don’t know what I’m talking about because I offer no alternative explanations for AIDS. There are many alternative explanations for “AIDS,” or severe immune deficiency. The immunosuppressive effects of malnutrition, chronic drug abuse (pharmaceutical as well as recreational), parasitic infections, psychological stress, and other risks were well-established long before “AIDS” became recognized in the early 1980s. The fact is that most (but not all) AIDS patients do belong to risk groups whose members are subject to one or more of the above assaults. This fact can be checked by reading the annual CDC surveillance reports, although drug use is hidden because the CDC gives priority to “sexual transmission.” And I should point out that the correlation between positive antibody tests and immune deficiency doesn’t necessarily imply that HIV is the cause. To shamelessly steal an analogy from Peter Duesberg, just because long-term smokers often tend to develop yellow fingers along with lung cancer, does not mean that yellow fingers cause lung cancer. This is what we refer to in statistics as a “lurking variable” – correlated but not the cause, and hence confounding the issue. In any case, pointing out the flaws in an existing theory in no way obliges me to produce an alternative.

What an excellent summary, intelligible even to the legion of logic-challenged supporters of HIV that float to the surface of the Web like stunned fish when a grenade of reason is tossed into their lake. Serge Lang would be delighted that a mathematician was demonstrating the lucidity that results from good mathematical training.

One post on a blog in response is a prize specimen of rationalization in the face of failure: apparently the writer thinks that if people die from the drugs administered to them for being HIV positive, this only proves how effective the drugs were in combating the dread virus!

And finally, a random blogger at LibertyPost.org appears to be lauding the toxicities of protease inhibitors:

“And worse, she claims that protease inhibitors are killing HIV patients, ‘And the leading cause of death in HIV-positives in the last few years has been liver failure, not an AIDS-defining disease in any way, but rather an acknowledged side effect of protease inhibitors, which asymptomatic individuals take in massive daily doses, for years,’ when that’s exactly what you would hope for (mortality drastically decreasing to the point that more deaths were the result of side effects) if protease inhibitors were in fact EFFECTIVE treatment for AIDS.” posted on 2006-03-03

However, it is unpleasant to see that even a mathematician has to worry about losing work if she refuses to join in what she has concluded is a superstition.

Many people inquired what impact the article would have on my job or career. I have not quit my job, nor have I been fired (so far). I’ve simply abandoned one area of research – I doubt I’ll ever be able to publish in mathematical biology again, but that was the risk I knew I was taking. Thank you all for your concern.

Let’s note that she is careful not to state the university in Texas where she is now an assistant professor. Her lack of confidence in her mathematics department’s politics is certainly no recommendation for that institution, which we hope is not Austin.

In a sane world she would state her university with pride and they would welcome the advertisement with pride in having on their faculty a young professor who is strong minded enough to speak up when she discerns that the officials of NIAIDS are parading past the crowd not even in their underwear, but stark naked.

Why I Quit HIV: The Aftermath

by Rebecca V. Culshaw

From LewRockwell.com

I want to start with an apology. I regret that I have not been able to individually answer every email I’ve received in the wake of my essay, “Why I Quit HIV,” which recently appeared on Lew Rockwell. I am grateful for this forum, and I hope that I will be able to clear up some confusion people appear to have experienced. I’d also like to express my gratitude for the many, many positive and indeed inspirational letters I’ve received.

Now I’d like to address some common questions I received.

Many people inquired what impact the article would have on my job or career. I have not quit my job, nor have I been fired (so far). I’ve simply abandoned one area of research – I doubt I’ll ever be able to publish in mathematical biology again, but that was the risk I knew I was taking. Thank you all for your concern.

A few individuals kindly suggested that I inject myself with the blood of a late-stage AIDS patient. While such an act might sensationalize my viewpoint, there are a number of problems with such an “experiment.” First, I can only imagine the non-HIV contaminants that might be found in such blood. Second, the data and results contained in the literature are sufficient to cast doubt on HIV. But most importantly, such an “experiment” would hardly settle anything, given the “latency period” of 10-15 years for progression to “AIDS.”

Many people insisted that I don’t know what I’m talking about because I offer no alternative explanations for AIDS. There are many alternative explanations for “AIDS,” or severe immune deficiency. The immunosuppressive effects of malnutrition, chronic drug abuse (pharmaceutical as well as recreational), parasitic infections, psychological stress, and other risks were well-established long before “AIDS” became recognized in the early 1980s. The fact is that most (but not all) AIDS patients do belong to risk groups whose members are subject to one or more of the above assaults. This fact can be checked by reading the annual CDC surveillance reports, although drug use is hidden because the CDC gives priority to “sexual transmission.” And I should point out that the correlation between positive antibody tests and immune deficiency doesn’t necessarily imply that HIV is the cause. To shamelessly steal an analogy from Peter Duesberg, just because long-term smokers often tend to develop yellow fingers along with lung cancer, does not mean that yellow fingers cause lung cancer. This is what we refer to in statistics as a “lurking variable” – correlated but not the cause, and hence confounding the issue. In any case, pointing out the flaws in an existing theory in no way obliges me to produce an alternative.

I did receive several emails from people like myself who work or have worked with AIDS every day, people who have growing doubts or who have abandoned the theory altogether. These include doctors, pharmacists, biologists and social workers.

“I volunteer in a Community Health Center, which was started twenty years ago, mainly for HIV positive people, though our clientele has expanded to all sections of our community. Also, as a former physician and then a psychiatrist, I was never able to understand this mysterious ‘disease’, and your writing has clarified a lot of that mystery.”

And there was also the following quote, from a social worker who works with HIV-positive prisoners:

“Having worked with women with HIV in a prison environment, they always seemed more scared than sick.”

The letters that particularly affected me were those from people diagnosed with HIV, or who have lost loved ones to AIDS. I have lost count of the number of people who have told me that they are convinced their friends and lovers died from AZT poisoning rather than HIV. I have nothing to offer but my utmost sympathy. I’ve received mail from people who are HIV-positive and healthy for years without any AIDS medications. I have also gotten more letters than I was expecting from people whose lives have been seriously affected by false positive diagnoses, including a man who lost his position in the military after a positive HIV test, despite being at very little risk, and despite having had malaria and numerous vaccinations. He’s out of work now.

“I am a low-low-low-low risk group guy who has been diagnosed with HIV as a part of yearly tests (military). As a hetero[sexual], monogamous (10 years with one NEG[ATIVE] partner), non-IV drug using male…I was skeptical. However the “system” is not skeptical and it has subsequently tubed my previously successful career…The fact that I have had malaria and about a billion weird immunization shots (incl[uding] Anthrax) has not been brought up as possible source of false positive.”

For everyone who has been affected by AIDS in one way or another, and for those of you who have an abiding concern about doing science correctly, please know that I read all of your letters and you are in my thoughts. What I wrote was very personal, but it was also intended to serve another purpose: the average person should be aware of all the information that exists, not just what’s been fed to us through the government propaganda machine. The individual citizen should be able to make informed choices about their health and their life. Let’s not allow overzealous, misinformed public health agencies to take away that right from us.

The article also attracted some comments from the blogosphere. The following comments appeared at a blog called Aetiology, which is owned and maintained by Seed magazine:

“That’s rich. First, as I mentioned, she’s a mathematician. I don’t know what her background is in infectious disease epi[demiology] (I contacted her but she did not respond), and she obviously shows little understanding of molecular biology in her comments about PCR (by her logic, any microbe shouldn’t cause us harm because they are so tiny).” March 9, 2006 10:43 AM

Yes, I am just a mathematician. I’ve never treated an AIDS patient, nor have I worked with HIV in the lab. But in the course of my work, I have studied both the microbiological and epidemiological aspects of AIDS, and the current HIV theory fails to explain either of these. Ever more convoluted explanations for HIV pathogenesis and epidemiology are not the signs of a mysterious virus, but rather the signs of a theory that is being shaped to fit the facts.

The following quote, as well as the quote above, indicate some confusion over what I had to say about PCR. This comes from an aspiring microbiology student:

“To understand my shock at the content of this article, you have to understand how incredibly steeped in the doctrine of the AIDS generation current education in Microbiology is. In the several years I have been working on my B.Sc, I have taken probably five courses that featured HIV or AIDS as prime examples of their precepts, have taken a course from one AIDS researcher, and have read about AIDS from several more. The idea of the AIDS virus has been one of the best known and studied examples of classical virology that we’ve ever had…I haven’t read the whole article yet, but from the part I’ve read, it seems that it’s written by a disgruntled HIV mathematician who got out of the race when she discovered that her paradigm and that of the establishment in this medical research field were radically different. From what I read, her science seems fine, except for some pretty disdainful and poorly-educated opinions on some of the best-used and most well-understood DNA techniques, such as PCR, or Polymerase Chain Reaction (the technique used by crime-scene units to amplify very small amounts of DNA so it can be identified, matched or analyzed):

If something has to be mass-produced to even be seen, and the result of that mass-production is used to estimate how much of a pathogen there is, it might lead a person to wonder how relevant the pathogen was in the first place.

First of all – to say this, a person needs to have absolutely no concept of how small DNA is, the degree of virulence of the pathogen being studied, and essentially no concept of how microbiology works. In short – a mathematician.” The AIDS “Theory.”

To be very clear, I did not mean that HIV cannot be pathogenic because it is so small, I meant it cannot be pathogenic because it is so sparse; there is so little of it to be found. I was comparing PCR to a Xerox machine, rather than a magnifying glass. We need the Xerox machine because traditional virus culture techniques fail to detect HIV. Worse yet, PCR is used to measure “viral load,” but this quantitative use of PCR has never been validated. As mathematician Mark Craddock has said, “If PCR is the only way that the virus can be detected, then how do you establish the precise viral load independently of PCR, so that you can be certain that the figures PCR gives are correct?” An alarmingly simple question, when you think about it; perhaps too simple for an AIDS establishment already fully committed to “surrogate markers,” protease inhibitors and “combination therapies.”

And finally, a random blogger at LibertyPost.org appears to be lauding the toxicities of protease inhibitors:

“And worse, she claims that protease inhibitors are killing HIV patients, ‘And the leading cause of death in HIV-positives in the last few years has been liver failure, not an AIDS-defining disease in any way, but rather an acknowledged side effect of protease inhibitors, which asymptomatic individuals take in massive daily doses, for years,’ when that’s exactly what you would hope for (mortality drastically decreasing to the point that more deaths were the result of side effects) if protease inhibitors were in fact EFFECTIVE treatment for AIDS.” posted on 2006-03-03

Finally, I received a series of odd emails from a prominent government HIV researcher, which includes the following quote:

“The AIDS denialists are making some noise about you being the ‘latest PhD researcher’ to refute HIV as the cause of AIDS. The document they are citing…does not contain any new research, but only repeats a lot of the standard denialist disinformation.”

The opening of this email begins with the use of the pejorative and entirely unnecessary term “denialist,” and this was followed by an “elucidation” of various aspects of virology that I imagine were intended to persuade me to change my mind, despite the fact that the arguments given were precisely those arguments that led me to doubt HIV in the first place.

The arguments I presented were not intended to be “new research,” but rather a short summary of the rather substantive questions that scientists such as Peter Duesberg and others have raised, which have still not been adequately answered. If the AIDS establishment is so convinced of the validity of what they say, they should have no fear of a public, adjudicated debate between the major orthodox and dissenting scientists to settle the matter once and for all. Yet all the major AIDS researchers have averted such a public debate, either by claiming that the “overwhelming scientific consensus” makes such a debate superfluous, or by saying that they are “too busy saving lives.” In place of public debate, clearly politically motivated documents such as the Durban Declaration remain the establishment’s standard response to dissenting voices. Even a cursory reading of this pathetic document reveals it to be a statement of faith, designed to divert attention from dissenters at the very moment when they were threatening to expose the orthodoxy in South Africa in 2000.

To clarify an issue that has caused some confusion, it was not the mathematical models themselves that caused me to doubt HIV, but rather the scientific literature on which the models are based. Billions of dollars have been spent on HIV, and this has not led to a greater understanding of the virus, but rather to a series of unproven or incorrect speculations which have been widely trumpeted in both the scientific and lay press. Such a track record is indicative of institutional problems in modern biomedicine.

The famous Ho/Shaw 1995 Nature papers are a typical example of this phenomenon. These were the papers largely responsible for popularizing HAART (the so-called “Highly Active Anti-Retroviral Therapy”) and the “Hit hard, hit early” regime as a treatment for “HIV disease” and “viral load” as a measure of treatment success. The mathematical models used in these papers were claimed to show that HIV replicated furiously from day one – in contrast to earlier evidence suggesting it to be quite inactive. Even now, few people are aware that these conclusions were based on very poorly constructed mathematical models. Anyone who has taken a first course in differential equations can see that, if analyzed properly, the models predict the onset of AIDS within weeks or months after infection by HIV, before antiviral immunity. (For anyone interested in a mathematical refutation of the Ho paper, I refer you to Mark Craddock’s analysis. Similar criticisms have been directed at the Shaw paper.)

This example illustrates a central flaw in the HIV theory. The vast majority of the literature I’ve seen uses what is known as circular logic – you assume that something will happen, and then you mold the definitions, models, experiments, and results to support that conclusion. Craddock describes a typical example of circular logic in the Shaw paper:

“They are trying to estimate viral production rates by measuring viral loads at different times and trying to fit the numbers to their formula for free virus. But if their formula is wrong, then their estimates for viral production will be wrong too.”

Such tactics, by definition, are excellent at maintaining the façade of a near-perfect correlation between HIV and AIDS, and of providing seemingly convincing explanations of HIV pathogenesis. But the resultant science does little to expand our actual understanding.

To fully appreciate how such tactics became common, one needs to revisit the beginning of AIDS science. In 1984, HIV was announced as the cause of AIDS at a press conference before any supporting literature was published and had a chance to be critiqued by the scientific community. By the time the supporting papers were published, the lay press had all but declared HIV to be “the AIDS virus,” and debate in the scientific arena was squelched. The current commonly used orthodox tactic of arguing by intimidation and forcing the conclusions to fit the facts became entrenched. Consider the time period in the scientific literature, when HIV went from being “the probable cause of AIDS” (1984) to simply “the cause of AIDS” (1985). What changed? What happened to make scientists come to such certainty? If you look at the actual papers, you’ll see quite clearly that the answer is: Nothing.

Returning to the Ho/Shaw papers, these have essentially been debunked by both establishment and dissenting researchers, on biological as well as mathematical grounds; they are now acknowledged to be wrong by the scientific community, and it remains a mystery how they were ever able to pass peer review in the first place. It is often asked, “Why should we care at this point? Those papers are 11 years old; our understanding has progressed since then.” The short answer is that “viral load” and combination therapies are used to this day, despite the fact that they were originally based on these incorrect papers. Although current therapeutic regimens have been scaled back from the “Hit hard, hit early” dogma that was popular ten years ago, the fact remains that a large population of people have been, and continue to be, treated on the basis of a theory that is fundamentally unsupportable.

Yet there is another answer to this question which is even more fundamental. It is a curious fact that few HIV researchers seem to be bothered by the events surrounding the Ho/Shaw papers. You might imagine that people might “care at this point” because of concern over the integrity of science. You might imagine that people might feel an urge to discuss how the papers got published, and if other such mistakes have happened since that time. You might imagine that the failure of the peer review process to detect such patently inept research would send off alarm bells within the HIV research community.

You would be wrong.

HIV researchers know the Ho/Shaw papers are wrong, yet they continue along the clinical path charted by the papers. They know that the quantitative use of PCR has never been validated, yet they continue to use “viral load” to make clinical decisions. They know that the history of HIV/AIDS is littered with documented cases of fraud, incompetence, and poor quality research, yet they find it almost impossible to imagine that this could be happening at the present moment. They know their predictions have never panned out, yet they keep inventing mysterious mechanisms for HIV pathogenesis. They know many therapies of the past are now acknowledged to be mistakes (AZT monotherapy, Hit hard, hit early), yet they never imagine that their current therapies (the ever-growing list of combination therapies) might one day be acknowledged as mistakes themselves.

As a final thought, I am often asked, “How could medicine have made such a big mistake? How could so many people be wrong?.” I believe the answer lies in the disintegration of scientific standards that have resulted, in large part, from the changing expectations of academic scientists. I’m an assistant professor, and my father is also a professor in the physical sciences, so I have had plenty of opportunity to see exactly how research expectations affect the quality of work we produce. It is clear to me that the pressure to obtain big government grants and to publish as many papers as possible is not necessarily helping the advancement of science. Rather, academics (and in particular, young ones) are pressured to choose projects that can be completed quickly and easily, so as to increase their publication list as fast as possible. As a result, quality suffers.

This lowering of scientific standards and critical thinking has been apparent in many aspects of research for some time, and after several generations of students, it is now beginning to infiltrate the classroom – the textbooks and the undergraduate curriculum. It is germane at this point to indicate that many of the common arguments presented in response to the queries of HIV/AIDS skeptics are essentially some form of appeal to the use of low standards. (For example, “You don’t need a reference that HIV causes AIDS,” “The fact that HIV and AIDS are so well correlated indicates that it must be the cause,” “HIV is a new virus, and new viruses will meet new standards,” “Koch’s postulates are outdated and don’t apply in this day and age,” “We don’t need to worry about actual infectious virus, viral ‘markers’ should suffice,” or “Real scientists do experiments; they don’t write review articles on the literature.”) All of these observations are eloquently summed up, again by Craddock:

“Science is about making observations and trying to fit them into a theoretical framework. Having the theoretical framework allows us to make predictions about phenomena that we can then test. HIV “science” long ago set off on a different path…People who ask simple, straightforward questions are labeled as loonies who are dangerous to public health.”

It is this decline in scientific standards that I point to, when I am asked how so many people could be so wrong. Given the current research atmosphere, it was almost inevitable that a really, really big scientific mistake was going to be made. But we can still have hope for the future – hope that institutional and political pressures will no longer continue to cost lives, and hope that we will soon see honest dialogue and debate, free of name-calling and intimidation.

March 21, 2006

Rebecca V. Culshaw, Ph.D. [send her mail], is a mathematical biologist who has been working on mathematical models of HIV infection for the past ten years. She received her Ph.D. (mathematics with a specialization in mathematical biology) from Dalhousie University in Canada in 2002 and is currently employed as an Assistant Professor of Mathematics at a university in Texas.

Copyright © 2006 LewRockwell.com

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How scientists block dissent from the media in HIV?AIDS

March 20th, 2006

Why journalists should be permitted to give their individual judgement

The expertly handled Lia Miller media piece last Monday An Article in Harper’s Ignites a Controversy Over H.I.V.:

The New York Times

March 13, 2006

An Article in Harper’s Ignites a Controversy Over H.I.V.

By LIA MILLER

In his last issue as the editor of Harper’s Magazine, Lewis Lapham has left a parting gift for his successor: a firestorm in the media and among AIDS researchers.

The source is a 15-page article in the March issue, titled “Out of Control: AIDS and the Corruption of Medical Science,” by Celia Farber. Ms. Farber, a longtime magazine journalist, has been a polarizing figure because she has frequently written about the position of “AIDS dissidents,” who argue that H.I.V. does not cause AIDS.

The Harper’s article centers on a clinical trial in Uganda for the drug Nevirapine that was later criticized for poor methodology and treatment of some test subjects. But the final third of the article focuses on the tangentially related topic of Dr. Peter Duesberg, a professor of molecular and cell biology at the University of California, Berkeley, and a leading AIDS dissident, and his strained relationship with the National Institutes of Health.

Soon after the article’s publication, rebuttals to Dr. Duesberg’s theories and to other aspects of Ms. Farber’s article were posted on Web sites like The Nation (www.nation.com) and www.poz.com. A 37-page document, written by eight prominent AIDS researchers, was posted on the Treatment Action Campaign Web site (www.tac.org.za), a group that campaigns for greater access to H.I.V. treatment in South Africa. Harper’s received a surge of letters and phone calls.

Roger Hodge, who will succeed Mr. Lapham at Harper’s next month, said that Mr. Lapham initially assigned Ms. Farber an article about Dr. Duesberg’s cancer research, but the assignment was changed when news of the drug trial broke. Mr. Hodge edited the article.

“We knew, of course, that everyone would be upset,” he said, adding that the article was thoroughly fact-checked. “This is a very contentious subject. We have gotten some very, very thoughtful responses. But other pieces have generated a lot more mail.”

John P. Moore, a professor of microbiology and immunology at the Weill Medical College of Cornell University and one of the authors of the Treatment Action Campaign’s rebuttal, said he was shocked when he first saw the article. He said it seemed apparent that Mr. Hodge wanted to “teach the controversy” of Dr. Duesberg’s ideas, a controversy that he said AIDS researchers had resolved long ago. He added that Harper’s reputation had “taken an irreparable hit.” Dr. Duesberg didn’t immediately return a phone call seeking comment.

Benjamin Ryan, an editor at large at HIV Plus magazine who writes a monthly health column on Gay.com, said he had lost faith in Harper’s. He said, as did many scientists, that the article was poorly fact-checked and had glaring errors.

Ms. Farber says that neither she nor Harper’s endorse Dr. Duesberg’s position, but that she is simply reporting on an unpopular view. “People can’t distinguish, it seems, between describing dissent and being dissent,” she said.

“I’m very familiar, since 20 years, with the hysteria end of the spectrum, the rage that breaks out when one touches certain tenets of dogma,” she wrote in an e-mail message. “Anger has been the dominant emotion in AIDS for a long time, almost the only emotion that seems to really function. Anger is connected to fear. I understand it. I’m used to it. I hope we can transcend it.”

Mr. Hodge said the magazine stood behind the article and Ms. Farber.

“The fact that she’s been covering this story does not make her a crackpot — it makes her a journalist. She’s a courageous journalist, I believe, because she has covered the story at great personal cost.”

* Copyright 2006The New York Times Company

was interesting for what it revealed about the way reporters have been handicapped in covering the HIV?AIDS dispute by a clever Catch-22 used on them by those trying to escape scrutiny of the paradigm.

The New York Observer with its usual smarts fastened onto that aspect in a Daily Transom comment on Celia Farber in Harper’s, which highlighted a problem which has long corrupted HIV?AIDS journalism: print reporters operate with one hand tied behind their back when they investigate issues in the science of HIV?AIDS. Even after twenty years, during which they build up exceptional expertise and instinct for truth in this area, they have to be careful to maintain the stance of “objectivity”, and not express any opinion of their own as to which side is right.

Ms. Farber says that neither she nor Harper’s endorse Dr. Duesberg’s position, but that she is simply reporting on an unpopular view. “People can’t distinguish, it seems, between describing dissent and being dissent,” she said.

What could possibly have confused people about the difference between description and outright dissent?

The one thing we do know, “categorically,” is that the myths that have sprung up from Africa about AIDS are “positively absurd,” [Farber] exploded, citing theories that HIV is rampantly spreading AIDS throughout Africa. “this really lifts off into science fiction.” […] “I suspect “they” got to him [Nelson Mandela]–Jimmy Carter and all those believing AIDS is pandemic in Africa, Black Africans know that to be loved by the West, you talk their line all the way–especially on AIDS.”

—Interview with Celia Farber, Dec 1, 2005, The Townsend Letter for Doctors and Patients.

Celia Farber: Has the Dissenter Become the… Dissentee?

The March Harper’s carries a piece by Celia Farber, who has written about AIDS—and HIV denialists such as Peter Duesberg—for 20 years. Says today’s New York Times:

Ms. Farber says that neither she nor Harper’s endorse Dr. Duesberg’s position, but that she is simply reporting on an unpopular view. “People can’t distinguish, it seems, between describing dissent and being dissent,” she said.

What could possibly have confused people about the difference between description and outright dissent?

The one thing we do know, “categorically,” is that the myths that have sprung up from Africa about AIDS are “positively absurd,” [Farber] exploded, citing theories that HIV is rampantly spreading AIDS throughout Africa. “this really lifts off into science fiction.” […] “I suspect “they” got to him [Nelson Mandela]–Jimmy Carter and all those believing AIDS is pandemic in Africa, Black Africans know that to be loved by the West, you talk their line all the way–especially on AIDS.”

—Interview with Celia Farber, Dec 1, 2005, The Townsend Letter for Doctors and Patients.

“Everybody who was wrong got journalism awards. Everybody who was right got all but driven from the profession,” Farber said.

Farber exposed the conspiracy between profit-hungry drug companies, researchers who wanted more funding, homosexuals who didn’t want the disease to be known as “the gay plague,” and conservatives who wanted to turn back the sexual revolution.

—March 19, 2004, New York Post, “Straight AIDS Myth Shattered.”

“Suffice to say, AIDS professionals will be aghast,” Farber declares. “Unless, of course, they’ve decided to take their cash and their ribbons and helicopter off to their chalets where they can hope to live out their days in anonymity.” [Rian] Milan’s findings debunk myths that the scientific community has been spreading for 20 years.

—Nov 4, 2001, New York Post, on the publication of Rian Milan’s “AIDS in Africa: In Search of the Truth” in Rolling Stone.

I fell silent, realizing from years of reporting on this issue how futile it is to argue when the big club of HIV has been pulled out. Like the child’s game of rock, paper, scissors, HIV is always the rock and the scissors.

—Celia Farber, 1998, Mothering, “AZT Roulette.”

March 13 05:58 PM | Filed as: Media

Comments

Celia Farber’s claims of objectivity and commitment to journalism – that her job is to “ask questions” – is about as sincere as Pat Robertson claiming the same of the homosexual lifestyle. At least Robertson wears his bias proudly on his chest.

Farber is a crank, a sad excuse for a journalist and unfortunately for the Harper’s fact-checkers, a patent liar – always has been on the HIV/AIDS topic. There are purveyors of misleading information – she is not one of them. Farber just outright lies. She treats scientific facts surrounding HIV/AIDS with the same care a termite does a piece of wood – she hacks it up, leaving nothing but a pile of unrecognizable shavings.

Many people have lost their lives by her words. She’s pathetic.

Posted by: Kate | March 13, 2006 07:55 PM

It is ludicrous for Farber to suddenly proclaim in 2006 that she is only the messenger. She has written on and argued for the denialist position for at least a decade and half. She wrote about nothing else in SPIN Magazine for years. There was never any question that she was espousing her own views. No one should be surprised by this new claim of being the messenger though. Her writing has been blatantly dishonest and misleading from day one. Like her apparent mentor Peter Duesberg, she simply ignores the principles of science, hiding all evidence contrary to her views while spotlighting the few specks of data that seem, at least to the untrained eye, to bolster her case. I have come to believe that HIV denialism, like Holocaust denialism, is a mental illness deeply rooted in problems accepting authority and an inability to admit error. Though sometimes harmless, in matters as grave as AIDS it has become criminal behavior resulting in the loss of thousands of lives.

Posted by: Martin Delaney | March 14, 2006 06:41 PM

what I loved was Harper’s editor Rodger Hodge telling the Times about the great personal cost to Farber of her “brave” reporting….really, Rodger? A greater personal toll than, say, losing both parents to AIDS, as more than 10 million African children have? Rodger Hodge, Rick MacArthur, and Harper’s should be ashamed of themselves.

Posted by: Anonymous | March 15, 2006 09:34 AM

Celia Farber is an extraordinarily gifted journalist who has had the temerity to report on an amazing scientific controversy that the national media and HIV/AIDS agencies would prefer to ignore or dismiss. This is the fact that some highly qualified scientists, including retrovirologists and Nobel laureates, believe that evidence is lacking that HIV causes AIDS. In reporting on the other side as well in the AIDS debate, Ms. Farber has acted as a truly objective journalist should and performed an outstanding public service. Her writings have helped to compensate for the extremely onesided party-line reporting that has typified the AIDS issue. Her article in Harper’s is a masterpiece that exposes the corruption in AIDS research and should merit the author a Pulitzer prize.

Posted by: Robert Houston | March 15, 2006 01:29 PM

What is the point of the Transom piece? Is it that sympathy for one side disqualifies one from writing about an issue? Then there would be no qualified journalists on anything, and HIV believers likewise should be silenced. Or was the point that journalists or editors who have a personal opinion on a scientific issue should issue conclusive scientific endorsements? This would be equally absurd.

The first three commentators engaged in scurrilous smear-tactics typical of HIV activist groups, which have become little more than goon squads for the government and the drug companies which finance them. One of the commentators leads a group – is it Project Misinform? – that is heavily bankrolled by the makers of HIV drugs. He speaks of “the loss of thousands of lives” from “denialism” when the nearly universal feature of longterm AIDS survivors has been refusal to take the drugs. In Lederer’s article in the current POZ (April), Joseph Sonnabend, M.D., founder of AMFAR, charges that “1200 mg a day of AZT (the first approved dose in the ’80s) killed thousands, as did so-called early intervention.” It was not Peter Duesberg but Robert Gallo who ignored the principles of science by announcing in 1984 that HIV was the cause of AIDS though it was absent in 64% of the AIDS patients he tested.

Posted by: Diogenes | March 18, 2006 02:10 PM

That last comment about the absence of HIV in most AIDS patients was a bit startling so I checked it out. The discovery paper for HIV (then called HTLV-III) states in the abstract: “Retroviruses… designated HTLV-III were isolated from…26 of 72 adult and juvenile patients with AIDS” (R.C. Gallo et al. Science 224:500, May 4, 1984). That’s only 36%, meaning that HIV could not be found in 64% of AIDS patients. To claim it the cause of AIDS on such a flimsy basis is a violation of Koch’s first postulate, which requires that the putative pathogen be found in all cases of the disease. This means that the “denialists” are correct: HIV failed the basic scientific principle for establishing causation.

This was one of the many striking points raised by Prof. Peter Duesberg in his critiques of the HIV theory. I have read several of his papers on AIDS and found them to be thoughtful, comprehensive, and meticulous in reviewing the data. Rather than “hiding all evidence,” as Mr. Delaney falsely claims, Duesberg examines it with respect to established scientific principles. His June 2003 paper (J. Biosci.) showss in Table 4 how the 17 claims of the HIV theory have each been disproven. In checking his references, I found they always accurately supported his statements. Ms. Farber’s quoted statements also ring true and are a refreshing change from the standard “group-think.”

Posted by: Researcher | March 19, 2006 02:17 PM

We have to agree with this, insofar as it points to a handicap of the few critical HIV?AIDS reporters which the defenders of HIV?AIDS have always taken advantage of, which is the absurdly blanket rule that all reporters (and editors) on the topic should be ‘objective’, and merely report on the two sides of the issue in a balanced fashion and refrain from coming to any conclusion of their own, but let the reader make up his or her mind.

The unbiased reporter

The comments provoked by this stricture are among the best so far. We like Diogenes’ comment best:

What is the point of the Transom piece? Is it that sympathy for one side disqualifies one from writing about an issue? Then there would be no qualified journalists on anything, and HIV believers likewise should be silenced. Or was the point that journalists or editors who have a personal opinion on a scientific issue should issue conclusive scientific endorsements? This would be equally absurd.

The first three commentators engaged in scurrilous smear-tactics typical of HIV activist groups, which have become little more than goon squads for the government and the drug companies which finance them. One of the commentators leads a group – is it Project Misinform? – that is heavily bankrolled by the makers of HIV drugs. He speaks of “the loss of thousands of lives” from “denialism” when the nearly universal feature of longterm AIDS survivors has been refusal to take the drugs. In Lederer’s article in the current POZ (April), Joseph Sonnabend, M.D., founder of AMFAR, charges that “1200 mg a day of AZT (the first approved dose in the ’80s) killed thousands, as did so-called early intervention.” It was not Peter Duesberg but Robert Gallo who ignored the principles of science by announcing in 1984 that HIV was the cause of AIDS though it was absent in 64% of the AIDS patients he tested.

Posted by: Diogenes | March 18, 2006 02:10 PM

The laughable idea that the reporter doesn’t develop an informed view of his or her own derives from a standard practice in journalism of not using reporters who are partisan in a dispute to cover that dispute, which a priori is reasonable enough. Like judges who are related to a defendant, they must recuse themselves.

The problem is that no distinction is made between a partisan and a reporter who studies and reports on a scientific issue where the evidence backing opposing judgements about the explanation of phenomena is in dispute , ie the facts backing a theory.

The reporter who draws on many sources on both sides of such a factual dispute about the validity of a theory may well end up one of the most expert lay observers in the field. His or her opinion of which side is right becomes very valuable to those who cannot spare the time to follow the science, or may not be able to understand it without long study, but who have to make policy decisions.

But the politics of HIV?AIDS have become so twisted that it is only those who agree with the paradigm of HIV=AIDS that are allowed to express their own opinion, usually extending to disparaging those who would disagree with them.

*****************************************************

“lack of objectivity”, a rule which has had the result in the case of HIV?AIDS that those who report on the dissident view have been almost completely shut out of mainstream journalism for two decades.

*****************************************************

This places a peculiar handicap on the reporters in HIV?AIDS. The burden is that if they are sufficiently interested to thoroughly fathom the science for themselves, perhaps simply by covering it long enough in their reporting, they tend to make up their own minds about who is right, the paradigm supporters or their critics. But they are not allowed to say so without losing their license to report on the topic.

The statement “I personally believe Duesberg is right” immediately disqualifies them from being the “objective” reporters so much beloved in journalistic myth here in the US. They are seen as “biased” in favor of Duesberg’s position. For some reason, however, offering a partisan opinion is fine if they support the paradigm, which history shows those with only a shallow exposure to Duesberg’s critique tend to do, often adding a little scorn and derision of Duesberg to boot.

If you conclude Duesberg is right, you are not ‘objective’

Those reporters who decide that it is Duesberg who is the reliable scientist in this altercation have plenty of reason to do so, since his critiques are enduring, repeated over the years without having to adjust significantly to new data (with one exception, the alleged`success of the HAART regimen in helping HIV?AIDS patients live “normal lives”), validated (refereed by peers who would dearly love to contradict him but apparently cannot do so effectively and so fail to stop publication of his papers in reputable journals) and are in effect endorsed by more hostile examination than any of the conventional papers in the field. They are treated differently, however. People with this judgement don’t get hired because they are not “objective” ie biased in favor of the consensus.

This seems a total misapplication of the standard rule of US journalism that reporters should not be involved in the politics of a field they cover, and should not take sides in a political dispute they report lest they be accused of “lack of objectivity”, a rule which has had the result in the case of HIV?AIDS that those who report on the dissident view have been almost completely shut out of mainstream journalism for two decades.

On the other hand, the evident bias of Larry Altman, Nicholas Wade and other science reporters and editors at the New York Times should have been questionable according to the conventional journalistic view, since they chose sides in a dispute with equal professional credentials on both sides (if anything, Peter Duesberg with his impeccable record, exceptionally generous NIH funding and early membership of the National Academy was in fact superior in reputation to Robert Gallo). But they have felt perfectly fine hewing to the paradigm position, and no one has criticized them for being partisan.

It is not only this one-sided license which is wrong. It is also the fact that the topic is science, which is meant to be a non-political activity. In political or social disputes, editors may well wish to hire reporters who are not taking part in the theater they are covering. But this is science we are reporting.

Of course, the thinking probably goes along these lines: the HIV?AIDS paradigm supporters quote the most established scientists in senior positions, and credit the majority opinion in the field. This is what editors prefer. Thus it seems perfectly OK for Times reporters to go along with those in power and support the conventional view in a scientific dispute. After all, what better sources could they use than those at the top of a field?

But in the case of HIV?AIDS, the paradigm skeptic Duesberg and many of his top supporters are equally well or better qualified as a reliable source. There are few if any better qualified than Peter Duesberg to make a good judgement on the paradigm issue. Not only is he clearly an exemplary scientist, since his work won him awards, golden boy funding from the NIH, a seat in the Academy at an early age, and even talk of him qualifying for the Nobel in the letter column of Nature, but he has never been accused of lowering scientific standards, or publishing questionable papers, as both Robert Gallo and David Baltimore, his chief opponents in the matter, have been.

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What is tragic is that they may be defending the paradigm at the cost of their own lives.

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And of course he has studied the whole question a lot longer and more thoroughly perforce than his opponents, apparently believing that it is the science that is at issue and not the politics.

So why shouldn’t the Times reporters give him equal time?

We imagine it is because against all logic then they would be considered not “objective”. But how ridiculous, whatever the reason, that they should have ignored Duesberg and the critique of HIV?AIDS for twenty years, except for barely three or four short news items and a review of his book, Inventing the AIDS Virus, by an insultingly inferior scientific mind.

A scientific issue, not political

Whether HIV is the cause of AIDS is a scientific issue, not a political one. It is a scientific issue that has been intensely politicized, but it is still not a political issue. The rush of activists to the defense of the paradigm, apparently at the implicit bidding of the drug companies who fund most or all of them, according to the Harpers article, is motivated by various emotions, none of them scientific.

The defense of the paradigm by the scientists standing on top of it is also possibly motivated by politics and psychology, rather than pure professionalism or innate love of truth, because their status and remuneration are heavily dependent on it. Many accuse them of this self-interest in their judgement. No one knows if this is true, of course, and whatever their motivations, they are irrelevant to the decision of who is right, and these intense politics just interfere with real science.

Certainly AIDS activists and their political demands have interfered with HIV?AIDS science from the start, pushing to release dangerous drugs early from incomplete trials before science has validated their effect. And they are still at it, according to the piece by Farber, which mentions that most if not all major activist groups in this arena are funded by the drug companies, and always have been. What activists are most active in is defending the ruling paradigm against challenge, acting in effect as the palace guard of the HIV?AIDS scientific elite. What is tragic is that they may be defending the paradigm at the cost of their own lives.

The tragic irony for the press in its turn may be that with the oddly unbalanced demand for “objectivity” HIV?AIDS reporters at the Times and elsewhere have ended up allied with the activists in shutting out the paradigm critique. They have become palace guards for the paradigm too.

For editors in the media, following the rule of hiring only uninvolved, objective reporters to cover an issue, have seldom hired reporters who are open minded to the dissident case, but published instead the ones who follow the established paradigm line that any challenges are spurious by definition.

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If the issues in science are not to be fathomed by outsiders, especially expert, worldy and perceptive writers and reporters with no initial axe to grind themselves, how will government officials ever hope to escape being taken in by a baseless paradigm which scientists succeed in getting funded, which is what has happened in this case according to all the critics?

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Thus they too have betrayed their own interests and policy and have used the reporters who are biased, rather than the ones who are objective when they first approach the story. In the case of Nicholas Wade of the Times for example, and probably most others, they have hired and published reporters who by their own admission (recently made to us after a CUNY panel) have not recently kept up with the papers Duesberg has so carefully prepared under such intense (and therefore validating) peer review. Surely such reporters are the ones who should be doubly banned from taking sides in a scientific dispute if they have not even read the source material.

This is the giant flaw in the system that can be seen in the Lia Miller article last week, sticking out like a sore thumb for everyone to see. The sad irony is that Harper’s editor Roger Hodge and writer Celia Farber, who have set such a proud example in not knuckling under to the ignorant media consensus on HIV?AIDS and instead explored the topic for themselves and made up their own minds, as good reporters and editors do, are evidently sticking to this very rule in the current affair, even though they are the ones who should break it and firmly stand up for the validity of Duesberg’s views as they have thoroughly researched them.

Handcuffed by a misapplied rule

For as the Observer points out, given the opportunity to say to Lia Miller of the Times that Duesberg appears to them to be right, neither Celia or Harpers editor Roger D. Hodge is willing to say this. Handcuffed by the obligatory myth of “objectivity” of US journalism, even after preparing a 15 page article over two years (with Celia over twenty years seasoned experience in this area) on this disputed issue in science, they apparently feel forced to pretend they haven’t made up their own minds.

As the Transom points out, in fact Farber clearly has made a judgment, as her interviews show. And why shouldn’t she? It may not be the scientific judgement of a scientist, but it is the highly informed opinion of a perceptive researcher in the field. We see reason to believe that Roger Hodge has made up his mind too, at least on the basis of becoming well informed on the case in editing the article and getting it into a form that he, as Harper’s new editor, would have to stand behind as valid. But if the two of them have made up the minds, they don’t want to tell us, because it is not their business as journalists to be “partisan”, as Hodge has put it to us.

Not being professional scientists, they have no authority to decide for all of us about scientific questions, for sure. But after unusually careful study – which certainly in Hodge’s case was utterly objective, since as far as we know he had never heard of the issue before the first draft of the article came in – their opinion is better informed than most people outside science, and most people in it.

And if the issues in science are not to be fathomed by outsiders, especially expert, worldly and perceptive writers and reporters with no initial axe to grind themselves, how will government officials ever hope to escape being taken in by a baseless paradigm which scientists succeed in getting funded, which is what has happened in this case according to all the critics?

We for sure want to know what they think. And we don’t view it as in any way compromising their journalistic professionalism to tell us. They should be prepared to give the public guidance, since they both presumably approached the subject with impartiality in the first place, and have studied it exhaustively. In fact, they are among the best people to ask who do NOT have an axe to grind. It is the paradigm scientists and their followers who are “partisan.”

Of course the absurdity is that their opinion is anyway inherent in the article and the way it is written for all to see. The mere fact that it is assigned, and successfully written, edited and published, implies the endorsement of the writer and editor of the material as worth taking seriously as an alternative viewpoint. If Hodge didn’t believe Duesberg was making valid points which have not been answered successfuly by the defenders of HIV?AIDS, he surely wouldn’t give him so much valuable space in his magazine. Harper’s instead would also point out key defects in his position and show that he had been convincingly answered and wasn’t able to refute the replies. The article would more prominently feature people who disagreed with him and deplored his influence.

It is time for this rule in journalism to be reassessed, and for reporters to be permitted to talk as individuals about this scientific dispute without being handcuffed by those in power.

(More in Comments below)

Duesberg on the coming bird flu global catastrophe: don’t bet on it

March 19th, 2006

Jay Leno anyway has bright idea on how to ward it off

Asked to give his view of the current bird flu global megathreat, Peter Duesberg finally found time to write the following email, which he copied to a group of insiders, including the editor of Harper’s, Roger D. Hodge, Lia Miller, the New York Times business media reporter, and Dean Esmay, who put it up on his blog, Dean Esmay blog, where it has attracted a number of comments, ranging from sensible to demented.

McKiernan:

Thank you, Dean.

Peter Duesbergs words are most welcome indeed if only to point to the madness, covertness and greed within the operations of the CDC and the moneyed interest groups in the health care and big pharma industries.

3.15.2006 1:11am

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willem:

Duesberg nails it. Perhaps we need to rename the discipline; change it from “Public Health” to “Political Health” to better reflect its role and function within society. The public hype and declaratory posturing about “getting ready” has been a bit bizarre. The opening point made by Duesberg may be the most important thing we have going for us; though I’m not sure the relative terrain is quite as good as we might hope given the national problem of inflammatory diseases that currently plague our population.

I’m grateful H5N1 remains essentially a disease of birds, but I am still concerned we could yet see the recombinant we fear. Should that occur, it will be entirely it’s own thing, and it will hit human populations in exactly the way Duesberg points out that H5N1 has not. I wouldn’t hold out much hope for vaccines or antiviral drugs in the first few months of such an outbreak. It would sweep through vulnerable populations with considerable finality.

3.15.2006 1:29am

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matoko-chan (mail) (www):

lol.

another reason we won’t die of bird flu is that we aren’t kept penned up like chickens so we can spread it.

I totally agree with Duesberg.

My take on it, Waiting for Captain Trips

we need to be researching mutagenic drugs and RNAi’s that would work on all RNA viruses, even man-made ones.

like in bioterrorism.

3.15.2006 1:47am

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Mike (mail):

He echoed my thoughts regarding the susceptibility of the populations of 1918 to a flu, especially the conditions of military life and how vast numbers of, literally, herded humans were moved from continent to contintent.

Anyone ever see photos of military transports? RMS Olympic was carrying about 5,000 a trip, when as a liner she was designed to carry about 2,000. Anyone else ever hear of a “forty-or-eight”?

Those conditions just aren’t present, especially in the developed world where proper sanitation is done and potable water is in abundance.

3.15.2006 7:31am

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sherard (mail):

This is just common sense. As, frankly, is the theory that HIV does not caue AIDS. At any snapshot in time, anything is theoretically possible, but as time passes, when the expected outcome does not come to pass, the theory becomes less and less viable.

The funniest thing is the disclaimer in every article about bird flu – “health officials fear the flu may mutate and become contagious between humans”. Yeah, and until then it’s a complete nothing. And when the press has been saying that same thing for MONTHS, eventually you have to start wondering if it’s even remotely likely.

3.15.2006 8:04am

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Scott Kirwin (mail) (www):

Sorry, but I don’t buy Duesberg’s argument:

The reason why the Flu was so successful in 1918 was primarily the “terrain”, namely the millions of immuno-deficient hosts and hostesses starved and stressed by 4 years of war.

If this was true, one could assume that the most “immuno-deficient hosts” would be the elderly and the young. However the 1918 strain did not target them. Most of those who died from the disease were in their prime – a fact which terrified people at the time.

In addition the 1918 virus did not kill people directly: What killed them was the overreaction of their immune systems responding to the virus. If Duesberg’s argument was true, then those with weakened immune systems should have better survived the disease.

Unless he believes that these immune compromised people acted as carriers of the disease who exposed those with healthy immune systems that then went into overdrive and killed them…

Clarification is needed methinks.

3.15.2006 9:09am

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Eric R. Ashley (mail) (www):

Forty men, or eight horses.

3.15.2006 10:02am

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McKiernan:

Major cause of death during the 1918 pandemic was untreatable pneumonia.

3.15.2006 10:12am

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zach.:

sherard,

The funniest thing is the disclaimer in every article about bird flu – “health officials fear the flu may mutate and become contagious between humans”. Yeah, and until then it’s a complete nothing.

duh. but the fear is not an irrational one. the flu virus is tricky enough to do this. perhaps one of the reasons it hasn’t happened yet is that thousands of dedicated people around the world are trying their best to respond to this “non-crisis” and keep it contained? duesberg’s dismissal of what the H5N1 has already caused is ludicrous. it has killed several people in china and tons of birds. it has not developed the ability to jump from human to human because it has not to date recombined with a human flu virus. that doesn’t mean it can’t happen, and regardless of the unlikelyhood of such an event i don’t think it’s beyond the pale for health workers to sound the alarm and by doing so reduce the likelyhood even further.

3.15.2006 10:13am

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mariner:

I agree about the “Political Health Service”.

Other “epidemics” they’ve been flogging for years are “handgun violence” and “domestic violence”.

3.15.2006 11:06am

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Hank Barnes (mail):

Ask me if I’m worried that the sun will one day burn out.

I’m not — it’s too remote

Ask me if I’m worried that the one day a meteorite will one day strike the earth causing much harm.

I’m not — it’s too unlikely

Ask me if I’m worried that one day I will be struck down by a lightning.

I’m not — it’s too unlikely.

Ask me if I’m worried that a few Nigerian ostriches (or is it European geese?) have contracted flu-like symptoms, which will somehow mutate into a super-duper, new virus, that will be transported across continents by swarms of infected flocks of our avian brethren.

Well, NO, I’m not.

I’m sorry, it’s just bullsh%t. Wrapped in hype, surrounded by exaggeration, encased in fear-mongering, propelled by Chicken-Littles at the CDC, who enjoy scaring the populace and pharmaceutical executives who need new and exotic diseases in order to market and sell new and exotic test kits, vaccines and drugs. All the better if the massive research $$ is funded by the Gov’t, picked up by the taxpayers.

So, NO, I ain’t worried about no stupid bird flu!

Barnes

3.15.2006 12:02pm

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Mike (mail):

You got Eric. Forty men or eight horses per boxcar. Lovely. In those kind of crowded conditions, when the healthy men were breathing the air of the unhealthy, literally stacked on top of each other as they moved through military posts built from scratch to handle large numbers of men for only a few years, is it any wonder such an epidemic could sweep through them?

And is it any wonder in permanent cities with adequate sanitation and potable water there wasn’t quite the sweep?

3.15.2006 12:22pm

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Mrs. du Toit (www):

Scott,

One of the theories regarding the 1918 pandemic on “prime health” targets was that many of these men were at war in the 5 years previous.

The theory is that there was lighter strains of the flu that these guys weren’t around to get and it made them more vulnerable to the 1918 strain.

Add to that the fact that young people are generally more mobile (spreading the disease among themselves).

On the current strain, however, anything can happen. Even if WHO and the CDC are as incompetent as he suggests, that should make us more prepared than less–they can’t predict in the affirmative or the negative. Catastrophes can happen and being prepared isn’t being paranoid–it means you are less likely to appear in a news loop on FoxNews standing on your house looking like an idiot. So while I agree that there may be an irrational fear with respect to the Bird Flu, if that makes a few more thousand people have water and supplies on hand in an emergency, it will be better for them (and all of us) in the long run.

3.15.2006 1:00pm

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Hank Barnes (mail):

Yawn.

Do y’all remember the hype over Y2K? True, I ain’t a computer geek, so I’m not exactly clear what the potential apocalyptical claims were (massive economic disruptions?) or whether they materialized (I’m pretty sure they didn’t).

My take then and now is that it was B.S.

We are experiencing a bizarre medical equivalent of Y2K — where medical authorities are hyping deadly “flu-variants” or other diseases that sound bad to the average Joe, but don’t do squat.

Liam Scheff has a great article with virologist, Dr. Stefan Lanka, who reminds those ‘fraidy cats among us:

In one litre of sea water, there are over 100 million viruses of various kinds very different from each other.

Dr. Lanka, with tongue firmly planted in cheek, notes that if we continue on the same path, the CDC might pass a law requiring us to wear full-body condoms, when we take a refreshing dip in the ocean.

Barnes

3.15.2006 1:12pm

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McKiernan:

My expertise at predicting the failure of eminent catastrophic pandemic flu events increases in direct proportion to the coming of the end of the flu season. While life is uncertain, its polar opposite is certain.

3.15.2006 1:21pm

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Angel:

dear Dean, I’m really trying to write to Doc. Peter Duesberg and hoping for an answer for too long now…I wish why he could not reply to me EVER!!!

I started writing to him from the time my husband was helth and HIV positive…then I wrote to him so many times on his web site when My husband got sick…and I also wrote to him when My husband died asking for help and for some clear answer from his point of view also for my self!!!

I arrived to think that he does not want to reply…and that made me think …Why he says that the orthodoxis doctors does not want to answer to ANY question about HIV and AIDS that are not about what they believe, when he does the same???I mean I know that he should have so many eamil but I really thought that mine at that time were a little bit more Urgent…Christine also wrote me to write to him.

Now i’m wondering , by the time you are able to speak to him…can you plaese ask him why he does not reply to his email???

I’m sorry to ask you soemthing like that but I really want to write and ask him lots of things…if his problem isthe money i can also try to pay for his time…

Thank you for your help!!!

PS: Is his email the one that you find on his web site???

Ciao

Take care

3.15.2006 5:34pm

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Dean Esmay:

Yes, his email is public. Yes he is busy but he does answer most emails. It may be that your English is not so good… I know he reads six languages, perhaps you should try something other than English?

But I would note that Duesberg could only guess on what happened to your husband. We know that people die from immune failure, no one has denied this. We also know people have died from the medications used to treat HIV–no one denies this anymore either. There are people with catastrophic immune failure who are HIV-, and no one denies that (although few seem very interested in them or what happens to them).

3.15.2006 5:51pm

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karishma (mail):

Prof. Duesberg’s reply made me think of another potential reason why there’s so much hype about an imminent flu pandemic.

People are just too well nourished these days, and thus have optimally maintained immune systems, for microbes to attack more than just the fringes of the ever growing human herd. That in fact is their historical share.

People most at risk of dying from the flu are those with weak immune systems – the young, the old, and those with diseases / treatments that weaken the immune system.

Since we are currently seeing a huge number of health-obsessed baby booners enter that ‘old’ category (age >65 is the std cutoff), they are naturally worried about anything that could disproportionately affect them. The fact that the rest of us would be far less affected is not much consolation, I guess…

3.15.2006 8:04pm

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Mike (mail):

But karishma, the conditions that encourage epidemics are not present in the developed world, with adequate heat and sanitation and nutrition for the vast bulk of the population.* And that really is the kicker, as the easy access for a disease to besiege the human system is not there as it was for all human history, up until this century.

Outhouses were once standard, but are gone, except for those who camp in rustic campsites. As an example.

*Lack of nutritious food is not the problem now.

3.15.2006 8:24pm

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Vic Stein (mail):

“People most at risk of dying from the flu are those with weak immune systems – the young, the old, and those with diseases / treatments that weaken the immune system.”

Of course! That’s why so many people with otherwise robust immune systems died in 1918: because they were secretly taking AZT!

If Duesberg is one thing, it’s consistent. Consistently narrow about how every single disease must work: all conforming to the same neat little box. From reading him, you’d think that there is such a thing as a universally “robust” immune system that is simply impregnable, making the contraction and spread of disease rare and impossible.

Fact is, the fact that the CDC is excitable (and, to be fair, a lot of the warnings they issued spurred people into actions that helped stop the spread of feared, but over-hyped disease) isn’t really a particularly relevant issue when looking at any individual pathogen and its potential for havoc. Still, I remain unconvinced that bird flu is any particular worry at the moment.

3.16.2006 5:13pm

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Dean Esmay:

Vic: Did people with otherwise robust immune systems die of the 1918 flu? I’ve not seen evidence of that. Yes it was a lot of young people, but we had poorer nutrition, poorer sanitation, people in living conditions that would be considered uncivilized today, and we had medical practices that often didn’t make sense (like, doctors and nurses would wear medical masks with the noses exposed because they thought you couldn’t get infected through your sinuses–really).

And I don’t see anything to suggest that Duesberg believes there is such a thing as a universally “robust” immune system, merely the view that for an infectious microbe to ravage a population, probably that population has to have some immune problems already–poor nutrition, poor sanitation, crowded living conditions, and so on.

If you think that’s wrong, I’m curious: can you name an infectious epidemic that ravaged a huge percentage of the population that did not fit that description–i.e. poor sanitation, poor nutrition, crowded living conditions, etc.?

3.17.2006 4:18am

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Angel:

Dear Dean,

Maybe YOU are RIGHT…YOU FINALLY GOT THE PROBLEM!!!

Only, stupid person,foolish,thick-headed, dumb, fool, idiot person LIKE YOU are can UNDERSTAND what I write and want to say!!!

Is MAYBE for that Reason that you were able to answer to my message???

I really am shokked about all the stupidity,nonsense, stupid remark that I read in your KIND Reply to my message!!!

I will NEVER let you offend myself or any one in my life.

You do not even KNOW WHO I’m, You do NOT KNOW WHAT I want and wanted to ask to Dot. Peter Duesberg, How could you!!!

For sure my English is not good, I know that…It’s not my language, are you able to WRITE AND SPEAK ITALIAN, FRENCH and Spanish Like ME???!!!

I really am very confused about people like you, I just want to tell you that you are RUDE, IMPOLITE, Bad Mannered, ILL-BRED.

I just asked you a suggestion to how comunicate with Dot Peter Duesberg.

I NEVER TOLD YOU WHAT I WANT TO ASK TO HIM…NEVER!!!

…You are looking for intellingent people to speak with…but how intelligent are you giving these kind of reply to people that you DO NOT KNOW!!!

Maybe Dot. Peter Duesberg is not interested in what I have to ask to him…but He is and he will be always a perfect polite human been…

and this type of Class, quality is not something that you can BUY…reading all the books that you read!!!

Whatever…I’m just here spending too much time writing to YOU and it does not worth it!!!

Sincerely

3.17.2006 6:05pm

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Dean Esmay:

You are taking offense at something you should not take offense at, Angel. I am being honest with you and making a sincere suggestion. And I do have some idea what you want to ask him since you have described it in the past.

I am sorry if you are offended, but, your English is sometimes hard to understand. Dr. Duesberg speaks 6 languages. You might try writing to him in French, which I am pretty sure he reads, and possibly he knows Italian but I’m not sure.

3.17.2006 10:23pm

The Duesberg flu comment is interesting for a number of reasons. In the first place, it appears he was a pioneer in the genetic analysis of the flu virus, so he speaks with some authority. Unfortunately, he doesn’t answer the $7 billion question, which is how likely it is that the virus will mutate into another version which will attack humans as lethally as the 1918 flu. Of course, no one knows this, and no one will as long as the WHO runs an exclusive data base on the topic.

Judging from what we have seen in the relatively few humans reportedly struck down so far by the non-mutated version, this will be because it generated the immune overreaction or cytokine storm in the lungs which causes you to suffocate from TNF (Tumor Necrosis Factor), and the description of the 1918 flu (fast death in 24 hours from “pneumonia”, which doesn’t normally act so quickly) suggests this is what happened then.

Duesberg doesn’t appear to be aware of this finding which is plentiful on PubMed as we have pointed out earlier, and instead simply accounts for the lethality of the 1918 flu by saying that it was the result of immunodeficiency from the starvation and stress of war, which as one commentator points out may not be good enough.


The reason why the Flu was so successful in 1918 was primarily the “terrain”, namely the millions of immuno-deficient hosts and hostesses starved and stressed by 4 years of war.

Secondarily, one can speculate that the 1918 flu strain may also have been a “new” recombinant to the 1918 population and thus more successful than a more established seasonal strain may have been. As I found in 1968, flu, unlike practically all other animal viruses, has multiple RNA segments, equivalent to multiple chromosomes and thus can readily form new recombinants – the reason why we have seasonal flus, but have measles, mumps, polio, pox etc. only once in a lifetime.

His third point is that the CDC does not have a good record predicting epidemics, and is unlikely to be any better at it with this one. What we need to know is how often the virus mutates in the lethal direction, and it seems clear that no one does. Apparently this variant has been around for eight years at least without turning infectious to humans, and flu hasn’t produced a lethal variant of this type since 1918, so presumably the chances are low and may be negligible. We need research to tell us what the chances are, if it can. Apparently with only one precedent in history, it cannot, though.

Thirdly, the odds that the Centers for Disease Control alias World Health Organization ever predicts an epidemic prior to its arrival are not good: They have predicted in past several years numerous epidemics or “pandemics” such as the flu, the hanta-virus, anthrax, the rotavirus, the Ebola virus, the West Nile virus, “mad cow” epidemic, the Sars-virus epidemic, an epi-pandemic of “random, eg. heterosexual non-drug user-AIDS” – but none of these ever materialized (see, Inventing the AIDS Virus, Regnery publishing, Washington DC, 1996). The last one that came close to an epidemic was polio in the 1950s and that was not predicted by American public health scientists.

Fourth, the currently hyped prospective Flu pandemic has long missed its chances. It has been hyped almost daily in the San Francisco Chronicle since November. But all that happened was a dead chicken in Nigeria, a hamster in Germany, two sick (dead?) kids in Turkey, a euthanized swan in Sweden, several dead or euthanized chicken in Iraq (Yes Iraq!!) etc. That is not the pattern of a potential killer microbe. All “new” killer viral or microbial epidemics of the past have spread exponentially within weeks to months and then declined exponentially owing to the induction of immunity or death of susceptible hosts – take Albert Camus’ “Plague” as a classical example.

The current Flu propaganda is thus a mix of ignorance and and self-interest and an exploitation of general ignorance by the CDC, WHO, the vaccine, pill and test-kit manufacturers of our universities and pharma companies, and of our “science” journalists, who need to fill their daily columns – and must sell their aging vaccine stocks before they decompose and their Tamiflu pills before the summer.

But despite hyping in dozens of microbial Godots – no Godot has come since polio. People are just too well nourished these days, and thus have optimally maintained immune systems, for microbes to attack more than just the fringes of the ever growing human herd. That in fact is their historical share. The 150 million+ Flu pandemics are hype for fund raising by the ever more costly science/health armies in search for real enemies. Their success is based on the invisible monsters of the microbial epidemics of the (earlier) times, when nutrition lacked vitamins, proteins and sanitation or was lacking all together – and on the never failing microbial and viral horror phantasies of our science writers, politicians and Hollywood producers.

Regards, Peter.

The idea that we are all well nourished these days and therefore immune to a 1918 type flu seems to be well founded. Flu travels around the world in normal circumstances and kills nearly 40,000 in the US annually, we are told. In fact, as Peter Doshi has shown, this figure is probably wildly exaggerated, possibly by one hundred times. If the flu variant which invades people retains the characteristics of H5N1 ie the same lethal TNG generating effect of the 1918 flu, it will presumably suffocate those with vitamin-poor nutrition, if Vitamin A levels really are the key that two studies so far have found (see earlier posts). But it won’t badly affect those with plenty of the vitamin in their nutrition, it seems clear, according to those studies.

Distributing extra doses of Vitamin A to the poorly defended would not be a Herculean task. There is an established aid program doing just that in many countries, rescuing the very young from a deficit of that vitamin which causes other ailments. This infrastructure is already in place in nearly a hundred countries.

So we agree wholeheartedly with Duesberg’ complacency in the face of this gigantic scare, on which so much is being spent to avoid what many are now saying will be a total economic and social shutdown lasting many weeks, unless half the bird population of the planet is executed in time.

Certainly the media are coming out of this one just as badly as they have in HIV?AIDS over two decades, exposed as entirely the slaves of ignorant scientists (ones who don’t even read their own literature) and their friendly aides, the scaremongering officials who play the public in exactly the way the other article in Harper’s this month points out (“Viral Marketing:The selling of the flu vaccine”, the one after the Farber article, where Peter Doshi deconstructs the blatantly self-promotional pr strategy of CDC officials from their own description).

How annoying it must be for the HIV?AIDS scare promoters to find that this year their thunder is being stolen by the Bird Flu crowd. Still, NIAID director Anthony Fauci must be thankful that his budget is still pumped up when it would otherwise have been deflated by the cutting of HIV?AIDS funds this time around.

The best suggestion for warding off bird flu we have heard so far (apart from our own recommendation that you run to the corner drugstore and buy some multi vitamin pills (see ALERT – Vitamin A is probably simple antidote to bird flu, mainstream literature shows and Bird flu flap continues needlessly. The antidote is Vitamin A, it’s clear) is Jay Leno’s, which is for the Statue of Liberty to be turned into a giant scarecrow.

Surgeon Don Miller writes of Duesberg as modern Copernicus

March 14th, 2006

A ten cannon salute on LewRockwell.com may be the best short guide to the HIV?AIDS mess

Is Lew Rockwell some kind of magnet for minds tough enough to handle the HIV?AIDS paradigm controversy objectively, rather than go into hysterics over the very idea that conventional wisdom is wrong?

On February 23 a solid piece written by a surgeon, Donald Miller was posted at A Modern-Day Copernicus:

Peter H. Duesberg. Miller is a cardiac surgeon and professor of surgery at the University of Washington in Seattle. He is a member of Doctors for Disaster Preparedness and writes articles on a variety of subjects for LewRockwell.com. His web site is Donald Miller.

Apparently Miller was converted by David Rasnick in a talk that colleague of Duesberg’s gave to the 2003 meeting of the Doctors for Disaster Preparedness. He then read Harvey Bialy’s irrefutable guide to the politics and science of HIV?AIDS and cancer, where Duesberg has also upturned a popular but sterile paradigm, Oncogenes, Aneuploidy, and AIDS: A Scientific Life & Times of Peter H. Duesberg (2004).

Not only has Miller prepared what now may be the best short guide to Duesberg’s overwhelming challenge to and expose of HIV?AIDS and cancer genetics as scientifically unfounded, but he is refreshingly different from most writers of such guides: he is willing to say plainly that Duesberg is right and the “germ theory of HIV/AIDS is wrong”.

Read A Modern-Day Copernicus:

Peter H. Duesberg if you are trying to catch up with this issue rapidly, and you don’t have the Harpers Farber piece handy.

Miller has also written on evidence based medicine, in Miller DW and Miller CG. On Evidence, Medical and Legal. Journal of American Physicians and Surgeons 2005 (Fall);10(3):70-75, which concludes that “Medicine needs to develop a better understanding of the nature of evidence and of evidential proof, by emulating law’s approach to evidence. Law in turn needs a better understanding of the shortcomings of medicine’s approach to evidence.”

This and his reliable handling of the Duesberg affair suggests that his April 2, 2004 paper on “Afraid of Radiation? Low Doses are Good for You” might be worth reading by skeptics on that topic to see if there is anything to it after all. PDFs of both articles are at the Donald Miller site.

The Times talks – but only in the Business Media section – to remove the sting in Harper’s tale

March 13th, 2006


Why the basic import of Duesberg is not going to be faced soon on 43rd Street

A nicely judged, “objective”, resolutely uninvolved piece, written over the weekend by Lia Miller for the New York Times’ Business section, An Article in Harper’s Ignites a Controversy Over H.I.V., is buried far from immediate notice today, Monday March 13, on page C5, noting, after three weeks silence, the Harpers piece and the teapot tempest it has brewed, but leaving the larger question strictly unaddressed: is Duesberg conceivably right?

The dissenters in HIV?AIDS must be pleased, for the article is shorn of the usual disparagement which creeps into every mainstream story on the dissenting view. But the science reporters and editors, particularly Larry Altman, must be slightly nervous that curiosity on the big question they have neglected so long might grow.

In his last issue as the editor of Harper’s Magazine, Lewis Lapham has left a parting gift for his successor: a firestorm in the media and among AIDS researchers.

The source is a 15-page article in the March issue, titled “Out of Control: AIDS and the Corruption of Medical Science,” by Celia Farber. Ms. Farber, a longtime magazine journalist, has been a polarizing figure because she has frequently written about the position of “AIDS dissidents,” who argue that H.I.V. does not cause AIDS.

Celia Farber is handled with care as a “long time journalist” rather than an insufferable “denialist”, editor Roger D. Hodge is allowed to confirm upfront that the piece was thoroughly fact checked, a scientist at Cornell who signed the 37 page rebuttal at TAC (Treatment Action Campaign of South Africa, which has posted it at TAC) is allowed to opine that Harpers’ reputation had taken an “irreparable hit” but not to quote specifics, “leading AIDS dissident” Duesberg was phoned but not reached, a magazine and Web gay columnist and “many scientists” are permitted to allege without a single example that the piece was “poorly fact-checked and had glaring errors”, Farber and Hodge are quoted as declining to take responsibility for Duesberg’s views, but merely for “covering dissent”, with Hodge standing behind Celia as no “crackpot” but “a courageous journalist” who has covered the story as a journalist at the cost of “great personal cost”.

On the while a nice job, in the inimitable Times style of handling a hot potato with tongs a foot long, which enables a reporter who knows nothing of the issue to cover the ground without a misstep.

Making the topic of Lia Miller’s assignment the lively reaction the Harpers article has provoked in certain quarters made it unnecessary for the Times reporter to read let alone report the Harpers article in detail, which presumably was the intention of the Times editors. It allowed the Times to deal with the topic and let the pressure off a little without placing itself in the line of fire. After all, if the Times has allowed itself to be led by the nose by a handful of misguided scientists and NIH officials who have willfully ignored the scientific literature for twenty years, which is the implication of the Duesberg section of the Harper’s piece, it has much to answer for.

Still, those copies of Harpers must be still lying on desks and perhaps even on the bedside table of more than one key figure at the Times, who must be asking questions of Larry and his colleagues, such as Nicholas Wade, who only recently has been thinking and writing about paradigm overthrow as we have reported earlier. We mentioned Duesberg to him a couple of months ago and were surprised to hear that he had neglected to read his Journal of Biosciences 2003 paper. Perhaps he has now.

The whole disturbance still threatens to turn into a scientific Katrina and puts these pillars of the HIV?AIDS established view into a slight pickle. For the Harpers article presents a problem for the Times if Farber’s coverage of Duesberg is taken seriously, for what it will lead to ultimately, if the can of worms is finally opened up fully, and Duesberg is eventually vindicated after a proper public illumination of his views and the twenty year failure of the scientists who run HIV?AIDS to produce argument or evidence to refute them, is a very grave accusation, far more momentous than anything the Times has faced to date in its recent history of having its credibility dented by its own Jayson Blair and Judith Miller’s misreporting, let alone the festering sore of its failure to report Stalin’s genocide long ago.

This is the accusation that its virtual complete omission of Duesberg’s views from its news and opinion columns over the years, and its occasional prejudicial damning of them when it has infrequently mentioned them, comprises a grave failure in journalistic responsibility to report the science of HIV?AIDS accurately and even handedly.

*****************************************************

If that unjustified assumption (that HIV causes AIDS) is as wholly wrong as Duesberg’s peer reviewed papers since 1987 say it is, (the Times has) been partly responsible for a waste of public funds running into the hundreds of billions world wide, and the premature deaths of thousands of people, including many prominent in the arts in New York City.

*****************************************************

The Times’ implicit endorsement of the conventional wisdom of AIDS in treating it as gospel over two decades, and mentioning Duesberg hardly at all, except in a dismissive review of his 1996 book, Inventing The AIDS Virus, by an insultingly inadequate mind in the mid-nineties, (this review , “Inventing the AIDS Virus” (April 7, 1996), by June E. Osborn, is mysteriously missing now from the notoriously inadequate Times search engine) but Duesberg’s letter in response to this shameful and abortive editorial disrespect is a classic:

AIDS and Drugs

(NYT) 589 words

Published: May 19, 1996

To the Editor:

In her review of my “Inventing the AIDS Virus” (April 7), June E. Osborn writes: “This book is destructive of personal morale, prevention efforts and public understanding both of H.I.V./AIDS and of biomedical science in general. It has the potential to wreak serious harm at a crucial point in the AIDS epidemic.” At the same time, Dr. Osborn faithfully defends the H.I.V.-AIDS orthodoxy with “enormous bodies of evidence . . . that firmly implicate H.I.V. in AIDS” but without being able to provide the one paper that proves that H.I.V. causes AIDS.

Yet 12 years and $35 billion after starting the war on AIDS in the name of the hypothesis that H.I.V. causes AIDS, America has no vaccine and no drug, has lost over 300,000 lives to AIDS and has yet to save the first AIDS patient. This is a sad testimony to the inability of the scientific and medical community to deal with AIDS properly.

In such a situation the scientific method calls for new, alternative hypotheses to compete with the unproductive H.I.V.-AIDS hypothesis. The scientific method functions very much like the free market economy: it provides the taxpayer and the patient with the most competitive and productive scientific theory.

“Inventing the AIDS Virus” has done exactly this. It provides a coherent and extensively documented alternative AIDS hypothesis. It is proposing that American and European AIDS is the medical consequence of the long-term consumption of recreational drugs and of antiviral drugs like AZT. This hypothesis is a synthesis and extension of the Centers for Disease Control’s very own pre-1984 “life style” hypothesis of AIDS, and of many recent studies that document the toxicity of AZT. The drug-AIDS hypothesis is very testable and could prevent, even cure, AIDS at a fraction of the annual $7.5 billion Federal AIDS budget currently invested in the unproductive H.I.V. hypothesis. In the light of the drug hypothesis, H.I.V. is a harmless passenger virus, and AIDS is an entirely preventable, and in part curable, consequence of the drug epidemic.

One would expect Dr. Osborn to give an alternative to the failed H.I.V. hypothesis some serious consideration. Yet there is not a single complimentary sentence in her review. Wearing her H.I.V.-AIDS blinkers, she not only misunderstands but also misrepresents the drug-AIDS hypothesis.

For example, contrary to Dr. Osborn’s assertion, “Inventing the AIDS Virus” does not assert that “gay men in whom AIDS was diagnosed in the early years . . . were not being truthful if they denied drug use.” The book documents with dozens of references that if asked, gay men with AIDS all reported abundant recreational drug use.

Also, contrary to Dr. Osborn, I do not “dismiss” AIDS in other countries. Both Chapter 6 and Chapter 8 and an appended scientific paper deal extensively with AIDS in other countries and its causes, which are malnutrition, parasitic infection and poor sanitation.

In the face of our AIDS epidemic and in the name of science, I object to a partial and political review of my book. Isn’t our common enemy AIDS rather than Peter Duesberg and other H.I.V. dissidents? Should AIDS be the winner of this debate because dissidents must be losers? Wouldn’t it be prudent to divert a few million dollars from the annual $7.5 billion AIDS budget into just one alternative hypothesis?

Peter Duesberg Berkeley, Calif.

) suggests that the responsible reporters in the area did not ever take the time to read Duesberg’s papers properly, since it is inconcievable that anyone intelligent and versed in the science could fail, if they did so, to respect his arguments as valid criticisms of the status quo, refereed as they were in the highest journals by peers who, politically speaking, were certainly nervous, and anxious to find as much fault as they could, and prevent publication of these “dangerous” views, which if they were as sound as the peer reviewers were forced to acknowledge, were not dangerous at all to AIDS patients, whom they would rescue from noxious drug regimens which would be revealed as misdirected, but a danger to the welfare and position of the HIV?AIDS scientists themselves.

To put it bluntly, if the New York Times has thus unjustifiably lent its weight to the dominant paradigm which Duesberg has so thoroughly critiqued and rejected over so many years by reporting only one side of the dispute, and using the HIV assumption in all its coverage without concern over its validity, in fact, reinforcing it with the mantra repeated in almost every report, “HIV, the virus that causes AIDS”, it has, if that unjustified assumption is as wholly wrong as Duesberg’s peer reviewed papers since 1987 say it is, been partly responsible for a waste of public funds running into the hundreds of billions world wide, and the premature deaths of thousands of people, including many prominent in the arts in New York City.

March 13, 2006

An Article in Harper’s Ignites a Controversy Over H.I.V.

By LIA MILLER

An Article in Harper’s Ignites a Controversy Over H.I.V.

The New York Times

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March 13, 2006

An Article in Harper’s Ignites a Controversy Over H.I.V.

By LIA MILLER

In his last issue as the editor of Harper’s Magazine, Lewis Lapham has left a parting gift for his successor: a firestorm in the media and among AIDS researchers.

The source is a 15-page article in the March issue, titled “Out of Control: AIDS and the Corruption of Medical Science,” by Celia Farber. Ms. Farber, a longtime magazine journalist, has been a polarizing figure because she has frequently written about the position of “AIDS dissidents,” who argue that H.I.V. does not cause AIDS.

The Harper’s article centers on a clinical trial in Uganda for the drug Nevirapine that was later criticized for poor methodology and treatment of some test subjects. But the final third of the article focuses on the tangentially related topic of Dr. Peter Duesberg, a professor of molecular and cell biology at the University of California, Berkeley, and a leading AIDS dissident, and his strained relationship with the National Institutes of Health.

Soon after the article’s publication, rebuttals to Dr. Duesberg’s theories and to other aspects of Ms. Farber’s article were posted on Web sites like The Nation (www.nation.com) and www.poz.com. A 37-page document, written by eight prominent AIDS researchers, was posted on the Treatment Action Campaign Web site (www.tac.org.za), a group that campaigns for greater access to H.I.V. treatment in South Africa. Harper’s received a surge of letters and phone calls.

Roger Hodge, who will succeed Mr. Lapham at Harper’s next month, said that Mr. Lapham initially assigned Ms. Farber an article about Dr. Duesberg’s cancer research, but the assignment was changed when news of the drug trial broke. Mr. Hodge edited the article.

“We knew, of course, that everyone would be upset,” he said, adding that the article was thoroughly fact-checked. “This is a very contentious subject. We have gotten some very, very thoughtful responses. But other pieces have generated a lot more mail.”

John P. Moore, a professor of microbiology and immunology at the Weill Medical College of Cornell University and one of the authors of the Treatment Action Campaign’s rebuttal, said he was shocked when he first saw the article. He said it seemed apparent that Mr. Hodge wanted to “teach the controversy” of Dr. Duesberg’s ideas, a controversy that he said AIDS researchers had resolved long ago. He added that Harper’s reputation had “taken an irreparable hit.” Dr. Duesberg didn’t immediately return a phone call seeking comment.

Benjamin Ryan, an editor at large at HIV Plus magazine who writes a monthly health column on Gay.com, said he had lost faith in Harper’s. He said, as did many scientists, that the article was poorly fact-checked and had glaring errors.

Ms. Farber says that neither she nor Harper’s endorse Dr. Duesberg’s position, but that she is simply reporting on an unpopular view. “People can’t distinguish, it seems, between describing dissent and being dissent,” she said.

“I’m very familiar, since 20 years, with the hysteria end of the spectrum, the rage that breaks out when one touches certain tenets of dogma,” she wrote in an e-mail message. “Anger has been the dominant emotion in AIDS for a long time, almost the only emotion that seems to really function. Anger is connected to fear. I understand it. I’m used to it. I hope we can transcend it.”

Mr. Hodge said the magazine stood behind the article and Ms. Farber.

“The fact that she’s been covering this story does not make her a crackpot — it makes her a journalist. She’s a courageous journalist, I believe, because she has covered the story at great personal cost.”

* Copyright 2006The New York Times Company

Peter Duesberg: the eyes of a powerful mind

March 9th, 2006


Evidence worth a thousand words

For the benefit of all those who wonder what Peter Duesberg looks like, that is, the scientist who has expertly analyzed the HIV?AIDS paradigm from the first moment it was launched, and in the minds of all we know who have carefully read and understood his papers, including (according to the record which shows that he was unable to answer Duesberg’s challenge even though he contracted to so do) Luc Montagnier, the discoverer of HIV in the blood of AIDS patients, as well as Robert Gallo, the discoverer of HIV in the Federal Express delivery from Montagnier (unable to answer as he promised the Duesberg article in the Proceedings of the National Academy), shot it down, we append a portrait of this distinguished scientific intellect taken a few months ago when he visited New York City with his family (click photo twice to enlarge fully).

Establishment denialists (those who deny that HIV?AIDS is the broken paradigm that Duesberg has demonstrated in the literature it is, with the reluctant endorsement of a score of nervous and hostile referees who would have dearly loved to found fault with his statements) please note the quality of intellect visible in the eyes of this distinguished critic of what he says is their favorite fantasy.

Culshaw, yet another beauty with scientific sense, speaks out

March 9th, 2006


Rebecca writes well, looks well, and is a mathematician

The great thing about the testimony of Rebecca V. Culshaw (left), Why I Quit HIV by Rebecca V. Culshaw is that it is well written. Also, that it contains a key reference, which everyone can click and stare at in disbelief – the original paper by Gallo which shows fairly convincingly that HIV by itself could not be sufficient to cause HIV?AIDS.

According to Why I Quite HIV Rebecca is a rather good looking mathematician in biology, and she was a good conformist in HIV?AIDS for years despite inner doubts until one day she came across Blinded By Science, David Rasnick’s disenchantment with HIV, equally well written, in Spin in 1997.

Suddenly everything made sense which had previously nagged at her unconscious, signalling all was not well in HIV?AIDS, as she produced one model after another.

After ten years involved in the academic side of HIV research, as well as in the academic world at large, I truly believe that the blame for the universal, unconditional, faith-based acceptance of such a flawed theory falls squarely on the shoulders of those among us who have actively endorsed a completely unproven hypothesis in the interests of furthering our careers. Of course, hypotheses in science deserve to be studied, but no hypothesis should be accepted as fact before it is proven, particularly one whose blind acceptance has such dire consequences.

What is it about being a mathematician, a woman, and a fair one to boot that inclines one to independent thought? We won’t even speculate about why all the female anti-HIV leaders – Celia Farber, Christine Maggiore (left), and now Rebecca Culshaw – are beauties, for fear of offending The Nation. But we think we know why mathematicians are liable to question HIV?AIDS.

Mathematicians are an exemplary academic species because their profession by its very nature forces honesty upon them. Either your proof stands up or it does not. There is some tiny room for opinion or temporary fudging in big new work which is still at the leap-of-intuition stage, we understand. Otherwise, mathematicians live in a black and white world. Backscratching doesn’t really help much, although presumably the meager spoils of departmental rank and the big prizes in the field are allocated through personal influence.

By the way, many people don’t yet realize that mathematicians can now vie for a prize far richer than the $9,500 Fields medal, which has always been their Nobel. Now they can jostle for the annual Oslo Abel prize, which is nearly a million dollars. The name of this year’s lucky winner will be announced on March 23. Last year it was Peter Lax of NYU (left).

Of course, as anybody who has met mathematicians in large numbers at meetings and conferences knows that they are not the materialistic type. It is as hard to find a mathematician wearing a fine suit as a rock star. Some mathematicians have famously got through life with only a pencil and a pad, leaving the problem of even their own income to their friends.

Perhaps this lack of materialism is why Rebecca Culshaw is not corralled by the conformity blandishments of the HIV?AIDS field. Instead of falling into line, having seen the light she has put one of the best worded Mea Culpas on the Web. Hard to think how she could have phrased it better.

As a mathematician, I was taught early on about the importance of clear definitions. AIDS, if you consider its definition, is far from clear, and is in fact not even a consistent entity. The classification “AIDS” was introduced in the early 1980s not as a disease but as a surveillance tool to help doctors and public health officials understand and control a strange “new” syndrome affecting mostly young gay men. In the two decades intervening, it has evolved into something quite different. AIDS today bears little or no resemblance to the syndrome for which it was named. For one thing, the definition has actually been changed by the CDC several times, continually expanding to include ever more diseases (all of which existed for decades prior to AIDS), and sometimes, no disease whatsoever. More than half of all AIDS diagnoses in the past several years in the United States have been made on the basis of a T-cell count and a “confirmed” positive antibody test – in other words, a deadly disease has been diagnosed over and over again on the basis of no clinical disease at all. And the leading cause of death in HIV-positives in the last few years has been liver failure, not an AIDS-defining disease in any way, but rather an acknowledged side effect of protease inhibitors, which asymptomatic individuals take in massive daily doses, for years.

She continues:

The epidemiology of HIV and AIDS is puzzling and unclear as well. In spite of the fact that AIDS cases increased rapidly from their initial observation in the early 1980s and reached a peak in 1993 before declining rapidly, the number of HIV-positive individuals in the U.S. has remained constant at one million since the advent of widespread HIV antibody testing. This cannot be due to anti-HIV therapy, since the annual mortality rate of North American HIV-positives who are treated with anti-HIV drugs is much higher – between 6.7 and 8.8% – than would be the approximately 1–2% global mortality rate of HIV-positives if all AIDS cases were fatal in a given year.

Even more strangely, HIV has been present everywhere in the U.S., in every population tested including repeat blood donors and military recruits, at a virtually constant rate since testing began in 1985. It is deeply confusing that a virus thought to have been brought to the AIDS epicenters of New York, San Francisco and Los Angeles in the early 1970s could possibly have spread so rapidly at first, yet have stopped spreading completely as soon as testing began.

All of it is beautifully succinct and flowing, one of the best brief summaries of all that is cockeyed about HIV?AIDS that we have seen anywhere, though we would get rid of the evasive word “confusing” and say plainly, “questionable”, as in “deeply questionable that… etc etc”.

Culshaw expresses in a nutshell exactly why the tests are misleading if not worthless.

There is good reason to believe the antibody tests are flawed as well. The two types of tests routinely used are the ELISA and the Western Blot (WB). The current testing protocol is to “verify” a positive ELISA with the “more specific” WB (which has actually been banned from diagnostic use in the UK because it is so unreliable). But few people know that the criteria for a positive WB vary from country to country and even from lab to lab. Put bluntly, a person’s HIV status could well change depending on the testing venue. It is also possible to test “WB indeterminate,” which translates to any one of “uninfected,” “possibly infected,” or even, absurdly, “partly infected” under the current interpretation. This conundrum is confounded by the fact that the proteins comprising the different reactive “bands” on the WB test are all claimed to be specific to HIV, raising the question of how a truly uninfected individual could possess antibodies to even one “HIV-specific” protein.

I have come to sincerely believe that these HIV tests do immeasurably more harm than good, due to their astounding lack of specificity and standardization. I can buy the idea that anonymous screening of the blood supply for some nonspecific marker of ill health (which, due to cross reactivity with many known pathogens, a positive HIV antibody test often seems to be) is useful. I cannot buy the idea that any individual needs to have a diagnostic HIV test. A negative test may not be accurate (whatever that means), but a positive one can create utter havoc and destruction in a person’s life – all for a virus that most likely does absolutely nothing. I do not feel it is going too far to say that these tests ought to be banned for diagnostic purposes.

She also draws attention to the rather absurd paper which is the seminal foundation stone of the field. The key reference she has made clickable is the original paper by Gallo announcing the “frequent” incidence of HIV he found in patient blood samples. Not very frequent at all, in fact. Actual virus was detected in only 26 out of 72 samples.

These results and those reported elsewhere in this issue suggest that HTLV-III may be the primary cause of AIDS.

Well, hardly. On the face of it they merely suggested that HIV (the name afterwards given to HTLV-III to clinch the deal) was passed around among active homosexuals quite easily. Correlation is not causation, except to the scientists in love with the paradigm who then married it like a rich widow and used as a premise for all their work in the field. Click for the abstract:

1: Science. 1984 May 4;224(4648):500-3. Related Articles, Links

Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS.

Gallo RC, Salahuddin SZ, Popovic M, Shearer GM, Kaplan M, Haynes BF, Palker TJ, Redfield R, Oleske J, Safai B, et al.

Peripheral blood lymphocytes from patients with the acquired immunodeficiency syndrome (AIDS) or with signs or symptoms that frequently precede AIDS (pre-AIDS) were grown in vitro with added T-cell growth factor and assayed for the expression and release of human T-lymphotropic retroviruses (HTLV). Retroviruses belonging to the HTLV family and collectively designated HTLV-III were isolated from a total of 48 subjects including 18 of 21 patients wih pre-AIDS, three of four clinically normal mothers of juveniles with AIDS, 26 of 72 adult and juvenile patients with AIDS, and from one of 22 normal male homosexual subjects. No HTLV-III was detected in or isolated from 115 normal heterosexual subjects. The number of HTLV-III isolates reported here underestimates the true prevalence of the virus since many specimens were received in unsatisfactory condition. Other data show that serum samples from a high proportion of AIDS patients contain antibodies to HTLV-III. That these new isolates are members of the HTLV family but differ from the previous isolates known as HTLV-I and HTLV-II is indicated by their morphological, biological, and immunological characteristics. These results and those reported elsewhere in this issue suggest that HTLV-III may be the primary cause of AIDS.

PMID: 6200936 [PubMed – indexed for MEDLINE]

It is one of the most remarkable examples of the madness of crowds that this totally inadequate basis for believing that HIV “causes” AIDS has given rise to one of the biggest global religions, that is to say, one of the best funded global paradigms in the history of science.

Why I Quit HIV

Why I Quit HIV

by Rebecca V. Culshaw

As I write this, in the late winter of 2006, we are more than twenty years into the AIDS era. Like many, a large part of my life has been irreversibly affected by AIDS. My entire adolescence and adult life – as well as the lives of many of my peers – has been overshadowed by the belief in a deadly, sexually transmittable pathogen and the attendant fear of intimacy and lack of trust that belief engenders.

To add to this impact, my chosen career has developed around the HIV model of AIDS. I received my Ph.D. in 2002 for my work constructing mathematical models of HIV infection, a field of study I entered in 1996. Just ten years later, it might seem early for me to be looking back on and seriously reconsidering my chosen field, yet here I am.

My work as a mathematical biologist has been built in large part on the paradigm that HIV causes AIDS, and I have since come to realize that there is good evidence that the entire basis for this theory is wrong. AIDS, it seems, is not a disease so much as a sociopolitical construct that few people understand and even fewer question. The issue of causation, in particular, has become beyond question – even to bring it up is deemed irresponsible.

Why have we as a society been so quick to accept a theory for which so little solid evidence exists? Why do we take proclamations by government institutions like the NIH and the CDC, via newscasters and talk show hosts, entirely on faith? The average citizen has no idea how weak the connection really is between HIV and AIDS, and this is the manner in which scientifically insupportable phrases like “the AIDS virus” or “an AIDS test” have become part of the common vernacular despite no evidence for their accuracy.

When it was announced in 1984 that the cause of AIDS had been found in a retrovirus that came to be known as HIV, there was a palpable panic. My own family was immediately affected by this panic, since my mother had had several blood transfusions in the early 1980s as a result of three late miscarriages she had experienced. In the early days, we feared mosquito bites, kissing, and public toilet seats. I can still recall the panic I felt after looking up in a public restroom and seeing some graffiti that read “Do you have AIDS yet? If not, sit on this toilet seat.”

But I was only ten years old then, and over time the panic subsided to more of a dull roar as it became clear that AIDS was not as easy to “catch” as we had initially believed. Fear of going to the bathroom or the dentist was replaced with a more realistic wariness of having sex with anyone we didn’t know really, really well. As a teenager who was in no way promiscuous, I didn’t have much to worry about.

That all changed – or so I thought – when I was twenty-one. Due to circumstances in my personal life and a bit of paranoia that (as it turned out, falsely and completely groundlessly) led me to believe I had somehow contracted “AIDS,” I got an HIV test. I spent two weeks waiting for the results, convinced that I would soon die, and that it would be “all my fault.” This was despite the fact that I was perfectly healthy, didn’t use drugs, and wasn’t promiscuous – low-risk by any definition. As it happened, the test was negative, and, having felt I had been granted a reprieve, I vowed not to take more risks, and to quit worrying so much.

Over the past ten years, my attitude toward HIV and AIDS has undergone a dramatic shift. This shift was catalyzed by the work I did as a graduate student, analyzing mathematical models of HIV and the immune system. As a mathematician, I found virtually every model I studied to be unrealistic. The biological assumptions on which the models were based varied from author to author, and this made no sense to me. It was around this time, too, that I became increasingly perplexed by the stories I heard about long-term survivors. From my admittedly inexpert viewpoint, the major thing they all had in common – other than HIV – was that they lived extremely healthy lifestyles. Part of me was becoming suspicious that being HIV-positive didn’t necessarily mean you would ever get AIDS.

By a rather curious twist of fate, it was on my way to a conference to present the results of a model of HIV that I had proposed together with my advisor, that I came across an article by Dr. David Rasnick about AIDS and the corruption of modern science. As I sat on the airplane reading this story, in which he said “the more I examined HIV, the less it made sense that this largely inactive, barely detectable virus could cause such devastation,” everything he wrote started making sense to me in a way that the currently accepted model did not. I didn’t have anywhere near all the information, but my instincts told me that what he said seemed to fit.

Over the past ten years, I nevertheless continued my research into mathematical models of HIV infection, all the while keeping an ear open for dissenting voices. By now, I have read hundreds of articles on HIV and AIDS, many from the dissident point of view but far, far more from that of the establishment, which unequivocally promotes the idea that HIV causes AIDS and that the case is closed. In that time, I even published four papers on HIV (from a modeling perspective). I justified my contributions to a theory I wasn’t convinced of by telling myself these were purely theoretical, mathematical constructs, never to be applied in the real world. I suppose, in some sense also, I wanted to keep an open mind.

So why is it that only now have I decided that enough is enough, and I can no longer in any capacity continue to support the paradigm on which my entire career has been built?

As a mathematician, I was taught early on about the importance of clear definitions. AIDS, if you consider its definition, is far from clear, and is in fact not even a consistent entity. The classification “AIDS” was introduced in the early 1980s not as a disease but as a surveillance tool to help doctors and public health officials understand and control a strange “new” syndrome affecting mostly young gay men. In the two decades intervening, it has evolved into something quite different. AIDS today bears little or no resemblance to the syndrome for which it was named. For one thing, the definition has actually been changed by the CDC several times, continually expanding to include ever more diseases (all of which existed for decades prior to AIDS), and sometimes, no disease whatsoever. More than half of all AIDS diagnoses in the past several years in the United States have been made on the basis of a T-cell count and a “confirmed” positive antibody test – in other words, a deadly disease has been diagnosed over and over again on the basis of no clinical disease at all. And the leading cause of death in HIV-positives in the last few years has been liver failure, not an AIDS-defining disease in any way, but rather an acknowledged side effect of protease inhibitors, which asymptomatic individuals take in massive daily doses, for years.

The epidemiology of HIV and AIDS is puzzling and unclear as well. In spite of the fact that AIDS cases increased rapidly from their initial observation in the early 1980s and reached a peak in 1993 before declining rapidly, the number of HIV-positive individuals in the U.S. has remained constant at one million since the advent of widespread HIV antibody testing. This cannot be due to anti-HIV therapy, since the annual mortality rate of North American HIV-positives who are treated with anti-HIV drugs is much higher – between 6.7 and 8.8% – than would be the approximately 1–2% global mortality rate of HIV-positives if all AIDS cases were fatal in a given year.

Even more strangely, HIV has been present everywhere in the U.S., in every population tested including repeat blood donors and military recruits, at a virtually constant rate since testing began in 1985. It is deeply confusing that a virus thought to have been brought to the AIDS epicenters of New York, San Francisco and Los Angeles in the early 1970s could possibly have spread so rapidly at first, yet have stopped spreading completely as soon as testing began.

Returning for a moment to the mathematical modeling, one aspect that had always puzzled me was the lack of agreement on how to accurately represent the actual biological mechanism of immune impairment. AIDS is said to be caused by a dramatic loss of the immune system’s T-cells, said loss being presumably caused by HIV. Why then could no one agree on how to mathematically model the dynamics of the fundamental disease process – that is, how are T-cells actually killed by HIV? Early models assumed that HIV killed T-cells directly, by what is referred to as lysis. An infected cell lyses, or bursts, when the internal viral burden is so high that it can no longer be contained, just like your grocery bag breaks when it’s too full. This is in fact the accepted mechanism of pathogenesis for virtually all other viruses. But it became clear that HIV did not in fact kill T-cells in this manner, and this concept was abandoned, to be replaced by various other ones, each of which resulted in very different models and, therefore, different predictions. Which model was “correct” never was clear.

As it turns out, the reason there was no consensus mathematically as to how HIV killed T-cells was because there was no biological consensus. There still isn’t. HIV is possibly the most studied microbe in history – certainly it is the best-funded – yet there is still no agreed-upon mechanism of pathogenesis. Worse than that, there are no data to support the hypothesis that HIV kills T-cells at all. It doesn’t in the test tube. It mostly just sits there, as it does in people – if it can be found at all. In Robert Gallo’s seminal 1984 paper in which he claims “proof” that HIV causes AIDS, actual HIV could be found in only 26 out of 72 AIDS patients. To date, actual HIV remains an elusive target in those with AIDS or simply HIV-positive.

This is starkly illustrated by the continued use of antibody tests to diagnose HIV infection. Antibody tests are fairly standard to test for certain microbes, but for anything other than HIV, the main reason they are used in place of direct tests (that is, actually looking for the bacteria or virus itself) is because they are generally much easier and cheaper than direct testing. Most importantly, such antibody tests have been rigorously verified against the gold standard of microbial isolation. This stands in vivid contrast to HIV, for which antibody tests are used because there exists no test for the actual virus. As to so-called “viral load,” most people are not aware that tests for viral load are neither licensed nor recommended by the FDA to diagnose HIV infection. This is why an “AIDS test” is still an antibody test. Viral load, however, is used to estimate the health status of those already diagnosed HIV-positive. But there are very good reasons to believe it does not work at all. Viral load uses either PCR or a technique called branched-chained DNA amplification (bDNA). PCR is the same technique used for “DNA fingerprinting” at crime scenes where only trace amounts of materials can be found. PCR essentially mass-produces DNA or RNA so that it can be seen. If something has to be mass-produced to even be seen, and the result of that mass-production is used to estimate how much of a pathogen there is, it might lead a person to wonder how relevant the pathogen was in the first place. Specifically, how could something so hard to find, even using the most sensitive and sophisticated technology, completely decimate the immune system? bDNA, while not magnifying anything directly, nevertheless looks only for fragments of DNA believed, but not proven, to be components of the genome of HIV – but there is no evidence to say that these fragments don’t exist in other genetic sequences unrelated to HIV or to any virus. It is worth noting at this point that viral load, like antibody tests, has never been verified against the gold standard of HIV isolation. bDNA uses PCR as a gold standard, PCR uses antibody tests as a gold standard, and antibody tests use each other. None use HIV itself.

There is good reason to believe the antibody tests are flawed as well. The two types of tests routinely used are the ELISA and the Western Blot (WB). The current testing protocol is to “verify” a positive ELISA with the “more specific” WB (which has actually been banned from diagnostic use in the UK because it is so unreliable). But few people know that the criteria for a positive WB vary from country to country and even from lab to lab. Put bluntly, a person’s HIV status could well change depending on the testing venue. It is also possible to test “WB indeterminate,” which translates to any one of “uninfected,” “possibly infected,” or even, absurdly, “partly infected” under the current interpretation. This conundrum is confounded by the fact that the proteins comprising the different reactive “bands” on the WB test are all claimed to be specific to HIV, raising the question of how a truly uninfected individual could possess antibodies to even one “HIV-specific” protein.

I have come to sincerely believe that these HIV tests do immeasurably more harm than good, due to their astounding lack of specificity and standardization. I can buy the idea that anonymous screening of the blood supply for some nonspecific marker of ill health (which, due to cross reactivity with many known pathogens, a positive HIV antibody test often seems to be) is useful. I cannot buy the idea that any individual needs to have a diagnostic HIV test. A negative test may not be accurate (whatever that means), but a positive one can create utter havoc and destruction in a person’s life – all for a virus that most likely does absolutely nothing. I do not feel it is going too far to say that these tests ought to be banned for diagnostic purposes.

The real victims in this mess are those whose lives are turned upside-down by the stigma of an HIV diagnosis. These people, most of whom are perfectly healthy, are encouraged to avoid intimacy and are further branded with the implication that they were somehow dreadfully foolish and careless. Worse, they are encouraged to take massive daily doses of some of the most toxic drugs ever manufactured. HIV, for many years, has fulfilled the role of a microscopic terrorist. People have lost their jobs, been denied entry into the Armed Forces, been refused residency in and even entry into some countries, even been charged with assault or murder for having consensual sex; babies have been taken from their mothers and had toxic medications forced down their throats. There is no precedent for this type of behavior, as it is all in the name of a completely unproven, fundamentally flawed hypothesis, on the basis of highly suspect, indirect tests for supposed infection with an allegedly deadly virus – a virus that has never been observed to do much of anything.

As to the question of what does cause AIDS, if it is not HIV, there are many plausible explanations given by people known to be experts. Before the discovery of HIV, AIDS was assumed to be a lifestyle syndrome caused mostly by indiscriminate use of recreational drugs. Immunosuppression has multiple causes, from an overload of microbes to malnutrition. Probably all of these are true causes of AIDS. Immune deficiency has many manifestations, and a syndrome with many manifestations is likely multicausal as well. Suffice it to say that the HIV hypothesis of AIDS has offered nothing but predictions – of its spread, of the availability of a vaccine, of a forthcoming animal model, and so on – that have not materialized, and it has not saved a single life.

After ten years involved in the academic side of HIV research, as well as in the academic world at large, I truly believe that the blame for the universal, unconditional, faith-based acceptance of such a flawed theory falls squarely on the shoulders of those among us who have actively endorsed a completely unproven hypothesis in the interests of furthering our careers. Of course, hypotheses in science deserve to be studied, but no hypothesis should be accepted as fact before it is proven, particularly one whose blind acceptance has such dire consequences.

For over twenty years, the general public has been greatly misled and ill-informed. As someone who has been raised by parents who taught me from a young age never to believe anything just because “everyone else accepts it to be true,” I can no longer just sit by and do nothing, thereby contributing to this craziness. And the craziness has gone on long enough. As humans – as honest academics and scientists – the only thing we can do is allow the truth to come to light.

March 3, 2006

Rebecca V. Culshaw, Ph.D. [send her mail], is a mathematical biologist who has been working on mathematical models of HIV infection for the past ten years. She received her Ph.D. (mathematics with a specialization in mathematical biology) from Dalhousie University in Canada in 2002 and is currently employed as an Assistant Professor of Mathematics at a university in Texas.

Copyright © 2006 LewRockwell.com

Balzac illuminates HIV?AIDS as “occult science”

March 9th, 2006


Ideas can kill, pointed out famed French novelist

“Prometheus: The Life of Balzac” by Andrew Maurois (1965, Hatchette) records how much time Balzac spent in the attentive study of his fellow man, which he would translate into “La Comedia Humaine”. One Maurois paragraph seems particularly prescient, for it captures Balzac expressing what many now acknowledge, which is that perhaps the gravest threat posed by the idea of HIV?AIDS may be the impact on the psyche.

In his youth, around 1824, Balzac held conversations with his more intelligent friends at the Cafe Voltaire near the Odeon Theatre, which he drew upon for his book Les Martyrs Ignores, published in 1843. One character who played dominoes at “the philosophers’ table”, as it became known, was Dr Phantasma, aged sixty three, a disciple of Mesmer. Maurois relates in his lively biography that in Les Martyrs the group talk, as they play, in a manner which sheds light on the thinking of the youthful Balzac.

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Thought is more powerful than the body; it devours, absorbs and destroys it. A thought can kill…victims die of imaginary poisoning, or some disease which they haven’t got, or are driven mad by the tyranny of an idea.

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“Physidor, who is Balzac’s mouthpiece, relates how an elderly physician, an adept in the occult sciences, once confided to him: “I’m going to tell you a secret. It is this. Thought is more powerful than the body; it devours, absorbs and destroys it.” A thought can kill….Every member of the circle has tales to tell of mysterious tragedies in which unregarded victims die of imaginary poisoning, or some disease which they haven’t got, or are driven mad by the tyranny of an idea. For thought is a material force. The dead can manifest themselves to the living because the life of ideas is more enduring than that of the body. We must believe in the occult sciences!”

Anyone who thinks that Balzac didn’t understand human nature should know that he also made the following observations:

“When women love us, they forgive us everything, even our crimes; when they do not love us, they give us credit for nothing, not even our virtues.”

“The more one judges, the less one loves.”

“A good marriage would be between a blind wife and a deaf husband.”

“A man falls in love through his eyes, a woman through her ears.”

“God made woman beautiful and foolish; beautiful, that man might love her; and foolish, that she might love him”

Of course, the editorial staff of the Nation will surely think some of those are not PC, and we apologize for the offense of repeating them.

Columbia Journalism School standards go over the cliff

March 8th, 2006

CJR Daily student cheers Farber/Harper’s DAIDS critique, but is horrified by Duesberg mention

Gregg Gonsalves of GMHC and the Nation blog tipped her off

Technorati searchers on “Celia Farber Harpers” this morning were sent to the front page of the CJR Daily to read “AIDS – What AIDS? Harper’s Races Right Over the Edge of a Cliff.”

The article castigates Harpers for not meeting the author’s professional standards in printing a piece which “wanders off the deep end” in granting “legitimacy to an illegitimate and discredited idea” (that HIV?AIDS is not soundly based). This judgement is rendered on the authority of comment by Gregg Gonsalves, director of the Gay Men’s Health Crisis, and the Nation blog.

The piece night be viewed as just another example of shallow Web comment, one of the BB shots aimed at the dark shape of the Harpers/Farber stealth bomber as it flies overhead. But it is worth noting that it comes from a journalism school student (one assumes he/she is a student and not, God forbid, a professor) who should know better. What is worrying is that CJRDaily apparently has no higher standards than the ordinary blog flamer when it comes to armchair criticism. Is this good enough for a great institution which is turning out future New York Times reporters?

First the author, Gal Beckerman, approves of Celia for whacking DAIDS with her literary baseball bat for abandoning scientific purpose and standards:

It’s an engaging piece of investigative journalism that exposes deep problems with the standards of medical research when it comes to AIDS. As she writes, “the emergence of the syndrome in the 1980s sparked a medical state of emergency in which scientific controls, the rules that are supposed to bracket the emotions and desires of individual researchers, were frequently compromised or removed entirely.”

But then Gal grabs the bat and in her turn whacks Celia and Harpers for even mentioning Duesberg and his “crackpot theory”:

(She)rather approvingly points to UC Berkeley virologist Peter Duesberg, who has taken much heat for questioning the causality between HIV and AIDS. Duesberg has gained a name as a “denialist” for asserting that AIDS is actually a “chemical syndrome, caused by accumulated toxins from heavy drug use,” or that “75 percent of AIDS cases in the West can be attributed to drug toxicity. If toxic AIDS therapies were discontinued … thousands of lives could be saved virtually overnight.” And, most bizarre to our ears: “AIDS in Africa is best understood as an umbrella term for a number of old diseases, formerly known by other names, that currently do not command high rates of international aid. The money spent on anti-retroviral drugs would be better spent on sanitation and improving access to safe drinking water.”

And why does Gal disapprove of this coverage, bizarre to her uninformed ears? Apparently without any reason or knowledge save that she has read Gregg Gonsalves comparing “AIDS denialists” to Intelligent Design advocates and Lyndon LaRouche, and seen the Nation blog adopting the same uninformed approach.

What’s most interesting in this latest dustup is that the Nation has decided to join the incensed scientists in shaming Harper’s for running the Farber piece.

All this is a poor specimen of what journalism students are learning at one of the great universities. Does Columbia really teach its students to indulge in uninformed and borrowed opinion when writing comment on the work of a magazine of long standing (156 years) reputation which by definition is careful where it places its bets? Only the greenest tyro would fail to understand that Harpers would not print a 15 page article on a contentious topic without knowing what it was doing. Gal seems to be confusing Harper’s highly edited and assiduously checked editorial pages with a blog comment thread.

Galloping Gal fails even to take the tip that Celia herself embedded in her piece, namely, that if Duesberg’s name comes “prestamped with wrongness,” as Celia wittily put it, caution is indicated, for this is evidently the work of self-interested scientists and fellow traveling, often drug company financed activists who have evaded Duesberg’s critique by playing very rough politics.

But then, given that the Harpers piece above all demonstrates to everyone who has read it thoroughly the power of strongly felt factual writing based on long experience and research, Gal evidently hasn’t had time to read it properly. This is a pity, since an unbiased reading would teach this student a great deal about good journalism, and we expect that “Out of Control” will in fact be used in journalism classes of the future as exhibit one in the history of this affair.

Gal’s effort, on the other hand, is in danger of being used as a classic example of ignorance generating confident opinion, and a failure to teach the art of researching your topic before writing on it.

Working journalists often wonder why journalism schools exist at all, given the fact that reporting and writing to deadline is a craft best learned on the job, and if expertise is needed, it is better to acquire a proper degree a topic rather than in how to research, write and network. Given that the annual fees are probably hitting $30,000 at Columbia now or soon (very rough guess, since they dont announce them very prominently on their site), and a job as an intern might pay $30,000, it would seem a sorry situation to be out $60,000 or so a year and not even learn the simple necessity of knowing what you are talking about.

But then, how many journalists and reporters today have the time or the incentive to do much more than repeat what they read in press releases and are told by the nearest phone source? Judging from their performance in science, very few in that field, and in HIV?AIDS, we know for sure that there are no more than can be counted on the fingers of one hand.

One thing Gal will have to learn is that what she (one assumes that the delightful name is female) thinks other journalists know may be less than meets the eye. Then she might restrain herself from joining them in dissing their betters.

In short: when the Nation, of all places, is criticizing you for your knee-jerk anti-establishmentarianism, it’s a pretty good bet that you have probably wandered off the deep end.

Next time, Harper’s should be more careful about giving so much legitimacy – 15 pages of it – to such an illegitimate and discredited idea.

We would like to make a humble but constructive suggestion. If only Gal would read our earlier posts here and reassess precisely which is the illegitimate and discredited idea in HIV?AIDS, she could jump bandwagons before it is too late. and write a distinguished thesis on The Media in AIDS: How Journalists Failed the American Public, which could then easily be turned into a best selling book which could make her name and even gain her a professorship at the Columbia School of Journalism.

Mar. 08, 2006 – 11:13 AM

AIDS – What AIDS?

Harper’s Races Right Over the Edge of a Cliff

Gal Beckerman

The essay on AIDS in this month’s Harper’s magazine by Celia Farber starts off like a scientific whodunit — as Farber herself puts it, the tale she tells sounds eerily like the “Constant Gardener,” the recent movie based on a John Le Carre novel about evil pharmaceutical companies engaged in unethical human testing.

In the first half of her article titled, “Out of Control: AIDS and the Corruption of Medical Science,” Farber describes what led to the death of a pregnant HIV-positive woman who was taking an experimental drug, Nevirapine, to avoid transmitting the virus to her unborn child. The drug’s toxicity, which had never been properly tested, killed the woman, and Farber traces the negligence back to tests in Uganda that were improperly conducted on human subjects. She also tells the story of a whistleblower at the NIH who was attacked for exposing the faulty trials.

It’s an engaging piece of investigative journalism that exposes deep problems with the standards of medical research when it comes to AIDS. As she writes, “the emergence of the syndrome in the 1980s sparked a medical state of emergency in which scientific controls, the rules that are supposed to bracket the emotions and desires of individual researchers, were frequently compromised or removed entirely.”

Her argument is that AIDS has become an industry and a certain kind of sloppiness has entered the search for new anti-retroviral drugs. So far, so good, and if this were the only story Farber hoped to tell, we might well be tipping our hat to her.

But she goes on to use the Nevirapine trial as a launching pad for what she really wants to say — that big pharmaceutical companies have basically invented the concept of AIDS in order to sell their product, which, being extremely toxic, is what is actually killing people who are diagnosed HIV-positive.

She doesn’t take responsibility herself for this startling — some might say preposterous — thesis, but rather approvingly points to UC Berkeley virologist Peter Duesberg, who has taken much heat for questioning the causality between HIV and AIDS. Duesberg has gained a name as a “denialist” for asserting that AIDS is actually a “chemical syndrome, caused by accumulated toxins from heavy drug use,” or that “75 percent of AIDS cases in the West can be attributed to drug toxicity. If toxic AIDS therapies were discontinued … thousands of lives could be saved virtually overnight.” And, most bizarre to our ears: “AIDS in Africa is best understood as an umbrella term for a number of old diseases, formerly known by other names, that currently do not command high rates of international aid. The money spent on anti-retroviral drugs would be better spent on sanitation and improving access to safe drinking water.”

Farber takes up that banner and complains that AIDS researchers “have spent many billions of dollars in the last twenty years on HIV research and practically nothing on alternative causes or co-factors.” Which, again, would be a legitimate complaint to make — were it not for the implication that HIV as the cause of AIDS has been invented for the sake of keeping certain scientists and pharmaceutical companies in business.

The article has inspired great anger among “so-called AIDS activists,” as Farber dismissively refers to them, who are seething at Harper’s decision to give Farber such a prominent soapbox. One example is a letter from Gregg Gonsalves, director of Gay Men’s Health Crisis: “Farber is a well-known AIDS denialist and publishing her work is akin to giving the folks at the Discovery Institute a place to expound upon the ‘science’ of intelligent design, Charles Davenport a venue to educate us about the racial inferiority of the Negro or Lyndon LaRouche a platform to warn us about aliens, bio-duplication, and nudity.”

The debate between the public health community and the “denialists” is an old one. What’s most interesting in this latest dustup is that the Nation has decided to join the incensed scientists in shaming Harper’s for running the Farber piece.

On the magazine’s blog, The Notion, Richard Kim claims that Farber does not do justice to the varying approaches taken by those researching AIDS, writing that “conspiracy theories like Duesberg’s warp and exploit some of the best political interventions made by AIDS activists: that patients should be engaged with their medical diagnosis and treatment, that clinical drug trials should be grounded in sound ethical practices, that the emphasis on virology has circumvented immunological approaches to AIDS and that attention to the effects of poverty, malnutrition and other diseases is vital to preventing and treating AIDS.”

Kim also writes that “it’s a shame that a magazine as well respected as Harper’s has shirked its duty to report on these issues and instead published Farber’s article.”

We have to agree. The if-it’s-conventional-wisdom-it-must-be-wrong ethos that Harper’s has come to embrace in the last days of the counterintuitive Lewis Lapham as editor has served the magazine poorly here, giving space to an idea that, as Kim points out, has been widely refuted for years — and one that, frankly, has been consigned to the dustbin of crackpot theories.

In short: when the Nation, of all places, is criticizing you for your knee-jerk anti-establishmentarianism, it’s a pretty good bet that you have probably wandered off the deep end.

Next time, Harper’s should be more careful about giving so much legitimacy — 15 pages of it — to such an illegitimate and discredited idea.

Gay paper reports on Harpers article as HIV challenge

March 6th, 2006

First print reaction focuses on Duesberg and HIV debate

It’s worth noting that the first article in print about the Harpers piece, Denialism in Harper’s Faulted in Gay City News, focuses on the challenge to HIV?AIDS ideology rather than the abandonment of scientific standards in the trials that the article puts upfront.

To our mind this reflects the vulnerability of this aspect of HIV?AIDS. The issue, and Duesberg’s name, tend to be a lightning rod for defensive anxiety because of the unconscious (or conscious) knowledge that the fundamental assumption is so easily questioned, yet so vital. As PCR Nobelist Kary Mullis is fond of pointing out, there is no paper in science that anyone can point to which demonstrates the basic assumption that HIV causes AIDS.

If the assumption is wrong then the entire scientific, social and institutional structure falls. The field of HIV?AIDS is rather like the Twin Towers of the World Trade Center before September 11, liable to collapse into total disintegration if this one idea is exploded. Every paper and every activity in the field is based upon the premise that HIV is the cause of AIDS.

Remove it successfully and we face a collapse of catastrophic proportions in every dimension, from the internal psychic confidence of all involved to institutional prestige and authority across all government and media. The size of the collapse is one reason to think that it will never happen.

This is the fundamental reason why HIV?AIDS skeptics till now have seemed like dogs barking at the moon. The Harpers article is probably the last best chance they have to make a difference. Will it prove a tipping point? We don’t know, of course, but for some reason we think it will.

This may be the beginning of the end of the ability of the leaders of HIV?AIDS to prevent full public discussion of the foundation of their field. Harpers is just too respectable a magazine to put down with the usual disparagement and dismissal by the scientists in the field, ;let alone the activists. Now it is the HIV activists who will look ineffectual as they try to throw mud at the moon.

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Denialism in Harper’s Faulted

Gay City News Volume 5, Number 9 | March 2 – 8, 2006

HEALTH

HIV Denialism in Harper’s Faulted

Researchers worldwide castigate magazine for giving credence to view virus unrelated to AIDS

By DUNCAN OSBORNE

AIDS groups around the globe are condemning a Harper’s magazine article that features leading AIDS denialists and makes a sweeping attack on AIDS research based on two clinical trials.

AIDS denialism directly kills a lot of people, said Nathan Geffen, policy coordinator at the Treatment Action Campaign in South Africa. It’s disgraceful and it needs to be stopped.

Geffen was among roughly 40 AIDS activists, researchers, and clinicians who sent an open letter to the monthly magazine denouncing the article that ran in its March issue. They have demanded a retraction, an apology, and that their documentation of the errors in the piece be published on the Harper’s Web site and in the magazine.

So far it’s well over 50 and counting, Geffen said, about his count of the article’s flaws. We’re not talking about trivial errors.

The story was written by Celia Farber, a journalist who has authored many pieces that have drawn on the views of researchers and activists who believe that HIV is not the cause of AIDS. Her work has appeared in Spin, USA Today, Gear, and other leading mainstream publications. She did not respond to a phone message seeking comment or an e-mail sent to her on behalf of Gay City News from a Harper’s editor.

Farber is on the board of the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, a group that includes AIDS denialists among its members, though her views are less clear. In a 2000 interview with Poz magazine she said, Does HIV cause AIDS? I’ve never said that it does or it does not. I’m not really equipped to know. But when I look around and see legions of respectable scientists arguing that it does not, then I cannot see why I shouldn’t report it. It’s not only news, it’s great human drama.

In part, the piece investigated two clinical trials, one in the U.S. and the second in Uganda, that weighed the efficacy and safety of nevirapine, an anti-HIV drug, in preventing mother-to-child transmission of HIV. Both studies gave the drug to pregnant women.

The U.S. trial recruited 38 women, but it was shut down after several women experienced serious side effects and one woman died. The Uganda trial, which was funded by the National Institutes of Health (NIH), a U.S. health agency, was criticized for sloppy record-keeping and mismanagement, but its conclusion that the drug is safe and effective has been endorsed by U.S. agencies that investigated the trial.

The story also described the mistreatment of an NIH employee after he blew the whistle on the Uganda trial.

Farber wrote that while the two trials should raise questions about the safety of nevirapine and the conduct of drug trials, the so-called community AIDS activists were sprung like cuckoo birds from grandfather clocks at the appointed hour to affirm the unwavering AIDS catechism: AIDS drugs save lives. To suggest otherwise is to endanger millions of African babies.

The piece also cited Dr. Peter Duesberg, a professor of molecular and cell biology at the University of California at Berkeley, and Dr. Kary B. Mullis, a chemist who shared the 1993 Nobel Prize in chemistry for inventing the polymerase chain reaction. Both men have long denied that HIV is the cause of AIDS and, the piece asserted, Duesberg has effectively been blackballed in the scientific community.

Roger D. Hodge, the Harper’s deputy editor and editor of the Farber story, told Gay City News that the story was not about whether HIV is the cause of AIDS, but concerned the mismanagement of drug studies and the censoring of debate.

It’s not as if this is happening in isolation, he said. There has been scandal after scandal after scandal… It’s not as if human experimentation doesn’t have it problems… Celia has covered the story for a long time. Part of the story is that a certain kind of name-calling, a certain kind of moral blackmail, takes the place of scientific debate. People like Peter Duesberg have been persecuted for trying to have a scientific debate. Hodge said the story was carefully vetted.

It was very, very thoroughly fact-checked over the course of three months, he said. A lot of what people are describing as errors are differences of opinion about the data.

Asked whether he believed that the HIV virus was the cause of AIDS, Hodge, who will become the magazine’s editor within a month, said, I don’t feel like I am qualified to judge it. Am I a partisan? My general position is I am very skeptical about absolutist arguments, so I want to hear the entire argument. More argument is better.

The open letter called the article pseudo-science and dangerous because of its potential to convince people in desperate need of antiretroviral medicines not to take them, with life-threatening consequences.

Farber is sympathetic to, and has herself long perpetuated, the factually incorrect views that HIV is not the cause of AIDS and that the risks of antiretrovirals outweigh their benefits, the letter read.

The view that HIV causes AIDS is supported by what most people would see as overwhelming evidence and that is the consensus among scientists and researchers. While AIDS drugs can have unpleasant side effects, they have maintained the lives and health of hundreds of thousands, if not millions, of people with HIV.

AIDS denialism can have serious consequences, Geffen said.

The only reason that AIDS denialism is so rampant in South Africa is because it has the support of the president and the health minister, he said, referring to Thabo Mbeki and his controversial top health adviser, Dr. Manto Tshabalala-Msimang.

Geffen said that some denialists were actively recruiting South Africans to participate in studies meant to prove the effectiveness of vitamins against HIV.

What they are doing is they are convincing people, very sick people with AIDS, not to take AIDS drugs and take vitamins instead, he said. It’s unbelievable that they are getting away with this. We are going to court to try and stop them.

Julie Davids, executive director of the Community HIV/AIDS Mobilization Project (CHAMP), said that denialists had not had a significant impact in the US.

I think so much of what happens with HIV, whether it’s prevention or care, there are so many factors that can weigh in on whether someone can access care, I don’t think the Harper’s article is going to have an impact, she said.

CHAMP was among the signatories on the open letter. For Davids, the article was about a misplaced desire to challenge accepted wisdom and be entertaining.

I understand that Harper’s wants to be outrageous and feel like they are doing things that others won’t, she said. I just have to ask why they would print an article that they know includes dramatic misinformation…There is an admiral role for challenging suspect consensus that’s not what this story is. It’s full of holes.

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Bob Gallo sends South African missile into New York

March 6th, 2006


But the payload seems rather short on explosive

What may be an exceedingly self-incriminating document has been sent to Harpers by the chief suspects in the HIV?AIDS true denialist camp.

By “true denialists” we mean those who most vociferously deny there have been many peer-reviewed fatal flaws pointed out in the paradigm which has ruled for so long, and been so well protected by the campaign conducted by these and other HIV?AIDS defenders, who are surely the true denialists.

The signatories include the hero of HIV, Bob Gallo, we notice, as well as the odd fish who recently visited this site to stir up mischief, Richard Jefferys.

Long silence is finally broken

The document is self-incriminating because it reveals the very lack of justification for supporting HIV?AIDS that they vehemently deny in the letter. So this is the first success of the Harpers piece – Farbers has finally lured out of hiding the key people who have so successfully prevented public debate from proceeding in one of the most important, life or death paradigm challenges extant.

For instead of ignoring the Harpers piece and poo pooing it to any media reporter who asked for their reaction, which is the successful strategy paradigm leaders have followed for twenty years, they have exposed their best arguments against it, and thus all the flaws inherent in their position, for public inspection. Instead of taking their time, they have “rushed” to get the letter out, which is unwise, judging from the language used, which is rather childish, as are their demands:

To save its good reputation, Harper’s should do the following:

* Withdraw editorial support for Farber’s article and publish this withdrawal on the Harper’s Magazine website.

* Publish a retraction in the April or May issue of Harper’s Magazine and on the website immediately.

* Publish the list of errors and corrections in a prominent position on the website as soon as you have been able to fact-check it (the fact-checkers obviously should not include the individuals who “fact-checked” Ms. Farber’s article, or any other individuals suggested to you by her, or them).

* Publish a general rebuttal of the Farber piece in the April or May issue of Harper’s Magazine. One or more of the authors of the errors’ document will prepare such a rebuttal once we hear from you that you will print it.

* Undertake to review Harper’s fact-checking process, with special regard to articles on science (the common procedure of a writer suggesting fact-checkers for the article is seriously flawed).

We expect a satisfactory response from Harper’s by Monday evening. Regards, Nathan Geffen.”

Presumably this is a tribute to the reputation of the magazine, which they call “prestigious” in their letter, and that they have detected that many people they know are taking it seriously. Harpers’ “influence” is apparently making itself felt. Perhaps those who prepared this overconfident broadside should have reflected on the source of that influence, which is that Harpers is run by intelligent and worldly people who operate outside the circle of influence of those who hold the purse strings which influence other media, such as the drug companies, since they are financed by a foundation.

Have HIV defenders shot themselves in foot by saying too much?

The precipitate nature of the communication and its political naivete are indicated by the crude terms in which it is expressed and the silliness of its demands, all of which are based on the assumption that Harpers doesn’t know what it is talking about and can easily be cowed into submission with scientific expertise.

Apparently the singers are not fully conscious of the fact that Farber is the most seasoned investigator of their shenanigans around, having been at it for twenty years, equal to ourselves but busier, and that the article took about two years to go through rewriting and expansion, editing and checking.

The one thing they can be sure of is that unlike the easily frightened Alexander, the blogger of DailyKos, it will take more than a little questionable scientific blather to get Harpers to do any more than ignore them, a nice twist that will serve the political defenders of HIV?AIDS a dose of their own medicine. Probably this overly strong reaction will only add to the Harpers momentum in the circles that count.

The one thing it will do is to provide a record that can easily be referenced by anybody who wishes to check out the strength of the arguments on either side without going to the scientific literature, which is the only reliable and up to date source. You can be sure that all serious paradigm challengers will be poring over this document.

They will certainly pick apart many of the statements made in the pdf criticising Farber for “56 errors”, which are expounded in no fewer than 36 pages. This is certainly an asset for those who support Harpers/Farber, for the longer the reply the more opportunity there is to make mincemeat out of it. From an initial skimming it seems to contain much that was standard in the early days of HIVB?AIDS theory which is now out of date, and much that has been decisively exploded in Duesberg’s papers. Presumably this reflects Bob Gallo recycling his old ideas, apparently unaware of some of the literature which now completely contradicts, for example, the possibility of a heterosexual AIDS epidemic.

We’ve only glanced at it and will post later on any egregious errors we discover, but already we have to note that we see correlation being asserted as causation, responses which avoid the point, appeals to authority compromised by drug company connections (as are some or all of these spokesmen, one suspects, not that this affects the argument), “errors” which are simply subjectively contradicted, “errors” which are true but are explained away, responses which are merely denials of misconduct, “errors” which are referenced as true in Duesberg papers, contradictions which are themselves false statements (PCR cannot count the amount of HIV in the blood, it merely can multiply what it finds, according to its inventor), “errors” contradicted by a reference that can itself be contradicted by another reference, “errors” contradicted by bad logic, “misleading statements” which are correct but they don’t like the phrasing, “errors” contradicted by out of date HIV theory abandoned in the leading mainstream literature (HIV is not held to “directly” kill T cells any more), “errors” contradicted by meaningless exceptions, errors” contradicted by claims that overlook the effect of treatment, “errors” proved by claims that so contradict mainstream literature that they amount to falsehoods (“most HIV transmission is through heterosexual sex”), “errors” proved by the use of logic that would also invalidate HIV theory, objections to the “denialist” case as “holocaust denial”, attacks on the credibility of various people quoted by Farber, and other specious nonsense.

On the whole it is difficult to imagine this amounts to much more than sticking the neck out to have it chopped off. The attempt to demean Duesberg’s authority and reputation seems likely to backfire, particular since it is claimed that most cancer authorities consider his new cancer hypothesis “pseudoscience.” Tell that to those who invited him to speak at the NCI, and the editors at Scientific American.

We detect the hand of Bob Gallo in this kind of schoolboy calumny. We were thinking of him the other day with fondness, as a consummate rogue who was charming in his bullying way. Now, however, he is old, like every major player in this affair. How tragic it must be to have spent your life making career capital out of mistakes great and small, especially a giant one which attacks the health of people all over the world instead of saving it, as Gallo MD once promised to do.

Let’s hope for his sake that he is able to maintain the belief to the end that he was right, and that HIV was really the scourge of the world, and he defended us all against it.

We recall once asking him if he would take AZT if he tested positive for HIV. He didn’t seem very keen. He said he would assess the situation carefully, or words to that effect.

Here is the page with the letter and the pdf: ACTUP offers a critique sent from South Africa

AIDS DENIALISM IN HARPER’S

March 2006

LISTING AND DESCRIBING IN DETAIL THE ERRORS IN CELIA FARBER’S

AIDS DENIALIST ARTICLE AS PUBLISHED MARCH 2006 IN HARPER’S

AIDS DENIALISM = SEEING WHAT YOU WANT TO SEE

Dear Sam Stark, Lewis H. Lapham and Roger D. Hodge

CC: Publishers and all staff of Harper’s

CC: Robert Gallo, Gregg Gonsalves Richard Jefferys, Daniel R. Kuritzkes, Bruce Mirken, John P. Moore, Jeffrey T. Safrit [co-authored response]

As promised, attached is a document listing and describing in detail the errors in Celia Farber’s March 2006 article in Harper’s. My co-authors are copied on this email. Because of the rush to get this to you, we reserve the option to make modifications to it during the next week. We do however consider it a public document.

We have categorised the errors as follows: 25 are outright false. 16 are misleading. 10 are biased. 5 are unfair. (i.e. 56 errors) These are underestimates, because in some cases we classified several errors as one. I have also not counted errors listed in table 2. Furthermore it would be unsurprising that if you properly fact-check the areas which we have not covered in detail (i.e. Farber’s allegations against the NIH, Jonathan Fishbein, the Hafford case) more errors would come to light. Every one of the errors we list should have been caught by a fact-checking team with appropriate scientific expertise. Many did not even require scientific expertise and just amount to sloppy journalism.

The printing of Farber’s error-filled piece by a prestigious magazine that has a fact-checking mechanism in place is scandalous. In contrast to the Stephen Glass case at New Republic, Farber’s distortions should have been spotted easily by a competent editor because all sources demonstrating her errors are public domain. Admittedly, spotting many of her errors requires some scientific expertise in your fact-checking team. If Harper’s does not have this scientific expertise then it is irresponsible to publish articles purporting to debunk the scientific consensus.

I note a number of disingenuous quotes attributed to Roger D. Hodge in Gay City News. In particular Hodge is quoted as stating “It was very, very thoroughly fact-checked over the course of three months,” and “A lot of what people are describing as errors are differences of opinion about the data.”

I sincerely hope these are misquotes. If they are not, it demonstrates that Mr. Hodge is unqualified to edit articles relevant to science and cannot differentiate between fact and opinion. To characterise research published in credible peer-reviewed scientific journals and the opinions of people with no track record of published AIDS research as differences of opinion is to have a very flawed understanding of truth. Farber’s article was not simply provocative or controversial, it is factually incorrect and unfair.

Hodge is further quoted as claiming that the story was not about whether HIV is the cause of AIDS. This is ridiculous. The story contains numerous assertions related to HIV as the cause of AIDS. Hodge is quoted that the story is rather about the mismanagement of drug studies and the censoring of debate. While this is certainly part of the focus of Farber’s story and an important topic to cover, Farber has covered this part of the story incompetently and unfairly.

To save its good reputation, Harper’s should do the following:

* Withdraw editorial support for Farber’s article and publish this withdrawal on the Harper’s Magazine website.

* Publish a retraction in the April or May issue of Harper’s Magazine and on the website immediately.

* Publish the list of errors and corrections in a prominent position on the website as soon as you have been able to fact-check it (the fact-checkers obviously should not include the individuals who “fact-checked” Ms. Farber’s article, or any other individuals suggested to you by her, or them).

* Publish a general rebuttal of the Farber piece in the April or May issue of Harper’s Magazine. One or more of the authors of the errors’ document will prepare such a rebuttal once we hear from you that you will print it.

* Undertake to review Harper’s fact-checking process, with special regard to articles on science (the common procedure of a writer suggesting fact-checkers for the article is seriously flawed).

We expect a satisfactory response from Harper’s by Monday evening.

Regards, Nathan Geffen

download attachment: “Errors in Farber article in Harpers” (pdf) (273 KB)

The key point in the Farber-Harpers vs AIDS Church dispute

March 5th, 2006

So why do the drugs appear to work very well?

Only one point in all the blog crowd response seems to us to be worth anything at all, and that is precisely what Jim Watson said to this writer when asked if he didn’t think he had misjudged HIV?AIDS. He replied, “but the (new) drugs work, don’t they?”

There it is time and again in the blog comments, we see, and the same point was repeatedly made to us in Washington last week, often with great force of conviction. Indeed, any skeptic is constantly told this by people who have dealt with HIV?AIDS patients as doctor, nurse, friend or social worker, that in their experience the drugs have worked, and this surely suggests they are directed at the right target.

Here is the latest letter in the POZ comment column, voicing precisely this point.

From Harry Wingfield, Birmingham, AL:

As a person who has lived with AIDS since 1990, my personal experience is that I was extremely ill until I got on the right regimen of HIV medications. I was too ill to work, and was on disability for 12 years. In 2002, thanks to antiretroviral medications, I was well enough to return to full time work again, and continue to work full time and stay healthy today.

Good diet and nutrition have also contributed to my health, but I give the major credit to finding the right combination of HIV medications. Some that I tried proved to be too toxic for my system, but with plenty of choices available, my doctors and I have found the right “cocktail” to keep me in good health. On the one occasion that I did go off medication, my health began to plummet again until I started the medicines back again.

I’ll leave it to the scientists to debate what causes HIV and AIDS. My experience, however, has been that the medicines that fight the HIV virus are responsible for my current good health. Simple logic tells me that the virus must be what has caused me to be sick.

Often they testify that patients virtually leap out of bed and climb mountains as soon as they are dosed with HAART. What have the HIV critics to say in answer to this point? Not enough, we have found in the past. They have three or four responses, but insufficient, and sound somewhat at a loss to account for it. Naturally, believers in HIV then dismiss them and all their otherwise copious reasoning and evidence against the prevailing paradigm.

But with all reason and evidence otherwise against it, as Duesberg has continually shown, without genuine refutation, it is impossible to accept that HIV is the correct target for medication after all, and that Duesberg despite his extraordinary crednetials and peer reviewed, superbly written testimony is really an ass. This seems as incredible to us as the HIV supporters find any challenge to HIV.

Currently, the HIV critics answer to this is largely not to fully credit the improvement, it seems to us. Their explanation for the apparently beneficial effect of antiretrovirals consists of four points. That a) it is a psychological effect rather than an actual bodily effect b) the antiretroviral agents erase some of the other viruses that actually are causing a problem, in the wake immune dysfunction c) it provokes the generation of antibodies which in itself makes people feel better and d) the temporary relative improvement does not last and the long term death rate is the same as before.

In the face of radical improvment in patients’ feeling of well being, which has clearly been observed time and again by people in the field, HIV critics have long clearly needed more cards in their hand, as Jim Watson observed.

We think we have this answer, which we will call Factor X, and as noted in the last post, we think the answer to AIDS is clearly indicated now in the scientific literature, and Factor X is part of this answer. We will post on it shortly.

Whatever the explanation, one thing is certain. This is currently the crucial issue in the minds of most lay observers of the highly contentious difference of opinion on HIV and AIDS.

Unless the objection of Watson – “the drugs work, don’t they?” – is laid to rest, critics of HIV?AIDS will always have a tough time persuading the world that they are right.

The true cause of and cure for HIV?AIDS to be announced

March 4th, 2006

The sun will set here on twenty years and $140 billion worth of irrational theory

At the end of our patience with the scientific scallywags and media lickspittles of the HIV?AIDS scene, not to mention the armchair activists, Web soapboxers and AIDS walkers and runners and rowers and all the other lemmings of this as yet scientifically unjustified and always medically oppressive paradigm, we are happy to announce that, not unlike Princeton mathematician Andrew Wiles solving Fermat’s Theorem (1630) after nearly four centuries, we have after a long two decades finally identified the solution to the last two remaining great puzzles of HIV?AIDS – its real cause and its real cure.

We do not joke, faithful readers. And this is no arrogant assertion made by an individual overcome by grandiosity at the sight of a blank screen on the Net. It is merely the result of an ordinary hack using the extraordinary secret weapon that our benevolent government has put into our hands over the last few years. Using this tool, even a brainless scribbler has more intellectual power over medical and scientific knowledge than Galileo, Newton, Copernicus, Einstein and Duesberg combined, sitting in the first Library of Alexandria.

For PubMed and its electronic cousins are the equivalent of being God when it comes to power over medical information. PubMed alone has some 16 million papers at its beck and call, or rather, your beck and call, and mine, if you only follow the simple instructions we announced in our earlier post.

That is how we can soon come forward and announce the True Cause and Cure of AIDS (patented). Moreover, unlike Wiles, we have found a solution that all will understand and support, not one that is beyond the ken of the lay reader. Ours, like Fermat’s own solution, will fit into the margin of a book. This simple answer was as close at the nearest screen serving up PubMed, we discovered, with a little additional nudging when an ordinary search using the obvious terms (“Cause cure HIV AIDS”) failed to come up with precisely what we were looking for.

The inspired nudging was designed by a certain distinguished medical researcher who like us has no taste for fame, but who we think deserves the Lasker prize for this breakthrough, though of course he won’t get it, since the solution is too simple and obvious, and the amount of funding it threatens too vast, for any such tribute to be on the cards.

Nevertheless, for the benefit of those who are still taking nevirapine and other revolting (see label) drugs, we will post the final answer to HIV?AIDS here shortly, for their benefit and for the general benefit of mankind, who for too long have been led over the edge of the cliff, when the easy path down to the shore to watch the sunset of HIV?AIDS was at hand all the time, courtesy of the feds, though not the ones at DAIDS, we are sorry to say.

Those who suppose that this announcement is facetious and that they can anticipate only disappointment may refer to our solution to the threat of bird flu earlier, which has so far withstood the test of public announcement without attracting a single challenge.

Watch this space for another, equally well referenced, mainstream researched statement.

Celia Farber’s “Out of Control” here at NAR, in its full glory

March 4th, 2006

Blogheads can quote accurately from the text (see below post)

The seminal Harpers expose of mismanagement and worse, not to mention lack of theoretical justification, in HIV?AIDS by Celia Farber is now on line in a corrupted version with chunks moved around at Out of Control: AIDS and the Corruption of Medical Science, so we reproduce it below, corrected, for reference.

The site where most of it is carried without comment (presumably OCR’d from Harpers) is Mindfully, run by conspiracy theorists who apparently believe that September 11 demolition of the WTC was helped along by Larry Silverstein. In general, it appears that they feel that the news fails to bring us all the facts, a reasonable suspicion which they then apply generously to every major news event.

In the HIV?AIDS case, rather like the stopped clock which is right twice a day, they are surely right to suspect, with Harpers/Farber, that all is not as it is made out to be in HIV?AIDS.

However, we think it is important to emphasize that while HIV?AIDS may be almost universally attributed to the wrong cause, and that the motivations for doing so may be consciously or unconsciously unscientific for each individual ie laziness, self-interest, timidity, lack of time, misplaced trust, intellectual befuddlement, group pressure, professional sanctions, status, establishment clubbiness, and the brain activity of mirror neurons, we doubt that there is any knowing and secretly planned conspiracy to do so, nor is one being alleged by the skeptics.

One reason is that it is not necessary. In science and medicine, it is clear, human nature is quite enough to lead vast numbers of people over the nearest cliff if they are pointed in the right direction.

Meanwhile, Mindfully having placed it on the Web (presumably unlawfully, but perhaps not losing too many newstand sales for Harpers at $6.95, which is the forbidding price per copy) even in a slightly inappropriate setting, it does allow us to point out the few tiny slips we have noticed so far in what is a well polished piece.

Duesberg lost his lab facilities and had to move twice within a few years to smaller labs on the Berkeley campus, where he spent much of his time writing futile research grant proposals asking to test his hypothesis that AIDS is a chemical syndrome, caused by accumulated toxins from heavy drug use.

This would be better with “AIDS” expanded to “AIDS here in the US”, since it does not apply to the supposed global pandemic.

(With all other viral diseases, by the way, the presence of antibodies signals immunity from the disease. Why this is not the case with HIV has never been demonstrated.)

This seems to be precisely true only if “immunity” is used in the more technical sense of “resistance”, since there are chronic diseases that do flare up after antibodies have reduced their initial impact. So perhaps it would be better if the word “typically” was added, as in “the presence of antibodies typically signals immunity from the disease.”

Or “with the virtual absence of the agent” added as in “the presence of antibodies with the virtual absence of the agent signals immunity from the disease”. Either way, the truth is that antibodies generated successfully and the agent disappearing, as happens in HIV?AIDS, would indeed signify that the body has overcome the agent and no further trouble should be expected. This is fact is the centuries old principle of vaccination. Why it isn’t true in HIV?AIDS as it appears from all indications to be, is something which has not yet been explained successfully.

She states that Duesberg was the youngest ever member of the National Academy of Sciences when he joined it in 1986, but this seems to be a rather obvious slip. Duesberg himself, asked about it, said he doubted it. He was 50 at the time and there have surely been younger members than that voted in.

Also, Celia’s book is being written anew, we understand, rather than simply being a collection of her previous writings on the topic.

Then there is the windup, which has Celia and the Harpers editors not joining the HIV skeptics as such, but simply making the reasonable request to have an “open and honest debate” about the risks of current treatments and the scientific questions concerning HIV.

It’s too late to save people like Joyce Ann Hafford, but it is possible that an open and honest debate about the risks of current AIDS treatments and the scientific questions concerning HIV could save others.

After their summary of all the points made by Duesberg against HIV and few if any answers from his opponents, it is fair to conclude that the editors probably are now closet HIV skeptics, who, as Walter Gilbert of Harvard once put it to me, would “not be surprised if there was another cause of AIDS altogether”.

Here is the full version of a piece which one day will be recognized as the tipping point for exposure of the Enron of science, a $140 billion dud paradigm, if sanity prevails: Out Of Control: AIDS and the Corruption of Medical Science

CELIA FARBER / Harper’s Magazine Mar 2006 (the text is fixed where we have noticed chunks missing from the Mindfully version).

Out Of Control: AIDS and the corruption of medical science

CELIA FARBER / Harper’s Magazine 1mar2006

Celia Farber is a writer based in New York City. A collection of her AIDS reporting, Serious Adverse Events, is forthcoming from Melville House.

Joyce Ann Hafford was a single mother living alone with her thirteen-year-old son, Jermal, in Memphis, Tennessee, when she learned that she was pregnant with her second child. She worked as a customer service representative at a company called CMC Call Center; her son was a top student, an athlete and musician. In April 2003, Hafford, four months pregnant, was urged by her obstetrician to take an HIV test. She agreed, even though she was healthy and had no reason to think she might be HIV positive. The test result came up positive, though Hafford was tested only once, and she did not know that pregnancy itself can cause a false positive HIV test. Her first thought was of her unborn baby. Hafford was immediately referred to an HIV/AIDS specialist, Dr. Edwin Thorpe, who happened to be one of the principal investigators recruiting patients for a clinical trial at the University of Tennessee Medical Group that was sponsored by the Division of AIDS (DAIDS)—the chief branch of HIV/AIDS research within the National Institutes of Health.

The objective of the trial, PACTG 1022, was to compare the “treatment-limiting toxicities” of two anti-HIV drug regimens. The core drugs being compared were nelfinavir (trade name Viracept) and nevirapine (trade name Viramune). To that regimen, in each arm, two more drugs were added—zidovudine (AZT) and lamivudine (Epivir) in a branded combination called Combivir. PACTG 1022 was a “safety” trial as well as an efficacy trial, which means that pregnant women were being used as research subjects to investigate “safety” and yet the trial was probing the outer limits of bearable toxicity. Given the reigning beliefs about HIV’s pathogenicity, such trials are fairly commonplace, especially in the post-1994 era, when AZT was hailed for cutting transmission rates from mother to child.

The goal of PACTG 1022 was to recruit at least 440 pregnant women across the nation, of which 15 were to he enrolled in the University of Tennessee Medical Group. The plan was to assign the study’s participants to one of two groups, with each receiving three HIV drugs, starting as early as ten weeks of gestation. Of the four drugs in this study, three belong to the FDA’s category “C,” which means that safety to either mother or fetus has not been adequately established.

Joyce Ann Hafford was thirty-three years old and had always been healthy. She showed no signs of any of the clinical markers associated with AIDS her CD4 counts, which measure the lymphocytes that are used to indicate how strong a person’s immune system is, and which HIV is believed to slowly corrode, were in the normal range, and she felt fine. In early June 2003, she was enrolled in the trial and on June 18 took her first doses of the drugs. “She felt very sick right away,” recalls her older sister, Rubbie King. “Within seventy-two hours, she had a very bad rash, welts all over her face, hands, and arms. That was the first sign that there was a problem. I told her to call her doctor and she did, but they just told her to put hydrocortisone cream on it. I later learned that a rash is a very had sign, but they didn’t seem alarmed at all.”

Hafford was on the drug regimen for thirty-eight days. “Her health started to deteriorate from the moment she went on the drugs,” says King. “She was always in pain, constantly throwing up, and finally she got to the point where all she could do was lie down.” The sisters kept the news of Hafford’s HIV test and of the trial itself from their mother, and Hafford herself attributed her sickness and nausea to being pregnant. She was a cheerful person, a noncomplainer, and was convinced that she was lucky to have gotten into this trial. “She said to me, `Nell’ —that’s what she called me—`I have got to get through this. I can’t let my baby get this virus.’ I said, `Well, I understand that, but you’re awful sick.’ But she never expressed any fear because she thought this was going to keep her baby from being HIV positive. She didn’t even know she was in trouble.”

On July 16, at her scheduled exam, Hafford’s doctor took note of the rash, which was “pruritic and macular-papular,” and also noted that she was suffering hyperpigmentation, as well as ongoing nausea, pain, and vomiting. By this time all she could keep down were cans of Ensure. Her blood was drawn for lab tests, but she was not taken off the study drugs, according to legal documents and internal NIH memos.

Eight days later, Hafford went to the Regional Medical Center “fully symptomatic,” with what legal documents characterize as including: “yellow eyes, thirst, darkening of her arms, tiredness, and nausea without vomiting.” She also had a rapid heartbeat and difficulty breathing. Labs were drawn, and she was sent home, still on the drugs. The next day, July 25, Hafford was summoned back to the hospital after her lab reports from nine days earlier were finally reviewed. She was admitted to the hospital’s ICU with “acute and subacute necrosis of the liver, secondary to drug toxicity, acute renal failure, anemia, septicemia, premature separation of the placenta,” and threatened “premature labor.” She was finally taken off the drugs but was already losing consciousness. Hafford’s baby, Sterling, was delivered by C-section on July 29, and she remained conscious long enough not to hold him but at least to see him and learn that she’d had a boy. “We joked about it a little, when she was still coming in and out of consciousness in ICU,” Rubbie recalls. “I said to her, `You talked about me so much when you were pregnant that that baby looks just like me.”‘ Hafford’s last words were a request to be put on a breathing tube. “She said she thought a breathing tube might help her,” says Rubbie. “That was the last conversation I had with my sister.” In the early morning hours of August 1, Rubbie and her mother got a call to come to the hospital, because doctors had lost Hafford’s pulse. Jermal was sleeping, and Rubbie woke her own daughter and instructed her not to tell Jermal anything yet. They went to the hospital, and had been there about ten minutes when Joyce Ann died.

Rubbie recalls that the hospital staff said they would clean her up and then let them sit with her. She also remembered a doctor who asked for their home phone numbers and muttered, “You got a law suit.” (That person has not resurfaced.) They hadn’t been sitting with Hafford’s body long when a hospital official came in and asked the family whether they wanted an autopsy performed. “We said yes, we sure do,” she says. The hospital official said it would have to be at their expense—at a cost of $3,000. “We said, `We don’t have $3,000.’ My sister didn’t have any life insurance or anything,” says Rubbie. “She had state health care coverage, and we were already worried about how to get the money together to bury her.” Consequently, no autopsy was done. There was a liver biopsy, however, which revealed, according to internal communiqués of DAIDS staff, that Hafford had died of liver failure brought on by nevirapine toxicity.

And what was the family told about the cause of Hafford’s death? “How did they put it?” Rubbie answers, carefully. “They told us how safe the drug was, they never attributed her death to the drug itself, at all. They said that her disease, AIDS, must have progressed rapidly.” But Joyce Ann Hafford never had AIDS, or anything even on the diagnostic scale of AIDS. “I told my mom when we were walking out of there that morning,” Rubbie recalls, “I said, `Something is wrong.’ She said, `What do you mean?’ I said, `On the one hand they’re telling us this drug is so safe, on the other hand they’re telling us they’re going to monitor the other patients more closely. If her disease was progressing, they could have changed the medication.’ I knew something was wrong with their story, but I just could not put my finger on what it was.”

When they got home that morning, they broke the news to Jermal. “I think he cried the whole day when we told him,” Rubbie recalls. “My mom had tried to prepare him. She said, `You know, Jermal, my mom died when I was very young,’ but he was just devastated. They were like two peas in a pod those two. You could never separate them.” Later on, Jermal became consumed with worry about how they would bury his mother, for which they had no funds and no insurance. The community pitched in, and Hafford was buried. “I haven’t even been able to go back to her grave since she passed,” says Rubbie.

Rubbie King is haunted by many questions, including whether her sister was really infected with HIV,1 and also what the long-term damage might be to Sterling, whom Rubbie is now raising, along with Jermal and her own child. Sterling, in addition to the drugs he was exposed to in the womb, was also on an eight-week AZT regimen after birth. One of the reasons the family suspects Hafford may have been a false positive is that St. Jude’s Children’s Research Hospital has not released Sterling’s medical records, and although they have been told that he is now HIV negative, they never had any evidence that he was even born positive. (All babies born to an HIV-positive mother are born positive, but most become negative within eighteen months.)

Hafford’s family was never told that she died of nevirapine toxicity. “They never said that. We never knew what she had died of until we got the call from [AP reporter] John Solomon, and he sent us the report,” says Rubbie King. “It was easier to accept that she died of a lethal disease. That was easier to handle.” The family has filed a $10 million lawsuit against the doctors who treated Hafford, the Tennessee Medical Group, St. Jude’s Children’s Research Hospital, and Boehringer Ingelheim, the drug’s manufacturer.2

Rubbie King made a final, disturbing discovery when she was going through Hafford’s medical records: In addition to discovering that her sister had only ever been given a single HIV test, she also came across the fifteen-page consent form, which was unsigned.

On August 8, 2003, Jonathan Fishbein, who had recently taken a job as the director of the Office for Policy in Clinical Research Operations at DAIDS, wrote an email to his boss, DAIDS director Ed Tramont, alerting him that “there was a fulminant liver failure resulting in death” in a DAIDS trial and that it looked like “nevirapine was the likely culprit.” He said that the FDA was being informed. He was referring to Joyce Ann Hafford. Tramont emailed him hack, “Ouch. Not much wwe can do about dumd docs!”

This email exchange came to light in December 2004, when AP reporter John Solomon broke the story that Fishbein was seeking whistle-blower protection, in part because he had refused to sign off on the reprimand of an NIH officer who had sent the FDA a safety report concerning the DAIDS trial that launched the worldwide use of nevirapine for pregnant women. The study was called HIVNET 012, and it began in Uganda in 1997.

The internal communiqués from DAIDS around the time of Hafford’s death made it clear that doctors knew she had died of nevirapine toxicity. Tramont’s reply to Fishbein suggests that he thought blame could he placed squarely with Hafford’s doctors, but it was the NIH itself that had conceived of the study as one that tested the “treatment-limiting toxicities” of HIV drugs in pregnant women.

The conclusion of the PACTG 1022 study team was published in the journal JAIDS in July of 2004. “The study was suspended,” the authors reported, “because of greater than expected toxicity and changes in nevirapine prescribing information.” They reported that within the nevirapine group, “one subject developed fulminant hepatic liver failure and died, and another developed Stevens-Johnson syndrome.” Stevens-Johnson syndrome is skin necrolysis—a severe toxic reaction that is similar to internal third-degree burns, in which the skin detaches from the body. Another paper, entitled “Toxicity with Continuous Nevirapine in Pregnancy: Results from PACTG 1022,” puts the results in charts, with artful graphics. A small illustration of Hafford’s liver floats in a box, with what looks like a jagged gash running through it. Four of the women in the nevirapine group developed hepatic toxicity.

As Terri Schiavo lay in her four-teenth year of a persistent vegetative state, and the nation erupted into a classically American moral opera over the sanctity of life, Joyce Ann Hafford’s story made only a fleeting appearance—accompanied by a photo of her holding a red rose in an article that was also written by the AP’s John Solomon. But soon a chorus of condemnation was turned against those who were sensationalizing Hafford’s death and the growing HIVNET controversy to condemn nevirapine, which had been branded by the AIDS industry as a “life-saving” drug and a “very important tool” to combat HIV in the Third World.

So-called community AIDS activists were sprung like cuckoo birds from grandfather clocks at the appointed hour to affirm the unwavering AIDS cathechism: AIDS drugs save lives. To suggest otherwise is to endanger millions of African babies. Front and center were organizations like the Elizabeth Glaser Pediatric AIDS Foundation, which extolled the importance of nevirapine. Elizabeth Glaser’s nevirapine defenders apparently didn’t encounter a single media professional who knew, or cared, that the organization had received $1 million from nevirapine’s maker, Boehringer Ingelheim, in 2000.3 This was no scandal but simply part of a landscape. Pharmaceutical companies fund AIDS organizations, which in turn are quoted uncritically in the media about how many lives their drugs save. This time the AIDS organizations were joined by none other than the White House, which was in the midst of promoting a major program to make nevirapine A available across Africa.4

….

America is a place where people rarely say: Stop. Extreme and unnatural things happen all the time, and nobody seems to know how to hit the brakes. In this muscular, can-do era, we are particularly prone to the seductions of the pharmaceutical industry, which has successfully marketed its ever growing arsenal of drugs as the latest American right. The buzzword is “access,” which has the advantage of short-circuiting the question of whether the drugs actually work, and of utterly obviating the question of whether they are even remotely safe. This situation has had particularly tragic ramifications on the border between the class of Americans with good health insurance, who are essentially consumers of pharmaceutical goods, and those without insurance, some of whom get drugs “free” but with a significant caveat attached: They agree to be experimented on. These people, known in the industry as “recruits,” are pulled in via doctors straight from clinics and even recruited on the Internet into the pharmaceutical industry and the government’s web of clinical trials, thousands of which have popped up in recent years across the nation and around the world. Such studies help maintain the industry’s carefully cultivated image of benign concern, of charity and progress, while at the same time feeding the experimental factories from which new blockbuster drugs emerge. “I call them what they are: human experiments,” says Vera Hassner Sharav, of the Alliance for Human Research Protection in New York City. “What’s happened over the last ten to fifteen years is that profits in medicine shifted from patient care to clinical trials, which is a huge industry now. Everybody involved, except the subject, makes money on it, like a food chain. At the center of it is the NIH, which quietly, while people weren’t looking, wound up becoming the partner of industry.”

By June 2004, the National Institutes of Health had registered 10,906 clinical trials in ninety countries. The size of these trials, which range from the hundreds to more than 10,000 people for a single study, creates a huge market for trial participants, who are motivated by different factors in different societies but generally by some combination of the promise of better health care, prenatal care, free “access” to drugs, and often—especially in the United States—cash payments. Participating doctors, whose patient-care profits have been dwindling in recent years because of insurance-company restrictions, beef up their incomes by recruiting patients.

…..

Dr. Jonathan Fishbein is hardly a rabble-rouser. But he is a passionate advocate of “good clinical practice,” or GCP, a set of international standards that were adopted in 1996, as clinical-trial research boomed. The GCP handbook states: “Compliance with this standard provides public assurance that the rights, safety, and well-being of trial subjects are protected, consistent with the principles that have their origin in the Declaration of Helsinki, and that the clinical trial data are credible.” During the decade prior to his arrival at DAIDS, Fishbein had overseen and consulted on hundreds of clinical trials for just about every pharmaceutical company. Fishbein knew, before he took his job as director of the Office for Policy in Clinical Research Operations at DAIDS, that there was a troubled study haunting the whole division. Nobody was supposed to talk about it, but it hung heavily in the air. “Something about Uganda, that’s all I knew,” he says. There was a trial staged there, a big one, that had been plagued with “problems,” and there was also a lot of talk about one particular employee connected to this trial who would need to he disciplined. Soon he discovered just how had the situation was. “The HIVNET thing,” he recalls, “it hit me like a fire hose when I walked in there.”

Fishbein’s position was new. “It sounded like a very important position,” he says. “I was to oversee the policies governing all the clinical-research operations, both here and abroad.” He was told he would have “go–no go” authority over individual trials. It wasn’t long before Fishbein realized that he was, in effect, taking a job that was the equivalent of piloting an already airborne plane. “They had all these trials going on, and hundreds of millions of dollars flowing in every year, but there was apparently no one in a senior position there who really had clinical expertise—who knew all the nuances, rules, and regulations in the day-to-day running of clinical trials.” DAIDS, when Fishbein came to work there in 2003, was running about 400 experimental trials both in the United States and abroad.

A DAIDS project officer close to the HIVNET study closed the door when she had her first meeting with Fishbein. She had also crossed over from the private sector, and so she and Fishbein shared a disillusionment over how much shoddier and more chaotic the research culture was within the government, compared with industry. “I’m really frightened about the stuff that goes on here,” she told him. “We really need somebody.” This project officer, who for her own protection cannot be named, told Fishbein that the division’s flagship study in Africa—HIVNET 012—had been wracked with problems and completely lacking in regulatory standards. She told Fishbein that the trial investigators were “out of control,” and that there was no oversight of them, and nobody with either the inclination or the authority to make them adhere to safety standards. What Fishbein subsequently learned entangled him in a story with eerie echoes of John Le Carre’s Constant Gardener.

For our purposes, the story of nevirapine begins in 1996, when the German pharmaceutical giant Boehringer Ingelheim applied for approval of the drug in Canada. The drug had been in development since the early 1990s, which was a boom time for new HIV drugs. Canada rejected nevirapine twice, once in 1996 and again in 1998, after the drug showed no effect on so-called surrogate markers (HIV viral load and CD4 counts) and was alarmingly toxic. In 1996, in the United States, the FDA nonetheless gave the drug conditional approval so that it could be used in combination with other HIV drugs.5

By this time, Johns Hopkins AIDS researcher Brooks Jackson had already generated major funding from the NIH to stage a large trial for nevirapine in Kampala, Uganda, where the benevolent dictator Yoweri Museveni had opened his country to the lucrative promise of AIDS drug research, as well as other kinds of pharmaceutically funded medical research. HIVNET 012, according to its original 1997 protocol, was intended to be a four-arm, Phase III, randomized, placebo-controlled trial.6 Its sole sponsor was listed as the National Institute of Allergy and Infectious Diseases (NIAID), though one of the investigators was a Boehringer employee. The “sample size” was to be 1,500 HIV-1 infected Ugandan women more than thirty-two weeks pregnant. The four arms they would be divided into were 1) A single dose of 200mg nevirapine at onset of labor and a single 2mg dose to the infant forty-eight to seventy-two hours post-delivery, and 2) a corresponding placebo group; 3) 600mg of AZT at onset of labor and 300mg until delivery, with a 4mg AZT dose for the infant lasting seven days after birth, and 4) a corresponding placebo group. There were to he 500 women in each “active agent” arm and 250 in each placebo arm. The study was to last eighteen months, and its “primary endpoints” were to see how these two regimens would affect rates of HIV transmission from mother to child, and to examine the “proportion of infants who are alive and free of HIV at 18 months of age.” Another primary objective was to test the “safety/tolerance” of nevirapine and AZT. HIVNET’s architects estimated that more than 4,200 HIV-positive pregnant women would deliver at Mulago hospital each year, allowing them to enroll eighty to eighty-five women per month. Consent forms were to be signed by either the mother or a guardian, by signature or “mark.” One of the exclusion criteria was “participation during current pregnancy in any other therapeutic or vaccine perinatal trial.”

Although HIVNET was designed to be a randomized, placebo-controlled, double-blind, Phase III trial of 1,500 mother/infant pairs, it wound up being a no-placebo, neither double- nor even single-blind Phase II trial of 626 mother/infant pairs. Virtually all of the parameters outlined for HIVNET 012 were eventually shifted, amended, or done away with altogether, beginning with perhaps the most important—the placebo controls. By a “Letter of Amendment” dated March 9, 1998, the placebo-control arms of HIVNET were eliminated. The study as reconstituted thus amounted to a simple comparison of AZT and nevirapine.

On September 4, 1999, The Lancet published HIVNET’s preliminary results, reporting that “Nevirapine lowered the risk of HIV-I transmission during the first 14–16 weeks of life by nearly 50 percent.” The report concluded that “the two regimens were well-tolerated and adverse events were similar in the two groups.” The article also reported that thirty-eight babies had died, sixteen in the nevirapine group and twenty-two in the AZT group. The rate of HIV transmission in the AZT arm was 25 percent, while in the nevirapine group it was only 13 percent. As Hopkins Medical News later reported, the study was received rapturously. “The data proved stunning. It showed that nevirapine was 47 percent more effective than AZT and had reduced the number of infected infants from 25 to 13 percent. Best of all, nevirapine was inexpensive—just $4 for both doses. If implemented widely, the drug could prevent HIV transmission in more than 300,000 new-borns a year.”

With the results of the study now published in The Lancet, Boehringer, which previously had shown little interest in HIVNET, now pressed for FDA approval to have nevirapine licensed for use in preventing the transmission of HIV in pregnancy.

There were complications, however. On December 6, 2000, a research letter in The Journal of the American Medical Association warned against using nevirapine for post-exposure treatment after two cases of life-threatening liver toxicity were reported among health-care workers who’d taken the drug for only a few days. (One of them required a liver transplant.) The January 5, 2001, issue of the CDC’s Morbidity and Mortality Weekly Report (MMWR) contained an FDA review of MedWatch—an informal reporting system of drug reactions—that highlighted an additional twenty cases of “serious adverse events” resulting from fairly brief nevirapine post-exposure prophylaxis. “Serious adverse events” were defined as anything “life-threatening, permanently disabling,” or requiring “prolonged hospitalization, or [.. . ] intervention to prevent permanent impairment or damage.” The MMWR stressed that there probably were more unreported cases, since the reporting by doctors to MedWatch is “voluntary” and “passive.”

But NIAID was on another track altogether, either oblivious of or undeterred by the toxicity controversy. In 2001, Boehringer Ingelheim submitted its supplemental licensing request to the FDA. The request was submitted based entirely on the results of HIVNET, as published in The Lancet. Around the same time, the South African Medicines Control Counsel (MCC) conditionally approved nevirapine for experimental use in mother-to-child transmission treatment. To its credit, however, the FDA decided to go to Kampala, inspect the site, and review the data itself.

Since Boehringer had not originally intended to use this study for licensing purposes, it decided to perform its own inspection before the FDA arrived. Boehringer’s team arrived in Kampala and did a sample audit. They were the first to discover what a shambles the study was. According to Boehringer’s preinspection report, “serious noncompliance with FDA Regulations was found” in the specific requirements of reporting serious adverse events. Problems also were found in the management of the trial drug and in informed-consent procedures. DAIDS then hired a private contractor, a company named Westat, to go to Uganda and do another preinspection. This time the findings were even more alarming. One of the main problems was a “loss of critical records.” One of two master logs that included follow-up data on adverse events, including deaths, was said to be missing as the result of a flood. The records failed to make clear which mothers had gotten which drug, when they’d gotten it, or even whether they were still alive at various follow-up points after the study. Drugs were given to the wrong babies, documents were altered, and there was infrequent follow-up, even though one third of the mothers were marked “abnormal” in their charts at discharge. The infants that did receive follow-up care were in many cases small and under-weight for their age. “It was thought to be likely that some, perhaps many, of these infants had serious health problems.” The Westat auditors looked at a sample of forty-three such infants, and all forty-three had “adverse events” at twelve months. Of these, only eleven were said to be HIV positive. The HIVNET team had essentially downgraded all serious adverse events several notches on a scale it had created to adapt to “local” standards. That downgrade meant, among other things, that even seemingly “life-threatening” events were logged as not serious. Deaths, unless they occurred within a certain time frame at the beginning of the study, were not reported or were listed as “serious adverse events” rather than deaths. In one case, “a still birth was reported as a Grade 3 adverse event for the mother.”

As a defense, the HIVNET team often cited ignorance. They told the Westat monitors that they were unaware of safety-reporting regulations, that they’d had no training in Good Clinical Practice, and that they had “never attempted a Phase III trial.” The principal investigators and subinvestigators “all acknowledged the findings [of the audit] as generally correct,” the Westat report said. “Dr. Guay and Dr. Jackson noted that many (‘thousands’) of unreported AE’s and SAE’s occurred… . They acknowledged their use of their own interpretation of `serious’ and of severity.” “All agreed” that the principal and subinvestigators “had generally not seen the trial patients,” and “all agreed” that in evaluating adverse and serious adverse events “they had relied almost entirely on second or third hand summaries . . . without attempting to verify accuracy.” Westat also discovered that half the HIV-positive infants were also enrolled in a vitamin A trial, which effectively invalidates any data associated with them.

In light of the Westat report, DAIDS and Boehringer asked the FDA for a postponement of its inspection visit. The FDA responded by demanding to see the report immediately. On March 14, 2002, the FDA called a meeting with DAIDS, Boehringer, and the trial investigators. “They reprimanded the whole gang,” says Fishbein. Then they said to Boehringer: Withdraw your application for extended approval, if you want to avoid a public rejection.” Boehringer complied with the FDA’s demand, though statements put out by NIAID made it sound as if the company had withdrawn the application for FDA approval in a spirit of profound concern for protocol. In South Africa, a few months later, the news focused on the angry chorus of AIDS experts and activists, speaking as one. The South African MCC was reconsidering its approval of nevirapine for pregnant women because of Boehringer’s withdrawal and the growing HIVNET controversy. The Associated Press reported that “activists fear the government, notorious for its sluggish response to the AIDS crisis, is pressuring the council to reject nevirapine, and that it could misrepresent the current discussions as proof the drug is toxic. Studies show nevirapine given to HIV-pregnant women during labor and to their newborn babies can reduce HIV transmission by up to 50 percent.” The problem with such statements, of course, is that the study in question was precisely the one that established the claim that nevirapine cut HIV transmission.

Two inspections had now declared HIVNET to be a complete mess: Boehringer’s own and Westat’s, which had been performed in conjunction with DAIDS. But the ways in which the various players were tethered together made it impossible for DAIDS to condemn the study without condemning itself.7 But DAIDS was well aware of what had transpired.

According to DAIDS’s public version of events, which was dutifully echoed in the AIDS press, the trouble with HIVNET was that it was unfairly assailed by pedantic saboteurs who could not grasp the necessary difference between U.S. safety standards and the more lenient standards that a country like Uganda deserved. Two weeks after the fifty-seven-page Westat report was delivered, the deputy director of NIAID, Dr. John LaMontagne, had set the tone by stating publicly: “There is no question about the validity [of the HIVNET results] …the problems are in the rather arcane requirements in record keeping.” DAIDS was so dismissive of the Westat report that Westat’s lawyers eventually put officials on notice that they were impugning Westat’s reputation.

Meanwhile, as the investigations continued, nevirapine had long since been recommended by the World Health Organization and registered in at least fifty-three countries, and Boehringer had begun shipping boxes of the drug to maternity wards across the developing world. In 2002, President Bush announced a $500 million program to prevent maternal transmission of HIV in which nevirapine therapy would play a major role—despite the fact that the drug has never received FDA approval for this purpose.

In 2003, when Jonathan Fishbein was drawn into the HIVNET saga, the cover-up (for that, ultimately, is what the NIH response had become) was ongoing. In response to the massive failures documented by Boehringer and Westat, DAIDS embarked on a “remonitoring review” in an attempt to validate the study’s results. Ordinarily, an outside contractor would be retained for such a complex project, but Tramont made the decision to keep the remonitoring in-house. Drafting the review was a massive undertaking that took months of research, lengthy interviews with the investigators, and painstaking analysis of poorly organized documentation, as the DAIDS team attempted to learn what had actually taken place in Kampala. Even so, Tramont wanted the HIVNET site reopened in time for President Bush’s visit to Uganda. In March 2003, Tramont and his staff gathered together the different sections and substantially rewrote the report, especially the safety section, minimizing the toxicities, deaths, and record-keeping problems. The rewritten report concluded that nevirapine was safe and effective for the treatment of mother-to-child transmission of HIV, thus saving HIVNET 012 from the scrapheap of failed scientific studies.

While preparing the safety review section, however, an NIH medical officer named Betsy Smith noticed a pattern of elevated liver counts among some of the babies in the AZT arm. Following FDA regulations, she drafted a safety report documenting this finding and gave it to Mary Anne Luzar, a DAIDS regulatory affairs branch chief. Luzar forwarded the safety report to the FDA. The HIVNET investigators were furious; Tramont, who had previously signed off on the safety report, ordered a new version to be drafted, essentially retracting the previous one, and sent it to the FDA.8 The political stakes were very high: nevirapine was now a major element in the Administration’s new $15 billion African AIDS program—on July 11, President Bush even toured the HIVNET site in Kampala, which DAIDS had reopened for the occasion over Fishbein’s objections.

By late June 2003, Jonathan Kagan, the deputy director of DAIDS, asked Fishbein to sign off on a reprimand of Luzar for insubordination. Fishbein reviewed the HIVNET documentation and concluded that Luzar had done nothing wrong, that she had simply followed protocol. Fishbein’s refusal to go along with Luzar’s reprimand amounted to a refusal to participate in the HIVNET cover-up. In July, Tramont sent an email to all DAIDS staff instructing them not to speak about HIVNET at all. “HIVNET 012 has been reviewed, remonitored, debated and scrutinized. To do any more would be beyond reason. It is time to put it behind us and move on. Henceforth, all questions, issues and inquiries regarding HIVNET 012 is [sic] to be referred to the Director, DAIDS.”9

What followed, as internal emails and memorandums clearly show, was a vicious and personal campaign on the part of Kagan and Tramont to terminate Fishbein’s employment. DAIDS officials wrote emails in which they worried about how to fire him without creating repercussions for NIAID director Anthony Fauci, who had given Fishbein a commendation for his work. The communiqués took on conspiratorial tones as Tramont led the operation and mapped out its challenges. On February 23, 2004, Tramont emailed Kagan: “Jon, Let’s start working on this—Tony [Fauci] will not want anything to come back on us, so we are going to have to have iron-clad documentation, no sense of harassment or unfairness and, like other personnel actions, this is going to take some work. In Clauswitzian style, we must overwhelm with `force.’ We will prepare our paper work, then . . . go from there.” The web now included several more NIH/NIAID employees, who weighed in with suggestions about how best to expel Fishbein without leaving damning legal fingerprints on the proceedings.

Fishbein spent months trying to get a fair hearing, petitioning everyone from Elias Zerhouni, the director of the NIH, to Secretary of Health Tommy Thompson. It was around this time that Fishbein became a “ghost.” Nobody addressed him in the corridors, in the elevators, in the cafeteria. “There was an active campaign to humiliate me,” he says. “It was as if I had AIDS in the early days. I was like Tom Hanks in Philadelphia. Nobody would come near me.”

In March 2004, Fishbein began seeking whistle-blower protection. He met with congressional staff and attracted enough attention on Capitol Hill to force the NIH to agree to a study by the National Academy’s Institute of Medicine (IOM). The terms of that inquiry were skewed from the outset, however, and the nine-member panel decreed that it would not deal with any questions of misconduct. The panel ignored Fishbein’s evidence that DAIDS had covered up the study’s failures and relied on testimony from the HIVNET investigators and NIH officials. Not surprisingly, it found that HIVNET’s conclusions were valid. Six of the nine members on the panel were NIH grant recipients, with yearly grants ranging from $120,000 to almost $2 million.10

Fishbein dismissed the IOM report as a whitewash. Indeed, the report’s conclusions are hard to credit, given the overwhelming evidence uncovered by the Westat investigation and documentation such as the following email, which was sent by Jonathan Kagan to Ed Tramont on June 19, 2003. Tramont was considering HIVNET researchers Jackson and Guay for an award:

Ed—I’ve been meaning to respond on this—the bit about the award. I think that’s a bit over the top. I think that before we start heaping praise on them we should wait to see if the lessons stick. We cannot lose sight of the fact that they screwed up big time. And you bailed their asses out. I’m all for forgiveness, etc. I’m not for punishing them. But it would be “over the top” to me, to be proclaiming them as heroes. Something to think about before pushing this award thing …

NIAID has issued a total ban against any employee speaking to the press about Fishbein’s allegations. Instead, they have posted “Questions and Answers” about the matter on their website. The first question is: “Is single-dose nevirapine a safe and effective drug for the prevention of mother-to-infant transmission of HIV?” Fishbein has said that due to the spectacular failures of the HIVNET trial, the answer to this is not known, and not knowable. Fishbein believes that ultimately the HIVNET affair is not “about” nevirapine or even AIDS, but about the conduct of the federal government, which has been entrusted to do research on human beings and to uphold basic standards of clinical safety and accuracy.

NIAID answers its first question mechanically and predictably: “Single-dose nevirapine is a safe and effective drug for preventing mother-to-infant transmission of HIV. This has been proven by multiple studies, including the HIVNET 012 study conducted in Uganda.” The phrase “safe and effective” has been baked into both the question and the answer, rendering both blank and devoid of meaning. The “multiple studies” line is a familiar tactic, designed to deflect from the study that is actually being addressed, and that is HIVNET 012.

A short letter published in the March 10, 2005, issue of Nature quietly unpegged the core claim of NIAID and its satellite organizations in the AIDS industry regarding nevirapine’s “effectiveness.” Written by Dr. Valendar Turner, a surgeon at the Department of Health in Perth, Australia, the letter read:

Sir—While raising concerns about “standards of record keeping” in the HIVNET 012 trial in Uganda, in your News story, “Activists and Researchers rally behind AIDS drug for mothers,” you overlook a greater flaw. None of the available evidence for nevirapine comes from a trial in which it was tested against a placebo. Yet, as the study’s senior author has said, a placebo is the only way a scientist can assess a drug’s effectiveness with scientific certainty.

The HIVNET 012 trial abandoned its placebo group in early 1998 after only 19 of the 645 mothers randomized had been treated, under pressure of complaints that the use of a placebo was unethical.

The HIV transmission rate reported for nevirapine in the HIVNET 012 study was 13.1%. However, without antiviral treatments, mother-to-child transmission rates vary from 12% to 48%. The HIVNET 012 outcome is higher than the 12% transmission rate reported in a prospective study of 561 African women given no antiretroviral treatment.

The letter concluded by asking: “On what basis can it be claimed that `there’s nothing that has in any way invalidated the conclusion that single-dose nevirapine is effective for reducing mother-to-child transmission’? Without supporting evidence from a placebo-controlled randomized trial, such statements seem unwarranted.” HIVNET claimed to reduce HIV transmission by “nearly 50 percent” by comparing a nevirapine arm to an AZT arm. Turner’s letter points out that 561 African women taking no antivirals transmitted HIV at a rate of 12 percent. Had nevirapine been asked to compete with that placebo group, it would have lost. As it was, there was no placebo group, so HIVNET’s results are a statistical trick, a shadow play, in which success is measured against another drug and not against a placebo group—the gold standard of clinical trials. The question should not be, Is nevirapine better than AZT? but, Is nevirapine better than nothing?

Independent evidence suggests that it is not.

A 1994 study, for example, that gave vitamin A to pregnant HIV-positive mothers in Malawi reported that those with the highest levels of Vitamin A transmitted HIV at a rate of only 7.2 percent. This is consistent with a vast body of research linking nutritional status to sero-conversion, as well as to general health. Another study on the efficacy of nevirapine in mother-to-child transmission was performed by researchers from Ghent University (Belgium) in Kenya and published in 2004.

Dr. Ann Quaghebeur, who led the Ghent study, was reached at her home near London. I asked her what she thought of the reaction to HIVNET 012. She replied in a very quiet voice, almost a whisper. “Our results showed that nevirapine had little effect. I actually felt it was a waste of resources. HIVNET was just one study, but usually before you apply it in a field setting there should be a few more studies to see if it works in real life. What I think they should have done is wait for more studies before they launched this in all those countries.” When I asked her how she explained this, she replied, “Well, I want to be careful, there seems to be an industry now.”

The failure of the HIVNET researchers to properly control their study with a placebo group is not as unusual as one might think. In fact, this failure is perhaps the outstanding characteristic of AIDS research in general. The 1986 Phase II trial that preceded the FDA’s unprecedented rapid approval of AZT was presented as a double-blind, placebo-controlled study, though it was anything but that. As became clear afterward through the efforts of a few journalists, as well as the testimony of participants, the trial was “unblinded” almost immediately because of the severe toxicity of the drug. Members of the control group began to acquire AZT independently or from other study participants, and eventually the study was aborted and everyone was put on the drug. As in the case of HIVNET, documents obtained by journalist John Lauritsen under the Freedom of Information Act subsequently suggested that data-tampering was widespread. Documents were altered, causes of death were unverified, and the researchers tended to assume what they wished to prove, i.e., that placebo-group diseases were AIDS-related but that those in the AZT group were not. So serious were the deviations from experimental protocol at one Boston hospital that an FDA inspector attempted to exclude data from that center. In the end, however, all the data were included in the results, and the FDA approved the drug in 1987.11

AZT was approved in record time, but that record didn’t stand for long. In 1991, the FDA approved another DNA chain terminator, ddI, without even the pretense of a controlled study. Anti-HIV drugs such as Crixivan were approved in as little as six weeks, and cast as a triumph of AIDS activism. This pattern of jettisoning standard experimental controls has continued up to the present, as the HIVNET affair amply demonstrates, and has characterized not only research into new drugs designed to exterminate HIV but the more fundamental questions at the root of AIDS research.

The HIVNET cover-up can only be understood within the larger political context of AIDS. The emergence of this syndrome in the 1980s sparked a medical state of emergency in which scientific controls, the rules that are supposed to bracket the emotions and desires of individual researchers, were frequently compromised or removed entirely. AIDS helped turn disease into politics, and politics, at least in the United States, is all about turning power into money.

No one has been more persistent in calling attention to the failings of AIDS research than Peter Duesberg, a virologist and cancer specialist at the University of California at Berkeley. If Duesherg’s name sounds familiar, it’s because he has been quite effectively branded in the international media as the virologist who is wrong about HIV. His name entered the popular culture in the late 1980s prestamped with wrongness. You knew he was wrong before you knew what he had said in the first place.

In 1987, Duesberg published a paper in the journal Cancer Research entitled “Retroviruses as Carcinogens and Pathogens: Expectations and Reality.” He was, at the time, at the top of the field of retrovirology, having mapped the genetic structure of retroviruses and defined the first cancer gene in the 1970s. He was the youngest member, at age fifty, ever elected into the National Academy of Sciences. In this paper, which in the words of his scientific biographer, Harvey Bialy, “sealed his scientific fate for a dozen years,” Duesberg argued that retroviruses don’t cause cancer and concluded by detailing how and why the retrovirus HIV cannot cause AIDS.

As AIDS grew in the 1980s into a global, multibillion-dollar juggernaut of diagnostics, drugs, and activist organizations, whose sole target in the fight against AIDS was HIV, condemning Duesberg became part of the moral crusade. Prior to that 1987 paper, Duesherg was one of a handful of the most highly funded and prized scientists in the country. Subsequently, his NIH funding was terminated and he has received not one single federal research dollar since his pre-1987 Outstanding Investigator Grant ran out. Duesberg lost his lab facilities and had to move twice within a few years to smaller labs on the Berkeley campus, where he spent much of his time writing futile research grant proposals asking to test his hypothesis that AIDS is a chemical syndrome, caused by accumulated toxins from heavy drug use. He lost his graduate students, who were warned that to emerge from his lab would blight their careers. He was denied and had to fight for routine pay increases by his employers at UC Berkeley, where he has tenure and still teaches. He was “disinvited” from scientific conferences, and colleagues even declared that they would refuse to attend any conference that included him. Duesberg also was banished from publishing in scientific journals that previously had welcomed his contributions, most theatrically by the editor of Nature, Sir John Maddox, who wrote a bizarre editorial declaring that Duesherg would he denied the standard scientific “right of reply” in response to personal attacks that were frequently published in that journal. Prior to 1987, Peter Duesberg never had a single grant proposal rejected by the NIH. Since 1991 he has written a total of twenty-five research proposals, every single one of which has been rejected. “They took him out, just took him right out,” says Richard Strohman, an emeritus professor of biology at UC Berkeley.

And what was it, exactly, that Peter Duesherg had done? He simply pointed out that no one had yet proven that HIV is capable of causing a single disease, much less the twenty-five diseases that are now part of the clinical definition of AIDS.12 He pointed to a number of paradoxes regarding HIV and argued that far from being evidence that HIV is “mysterious” or “enigmatic,” these paradoxes were evidence that HIV is a passenger virus.

The classical tests of whether or not a microorganism is the cause of infectious disease are known as Koch’s postulates. They state: 1) the microorganism must be found in all cases of the disease; 2) it must be isolated from the host and grown in pure culture; 3) it must reproduce the original disease when introduced into a susceptible host; and 4) it must be found present in the experimental host so infected. Although claims to the contrary have been made, Duesberg maintains that it has never been demonstrated that HIV satisfies all of Koch’s postulates. His exhaustive analysis of the peer-reviewed scientific literature has revealed more than 4,000 documented AIDS cases in which there is no trace of HIV or HIV antibodies. This number is significant, because there are strong institutional forces deterring such descriptions and because the vast majority of AIDS cases are never described in formal scientific papers. In fact, most AIDS patients have no active HIV in their systems, because the virus has been neutralized by antibodies. (With all other viral diseases, by the way, the presence of antibodies signals immunity from the disease. Why this is not the case with HIV has never been demonstrated.) Generally speaking, HIV can be isolated only by “reactivating” latent copies of the virus, and then only with extraordinary difficulty. Viral load, one of the clinical markers for HIV, is not a measurement of actual, live virus in the body but the amplified fragments of DNA left over from an infection that has been suppressed by antibodies. Another embarrassment for the HIV hypothesis is the extraordinary latency period between infection and the onset of disease, despite the fact that HIV is biochemically most active within weeks of initial infection. This latency period, which apparently grows with every passing year, enables proponents of the theory to evade Koch’s third and fourth postulates.

The foregoing is merely a sketch of the central mystery presented by the HIV theory of AIDS. There are many more, which Duesherg has laid out very carefully in his scientific papers and in a trade book published ten years ago, but they all boil down to the central point that when it comes to AIDS, basic scientific standards seem no longer to apply.13 AIDS is a “syndrome” defined by twenty-five diseases, all of which exist independently of HIV. No one has ever demonstrated the cell-killing mechanism by which HIV is supposed to cause all these different diseases, and no one has ever demonstrated how a sexually transmitted virus can manage to restrict itself overwhelmingly to gay men and other AIDS risk groups instead of spreading randomly through the population, as do all other infectious diseases. The “overwhelming” character of the evidence for HIV’s causation has always been epidemiological; which is to say, a correlation, a coincidence. Whenever we have AIDS, researchers say, we also have HIV. But this correlation is a result of the official definition of AIDS, which state, that a disease counts as AIDS only if it corresponds with HIV antibodies. (“AIDS without HIV” has been given a singularly unmemorable name: idiopathic CD4 lymphocytopenia.)

Given that the evidence for HIV is coincidental, a number of research avenues suggest themselves, yet orthodox AIDS researchers have failed to demonstrate, using large-scale controlled studies, that the incidence of AIDS-defining diseases is higher among individuals infected with HIV than among the general uninfected population. Consequently, it could very well be the case that HIV is a harmless passenger virus that infects a small percentage of the population and is spread primarily from mother to child, though at a relatively low rate. (This hypothesis would tend to explain the fact that the estimated number of HIV-positive Americans has remained constant at about 1 million since 1985.) Nor have large-scale controlled studies been carried out to directly test the AIDS-drug hypothesis, which holds that many cases of AIDS are the consequence of heavy drug use, both recreational (poppers, cocaine, methamphetamines, etc.) and medical (AZT, etc.).14 Nor have controlled studies been carried out to prove that hemophiliacs infected with HIV die sooner than those who are not infected. Such studies might be expensive and tedious, but expense has never been a serious objection to AIDS researchers, who have spent many billions of dollars in the last twenty years on HIV research and practically nothing on alternative causes or even cofactors. (Even Luc Montagnier, the discoverer of HIV, has stated repeatedly that the virus cannot cause AIDS without contributing causes.)

Attempts to rigorously test the ruling medical hypothesis of the age are met not with reasoned debate but with the rhetoric of moral blackmail: Peter Duesherg has the blood of African AIDS babies on his hands. Duesherg is evil, a scientific psychopath. He should be imprisoned. Those who wish to engage the AIDS research establishment in the sort of causality debate that is carried on in most other branches of scientific endeavor are tarred as AIDS “denialists,” as if skepticism about the pathogenicity of a retrovirus were the moral equivalent of denying that the Nazis slaughtered 6 million Jews. Moral zeal rather than scientific skepticism defines the field. It has been decided in advance that HIV causes AIDS; consequently all research and all funding must proceed from that assumption. Similarly, it was known in advance that AZT was a “magic bullet” against HIV; the word was out that it was a “life-saving drug” before anyone could possibly verify this, and so scientific controls were compromised. Journalists (myself included) who reported at the time that the drug apparently was killing patients were labeled “AZT refuseniks” and even “murderers.”

The nevirapine debate follows the same histrionic, antiscientific pattern. Because of his concerns about the toxicity of this and other antiretroviral drugs, President Thabo Mbeki of South Africa was pilloried in the international press as pharmaceutical companies and their well-funded “activist” ambassadors repeated their mantra about “life-saving drugs.” So, too, was Jonathan Fishbein, who never questioned the premise that HIV causes AIDS, tarred and feathered for pointing out that the NIH flagship study on nevirapine was a complete disaster. Fishbein’s failure to fall into line, his failure to understand in advance of experimental proof that nevirapine was too important to fail, meant that the AIDS bureaucracy’s neutralizing antibodies had to be activated to destroy them.

In the end, the NIH failed to silence Fishbein. In late December 2005, he won his case and was retroactively reinstated at the agency, though he won’t be returning to DAIDS. He is unable to discuss the terms of his settlement, but he has promised to continue his commitment to research integrity and the protection of human research subjects. Peter Duesberg has been less successful, though there are signs of rehabilitation.

Regardless of whether Duesberg is right about HIV, his case, like Fishbein’s, lays bare the political machinery of American science, and reveals its reflexive hostility to ideas that challenge the dominant paradigm. Such hostility is not unusual in the history of science,15 but the contemporary situation is dramatically different from those faced by maverick scientists in the past. Today’s scientists are almost wholly dependent upon the goodwill of government researchers and powerful peer-review boards, who control a financial network binding together the National Institutes of Health, academia, and the biotech and pharmaceutical industries. Many scientists live in fear of losing their funding. “Nobody is safe,” one NIH-funded researcher told me. “The scientific-medical complex is a $2 trillion industry,” says former drug developer Dr. David Rasnick, who now works on nutrition-based AIDS programs in Pretoria, South Africa. “You can buy a tremendous amount of consensus for that kind of money.”

“You have to write a grant a year almost. And you have to write four to get one, if you’re any good. I got out just in time. Everybody who’s still in there says the same thing,” says Berkeley’s Strohman. “Before the biotech boom, we never had this incessant urging to produce something useful, meaning profitable. Eyerybody is caught up in it. Grants, millions of dollars flowing into laboratories, careers and stars being made. The only way to be a successful scientist today is to follow consensus. If you’re going to produce something and put it on the market you don’t want any goddamn surprises. You’ve got the next quarter to report and you don’t want any bad news. It’s all about the short term now. Science has totally capitulated to corporate interests. Given their power and money, it’s going to be very hard to work our way out of this.”

Duesberg has never been afraid to challenge consensus, but contrary to what many in the AIDS establishment would have us believe, he is very far from being a scientific psychopath.16 In 1997, on the brink of scientific demise in the U.S., Duesberg was quietly invited back to his native Germany to resume his cancer research. During this time, commuting biannually between Mannheim and Berkeley, Duesberg formulated and tested a theory that shifts the focus of cancer causation from the “mutant gene” theory that has reigned for about three decades to a simpler explanation that revives an abandoned thread of research from early in the twentieth century, which posited that cancer is caused by chromosomal malfunction, now known as “aneuploidy.”

Harvey Bialy, the founding scientific editor of Nature Biotechnology, a sister journal to Nature, recently spent four years writing a scientific biography of Duesberg entitled Oncogenes, Aneuploidy, and AIDS. The book is a history of the papers, review articles, and letters that Duesberg published between 1983 and 2003, and the responses they generated. I asked him why he wrote the book. “I am persuaded that aneuploidy is the initiating event in carcinogenesis”, Bialy said. “Peter has found the genetic basis for cancer. The most immediate application of it will be early diagnosis.”

“When aneuploidy, or genetic instability, or whatever linguistic term you want to use, gets reincarnated as the dominant theoretical explanation for the genesis of cancer, Peter Duesberg will be recognized as a major contributor to that,” Bialy said. “I wanted to make sure that his contributions were not swept aside or ignored.” I asked him about the AIDS controversy. “AIDS is a political thing, and Peter’s stuck in it. There’s nothing to discuss anymore on that.” Bialy made a critical point. Science is amoral and should be. There is no right and wrong, only correct and incorrect. “Duesberg,” Bialy said, “is a classical molecular biologist. All he is interested in is rigorously testing dueling hypotheses. The twin pillars, AIDS and oncogenes, both are crumbling because of the questions Peter Duesherg put into motion.”

“The basis of speciation is changing the content and the number of chromosomes,” says Duesherg. “Cancer is essentially a failed speciation. It’s not mutation. Cancer is a species. A really bad breast, lung, or prostate cancer has seventy, eighty, or more chromosomes. Those are the real had guys they’re way outside our species. But it’s a rare kind of species that as a parasite is more successful in its host than the normal host cell is.”

There has been considerable international interest in Duesberg’s new research.17 In January 2004, he hosted a conference on aneuploidy and invited fifty cancer researchers from around the world who also have been working on the connections between aneuploidy and cancer. Seventy showed up, including such luminaries as Thomas Ried, the National Cancer Institute’s head of cancer genomics, Gert Auer from the Karolinska Institute in Stockholm, and Walter Giaretti, who heads the equivalent of the NCI in Italy. And on May 31 of last year, amid considerable tension, Duesherg was invited by the National Cancer Institute to give a talk at the NIH. The auditorium crackled with nervous tension as people filed in and took their seats. His talk was succinct and laced with his characteristic irony, but the questions afterward were civilized, with no tangible hostility. All was not forgiven, however. After the talk, while Duesberg remained at the podium talking to a group of people from the audience, I noticed a very angry-looking NIH publicist standing at the back of the room admonishing a colleague, a scientist, who’d posed a question that somehow connected aneuploidy to HIV. “You opened it up,” she scolded. “We got through it okay, but you opened it up.” As the questioner tried to defend himself, a thick-set man who’d been standing in the circle said loudly, as though intending to broadcast it across the room: “Well, at least if he’s wrong about this lie won’t he killing millions of people.”

Nobel laureate Kary Mullis, who discovered the revolutionary DNA technique called the polymerase chain reaction, has long been a supporter of Duesberg, but he has grown weary of the AIDS wars and the political attacks on contrarian scientists. “Look, there’s no sociological mystery here,” he told me. “It’s just people’s income and position being threatened by the things Peter Duesberg is saying. That’s why they’re so nasty. In the AIDS field, there is a widespread neurosis among scientists, but the frenzy with which people approach the HIV debate has slacked off, because there’s just so much slowly accumulating evidence against them. It’s really hard for them to deal with it. They made a really big mistake and they’re not ever going to fix it. They’re still poisoning people.”

Duesberg thinks that up to 75 percent of AIDS cases in the West can he attributed to drug toxicity. If toxic AIDS therapies were discontinued, he says, thousands of lives could he saved virtually overnight. And when it comes to Africa, he agrees with those who argue that AIDS in Africa is best understood as an umbrella term for a number of old diseases, formerly known by other names, that currently do not command high rates of international aid. The money spent on antiretroviral drugs would be better spent on sanitation and improving access to safe drinking water (the absence of which kills 1.4 million children a year).

It’s too late to save people like Joyce Ann Hafford, but it is possible that an open and honest debate about the risks of current AIDS treatments and the scientific questions concerning HIV could save others.

REFERENCES

1 HIV tests detect footprints, never the animal itself. These footprints, antibodies, are identified by means of molecular protein weights, and were limited to two in 1984, when the first test was developed and patented, but over the years expanded to include many proteins previously not associated with HIV. Like most Americans, Hafford thought that a single HIV-positive test meant that she “had” HIV—a surefire death sentence. But a majority of HIV-positive tests, when retested, come back indeterminate or negative. In many cases, different results emerge from the same blood tested in different labs. There are currently at least eleven different criteria for how many and what proteins at which hand density signal “positive.” The most stringent criteria (four hands) are upheld in Australia and France; the least stringent (two hands), in Africa, where an HIV test is not even required as part of an AIDS diagnosis. The U.S. standard is three reactive hands. It has been pointed out that a person could revert to being HIV negative simply by buying a plane ticket from Uganda to Australia.

2 Dr. Thorpe declined to comment, citing ongoing litigation, as did the Tennessee Medical Group, the Regional Medical Center at Memphis, and St. Jude’s Children’s Research Hospital.

3 “Our mission of eradicating AIDS is always informed and driven by the best available science, not by donations,” said Mark Isaac, Elizabeth Glazer’s vice president for policy, when asked to comment. “The full body of research, as well as our extensive experience, validates the safety and efficacy of single-dose nevirapine as one of several options to prevent mother-to-child transmission of HIV.”

4 Africa, as the news media never tires of telling us, has become ground zero of the AIDS epidemic. The clinical definition of AIDS in Africa, however, is stunningly broad and generic, and was seemingly designed to be little other than a signal for funding. It is in no way comparable to Western definitions. The “Bangui definition” of AIDS was established in the city of Bangui in the Central African Republic, at a conference in 1985. The definition requires neither a positive HIV test nor a low T-cell count, as in the West, but only the presence of chronic diarrhea, fever, significant weight loss, and asthenia, as well as other minor symptoms. These happen to be the symptoms of chronic malnutrition, malaria, parasitic infections, and other common African illnesses. (In 1994 the definition was updated to suggest the use of HIV tests, but in practice they are prohibitively expensive.) Even when HIV tests are performed, many diseases that are endemic to Africa, such as malaria and TB, are known to cause false positives. The statistical picture of AIDS in Africa, consequently, is a communal projection based on very rough estimates of HIV positives, culled from select and small samples, which are extrapolated across the continent using computer models and highly questionable assumptions.

5 Asked to comment about the Hafford case, HIVNET 012, and the larger nevirapine controversy, Boehringer Ingelheim provided the following statement: “Viramune ® (nevirapine) was an innovation in anti-HIV treatment as the first member of the nonnucleoside reverse transcriptase inhibitor (NNRTI) class of drugs. Now in its tenth year of use, Viramune has been used as a treatment in more than 800,000 patient-years worldwide.”

6 The study was originally titled “HIVNET 012: A Phase III Placebo-Controlled Trial to Determine the Efficacy of Oral AZT and the Efficacy of Oral Nevirapine for the Prevention of Vertical Transmission of HIV-1 Infection in Pregnant Ugandan Women and Their Neonates.” “Randomization” means that people are randomly chosen for one arm of the study or another, a procedure that is supposed to even out the variables that could affect the outcome. “Placebo controls” are the bedrock of drug testing and are the only way to know whether the treatment is effective. Phase I trials involve a small group of people, twenty to eighty, and are focused on safety and side effects. In Phase II trials the drug is given to an expanded cohort, between 100 and 300, to further evaluate safety and begin to study effectiveness. Phase III drug trials expand further the number of people enrolled, often to more than 1,000, and are meant to confirm a drug’s effectiveness, monitor side effects, and compare it with other treatments commonly used. A small Phase I trial preceded HIVNET 012 that studied the safety, primarily, of nevirapine in pregnant women but also looked at efficacy. It was called HIVNET 006, and it enrolled twenty-one pregnant women for initial study. Of twenty-two infants horn, four died. There were twelve “serious adverse events” reported. The study also showed that there was no lowering of viral load in the mothers who took the study drug (the industry’s agreed-upon standard for interrupting maternal transmission).

7 Brooks Jackson declined to comment for this article. Laura Guay responded with the following statement: “Several in-depth reviews of the conduct and results of the HIVNET 012 trial as well as the data collected from subsequent trials and PMTCT programs, have substantiated the HIVNET 012 conclusions that Nevirapine is safe and effective in preventing mother-to-child HIV transmission. Nevirapine remains one of the most important tools for the prevention of mother-to-child HIV transmission in the developing world, where there are still hundreds of thousands of HIV-infected pregnant women who do not have access to any HIV testing, antiretroviral therapy, or HIV care at all. For many programs struggling to establish PMTCT programs with limited resources, Nevirapine is often the only option available.” Family Health International, the NIH contractor originally responsible for monitoring HIVNET 012, contested the Westat report and said that the results of the study had been validated by the NIH and the Institute of Medicine.

8 Smith and Luzar have been forbidden by the NIH to speak to the press about HIVNET. Luzar was deposed by Fishbein’s attorney in his wrongful-termination lawsuit, Stephen Kohn, in December 2004, and this account is partially based on her deposition.

9 At this point the story grows ever more complicated, as Fishbein supported Luzar in a sexual-harassment claim against Kagan.

10 An internal NIH investigation, which was obtained by the Associated Press last summer, vindicated many of Fishbein’s charges and concluded that “it is clear that DAIDS is a troubled organization,” and that the Fishbein case “is clearly a sketch of a deeper issue.” Kagan and Tramont did not return repeated calls for comment. Instead, an NIH spokesman, Dr. Cliff Lane, said that the agency stands by HIVNET 012.

11 AZT, which was developed as a chemotherapeutic agent in 1964 but shelved because of its extreme toxicity, is a DNA chain terminator, which means that it brings DNA synthesis to a halt. It is therefore an extremely efficient cell killer. HIV is a retrotirus, and as such replicates itself by inserting its genes into a cell’s genome so that when the cell divides a new copy of the virus is produced. AZT prevents the replication of HIV by killing infected T-cells; unfortunately, it kills all dividing cells indiscriminately, whether they are infected with a retrovirus or not, and will very quickly decimate even a healthy person’s immune system. AZT’s manufacturer, GlaxoSmith Kline, chose not to comment for this article.

12 HIV was declared the probable cause of AIDS in a U.S. government press conference in 1984. It was claimed that the virus had been discovered by NIH researcher Robert Gallo. In fact, Gallo had not discovered HTLV-III (Human T-cell Lymphotropic Virus III, as it was known before it was rechristened with the more memorable name HIV) . That honor belongs primarily to Luc Montagnier, of the Pasteur Institute, who had sent Gallo a sample of the virus.

13 It has been claimed that HIV somehow causes cell death even when it is not present by remote programmed “suicidal” mechanisms. Some researchers claim that HIV exploits special receptors on human T-cells that, due to a hypothetical genetic mutation, many “Caucasian Europeans” lack, but most Africans have. What’s interesting is that many gay men also seem to possess these mysterious receptors, as do intravenous drug users and transfusion recipients.

It is claimed that although HIV does not kill the laboratory T-cells used to manufacture AIDS tests, it does kill T-cells in the human body, even though it infects only a very small proportion of them, typically an average of 0.1 percent. HIV does not sicken or kill chimpanzees, though they do produce antibodies. It was recently claimed that HIV appears to be evolving into a form less dangerous to human beings. Such unproven hypotheses about the ingenuity of HIV proliferate in the popular and scientific media like the seasonal flu. Seldom do journalists insist on good hard evidence for these assertions.

14 There is ample statistical and epidemiological evidence linking the rise of mass drug abuse in the late Sixties and Seventies with the sudden appearance of AIDS. The overwhelming majority of AIDS patients with Karposi’s sarcoma, for example, have been heavy users of nitrate inhalers, or “poppers.” The case of “super AIDS” that was recently reported in New York turned out upon closer examination to he an individual with an extraordinarily heavy methamphetamine habit.

15 Few today remember the controversies over scurvy and pellagra, which, until the discovery of vitamin C and niacin, were blamed by the medical establishment on mysterious infectious agents. Those who pointed out, even before they knew the cause, that dietary changes cured both conditions were dismissed as flat-earthers.

16 Nor is Duesberg alone in dissenting from AIDS orthodoxy. More than 2,300 people, mostly scientists and doctors, including Nobelists in chemistry and medicine, have signed the petition of the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, which calls for a more independent and skeptical approach to the question of AIDS causality.

17 Even so, the National Cancer Institute still refuses to fund him. Duesberg has submitted five grant proposals to study aneuploidy, and all have been rejected. One of the most influential cancer researchers in the country, Bert Vogelstein, Clayton Professor of Oncology and Pathology at Johns Hopkins University, has written a letter urging the NCI to reconsider. “1 agree with him that aneuploidy is an essential part of cancer,” Vogelstein wrote. “Dr. Duesberg continues to have a major impact on this burgeoning area of research, through his careful experimental observations as well as through his thoughtful reviews and critiques of the subject. There is no question that he is a world leader in this field of investigation.”

(Harper’s Magazine is an American journal of literature, politics, culture, and the arts published continuously from 1850. You can subscribe to Harper’s Magazine for as little as $14.97 a year.)

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The Celia Farber piece is now on line here, in its full glory

March 4th, 2006

Blogheads can now quote accurately from the text

The seminal Harpers expose of mismanagement and worse, not to mention lack of theoretical justification, in HIV?AIDS by Celia Farber is now on line in a corrupted version with chunks moved around at Out of Control: AIDS and the Corruption of Medical Science, so we reproduce it here, corrected, for reference.

The site where most of it is carried without comment (presumably OCR’d from Harpers) is Mindfully, run by conspiracy theorists who apparently believe that September 11 demolition of the WTC was helped along by Larry Silverstein. In general, it appears that they feel that the news fails to bring us all the facts, a reasonable suspicion which they then apply generously to every major news event.

In the HIV?AIDS case, rather like the stopped clock which is right twice a day, they are surely right to suspect, with Harpers/Farber, that all is not as it is made out to be in HIV?AIDS.

However, we think it is important to emphasize that while HIV?AIDS may be almost universally attributed to the wrong cause, and that the motivations for doing so may be consciously or unconsciously unscientific for each individual ie laziness, self-interest, timidity, lack of time, misplaced trust, intellectual befuddlement, group pressure, professional sanctions, status, establishment clubbiness, and the brain activity of mirror neurons, we doubt that there is any knowing and secretly planned conspiracy to do so, nor is one being alleged by the skeptics.

One reason is that it is not necessary. In science and medicine, it is clear, human nature is quite enough to lead vast numbers of people over the nearest cliff if they are pointed in the right direction.

Meanwhile, Mindfully having placed it on the Web (presumably unlawfully, but perhaps not losing too many newstand sales for Harpers at $6.95, which is the forbidding price per copy) even in a slightly inappropriate setting, it does allow us to point out the few tiny slips we have noticed so far in what is a well polished piece.

Duesberg lost his lab facilities and had to move twice within a few years to smaller labs on the Berkeley campus, where he spent much of his time writing futile research grant proposals asking to test his hypothesis that AIDS is a chemical syndrome, caused by accumulated toxins from heavy drug use.

This would be better with “AIDS” expanded to “AIDS here in the US”, since it does not apply to the supposed global pandemic.

(With all other viral diseases, by the way, the presence of antibodies signals immunity from the disease. Why this is not the case with HIV has never been demonstrated.)

This seems to be precisely true only if “immunity” is used in the more technical sense of “resistance”, since there are chronic diseases that do flare up after antibodies have reduced their initial impact. So perhaps it would be better if the word “typically” was added, as in “the presence of antibodies typically signals immunity from the disease.”

Or “with the virtual absence of the agent” added as in “the presence of antibodies with the virtual absence of the agent signals immunity from the disease”. Either way, the truth is that antibodies generated successfully and the agent disappearing, as happens in HIV?AIDS, would indeed signify that the body has overcome the agent and no further trouble should be expected. This is fact is the centuries old principle of vaccination. Why it isn’t true in HIV?AIDS as it appears from all indications to be, is something which has not yet been explained successfully.

She states that Duesberg was the youngest ever member of the National Academy of Sciences when he joined it in 1986, but this seems to be a rather obvious slip. Duesberg himself, asked about it, said he doubted it. He was 50 at the time and there have surely been younger members than that voted in.

Also, Celia’s book is being written anew, we understand, rather than simply being a collection of her previous writings on the topic.

Then there is the windup, which has Celia and the Harpers editors not joining the HIV skeptics as such, but simply making the reasonable request to have an “open and honest debate” about the risks of current treatments and the scientific questions concerning HIV.

It’s too late to save people like Joyce Ann Hafford, but it is possible that an open and honest debate about the risks of current AIDS treatments and the scientific questions concerning HIV could save others.

After their summary of all the points made by Duesberg against HIV and few if any answers from his opponents, it is fair to conclude that the editors probably are now closet HIV skeptics, who, as Walter Gilbert of Harvard once put it to me, would “not be surprised if there was another cause of AIDS altogether”.

Here is the full version of a piece which one day will be recognized as the tipping point for exposure of the Enron of science, a $140 billion dud paradigm, if sanity prevails: Out Of Control: AIDS and the Corruption of Medical Science

CELIA FARBER / Harper’s Magazine Mar 2006 (the text is fixed where we have noticed chunks missing from the Mindfully version).

Out Of Control: AIDS and the corruption of medical science

CELIA FARBER / Harper’s Magazine 1mar2006

Celia Farber is a writer based in New York City. A collection of her AIDS reporting, Serious Adverse Events, is forthcoming from Melville House.

Joyce Ann Hafford was a single mother living alone with her thirteen-year-old son, Jermal, in Memphis, Tennessee, when she learned that she was pregnant with her second child. She worked as a customer service representative at a company called CMC Call Center; her son was a top student, an athlete and musician. In April 2003, Hafford, four months pregnant, was urged by her obstetrician to take an HIV test. She agreed, even though she was healthy and had no reason to think she might be HIV positive. The test result came up positive, though Hafford was tested only once, and she did not know that pregnancy itself can cause a false positive HIV test. Her first thought was of her unborn baby. Hafford was immediately referred to an HIV/AIDS specialist, Dr. Edwin Thorpe, who happened to be one of the principal investigators recruiting patients for a clinical trial at the University of Tennessee Medical Group that was sponsored by the Division of AIDS (DAIDS)—the chief branch of HIV/AIDS research within the National Institutes of Health.

The objective of the trial, PACTG 1022, was to compare the “treatment-limiting toxicities” of two anti-HIV drug regimens. The core drugs being compared were nelfinavir (trade name Viracept) and nevirapine (trade name Viramune). To that regimen, in each arm, two more drugs were added—zidovudine (AZT) and lamivudine (Epivir) in a branded combination called Combivir. PACTG 1022 was a “safety” trial as well as an efficacy trial, which means that pregnant women were being used as research subjects to investigate “safety” and yet the trial was probing the outer limits of bearable toxicity. Given the reigning beliefs about HIV’s pathogenicity, such trials are fairly commonplace, especially in the post-1994 era, when AZT was hailed for cutting transmission rates from mother to child.

The goal of PACTG 1022 was to recruit at least 440 pregnant women across the nation, of which 15 were to he enrolled in the University of Tennessee Medical Group. The plan was to assign the study’s participants to one of two groups, with each receiving three HIV drugs, starting as early as ten weeks of gestation. Of the four drugs in this study, three belong to the FDA’s category “C,” which means that safety to either mother or fetus has not been adequately established.

Joyce Ann Hafford was thirty-three years old and had always been healthy. She showed no signs of any of the clinical markers associated with AIDS her CD4 counts, which measure the lymphocytes that are used to indicate how strong a person’s immune system is, and which HIV is believed to slowly corrode, were in the normal range, and she felt fine. In early June 2003, she was enrolled in the trial and on June 18 took her first doses of the drugs. “She felt very sick right away,” recalls her older sister, Rubbie King. “Within seventy-two hours, she had a very bad rash, welts all over her face, hands, and arms. That was the first sign that there was a problem. I told her to call her doctor and she did, but they just told her to put hydrocortisone cream on it. I later learned that a rash is a very had sign, but they didn’t seem alarmed at all.”

Hafford was on the drug regimen for thirty-eight days. “Her health started to deteriorate from the moment she went on the drugs,” says King. “She was always in pain, constantly throwing up, and finally she got to the point where all she could do was lie down.” The sisters kept the news of Hafford’s HIV test and of the trial itself from their mother, and Hafford herself attributed her sickness and nausea to being pregnant. She was a cheerful person, a noncomplainer, and was convinced that she was lucky to have gotten into this trial. “She said to me, `Nell’ —that’s what she called me—`I have got to get through this. I can’t let my baby get this virus.’ I said, `Well, I understand that, but you’re awful sick.’ But she never expressed any fear because she thought this was going to keep her baby from being HIV positive. She didn’t even know she was in trouble.”

On July 16, at her scheduled exam, Hafford’s doctor took note of the rash, which was “pruritic and macular-papular,” and also noted that she was suffering hyperpigmentation, as well as ongoing nausea, pain, and vomiting. By this time all she could keep down were cans of Ensure. Her blood was drawn for lab tests, but she was not taken off the study drugs, according to legal documents and internal NIH memos.

Eight days later, Hafford went to the Regional Medical Center “fully symptomatic,” with what legal documents characterize as including: “yellow eyes, thirst, darkening of her arms, tiredness, and nausea without vomiting.” She also had a rapid heartbeat and difficulty breathing. Labs were drawn, and she was sent home, still on the drugs. The next day, July 25, Hafford was summoned back to the hospital after her lab reports from nine days earlier were finally reviewed. She was admitted to the hospital’s ICU with “acute and subacute necrosis of the liver, secondary to drug toxicity, acute renal failure, anemia, septicemia, premature separation of the placenta,” and threatened “premature labor.” She was finally taken off the drugs but was already losing consciousness. Hafford’s baby, Sterling, was delivered by C-section on July 29, and she remained conscious long enough not to hold him but at least to see him and learn that she’d had a boy. “We joked about it a little, when she was still coming in and out of consciousness in ICU,” Rubbie recalls. “I said to her, `You talked about me so much when you were pregnant that that baby looks just like me.”‘ Hafford’s last words were a request to be put on a breathing tube. “She said she thought a breathing tube might help her,” says Rubbie. “That was the last conversation I had with my sister.” In the early morning hours of August 1, Rubbie and her mother got a call to come to the hospital, because doctors had lost Hafford’s pulse. Jermal was sleeping, and Rubbie woke her own daughter and instructed her not to tell Jermal anything yet. They went to the hospital, and had been there about ten minutes when Joyce Ann died.

Rubbie recalls that the hospital staff said they would clean her up and then let them sit with her. She also remembered a doctor who asked for their home phone numbers and muttered, “You got a law suit.” (That person has not resurfaced.) They hadn’t been sitting with Hafford’s body long when a hospital official came in and asked the family whether they wanted an autopsy performed. “We said yes, we sure do,” she says. The hospital official said it would have to be at their expense—at a cost of $3,000. “We said, `We don’t have $3,000.’ My sister didn’t have any life insurance or anything,” says Rubbie. “She had state health care coverage, and we were already worried about how to get the money together to bury her.” Consequently, no autopsy was done. There was a liver biopsy, however, which revealed, according to internal communiqués of DAIDS staff, that Hafford had died of liver failure brought on by nevirapine toxicity.

And what was the family told about the cause of Hafford’s death? “How did they put it?” Rubbie answers, carefully. “They told us how safe the drug was, they never attributed her death to the drug itself, at all. They said that her disease, AIDS, must have progressed rapidly.” But Joyce Ann Hafford never had AIDS, or anything even on the diagnostic scale of AIDS. “I told my mom when we were walking out of there that morning,” Rubbie recalls, “I said, `Something is wrong.’ She said, `What do you mean?’ I said, `On the one hand they’re telling us this drug is so safe, on the other hand they’re telling us they’re going to monitor the other patients more closely. If her disease was progressing, they could have changed the medication.’ I knew something was wrong with their story, but I just could not put my finger on what it was.”

When they got home that morning, they broke the news to Jermal. “I think he cried the whole day when we told him,” Rubbie recalls. “My mom had tried to prepare him. She said, `You know, Jermal, my mom died when I was very young,’ but he was just devastated. They were like two peas in a pod those two. You could never separate them.” Later on, Jermal became consumed with worry about how they would bury his mother, for which they had no funds and no insurance. The community pitched in, and Hafford was buried. “I haven’t even been able to go back to her grave since she passed,” says Rubbie.

Rubbie King is haunted by many questions, including whether her sister was really infected with HIV,1 and also what the long-term damage might be to Sterling, whom Rubbie is now raising, along with Jermal and her own child. Sterling, in addition to the drugs he was exposed to in the womb, was also on an eight-week AZT regimen after birth. One of the reasons the family suspects Hafford may have been a false positive is that St. Jude’s Children’s Research Hospital has not released Sterling’s medical records, and although they have been told that he is now HIV negative, they never had any evidence that he was even born positive. (All babies born to an HIV-positive mother are born positive, but most become negative within eighteen months.)

Hafford’s family was never told that she died of nevirapine toxicity. “They never said that. We never knew what she had died of until we got the call from [AP reporter] John Solomon, and he sent us the report,” says Rubbie King. “It was easier to accept that she died of a lethal disease. That was easier to handle.” The family has filed a $10 million lawsuit against the doctors who treated Hafford, the Tennessee Medical Group, St. Jude’s Children’s Research Hospital, and Boehringer Ingelheim, the drug’s manufacturer.2

Rubbie King made a final, disturbing discovery when she was going through Hafford’s medical records: In addition to discovering that her sister had only ever been given a single HIV test, she also came across the fifteen-page consent form, which was unsigned.

On August 8, 2003, Jonathan Fishbein, who had recently taken a job as the director of the Office for Policy in Clinical Research Operations at DAIDS, wrote an email to his boss, DAIDS director Ed Tramont, alerting him that “there was a fulminant liver failure resulting in death” in a DAIDS trial and that it looked like “nevirapine was the likely culprit.” He said that the FDA was being informed. He was referring to Joyce Ann Hafford. Tramont emailed him hack, “Ouch. Not much wwe can do about dumd docs!”

This email exchange came to light in December 2004, when AP reporter John Solomon broke the story that Fishbein was seeking whistle-blower protection, in part because he had refused to sign off on the reprimand of an NIH officer who had sent the FDA a safety report concerning the DAIDS trial that launched the worldwide use of nevirapine for pregnant women. The study was called HIVNET 012, and it began in Uganda in 1997.

The internal communiqués from DAIDS around the time of Hafford’s death made it clear that doctors knew she had died of nevirapine toxicity. Tramont’s reply to Fishbein suggests that he thought blame could he placed squarely with Hafford’s doctors, but it was the NIH itself that had conceived of the study as one that tested the “treatment-limiting toxicities” of HIV drugs in pregnant women.

The conclusion of the PACTG 1022 study team was published in the journal JAIDS in July of 2004. “The study was suspended,” the authors reported, “because of greater than expected toxicity and changes in nevirapine prescribing information.” They reported that within the nevirapine group, “one subject developed fulminant hepatic liver failure and died, and another developed Stevens-Johnson syndrome.” Stevens-Johnson syndrome is skin necrolysis—a severe toxic reaction that is similar to internal third-degree burns, in which the skin detaches from the body. Another paper, entitled “Toxicity with Continuous Nevirapine in Pregnancy: Results from PACTG 1022,” puts the results in charts, with artful graphics. A small illustration of Hafford’s liver floats in a box, with what looks like a jagged gash running through it. Four of the women in the nevirapine group developed hepatic toxicity.

As Terri Schiavo lay in her four-teenth year of a persistent vegetative state, and the nation erupted into a classically American moral opera over the sanctity of life, Joyce Ann Hafford’s story made only a fleeting appearance—accompanied by a photo of her holding a red rose in an article that was also written by the AP’s John Solomon. But soon a chorus of condemnation was turned against those who were sensationalizing Hafford’s death and the growing HIVNET controversy to condemn nevirapine, which had been branded by the AIDS industry as a “life-saving” drug and a “very important tool” to combat HIV in the Third World.

So-called community AIDS activists were sprung like cuckoo birds from grandfather clocks at the appointed hour to affirm the unwavering AIDS cathechism: AIDS drugs save lives. To suggest otherwise is to endanger millions of African babies. Front and center were organizations like the Elizabeth Glaser Pediatric AIDS Foundation, which extolled the importance of nevirapine. Elizabeth Glaser’s nevirapine defenders apparently didn’t encounter a single media professional who knew, or cared, that the organization had received $1 million from nevirapine’s maker, Boehringer Ingelheim, in 2000.3 This was no scandal but simply part of a landscape. Pharmaceutical companies fund AIDS organizations, which in turn are quoted uncritically in the media about how many lives their drugs save. This time the AIDS organizations were joined by none other than the White House, which was in the midst of promoting a major program to make nevirapine A available across Africa.4

….

America is a place where people rarely say: Stop. Extreme and unnatural things happen all the time, and nobody seems to know how to hit the brakes. In this muscular, can-do era, we are particularly prone to the seductions of the pharmaceutical industry, which has successfully marketed its ever growing arsenal of drugs as the latest American right. The buzzword is “access,” which has the advantage of short-circuiting the question of whether the drugs actually work, and of utterly obviating the question of whether they are even remotely safe. This situation has had particularly tragic ramifications on the border between the class of Americans with good health insurance, who are essentially consumers of pharmaceutical goods, and those without insurance, some of whom get drugs “free” but with a significant caveat attached: They agree to be experimented on. These people, known in the industry as “recruits,” are pulled in via doctors straight from clinics and even recruited on the Internet into the pharmaceutical industry and the government’s web of clinical trials, thousands of which have popped up in recent years across the nation and around the world. Such studies help maintain the industry’s carefully cultivated image of benign concern, of charity and progress, while at the same time feeding the experimental factories from which new blockbuster drugs emerge. “I call them what they are: human experiments,” says Vera Hassner Sharav, of the Alliance for Human Research Protection in New York City. “What’s happened over the last ten to fifteen years is that profits in medicine shifted from patient care to clinical trials, which is a huge industry now. Everybody involved, except the subject, makes money on it, like a food chain. At the center of it is the NIH, which quietly, while people weren’t looking, wound up becoming the partner of industry.”

By June 2004, the National Institutes of Health had registered 10,906 clinical trials in ninety countries. The size of these trials, which range from the hundreds to more than 10,000 people for a single study, creates a huge market for trial participants, who are motivated by different factors in different societies but generally by some combination of the promise of better health care, prenatal care, free “access” to drugs, and often—especially in the United States—cash payments. Participating doctors, whose patient-care profits have been dwindling in recent years because of insurance-company restrictions, beef up their incomes by recruiting patients.

…..

Dr. Jonathan Fishbein is hardly a rabble-rouser. But he is a passionate advocate of “good clinical practice,” or GCP, a set of international standards that were adopted in 1996, as clinical-trial research boomed. The GCP handbook states: “Compliance with this standard provides public assurance that the rights, safety, and well-being of trial subjects are protected, consistent with the principles that have their origin in the Declaration of Helsinki, and that the clinical trial data are credible.” During the decade prior to his arrival at DAIDS, Fishbein had overseen and consulted on hundreds of clinical trials for just about every pharmaceutical company. Fishbein knew, before he took his job as director of the Office for Policy in Clinical Research Operations at DAIDS, that there was a troubled study haunting the whole division. Nobody was supposed to talk about it, but it hung heavily in the air. “Something about Uganda, that’s all I knew,” he says. There was a trial staged there, a big one, that had been plagued with “problems,” and there was also a lot of talk about one particular employee connected to this trial who would need to he disciplined. Soon he discovered just how had the situation was. “The HIVNET thing,” he recalls, “it hit me like a fire hose when I walked in there.”

Fishbein’s position was new. “It sounded like a very important position,” he says. “I was to oversee the policies governing all the clinical-research operations, both here and abroad.” He was told he would have “go–no go” authority over individual trials. It wasn’t long before Fishbein realized that he was, in effect, taking a job that was the equivalent of piloting an already airborne plane. “They had all these trials going on, and hundreds of millions of dollars flowing in every year, but there was apparently no one in a senior position there who really had clinical expertise—who knew all the nuances, rules, and regulations in the day-to-day running of clinical trials.” DAIDS, when Fishbein came to work there in 2003, was running about 400 experimental trials both in the United States and abroad.

A DAIDS project officer close to the HIVNET study closed the door when she had her first meeting with Fishbein. She had also crossed over from the private sector, and so she and Fishbein shared a disillusionment over how much shoddier and more chaotic the research culture was within the government, compared with industry. “I’m really frightened about the stuff that goes on here,” she told him. “We really need somebody.” This project officer, who for her own protection cannot be named, told Fishbein that the division’s flagship study in Africa—HIVNET 012—had been wracked with problems and completely lacking in regulatory standards. She told Fishbein that the trial investigators were “out of control,” and that there was no oversight of them, and nobody with either the inclination or the authority to make them adhere to safety standards. What Fishbein subsequently learned entangled him in a story with eerie echoes of John Le Carre’s Constant Gardener.

For our purposes, the story of nevirapine begins in 1996, when the German pharmaceutical giant Boehringer Ingelheim applied for approval of the drug in Canada. The drug had been in development since the early 1990s, which was a boom time for new HIV drugs. Canada rejected nevirapine twice, once in 1996 and again in 1998, after the drug showed no effect on so-called surrogate markers (HIV viral load and CD4 counts) and was alarmingly toxic. In 1996, in the United States, the FDA nonetheless gave the drug conditional approval so that it could be used in combination with other HIV drugs.5

By this time, Johns Hopkins AIDS researcher Brooks Jackson had already generated major funding from the NIH to stage a large trial for nevirapine in Kampala, Uganda, where the benevolent dictator Yoweri Museveni had opened his country to the lucrative promise of AIDS drug research, as well as other kinds of pharmaceutically funded medical research. HIVNET 012, according to its original 1997 protocol, was intended to be a four-arm, Phase III, randomized, placebo-controlled trial.6 Its sole sponsor was listed as the National Institute of Allergy and Infectious Diseases (NIAID), though one of the investigators was a Boehringer employee. The “sample size” was to be 1,500 HIV-1 infected Ugandan women more than thirty-two weeks pregnant. The four arms they would be divided into were 1) A single dose of 200mg nevirapine at onset of labor and a single 2mg dose to the infant forty-eight to seventy-two hours post-delivery, and 2) a corresponding placebo group; 3) 600mg of AZT at onset of labor and 300mg until delivery, with a 4mg AZT dose for the infant lasting seven days after birth, and 4) a corresponding placebo group. There were to he 500 women in each “active agent” arm and 250 in each placebo arm. The study was to last eighteen months, and its “primary endpoints” were to see how these two regimens would affect rates of HIV transmission from mother to child, and to examine the “proportion of infants who are alive and free of HIV at 18 months of age.” Another primary objective was to test the “safety/tolerance” of nevirapine and AZT. HIVNET’s architects estimated that more than 4,200 HIV-positive pregnant women would deliver at Mulago hospital each year, allowing them to enroll eighty to eighty-five women per month. Consent forms were to be signed by either the mother or a guardian, by signature or “mark.” One of the exclusion criteria was “participation during current pregnancy in any other therapeutic or vaccine perinatal trial.”

Although HIVNET was designed to be a randomized, placebo-controlled, double-blind, Phase III trial of 1,500 mother/infant pairs, it wound up being a no-placebo, neither double- nor even single-blind Phase II trial of 626 mother/infant pairs. Virtually all of the parameters outlined for HIVNET 012 were eventually shifted, amended, or done away with altogether, beginning with perhaps the most important—the placebo controls. By a “Letter of Amendment” dated March 9, 1998, the placebo-control arms of HIVNET were eliminated. The study as reconstituted thus amounted to a simple comparison of AZT and nevirapine.

On September 4, 1999, The Lancet published HIVNET’s preliminary results, reporting that “Nevirapine lowered the risk of HIV-I transmission during the first 14–16 weeks of life by nearly 50 percent.” The report concluded that “the two regimens were well-tolerated and adverse events were similar in the two groups.” The article also reported that thirty-eight babies had died, sixteen in the nevirapine group and twenty-two in the AZT group. The rate of HIV transmission in the AZT arm was 25 percent, while in the nevirapine group it was only 13 percent. As Hopkins Medical News later reported, the study was received rapturously. “The data proved stunning. It showed that nevirapine was 47 percent more effective than AZT and had reduced the number of infected infants from 25 to 13 percent. Best of all, nevirapine was inexpensive—just $4 for both doses. If implemented widely, the drug could prevent HIV transmission in more than 300,000 new-borns a year.”

With the results of the study now published in The Lancet, Boehringer, which previously had shown little interest in HIVNET, now pressed for FDA approval to have nevirapine licensed for use in preventing the transmission of HIV in pregnancy.

There were complications, however. On December 6, 2000, a research letter in The Journal of the American Medical Association warned against using nevirapine for post-exposure treatment after two cases of life-threatening liver toxicity were reported among health-care workers who’d taken the drug for only a few days. (One of them required a liver transplant.) The January 5, 2001, issue of the CDC’s Morbidity and Mortality Weekly Report (MMWR) contained an FDA review of MedWatch—an informal reporting system of drug reactions—that highlighted an additional twenty cases of “serious adverse events” resulting from fairly brief nevirapine post-exposure prophylaxis. “Serious adverse events” were defined as anything “life-threatening, permanently disabling,” or requiring “prolonged hospitalization, or [.. . ] intervention to prevent permanent impairment or damage.” The MMWR stressed that there probably were more unreported cases, since the reporting by doctors to MedWatch is “voluntary” and “passive.”

But NIAID was on another track altogether, either oblivious of or undeterred by the toxicity controversy. In 2001, Boehringer Ingelheim submitted its supplemental licensing request to the FDA. The request was submitted based entirely on the results of HIVNET, as published in The Lancet. Around the same time, the South African Medicines Control Counsel (MCC) conditionally approved nevirapine for experimental use in mother-to-child transmission treatment. To its credit, however, the FDA decided to go to Kampala, inspect the site, and review the data itself.

Since Boehringer had not originally intended to use this study for licensing purposes, it decided to perform its own inspection before the FDA arrived. Boehringer’s team arrived in Kampala and did a sample audit. They were the first to discover what a shambles the study was. According to Boehringer’s preinspection report, “serious noncompliance with FDA Regulations was found” in the specific requirements of reporting serious adverse events. Problems also were found in the management of the trial drug and in informed-consent procedures. DAIDS then hired a private contractor, a company named Westat, to go to Uganda and do another preinspection. This time the findings were even more alarming. One of the main problems was a “loss of critical records.” One of two master logs that included follow-up data on adverse events, including deaths, was said to be missing as the result of a flood. The records failed to make clear which mothers had gotten which drug, when they’d gotten it, or even whether they were still alive at various follow-up points after the study. Drugs were given to the wrong babies, documents were altered, and there was infrequent follow-up, even though one third of the mothers were marked “abnormal” in their charts at discharge. The infants that did receive follow-up care were in many cases small and under-weight for their age. “It was thought to be likely that some, perhaps many, of these infants had serious health problems.” The Westat auditors looked at a sample of forty-three such infants, and all forty-three had “adverse events” at twelve months. Of these, only eleven were said to be HIV positive. The HIVNET team had essentially downgraded all serious adverse events several notches on a scale it had created to adapt to “local” standards. That downgrade meant, among other things, that even seemingly “life-threatening” events were logged as not serious. Deaths, unless they occurred within a certain time frame at the beginning of the study, were not reported or were listed as “serious adverse events” rather than deaths. In one case, “a still birth was reported as a Grade 3 adverse event for the mother.”

As a defense, the HIVNET team often cited ignorance. They told the Westat monitors that they were unaware of safety-reporting regulations, that they’d had no training in Good Clinical Practice, and that they had “never attempted a Phase III trial.” The principal investigators and subinvestigators “all acknowledged the findings [of the audit] as generally correct,” the Westat report said. “Dr. Guay and Dr. Jackson noted that many (‘thousands’) of unreported AE’s and SAE’s occurred… . They acknowledged their use of their own interpretation of `serious’ and of severity.” “All agreed” that the principal and subinvestigators “had generally not seen the trial patients,” and “all agreed” that in evaluating adverse and serious adverse events “they had relied almost entirely on second or third hand summaries . . . without attempting to verify accuracy.” Westat also discovered that half the HIV-positive infants were also enrolled in a vitamin A trial, which effectively invalidates any data associated with them.

In light of the Westat report, DAIDS and Boehringer asked the FDA for a postponement of its inspection visit. The FDA responded by demanding to see the report immediately. On March 14, 2002, the FDA called a meeting with DAIDS, Boehringer, and the trial investigators. “They reprimanded the whole gang,” says Fishbein. Then they said to Boehringer: Withdraw your application for extended approval, if you want to avoid a public rejection.” Boehringer complied with the FDA’s demand, though statements put out by NIAID made it sound as if the company had withdrawn the application for FDA approval in a spirit of profound concern for protocol. In South Africa, a few months later, the news focused on the angry chorus of AIDS experts and activists, speaking as one. The South African MCC was reconsidering its approval of nevirapine for pregnant women because of Boehringer’s withdrawal and the growing HIVNET controversy. The Associated Press reported that “activists fear the government, notorious for its sluggish response to the AIDS crisis, is pressuring the council to reject nevirapine, and that it could misrepresent the current discussions as proof the drug is toxic. Studies show nevirapine given to HIV-pregnant women during labor and to their newborn babies can reduce HIV transmission by up to 50 percent.” The problem with such statements, of course, is that the study in question was precisely the one that established the claim that nevirapine cut HIV transmission.

Two inspections had now declared HIVNET to be a complete mess: Boehringer’s own and Westat’s, which had been performed in conjunction with DAIDS. But the ways in which the various players were tethered together made it impossible for DAIDS to condemn the study without condemning itself.7 But DAIDS was well aware of what had transpired.

According to DAIDS’s public version of events, which was dutifully echoed in the AIDS press, the trouble with HIVNET was that it was unfairly assailed by pedantic saboteurs who could not grasp the necessary difference between U.S. safety standards and the more lenient standards that a country like Uganda deserved. Two weeks after the fifty-seven-page Westat report was delivered, the deputy director of NIAID, Dr. John LaMontagne, had set the tone by stating publicly: “There is no question about the validity [of the HIVNET results] …the problems are in the rather arcane requirements in record keeping.” DAIDS was so dismissive of the Westat report that Westat’s lawyers eventually put officials on notice that they were impugning Westat’s reputation.

Meanwhile, as the investigations continued, nevirapine had long since been recommended by the World Health Organization and registered in at least fifty-three countries, and Boehringer had begun shipping boxes of the drug to maternity wards across the developing world. In 2002, President Bush announced a $500 million program to prevent maternal transmission of HIV in which nevirapine therapy would play a major role—despite the fact that the drug has never received FDA approval for this purpose.

In 2003, when Jonathan Fishbein was drawn into the HIVNET saga, the cover-up (for that, ultimately, is what the NIH response had become) was ongoing. In response to the massive failures documented by Boehringer and Westat, DAIDS embarked on a “remonitoring review” in an attempt to validate the study’s results. Ordinarily, an outside contractor would be retained for such a complex project, but Tramont made the decision to keep the remonitoring in-house. Drafting the review was a massive undertaking that took months of research, lengthy interviews with the investigators, and painstaking analysis of poorly organized documentation, as the DAIDS team attempted to learn what had actually taken place in Kampala. Even so, Tramont wanted the HIVNET site reopened in time for President Bush’s visit to Uganda. In March 2003, Tramont and his staff gathered together the different sections and substantially rewrote the report, especially the safety section, minimizing the toxicities, deaths, and record-keeping problems. The rewritten report concluded that nevirapine was safe and effective for the treatment of mother-to-child transmission of HIV, thus saving HIVNET 012 from the scrapheap of failed scientific studies.

While preparing the safety review section, however, an NIH medical officer named Betsy Smith noticed a pattern of elevated liver counts among some of the babies in the AZT arm. Following FDA regulations, she drafted a safety report documenting this finding and gave it to Mary Anne Luzar, a DAIDS regulatory affairs branch chief. Luzar forwarded the safety report to the FDA. The HIVNET investigators were furious; Tramont, who had previously signed off on the safety report, ordered a new version to be drafted, essentially retracting the previous one, and sent it to the FDA.8 The political stakes were very high: nevirapine was now a major element in the Administration’s new $15 billion African AIDS program—on July 11, President Bush even toured the HIVNET site in Kampala, which DAIDS had reopened for the occasion over Fishbein’s objections.

By late June 2003, Jonathan Kagan, the deputy director of DAIDS, asked Fishbein to sign off on a reprimand of Luzar for insubordination. Fishbein reviewed the HIVNET documentation and concluded that Luzar had done nothing wrong, that she had simply followed protocol. Fishbein’s refusal to go along with Luzar’s reprimand amounted to a refusal to participate in the HIVNET cover-up. In July, Tramont sent an email to all DAIDS staff instructing them not to speak about HIVNET at all. “HIVNET 012 has been reviewed, remonitored, debated and scrutinized. To do any more would be beyond reason. It is time to put it behind us and move on. Henceforth, all questions, issues and inquiries regarding HIVNET 012 is [sic] to be referred to the Director, DAIDS.”9

What followed, as internal emails and memorandums clearly show, was a vicious and personal campaign on the part of Kagan and Tramont to terminate Fishbein’s employment. DAIDS officials wrote emails in which they worried about how to fire him without creating repercussions for NIAID director Anthony Fauci, who had given Fishbein a commendation for his work. The communiqués took on conspiratorial tones as Tramont led the operation and mapped out its challenges. On February 23, 2004, Tramont emailed Kagan: “Jon, Let’s start working on this—Tony [Fauci] will not want anything to come back on us, so we are going to have to have iron-clad documentation, no sense of harassment or unfairness and, like other personnel actions, this is going to take some work. In Clauswitzian style, we must overwhelm with `force.’ We will prepare our paper work, then . . . go from there.” The web now included several more NIH/NIAID employees, who weighed in with suggestions about how best to expel Fishbein without leaving damning legal fingerprints on the proceedings.

Fishbein spent months trying to get a fair hearing, petitioning everyone from Elias Zerhouni, the director of the NIH, to Secretary of Health Tommy Thompson. It was around this time that Fishbein became a “ghost.” Nobody addressed him in the corridors, in the elevators, in the cafeteria. “There was an active campaign to humiliate me,” he says. “It was as if I had AIDS in the early days. I was like Tom Hanks in Philadelphia. Nobody would come near me.”

In March 2004, Fishbein began seeking whistle-blower protection. He met with congressional staff and attracted enough attention on Capitol Hill to force the NIH to agree to a study by the National Academy’s Institute of Medicine (IOM). The terms of that inquiry were skewed from the outset, however, and the nine-member panel decreed that it would not deal with any questions of misconduct. The panel ignored Fishbein’s evidence that DAIDS had covered up the study’s failures and relied on testimony from the HIVNET investigators and NIH officials. Not surprisingly, it found that HIVNET’s conclusions were valid. Six of the nine members on the panel were NIH grant recipients, with yearly grants ranging from $120,000 to almost $2 million.10

Fishbein dismissed the IOM report as a whitewash. Indeed, the report’s conclusions are hard to credit, given the overwhelming evidence uncovered by the Westat investigation and documentation such as the following email, which was sent by Jonathan Kagan to Ed Tramont on June 19, 2003. Tramont was considering HIVNET researchers Jackson and Guay for an award:

Ed—I’ve been meaning to respond on this—the bit about the award. I think that’s a bit over the top. I think that before we start heaping praise on them we should wait to see if the lessons stick. We cannot lose sight of the fact that they screwed up big time. And you bailed their asses out. I’m all for forgiveness, etc. I’m not for punishing them. But it would be “over the top” to me, to be proclaiming them as heroes. Something to think about before pushing this award thing …

NIAID has issued a total ban against any employee speaking to the press about Fishbein’s allegations. Instead, they have posted “Questions and Answers” about the matter on their website. The first question is: “Is single-dose nevirapine a safe and effective drug for the prevention of mother-to-infant transmission of HIV?” Fishbein has said that due to the spectacular failures of the HIVNET trial, the answer to this is not known, and not knowable. Fishbein believes that ultimately the HIVNET affair is not “about” nevirapine or even AIDS, but about the conduct of the federal government, which has been entrusted to do research on human beings and to uphold basic standards of clinical safety and accuracy.

NIAID answers its first question mechanically and predictably: “Single-dose nevirapine is a safe and effective drug for preventing mother-to-infant transmission of HIV. This has been proven by multiple studies, including the HIVNET 012 study conducted in Uganda.” The phrase “safe and effective” has been baked into both the question and the answer, rendering both blank and devoid of meaning. The “multiple studies” line is a familiar tactic, designed to deflect from the study that is actually being addressed, and that is HIVNET 012.

A short letter published in the March 10, 2005, issue of Nature quietly unpegged the core claim of NIAID and its satellite organizations in the AIDS industry regarding nevirapine’s “effectiveness.” Written by Dr. Valendar Turner, a surgeon at the Department of Health in Perth, Australia, the letter read:

Sir—While raising concerns about “standards of record keeping” in the HIVNET 012 trial in Uganda, in your News story, “Activists and Researchers rally behind AIDS drug for mothers,” you overlook a greater flaw. None of the available evidence for nevirapine comes from a trial in which it was tested against a placebo. Yet, as the study’s senior author has said, a placebo is the only way a scientist can assess a drug’s effectiveness with scientific certainty.

The HIVNET 012 trial abandoned its placebo group in early 1998 after only 19 of the 645 mothers randomized had been treated, under pressure of complaints that the use of a placebo was unethical.

The HIV transmission rate reported for nevirapine in the HIVNET 012 study was 13.1%. However, without antiviral treatments, mother-to-child transmission rates vary from 12% to 48%. The HIVNET 012 outcome is higher than the 12% transmission rate reported in a prospective study of 561 African women given no antiretroviral treatment.

The letter concluded by asking: “On what basis can it be claimed that `there’s nothing that has in any way invalidated the conclusion that single-dose nevirapine is effective for reducing mother-to-child transmission’? Without supporting evidence from a placebo-controlled randomized trial, such statements seem unwarranted.” HIVNET claimed to reduce HIV transmission by “nearly 50 percent” by comparing a nevirapine arm to an AZT arm. Turner’s letter points out that 561 African women taking no antivirals transmitted HIV at a rate of 12 percent. Had nevirapine been asked to compete with that placebo group, it would have lost. As it was, there was no placebo group, so HIVNET’s results are a statistical trick, a shadow play, in which success is measured against another drug and not against a placebo group—the gold standard of clinical trials. The question should not be, Is nevirapine better than AZT? but, Is nevirapine better than nothing?

Independent evidence suggests that it is not.

A 1994 study, for example, that gave vitamin A to pregnant HIV-positive mothers in Malawi reported that those with the highest levels of Vitamin A transmitted HIV at a rate of only 7.2 percent. This is consistent with a vast body of research linking nutritional status to sero-conversion, as well as to general health. Another study on the efficacy of nevirapine in mother-to-child transmission was performed by researchers from Ghent University (Belgium) in Kenya and published in 2004.

Dr. Ann Quaghebeur, who led the Ghent study, was reached at her home near London. I asked her what she thought of the reaction to HIVNET 012. She replied in a very quiet voice, almost a whisper. “Our results showed that nevirapine had little effect. I actually felt it was a waste of resources. HIVNET was just one study, but usually before you apply it in a field setting there should be a few more studies to see if it works in real life. What I think they should have done is wait for more studies before they launched this in all those countries.” When I asked her how she explained this, she replied, “Well, I want to be careful, there seems to be an industry now.”

The failure of the HIVNET researchers to properly control their study with a placebo group is not as unusual as one might think. In fact, this failure is perhaps the outstanding characteristic of AIDS research in general. The 1986 Phase II trial that preceded the FDA’s unprecedented rapid approval of AZT was presented as a double-blind, placebo-controlled study, though it was anything but that. As became clear afterward through the efforts of a few journalists, as well as the testimony of participants, the trial was “unblinded” almost immediately because of the severe toxicity of the drug. Members of the control group began to acquire AZT independently or from other study participants, and eventually the study was aborted and everyone was put on the drug. As in the case of HIVNET, documents obtained by journalist John Lauritsen under the Freedom of Information Act subsequently suggested that data-tampering was widespread. Documents were altered, causes of death were unverified, and the researchers tended to assume what they wished to prove, i.e., that placebo-group diseases were AIDS-related but that those in the AZT group were not. So serious were the deviations from experimental protocol at one Boston hospital that an FDA inspector attempted to exclude data from that center. In the end, however, all the data were included in the results, and the FDA approved the drug in 1987.11

AZT was approved in record time, but that record didn’t stand for long. In 1991, the FDA approved another DNA chain terminator, ddI, without even the pretense of a controlled study. Anti-HIV drugs such as Crixivan were approved in as little as six weeks, and cast as a triumph of AIDS activism. This pattern of jettisoning standard experimental controls has continued up to the present, as the HIVNET affair amply demonstrates, and has characterized not only research into new drugs designed to exterminate HIV but the more fundamental questions at the root of AIDS research.

The HIVNET cover-up can only be understood within the larger political context of AIDS. The emergence of this syndrome in the 1980s sparked a medical state of emergency in which scientific controls, the rules that are supposed to bracket the emotions and desires of individual researchers, were frequently compromised or removed entirely. AIDS helped turn disease into politics, and politics, at least in the United States, is all about turning power into money.

No one has been more persistent in calling attention to the failings of AIDS research than Peter Duesberg, a virologist and cancer specialist at the University of California at Berkeley. If Duesherg’s name sounds familiar, it’s because he has been quite effectively branded in the international media as the virologist who is wrong about HIV. His name entered the popular culture in the late 1980s prestamped with wrongness. You knew he was wrong before you knew what he had said in the first place.

In 1987, Duesberg published a paper in the journal Cancer Research entitled “Retroviruses as Carcinogens and Pathogens: Expectations and Reality.” He was, at the time, at the top of the field of retrovirology, having mapped the genetic structure of retroviruses and defined the first cancer gene in the 1970s. He was the youngest member, at age fifty, ever elected into the National Academy of Sciences. In this paper, which in the words of his scientific biographer, Harvey Bialy, “sealed his scientific fate for a dozen years,” Duesberg argued that retroviruses don’t cause cancer and concluded by detailing how and why the retrovirus HIV cannot cause AIDS.

As AIDS grew in the 1980s into a global, multibillion-dollar juggernaut of diagnostics, drugs, and activist organizations, whose sole target in the fight against AIDS was HIV, condemning Duesberg became part of the moral crusade. Prior to that 1987 paper, Duesherg was one of a handful of the most highly funded and prized scientists in the country. Subsequently, his NIH funding was terminated and he has received not one single federal research dollar since his pre-1987 Outstanding Investigator Grant ran out. Duesberg lost his lab facilities and had to move twice within a few years to smaller labs on the Berkeley campus, where he spent much of his time writing futile research grant proposals asking to test his hypothesis that AIDS is a chemical syndrome, caused by accumulated toxins from heavy drug use. He lost his graduate students, who were warned that to emerge from his lab would blight their careers. He was denied and had to fight for routine pay increases by his employers at UC Berkeley, where he has tenure and still teaches. He was “disinvited” from scientific conferences, and colleagues even declared that they would refuse to attend any conference that included him. Duesberg also was banished from publishing in scientific journals that previously had welcomed his contributions, most theatrically by the editor of Nature, Sir John Maddox, who wrote a bizarre editorial declaring that Duesherg would he denied the standard scientific “right of reply” in response to personal attacks that were frequently published in that journal. Prior to 1987, Peter Duesberg never had a single grant proposal rejected by the NIH. Since 1991 he has written a total of twenty-five research proposals, every single one of which has been rejected. “They took him out, just took him right out,” says Richard Strohman, an emeritus professor of biology at UC Berkeley.

And what was it, exactly, that Peter Duesherg had done? He simply pointed out that no one had yet proven that HIV is capable of causing a single disease, much less the twenty-five diseases that are now part of the clinical definition of AIDS.12 He pointed to a number of paradoxes regarding HIV and argued that far from being evidence that HIV is “mysterious” or “enigmatic,” these paradoxes were evidence that HIV is a passenger virus.

The classical tests of whether or not a microorganism is the cause of infectious disease are known as Koch’s postulates. They state: 1) the microorganism must be found in all cases of the disease; 2) it must be isolated from the host and grown in pure culture; 3) it must reproduce the original disease when introduced into a susceptible host; and 4) it must be found present in the experimental host so infected. Although claims to the contrary have been made, Duesberg maintains that it has never been demonstrated that HIV satisfies all of Koch’s postulates. His exhaustive analysis of the peer-reviewed scientific literature has revealed more than 4,000 documented AIDS cases in which there is no trace of HIV or HIV antibodies. This number is significant, because there are strong institutional forces deterring such descriptions and because the vast majority of AIDS cases are never described in formal scientific papers. In fact, most AIDS patients have no active HIV in their systems, because the virus has been neutralized by antibodies. (With all other viral diseases, by the way, the presence of antibodies signals immunity from the disease. Why this is not the case with HIV has never been demonstrated.) Generally speaking, HIV can be isolated only by “reactivating” latent copies of the virus, and then only with extraordinary difficulty. Viral load, one of the clinical markers for HIV, is not a measurement of actual, live virus in the body but the amplified fragments of DNA left over from an infection that has been suppressed by antibodies. Another embarrassment for the HIV hypothesis is the extraordinary latency period between infection and the onset of disease, despite the fact that HIV is biochemically most active within weeks of initial infection. This latency period, which apparently grows with every passing year, enables proponents of the theory to evade Koch’s third and fourth postulates.

The foregoing is merely a sketch of the central mystery presented by the HIV theory of AIDS. There are many more, which Duesherg has laid out very carefully in his scientific papers and in a trade book published ten years ago, but they all boil down to the central point that when it comes to AIDS, basic scientific standards seem no longer to apply.13 AIDS is a “syndrome” defined by twenty-five diseases, all of which exist independently of HIV. No one has ever demonstrated the cell-killing mechanism by which HIV is supposed to cause all these different diseases, and no one has ever demonstrated how a sexually transmitted virus can manage to restrict itself overwhelmingly to gay men and other AIDS risk groups instead of spreading randomly through the population, as do all other infectious diseases. The “overwhelming” character of the evidence for HIV’s causation has always been epidemiological; which is to say, a correlation, a coincidence. Whenever we have AIDS, researchers say, we also have HIV. But this correlation is a result of the official definition of AIDS, which state, that a disease counts as AIDS only if it corresponds with HIV antibodies. (“AIDS without HIV” has been given a singularly unmemorable name: idiopathic CD4 lymphocytopenia.)

Given that the evidence for HIV is coincidental, a number of research avenues suggest themselves, yet orthodox AIDS researchers have failed to demonstrate, using large-scale controlled studies, that the incidence of AIDS-defining diseases is higher among individuals infected with HIV than among the general uninfected population. Consequently, it could very well be the case that HIV is a harmless passenger virus that infects a small percentage of the population and is spread primarily from mother to child, though at a relatively low rate. (This hypothesis would tend to explain the fact that the estimated number of HIV-positive Americans has remained constant at about 1 million since 1985.) Nor have large-scale controlled studies been carried out to directly test the AIDS-drug hypothesis, which holds that many cases of AIDS are the consequence of heavy drug use, both recreational (poppers, cocaine, methamphetamines, etc.) and medical (AZT, etc.).14 Nor have controlled studies been carried out to prove that hemophiliacs infected with HIV die sooner than those who are not infected. Such studies might be expensive and tedious, but expense has never been a serious objection to AIDS researchers, who have spent many billions of dollars in the last twenty years on HIV research and practically nothing on alternative causes or even cofactors. (Even Luc Montagnier, the discoverer of HIV, has stated repeatedly that the virus cannot cause AIDS without contributing causes.)

Attempts to rigorously test the ruling medical hypothesis of the age are met not with reasoned debate but with the rhetoric of moral blackmail: Peter Duesherg has the blood of African AIDS babies on his hands. Duesherg is evil, a scientific psychopath. He should be imprisoned. Those who wish to engage the AIDS research establishment in the sort of causality debate that is carried on in most other branches of scientific endeavor are tarred as AIDS “denialists,” as if skepticism about the pathogenicity of a retrovirus were the moral equivalent of denying that the Nazis slaughtered 6 million Jews. Moral zeal rather than scientific skepticism defines the field. It has been decided in advance that HIV causes AIDS; consequently all research and all funding must proceed from that assumption. Similarly, it was known in advance that AZT was a “magic bullet” against HIV; the word was out that it was a “life-saving drug” before anyone could possibly verify this, and so scientific controls were compromised. Journalists (myself included) who reported at the time that the drug apparently was killing patients were labeled “AZT refuseniks” and even “murderers.”

The nevirapine debate follows the same histrionic, antiscientific pattern. Because of his concerns about the toxicity of this and other antiretroviral drugs, President Thabo Mbeki of South Africa was pilloried in the international press as pharmaceutical companies and their well-funded “activist” ambassadors repeated their mantra about “life-saving drugs.” So, too, was Jonathan Fishbein, who never questioned the premise that HIV causes AIDS, tarred and feathered for pointing out that the NIH flagship study on nevirapine was a complete disaster. Fishbein’s failure to fall into line, his failure to understand in advance of experimental proof that nevirapine was too important to fail, meant that the AIDS bureaucracy’s neutralizing antibodies had to be activated to destroy them.

In the end, the NIH failed to silence Fishbein. In late December 2005, he won his case and was retroactively reinstated at the agency, though he won’t be returning to DAIDS. He is unable to discuss the terms of his settlement, but he has promised to continue his commitment to research integrity and the protection of human research subjects. Peter Duesberg has been less successful, though there are signs of rehabilitation.

Regardless of whether Duesberg is right about HIV, his case, like Fishbein’s, lays bare the political machinery of American science, and reveals its reflexive hostility to ideas that challenge the dominant paradigm. Such hostility is not unusual in the history of science,15 but the contemporary situation is dramatically different from those faced by maverick scientists in the past. Today’s scientists are almost wholly dependent upon the goodwill of government researchers and powerful peer-review boards, who control a financial network binding together the National Institutes of Health, academia, and the biotech and pharmaceutical industries. Many scientists live in fear of losing their funding. “Nobody is safe,” one NIH-funded researcher told me. “The scientific-medical complex is a $2 trillion industry,” says former drug developer Dr. David Rasnick, who now works on nutrition-based AIDS programs in Pretoria, South Africa. “You can buy a tremendous amount of consensus for that kind of money.”

“You have to write a grant a year almost. And you have to write four to get one, if you’re any good. I got out just in time. Everybody who’s still in there says the same thing,” says Berkeley’s Strohman. “Before the biotech boom, we never had this incessant urging to produce something useful, meaning profitable. Eyerybody is caught up in it. Grants, millions of dollars flowing into laboratories, careers and stars being made. The only way to be a successful scientist today is to follow consensus. If you’re going to produce something and put it on the market you don’t want any goddamn surprises. You’ve got the next quarter to report and you don’t want any bad news. It’s all about the short term now. Science has totally capitulated to corporate interests. Given their power and money, it’s going to be very hard to work our way out of this.”

Duesberg has never been afraid to challenge consensus, but contrary to what many in the AIDS establishment would have us believe, he is very far from being a scientific psychopath.16 In 1997, on the brink of scientific demise in the U.S., Duesberg was quietly invited back to his native Germany to resume his cancer research. During this time, commuting biannually between Mannheim and Berkeley, Duesberg formulated and tested a theory that shifts the focus of cancer causation from the “mutant gene” theory that has reigned for about three decades to a simpler explanation that revives an abandoned thread of research from early in the twentieth century, which posited that cancer is caused by chromosomal malfunction, now known as “aneuploidy.”

Harvey Bialy, the founding scientific editor of Nature Biotechnology, a sister journal to Nature, recently spent four years writing a scientific biography of Duesberg entitled Oncogenes, Aneuploidy, and AIDS. The book is a history of the papers, review articles, and letters that Duesberg published between 1983 and 2003, and the responses they generated. I asked him why he wrote the book. “I am persuaded that aneuploidy is the initiating event in carcinogenesis”, Bialy said. “Peter has found the genetic basis for cancer. The most immediate application of it will be early diagnosis.”

“When aneuploidy, or genetic instability, or whatever linguistic term you want to use, gets reincarnated as the dominant theoretical explanation for the genesis of cancer, Peter Duesberg will be recognized as a major contributor to that,” Bialy said. “I wanted to make sure that his contributions were not swept aside or ignored.” I asked him about the AIDS controversy. “AIDS is a political thing, and Peter’s stuck in it. There’s nothing to discuss anymore on that.” Bialy made a critical point. Science is amoral and should be. There is no right and wrong, only correct and incorrect. “Duesberg,” Bialy said, “is a classical molecular biologist. All he is interested in is rigorously testing dueling hypotheses. The twin pillars, AIDS and oncogenes, both are crumbling because of the questions Peter Duesherg put into motion.”

“The basis of speciation is changing the content and the number of chromosomes,” says Duesherg. “Cancer is essentially a failed speciation. It’s not mutation. Cancer is a species. A really bad breast, lung, or prostate cancer has seventy, eighty, or more chromosomes. Those are the real had guys they’re way outside our species. But it’s a rare kind of species that as a parasite is more successful in its host than the normal host cell is.”

There has been considerable international interest in Duesberg’s new research.17 In January 2004, he hosted a conference on aneuploidy and invited fifty cancer researchers from around the world who also have been working on the connections between aneuploidy and cancer. Seventy showed up, including such luminaries as Thomas Ried, the National Cancer Institute’s head of cancer genomics, Gert Auer from the Karolinska Institute in Stockholm, and Walter Giaretti, who heads the equivalent of the NCI in Italy. And on May 31 of last year, amid considerable tension, Duesherg was invited by the National Cancer Institute to give a talk at the NIH. The auditorium crackled with nervous tension as people filed in and took their seats. His talk was succinct and laced with his characteristic irony, but the questions afterward were civilized, with no tangible hostility. All was not forgiven, however. After the talk, while Duesberg remained at the podium talking to a group of people from the audience, I noticed a very angry-looking NIH publicist standing at the back of the room admonishing a colleague, a scientist, who’d posed a question that somehow connected aneuploidy to HIV. “You opened it up,” she scolded. “We got through it okay, but you opened it up.” As the questioner tried to defend himself, a thick-set man who’d been standing in the circle said loudly, as though intending to broadcast it across the room: “Well, at least if he’s wrong about this lie won’t he killing millions of people.”

Nobel laureate Kary Mullis, who discovered the revolutionary DNA technique called the polymerase chain reaction, has long been a supporter of Duesberg, but he has grown weary of the AIDS wars and the political attacks on contrarian scientists. “Look, there’s no sociological mystery here,” he told me. “It’s just people’s income and position being threatened by the things Peter Duesberg is saying. That’s why they’re so nasty. In the AIDS field, there is a widespread neurosis among scientists, but the frenzy with which people approach the HIV debate has slacked off, because there’s just so much slowly accumulating evidence against them. It’s really hard for them to deal with it. They made a really big mistake and they’re not ever going to fix it. They’re still poisoning people.”

Duesberg thinks that up to 75 percent of AIDS cases in the West can he attributed to drug toxicity. If toxic AIDS therapies were discontinued, he says, thousands of lives could he saved virtually overnight. And when it comes to Africa, he agrees with those who argue that AIDS in Africa is best understood as an umbrella term for a number of old diseases, formerly known by other names, that currently do not command high rates of international aid. The money spent on antiretroviral drugs would be better spent on sanitation and improving access to safe drinking water (the absence of which kills 1.4 million children a year).

It’s too late to save people like Joyce Ann Hafford, but it is possible that an open and honest debate about the risks of current AIDS treatments and the scientific questions concerning HIV could save others.

REFERENCES

1 HIV tests detect footprints, never the animal itself. These footprints, antibodies, are identified by means of molecular protein weights, and were limited to two in 1984, when the first test was developed and patented, but over the years expanded to include many proteins previously not associated with HIV. Like most Americans, Hafford thought that a single HIV-positive test meant that she “had” HIV—a surefire death sentence. But a majority of HIV-positive tests, when retested, come back indeterminate or negative. In many cases, different results emerge from the same blood tested in different labs. There are currently at least eleven different criteria for how many and what proteins at which hand density signal “positive.” The most stringent criteria (four hands) are upheld in Australia and France; the least stringent (two hands), in Africa, where an HIV test is not even required as part of an AIDS diagnosis. The U.S. standard is three reactive hands. It has been pointed out that a person could revert to being HIV negative simply by buying a plane ticket from Uganda to Australia.

2 Dr. Thorpe declined to comment, citing ongoing litigation, as did the Tennessee Medical Group, the Regional Medical Center at Memphis, and St. Jude’s Children’s Research Hospital.

3 “Our mission of eradicating AIDS is always informed and driven by the best available science, not by donations,” said Mark Isaac, Elizabeth Glazer’s vice president for policy, when asked to comment. “The full body of research, as well as our extensive experience, validates the safety and efficacy of single-dose nevirapine as one of several options to prevent mother-to-child transmission of HIV.”

4 Africa, as the news media never tires of telling us, has become ground zero of the AIDS epidemic. The clinical definition of AIDS in Africa, however, is stunningly broad and generic, and was seemingly designed to be little other than a signal for funding. It is in no way comparable to Western definitions. The “Bangui definition” of AIDS was established in the city of Bangui in the Central African Republic, at a conference in 1985. The definition requires neither a positive HIV test nor a low T-cell count, as in the West, but only the presence of chronic diarrhea, fever, significant weight loss, and asthenia, as well as other minor symptoms. These happen to be the symptoms of chronic malnutrition, malaria, parasitic infections, and other common African illnesses. (In 1994 the definition was updated to suggest the use of HIV tests, but in practice they are prohibitively expensive.) Even when HIV tests are performed, many diseases that are endemic to Africa, such as malaria and TB, are known to cause false positives. The statistical picture of AIDS in Africa, consequently, is a communal projection based on very rough estimates of HIV positives, culled from select and small samples, which are extrapolated across the continent using computer models and highly questionable assumptions.

5 Asked to comment about the Hafford case, HIVNET 012, and the larger nevirapine controversy, Boehringer Ingelheim provided the following statement: “Viramune ® (nevirapine) was an innovation in anti-HIV treatment as the first member of the nonnucleoside reverse transcriptase inhibitor (NNRTI) class of drugs. Now in its tenth year of use, Viramune has been used as a treatment in more than 800,000 patient-years worldwide.”

6 The study was originally titled “HIVNET 012: A Phase III Placebo-Controlled Trial to Determine the Efficacy of Oral AZT and the Efficacy of Oral Nevirapine for the Prevention of Vertical Transmission of HIV-1 Infection in Pregnant Ugandan Women and Their Neonates.” “Randomization” means that people are randomly chosen for one arm of the study or another, a procedure that is supposed to even out the variables that could affect the outcome. “Placebo controls” are the bedrock of drug testing and are the only way to know whether the treatment is effective. Phase I trials involve a small group of people, twenty to eighty, and are focused on safety and side effects. In Phase II trials the drug is given to an expanded cohort, between 100 and 300, to further evaluate safety and begin to study effectiveness. Phase III drug trials expand further the number of people enrolled, often to more than 1,000, and are meant to confirm a drug’s effectiveness, monitor side effects, and compare it with other treatments commonly used. A small Phase I trial preceded HIVNET 012 that studied the safety, primarily, of nevirapine in pregnant women but also looked at efficacy. It was called HIVNET 006, and it enrolled twenty-one pregnant women for initial study. Of twenty-two infants horn, four died. There were twelve “serious adverse events” reported. The study also showed that there was no lowering of viral load in the mothers who took the study drug (the industry’s agreed-upon standard for interrupting maternal transmission).

7 Brooks Jackson declined to comment for this article. Laura Guay responded with the following statement: “Several in-depth reviews of the conduct and results of the HIVNET 012 trial as well as the data collected from subsequent trials and PMTCT programs, have substantiated the HIVNET 012 conclusions that Nevirapine is safe and effective in preventing mother-to-child HIV transmission. Nevirapine remains one of the most important tools for the prevention of mother-to-child HIV transmission in the developing world, where there are still hundreds of thousands of HIV-infected pregnant women who do not have access to any HIV testing, antiretroviral therapy, or HIV care at all. For many programs struggling to establish PMTCT programs with limited resources, Nevirapine is often the only option available.” Family Health International, the NIH contractor originally responsible for monitoring HIVNET 012, contested the Westat report and said that the results of the study had been validated by the NIH and the Institute of Medicine.

8 Smith and Luzar have been forbidden by the NIH to speak to the press about HIVNET. Luzar was deposed by Fishbein’s attorney in his wrongful-termination lawsuit, Stephen Kohn, in December 2004, and this account is partially based on her deposition.

9 At this point the story grows ever more complicated, as Fishbein supported Luzar in a sexual-harassment claim against Kagan.

10 An internal NIH investigation, which was obtained by the Associated Press last summer, vindicated many of Fishbein’s charges and concluded that “it is clear that DAIDS is a troubled organization,” and that the Fishbein case “is clearly a sketch of a deeper issue.” Kagan and Tramont did not return repeated calls for comment. Instead, an NIH spokesman, Dr. Cliff Lane, said that the agency stands by HIVNET 012.

11 AZT, which was developed as a chemotherapeutic agent in 1964 but shelved because of its extreme toxicity, is a DNA chain terminator, which means that it brings DNA synthesis to a halt. It is therefore an extremely efficient cell killer. HIV is a retrotirus, and as such replicates itself by inserting its genes into a cell’s genome so that when the cell divides a new copy of the virus is produced. AZT prevents the replication of HIV by killing infected T-cells; unfortunately, it kills all dividing cells indiscriminately, whether they are infected with a retrovirus or not, and will very quickly decimate even a healthy person’s immune system. AZT’s manufacturer, GlaxoSmith Kline, chose not to comment for this article.

12 HIV was declared the probable cause of AIDS in a U.S. government press conference in 1984. It was claimed that the virus had been discovered by NIH researcher Robert Gallo. In fact, Gallo had not discovered HTLV-III (Human T-cell Lymphotropic Virus III, as it was known before it was rechristened with the more memorable name HIV) . That honor belongs primarily to Luc Montagnier, of the Pasteur Institute, who had sent Gallo a sample of the virus.

13 It has been claimed that HIV somehow causes cell death even when it is not present by remote programmed “suicidal” mechanisms. Some researchers claim that HIV exploits special receptors on human T-cells that, due to a hypothetical genetic mutation, many “Caucasian Europeans” lack, but most Africans have. What’s interesting is that many gay men also seem to possess these mysterious receptors, as do intravenous drug users and transfusion recipients.

It is claimed that although HIV does not kill the laboratory T-cells used to manufacture AIDS tests, it does kill T-cells in the human body, even though it infects only a very small proportion of them, typically an average of 0.1 percent. HIV does not sicken or kill chimpanzees, though they do produce antibodies. It was recently claimed that HIV appears to be evolving into a form less dangerous to human beings. Such unproven hypotheses about the ingenuity of HIV proliferate in the popular and scientific media like the seasonal flu. Seldom do journalists insist on good hard evidence for these assertions.

14 There is ample statistical and epidemiological evidence linking the rise of mass drug abuse in the late Sixties and Seventies with the sudden appearance of AIDS. The overwhelming majority of AIDS patients with Karposi’s sarcoma, for example, have been heavy users of nitrate inhalers, or “poppers.” The case of “super AIDS” that was recently reported in New York turned out upon closer examination to he an individual with an extraordinarily heavy methamphetamine habit.

15 Few today remember the controversies over scurvy and pellagra, which, until the discovery of vitamin C and niacin, were blamed by the medical establishment on mysterious infectious agents. Those who pointed out, even before they knew the cause, that dietary changes cured both conditions were dismissed as flat-earthers.

16 Nor is Duesberg alone in dissenting from AIDS orthodoxy. More than 2,300 people, mostly scientists and doctors, including Nobelists in chemistry and medicine, have signed the petition of the Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, which calls for a more independent and skeptical approach to the question of AIDS causality.

17 Even so, the National Cancer Institute still refuses to fund him. Duesberg has submitted five grant proposals to study aneuploidy, and all have been rejected. One of the most influential cancer researchers in the country, Bert Vogelstein, Clayton Professor of Oncology and Pathology at Johns Hopkins University, has written a letter urging the NCI to reconsider. “1 agree with him that aneuploidy is an essential part of cancer,” Vogelstein wrote. “Dr. Duesberg continues to have a major impact on this burgeoning area of research, through his careful experimental observations as well as through his thoughtful reviews and critiques of the subject. There is no question that he is a world leader in this field of investigation.”

(Harper’s Magazine is an American journal of literature, politics, culture, and the arts published continuously from 1850. You can subscribe to Harper’s Magazine for as little as $14.97 a year.)

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