Damned Heretics

Condemned by the established, but very often right

I am Nicolaus Copernicus, and I approve of this blog

I am Richard Feynman and I approve of this blog

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.

HONOR ROLL OF SCIENTIFIC TRUTHSEEKERS

Henry Bauer, Peter Breggin , Harvey Bialy, Giordano Bruno, Erwin Chargaff, Nicolaus Copernicus, Francis Crick, Paul Crutzen, Marie Curie, Rebecca Culshaw, Freeman Dyson, Peter Duesberg, Albert Einstein, Richard Feynman, John Fewster, Galileo Galilei, Alec Gordon, James Hansen, Edward Jenner, Benjamin Jesty, Michio Kaku, Adrian Kent, Ernst Krebs, Thomas Kuhn, Serge Lang, John Lauritsen, Mark Leggett, Richard Lindzen, Lynn Margulis, Barbara McClintock, George Miklos, Marco Mamone Capria, Peter Medawar, Kary Mullis, Linus Pauling, Eric Penrose, Max Planck, Rainer Plaga, David Rasnick, Sherwood Rowland, Carl Sagan, Otto Rossler, Fred Singer, Thomas Szasz, Alfred Wegener, Edward O. Wilson, James Watson.
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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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‘Denialists’ Deplored

August 21st, 2007

Tara and Steven assess HIV?AIDS criticism on the Internet and find it hollow, misleading and a danger to the community

We admire Tara, but is this scientific argument – or toadying propaganda?

With the Internet as with truth, time will tell

According to an item at Science Daily, HIV Denialists Spread Misinformation Online: Consequences Could Be Deadly, one great danger of the Web is that it allows critics of the science of HIV?AIDS full rein, and they have taken advantage of this license to undermine the faith of patients and the public at large in the validity of the globally established paradigm.

Science Daily is reporting the essay published last week on line at the Library of Science, HIV Denial in the Internet Era. The message of this broadside against critical reviewers of the HIV?AIDS paradigm is the same as John P. Moore of Weill Cornell’s Deadly Quackery, the scientifically embarrassing Times Op-Ed piece last June: Don’t question accepted wisdom, it might alarm the clients.

HIV deniers accuse scientists of quashing dissent regarding the cause of AIDS, and not allowing so-called ‘alternative’ theories to be heard. However, this claim could be applied to any well-established scientific theory that is being challenged by politically motivated pseudoscientific notions, for example, creationist challenges to evolution. Further, as HIV denial can plausibly reduce compliance with safe sex practices and anti-HIV drugs, potentially costing lives, this motivates the scientific and health care communities to exclude HIV denial from any public forum. (As one editorial has bluntly phrased it, HIV denial is ‘deadly quackery’ [24]. Because HIV denial is not scientifically legitimate, such exclusion is justified, but it further fuels the deniers’ claims of oppression.

Or, please join us in assuming that what is being questioned is true without question, so that high level review can be politically repressed as “pseudoscience” rather than answered with science, and there will be no danger that patients question the need to take extremely dangerous drugs.

The only problem with this line of paradigm defense, of course, is that the serious paradigm debunking has in fact occurred in peer reviewed scientific literature at the highest level, and has gone unanswered there at the same, peer reviewed level, in the same journals. Instead, the defense team has abandoned ship and gone to lower levels, where peer review does not handicap bad argument and misleading assertions, where “fact sheets” can be quoted in response to peer-reviewed critique, and where lay critics can be answered with politically charged prejudice (“dangerous” “pseudoscience”) and smearing (“not scientifically legitimate” “denialist” (similar to Holocaust denialists) “conspiracy theorists” motivated by “profit”) and so on.

A notable blogger

tarasmith.jpgThe authors of the complaint are two, the first being none other than Tara Smith, the youthful epidemiologist blogger who at her scienceblogs site, Aetiology, has maintained a reflex scorn for HIV critics (“deniers”) based on her under researched (because very little is without question in the paradigm literature now) support of the conventional wisdom, a handicap which is understandable since assistant professor Tara has a very busy life as well as covering a wide range of topics on her lively blog.

Her main contribution to HIV?AIDS enlightenment has been to host several long threads where second level supporters of both sides of the debate have battled it out, typically on the level of the trees rather than the forest. Sorry to say all this has had little effect in clarifying the issue for the average reader, since the discussion is handicapped by the prejudice of the hostess, and more informed thinkers tend to avoid such arenas, as we do.

As a bonus attraction, visits to the site were long enhanced by the sight of Tara’s svelte portrait in form fitting costume, and the latest one is just as pretty as the first one she posted for a long time, though perhaps less like a bathing suit (we hope our appreciation of this first portrait here was not responsible for the replacement). We have reproduced it above, at the start of the mention of this attractive scientist.

tara-smith.jpgHowever, the meeting this last weekend of science bloggers corralled at Seed Magazine’s ScienceBlogs site yielded some more realistic pictures of Tara and others from the beer drinking gatherings involved, and here is the best one we could find (left). Others are at A Blog Around the Clock, Neurophilosophy and Pharyngula. Readers with an interest in such research will see if intelligence correlates with beauty in the science blogging world.

More mudslinging at HIV critics

Meanwhile, back to the more serious topic of the lengthy diatribe against “AIDS denialists” penned by Smith and another writer for the Library of Science. Her co-author is Steven P. Novella, who is with the Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America.

Intelligent readers will read HIV Denialists Spread Misinformation Online: Consequences Could Be Deadly through for themselves and immediately see that it is nothing more than a John P. Moore type piece of prejudicial propaganda, a rote recitation of all the reasons why established wisdom endorsed by long established and trusted institutions relied upon by the media and the public, not to mention almost all scientists, physicians, health workers, policymakers and government officials around the globe, should not be questioned by independent critics, especially those without professional expertise in the science concerned, retrovirology and its two human diseases alleged so far, even if the scientific literature at the top level contains an ever growing pile of rejecting reviews and studies which contradict the basic tenets of the paradigm and its medical approach.

While being presented with a reasonably good historical update readers will note that the authors in deploring the dissenting view present no good scientific arguments of their own and reference inaccurate sources as often as they reference accurate sources for their point of view (Christine Maggiore’s child was not HIV positive). In all these politics and generalities, the points made against the group they attacked can just as easily be used to condemn the writers, which we will show when we return to expand this post. (Note: We have moved this to a new post, since another Scienceblogs blogger, Orac, has in his riposte supporting the Tara essay as Essential Reading on HIV Denialism and an “essential primer on the dangerous pseudoscience and quackery that is HIV/AIDS denialism” accused us of making feeble points in reply, so we feel we had better pull up our socks and put our best foot forward, given the respect we have for Scienceblog bloggers, even though apparently none of them have read the literature on the topic (the Proceedings of the National Academy does not publish ‘pseudoscience’, Orac!)).

Its chief value lies in the fact that it will inform readers of the existence of substantial criticism of HIV?AIDS and that some will be provoked into checking the full list of references for themselves, including as it happens this blog, New AIDS Review, which is referenced.

The Net’s biggest danger – long run embarrassment

It is true that the Net is a wonderful thing, allowing all voices to speak out, from the illiterate and juvenile to the scholarly and thoughtful, some of them bringing to the attention of the public good information which would otherwise be kept from view. But there are other, less obvious perils.

In the long run, Tara Smith and Steven Novella will learn the biggest danger of the Internet, which will eventually emerge as its dominant long run characteristic: its permanence.

Every single half baked, under researched opinion everybody writes on the world’s bulletin board will be there twenty years from now, when time itself will have ensured that any nonsense one ventures too precipitately for the wrong reasons will be exposed for all to see, as clear as the day it was scribbled, hanging like dirty laundry in the sun.

Let’s hope for their sake that all the signs in the scientific literature that Tara and her friend Steven are ignoring are somehow proven to be wrong, as they like to assume, apparently without examining them carefully enough. Since they all point in the same direction, to the eventual defeat of a paradigm which never genuinely flew, scientifically speaking, even at the beginning, this seems unlikely. More likely is their embarrassment, as grownups, at what they wrote as babes in the woods.

Right or wrong, their piece with its absurd reasoning is shameful enough at this very moment. Anyone in science who argues against examining any assumption is no scientist worthy of the name. Maybe the editors at the Library of Science should read their own front page, which displays this quote:

I thoroughly support universal free access to research. The wonderful thing about ideas is more people being exposed to more ideas leads to still more ideas.” — Dr. Richard Smith, former Editor of the British Medical Journal, member of the PLoS Board of Directors

What they are, and reveal themselves to be, is…political babes in the wood. Unless … of course, they may be knowing babes whose secret motivation, hidden even from themselves, is toadying. But we wouldn’t know, and have no further data to prove it.

Uninformed opinionating

Not that Tara Smith sets a very good example for informed opinion at the best of times, judging from her other posts. For example, she attacked the New York popularizer of nutrient and dietary research, Gary Null, for selling magnetic trousers and other products which interest people who think magnetism has good effects on their systems.

Calling this a “despicable” moneymaking “scam”, Tara shows no sign of being informed on any of the research on magnetic fields and their effects on biological activity conducted over the past thirty years, which have resulted in entire books on the topic. These studies have found some effects, for instance, on the digestion of proteins by the proteolytic enzyme trypsin, which is more active in a polarized magnetic field , as we recall.

Well, we’ve certainly seen HIV deniers advocate a number of quack cures to replace antiretroviral drugs, including megadoses of vitamins and the aforementioned potato cure, so it probably won’t come as a surprise to anyone that Null also espouses some, erm, rather “wacky” ideas regarding what makes one healthy. But some of these were new even to me; more after the jump.

Let me first note that none of these are specifically recommended for HIV. Rather, Null is anti- lots of mainstream medical science, of which HIV/AIDS is just a part. So rather than the evil drugs pushed upon unsuspecting, naive Americans, what does Null recommend for healthy living?

Magnetic pants. And magnetic bras–a bargain at only $72. If you really want to splurge, how about a king-sized magnetic mattress pad for $400 more? Or try his “new and improved!” Brainy caps, only $50 for a month’s supply. And don’t forget your pets!

Once again, I find it hard to believe the hypocrisy of HIV deniers, including Null himself, who decry the “profits” supposedly made by all these “unethical” HIV researchers, and yet go and make money off of scams like magnetic pants. Despicable.

Whether trousers (or magnetic bras) would work any biological magic beyond the placebo effect we do not know (we too very much doubt it, since it is hard to imagine how the fields could be polarized), but it would be better if Tara would do a little research before shooting from the hip, if she is going to indulge her common reflex prejudice that something she has never heard of must lack any basis in research just because it sounds wacky.

We happen to know that Gary Null has in the past gone to some lengths to check out the potential of various novel notions by having research experiments done, and when these failed to find any effect, accepted the results.

It is this kind of self righteous opinionating, based on mistaking a familiarity with the conventional wisdom of one’s elders and better for being genuinely informed on a disputed topic, which renders so much Web commentary empty and foolish, and HIV Denial in the Internet Era is a classic of this kind.

We sympathize with the critics of HIV∫AIDS in having to dodge this mudslinging, when all they have ever asked for is that responsible people should learn to read the scientific literature or have it independently analyzed for them before assuming that all is well in HIV∫AIDS science just because HIV researchers tell them so.

Instead they have these blog dogs snapping at their heels, imagining they are barking in defense of the citadel of true science when all they are doing is getting in the way of its proper operation, which is to double check assumptions when contradictions multiply.

The full article, HIV Denial in the Internet Era, is as follows:
PLoS Medicine

A peer-reviewed, open-access journal published by the Public Library of Science

The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies.
HIV Denial in the Internet Era

Tara C. Smith*, Steven P. Novella

Funding: Tara C Smith received research start-up funding from the University of Iowa, but received no specific funding for this article.

Competing Interests: The authors have declared that no competing interests exist.

Citation: Smith TC, Novella SP (2007) HIV Denial in the Internet Era. PLoS Med 4(8): e256 doi:10.1371/journal.pmed.0040256

Published: August 21, 2007

Copyright: © 2007 Smith and Novella. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Tara C. Smith (to whom correspondence should be addressed. E-mail: tara-smith@uiowa.edu) is with the Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, United States of America. Steven P. Novella is with the Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, United States of America.

HIV Denial in the Internet Era

It may seem remarkable that, 23 years after the identification of the human immunodeficiency virus (HIV), there is still denial that the virus is the cause of acquired immune deficiency syndrome (AIDS). This denial was highlighted on an international level in 2000, when South African president Thabo Mbeki convened a group of panelists to discuss the cause of AIDS, acknowledging that he remained unconvinced that HIV was the cause [1]. His ideas were derived at least partly from material he found on the Internet [2]. Though Mbeki agreed later that year to step back from the debate [3], he subsequently suggested a re-analysis of health spending with a decreased emphasis on HIV/AIDS [4].

HIV denial has taken root in the general population and has shown its potential to frustrate public education efforts and adversely affect public funding for AIDS research and prevention programs. For example, the AIDS Coalition to Unleash Power (ACT UP) was for many years on the front lines of AIDS education and activism. But now a San Francisco chapter of the group has joined the denialist movement, stating on its Web site that “HIV does not cause AIDS… HIV antibody tests are flawed and dangerous…AIDS drugs are poison” (http://www.actupsf.com/aids/index.htm). In 2000 the chapter wrote letters to every member of Congress asking them to stop funding research into HIV [5]. ACT UP San Francisco’s position has been condemned by other ACT UP chapters, such as ACT UP Philadelphia and ACT UP East Bay (http://www.actupny.org/indexfolder/actupgg.html). Rock stars have weighed in on the topic. Members of the group “The Foo Fighters” provided music for a soundtrack of the recent documentary, “The Other Side of AIDS” (http://www.theothersideofaids.com/), which questions whether HIV is the cause of AIDS. The band has spread its message that HIV does not cause AIDS at concerts [6], and it lists the HIV denial group “Alive and Well” as a worthy cause on its Web site (http://www.foofighters.com/community_cause.html).

As these challenges to mainstream theories have largely occurred outside of the scientific literature, many physicians and researchers have had the luxury of ignoring them as fringe beliefs and therefore inconsequential. Indeed, the Internet has served as a fertile and un-refereed medium to spread these denialist beliefs. The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis (“Reappraising AIDS”) noted, “Thanks to the ascendance of the internet, we are now able to reinvigorate our informational campaign” [7]. The Internet is an effective tool for targeting young people, and for spreading misinformation within a group at high risk for HIV infection.

Two excellent online fact sheets have been prepared to counter many of the most commonly used arguments to deny HIV causation of AIDS [8,9]; as such, we will not discuss these in this article. Instead, we will review the current intellectual strategies used by the HIV denial movement. Although other forms of science denial will not be specifically discussed, the characteristics described below apply to many other forms of popular denial, including denial of evolution, mental illness, and the Holocaust.

Three Prominent Deniers and Denial Groups

One of the prominent HIV denial groups currently is Christine Maggiore’s “Alive and Well” (formerly “HEAL,” Health Education AIDS Liaison) (http://www.aliveandwell.org/). Maggiore’s life story is at the center of this group. Diagnosed with HIV in 1992, Maggiore claims she has since been symptom-free for the past 14 years without the use of antiretroviral drugs, including protease inhibitors [10]. She has risen to prominence, and been embroiled in controversy, in recent years after giving birth to and openly breast-feeding her two children, Charles and Eliza Jane. She had neither child tested for HIV, and did not take antiretroviral medication during her pregnancy or subsequent breast-feeding [11]. Eliza Jane died in September 2005 of HIV-related pneumonia [12], though Maggiore remains unconvinced that HIV had any role in her daughter’s death [13], and continues to preach her message to other HIV-positive mothers.

Peter Duesberg initiated the HIV denial movement with a 1987 article suggesting that HIV does not cause AIDS [14]. While he is no longer on the front lines of this movement, the arguments put forth by others trace back to his publications.

Celia Farber is a journalist who has spent much of her career covering HIV. Farber is the author of a recent Harper’s article repeating Duesberg’s claims that HIV does not cause AIDS [15], and has recently authored a book on “the shadowy story of AIDS science” [16].

There are serious inconsistencies within the broad HIV denial movement, and the individuals mentioned above are only the tip of the iceberg. HIV denial groups diverge even on the most basic tenet: does HIV exist at all? Nevertheless, disagreements within the movement are overlooked for the sake of presenting a unified front.
Conspiracy Theories and Selective Distrust of Scientific Authority

That HIV is the primary cause of AIDS is the strongly held consensus opinion of the scientific community, based upon over two decades of robust research. Deniers must therefore reject this consensus, either by denigrating the notion of scientific authority in general, or by arguing that the mainstream HIV community is intellectually compromised. It is therefore not surprising that much of the newer denial literature reflects a basic distrust of authority and of the institutions of science and medicine. In her book, Christine Maggiore thanks her father Robert, “who taught me to question authority and stand up for what’s right” [10]. Similarly, mathematical modeler Dr. Rebecca Culshaw, another HIV denier, states: “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” [17].

Distrusting mainstream medical practitioners, many HIV deniers turn to “alternative” medicine in search of treatment. One such practitioner, Dr. Mohammed Al-Bayati, suggests that “toxins” and drug use, rather than HIV, cause AIDS [18]. Dr Al-Bayati personally profits from his HIV denialism: for $100 per hour, Al-Bayati will consult “on health issues related to AIDS, adverse reactions to vaccines and medications, exposure to chemicals in the home, environment or workplace” (http://www.toxi-health.com/). Similarly, German vitamin supplier and HIV denier Matthias Rath not only pushed his vitamins as a treatment for AIDS [19], but his spokesman refused to be interviewed by Nature Medicine about the case because he claimed the journal is “funded to the hilt with drug money” [20].

Deniers argue that because scientists receive grant money, fame, and prestige as a result of their research, it is in their best interest to maintain the status quo [15]. This type of thinking is convenient for deniers as it allows them to choose which authorities to believe and which ones to dismiss as part of a grand conspiracy. In addition to being selective, their logic is also internally inconsistent. For example, they dismiss studies that support the HIV hypothesis as being biased by “drug money,” while they accept uncritically the testimony of HIV deniers who have a heavy financial stake in their alternative treatment modalities.
Portraying Science as Faith and Consensus as Dogma

Since the ideas proposed by deniers do not meet rigorous scientific standards, they cannot hope to compete against the mainstream theories. They cannot raise the level of their beliefs up to the standards of mainstream science; therefore they attempt to lower the status of the denied science down to the level of religious faith, characterizing scientific consensus as scientific dogma [21]. As one HIV denier quoted in Maggiore’s book [10] remarked,
“There is classical science, the way it’s supposed to work, and then there’s religion. I regained my sanity when I realized that AIDS science was a religious discourse. The one thing I will go to my grave not understanding is why everyone was so quick to accept everything the government said as truth. Especially the central myth: the cause of AIDS is known.”

Others suggest that the entire spectrum of modern medicine is a religion [22].

Deniers also paint themselves as skeptics working to break down a misguided and deeply rooted belief. They argue that when mainstream scientists speak out against the scientific “orthodoxy,” they are persecuted and dismissed. For example, HIV deniers make much of the demise of Peter Duesberg’s career, claiming that when he began speaking out against HIV as the cause of AIDS, he was “ignored and discredited” because of his dissidence [23]. South African President Mbeki went even further, stating: “In an earlier period in human history, these [dissidents] would be heretics that would be burnt at the stake!” [1].

HIV deniers accuse scientists of quashing dissent regarding the cause of AIDS, and not allowing so-called “alternative” theories to be heard. However, this claim could be applied to any well-established scientific theory that is being challenged by politically motivated pseudoscientific notions—for example, creationist challenges to evolution. Further, as HIV denial can plausibly reduce compliance with safe sex practices and anti-HIV drugs, potentially costing lives, this motivates the scientific and health care communities to exclude HIV denial from any public forum. (As one editorial has bluntly phrased it, HIV denial is “deadly quackery”) [24]. Because HIV denial is not scientifically legitimate, such exclusion is justified, but it further fuels the deniers’ claims of oppression.
Expert Opinion and the Promise of Forthcoming Scientific Acceptance

Although the HIV deniers condemn scientific authority and consensus, they have nevertheless worked to assemble their own lists of scientists and other professionals who support their ideas. As a result, the deniers claim that they are just on the cusp of broader acceptance in the scientific community and that they remain an underdog due to the “established orthodoxy” represented by scientists who believe that HIV causes AIDS.

In an effort to support its claim that an increasing number of scientists do not believe that HIV causes AIDS, Reappraising AIDS has published a list of signatories agreeing to the following statement:

“It is widely believed by the general public that a retrovirus called HIV causes the group [of] diseases called AIDS. Many biochemical scientists now question this hypothesis. We propose that a thorough reappraisal of the existing evidence for and against this hypothesis be conducted by a suitable independent group. We further propose that critical epidemiological studies be devised and undertaken” [25].

These signatories do not, however, suggest who the “suitable independent” group should be, since, presumably, many scientists have already been “indoctrinated” into believing that HIV causes AIDS. (Indeed, many of the signatories to this statement lack any qualifications in virology, epidemiology, or even basic biology.) They also ignore thousands of epidemiological studies that have already been published in the scientific literature. And the signatories fail to provide a convincing case that there is widespread acceptance in the scientific community for their marginal position.

Nevertheless, Farber wrote in a 1992 article that “more and more scientists are beginning to question the hypothesis that HIV single-handedly creates the chaos in the immune system that leads to AIDS” [26]. Similarly, a March 2006 article appearing on the AIDS denial Web site “New AIDS Review” claims that, in reference to the theory that HIV causes AIDS: “…the fabric of this theoretical mantle is threadbare to the point of disintegration” [27]. Mainstream scientists, of course, do not believe in the imminent demise of the HIV theory; instead they continue to produce novel research on preventing and treating HIV and publish thousands of papers every year on the topic.

Further, deniers exploit the sense of fair play present in most scientists, and also in the general public, especially in open and democratic societies. Calling for a fair discussion of dissenting views, independent analysis of evidence, and openness to alternatives is likely to garner support, regardless of the context. But it is misleading for the HIV denial movement to suggest that there is any real doubt about the cause of AIDS.
Pushing Back the Goalpost

Of all the characteristics of deniers, repeatedly nudging back the goalpost—or the threshold of evidence required for acceptance of a theory—is often the most telling. The strategy behind goalpost-moving is simple: always demand more evidence than can currently be provided. If the evidence is then provided at a later date, simply change the demand to require even more evidence, or refuse to accept the kind of evidence that is being offered.

In the 1980s, HIV deniers argued that drug therapy for AIDS was ineffective, did not significantly prolong survival, and in fact was toxic and damaged the immune system [28]. However, after the introduction of a cocktail of newer and more effective agents in the 1990s, survival rates did impressively increase [29]. HIV deniers no longer accept this criterion as evidence for drug effectiveness, and therefore the HIV theory of AIDS. Even stacks of papers and books published on the subject are not enough. Christine Maggiore writes in her book, “Since 1984, more than 100,000 papers have been published on HIV. None of these papers, singly or collectively, has been able to reasonably demonstrate or effectively prove that HIV can cause AIDS” [10].

HIV deniers also arbitrarily reject categories of evidence, even though they are generally accepted across scientific disciplines. For example, they deny inferential evidence that HIV causes AIDS, including data examining the closely related simian immunodeficiency virus (SIV) in genomic and animal studies [30]. Likewise they reject correlation as insufficient to establish causation [28]. However, multiple independent correlations pointing to the same causation—in this case that HIV causes AIDS—is a legitimate and generally accepted form of epidemiological evidence used to establish causation. The same type of evidence, for example, has been used to establish that smoking causes certain types of lung cancer.
What Are Their Alternatives?

After so much criticism levied upon the prevailing theories by deniers, one might think they would have something to offer to replace HIV as the cause of AIDS. However, the alternatives they offer are much more speculative than the mainstream theories they decry as lacking evidence. Further, their arguments amount to little more than another logical fallacy, the false dichotomy: they assume that overturning the prevailing theory will prove their theory correct, by default.

Interestingly, alternative hypotheses for AIDS causation depend on where the patient lives. In Africa, HIV deniers attribute AIDS to a combination of malnutrition and poor sanitation, i.e., they believe that AIDS is simply a relabeling of old diseases. In America and other wealthy countries, they claim AIDS is caused by drug use and promiscuity. Duesberg has long been an advocate of the idea that the use of “poppers,” or amyl nitrate, is a cause of AIDS in the gay community [31]. With the identification of AIDS in individuals who have never used poppers, this hypothesis has been widened by HIV deniers to implicate a number of recreational drugs (cocaine, crack, heroin, methamphetamines) as well as prescription drugs such as antibiotics and steroids in the etiology of AIDS. HIV deniers have criticized the idea that immunosuppression due to infection with HIV could result in all of the different infections that characterize AIDS, and yet they support the idea that poppers or other drugs—including many that have not been shown to cause severe immune deficiencies—could cause AIDS. In the past decade, the very drugs used to treat HIV/AIDS have come under fire by HIV deniers, who have suggested that the medicines themselves are a cause of AIDS (http://www.aliveandwell.org/) .
Conclusion

Because these denialist assertions are made in books and on the Internet rather than in the scientific literature, many scientists are either unaware of the existence of organized denial groups, or believe they can safely ignore them as the discredited fringe. And indeed, most of the HIV deniers’ arguments were answered long ago by scientists. However, many members of the general public do not have the scientific background to critique the assertions put forth by these groups, and not only accept them but continue to propagate them. A recent editorial in Nature Medicine [32] stresses the need to counteract AIDS misinformation spread by the deniers.

While the descriptions of HIV denialism above refer to relatively organized campaigns, there are other less orchestrated examples of such denialism. A recent study, for example, showed that a large percentage of African Americans are suspicious of mainstream AIDS theories due to a general distrust of government authorities [33]. Arguments by denial groups may have played a role in the formation of their opinion. Indeed, the effect of denial groups on public perception of HIV infection is an area ripe for careful research, as this denial can have lethal consequences. In the recent study, stronger conspiracy beliefs were significantly associated with more negative attitudes towards using condoms and with inconsistent condom use, independent of selected sociodemographic characteristics, partner variables, sexually transmitted disease history, perceived risk, and psychosocial factors [33].

How much of this lingering denial is the fault of scientists and the media for originally proclaiming AIDS a universal “death sentence”? Even though this idea may no longer appear in the scientific literature, it remains a public perception of the disease. It is difficult to strike the correct balance between providing information conveying on one hand the severity of the disease, and on the other optimism about treatment and advances in understanding HIV pathogenesis (including research about individuals who may indeed be somewhat resistant to the virus). Oversimplifying AIDS science to the public lends itself to exploitation by AIDS deniers who remain “alive and well” years after diagnosis with HIV. Yet these concerns must be balanced with the desire to convey the proper gravity of the situation and motivate those who are known to be HIV positive to seek treatment: a difficult line to walk.

This balancing act, in fact, deserves increasing attention from medical scientists in the age of the Internet and a broadening gap between the practice of science and public understanding of science. Successful public health education requires the presentation of a clear and simple message supported by a solid consensus of the medical community. Yet the reality behind the scenes is often quite different. Every medical field has its legitimate controversies and complexities, and the process of science is often messy. Denial groups exploit the gap between public education and scientific reality.

Further, countering the misinformation of HIV deniers needs to be conducted in the broader societal context of countering anti-science and pseudoscience. The strategies of HIV deniers, like many other denialist movements, seek to undermine the very philosophy of science itself, to distort public understanding of the scientific process, and to sow distrust of scientific institutions. Unscientific alternative medical modalities have made significant inroads into the institutions of health care through political means, despite a continued lack of scientific legitimacy: vaccines are characterized as dangerous instead of life-saving; psychiatry is mocked by celebrities and others in the public eye. Meanwhile, many leaders in science and business are concerned that the United States is losing its edge as a scientific powerhouse.

There remains a deep problem of overall scientific illiteracy in this country and others, creating fertile soil for those who wish to spread scientific misinformation [34]. The scientific community must collectively defend and promote the role of science in society, and combat the growing problem of scientific illiteracy. We must all strive to do our part to make science accessible to the general public, and to explain the process by which scientific evidence is gathered, analyzed, and eventually accepted, and academic institutions should provide greater incentive for their researchers to expend the time and effort to do so. A solid understanding of the scientific method may not eliminate science denial, but it may act as a buffer against the further spread of such denialist beliefs.
Example of a typical slogan from an HIV denialist group
References

1. Sidley P (2000) Mbeki appoints team to look at cause of AIDS. BMJ 320: 1291. Find this article online
2. Mbeki T (1999) Address to the National Council of Provinces, Cape Town. Available: http://www.dfa.gov.za/docs/speeches/1999/mbek1028.htm. Accessed 16 July 2007.
3. Cherry M (2000) Mbeki agrees to step back from AIDS debate. Nature 407: 822. Find this article online
4. Sidley P (2001) Mbeki plays down AIDS and orders a rethink on spending. BMJ 323: 650. Find this article online
5. Wohlfeiler D, Lew S, Wilson H (2000) Enough of ACT UP S.F. acting out. San Francisco Chronicle. Available: http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2000/09/21/ED83985.DTL. Accessed 16 July 2007.
6. Talvi S (2000) Foo Fighters, HIV deniers. Mother Jones. Available: http://www.motherjones.com/news/feature/2000/02/foo.html. Accessed 16 July 2007.
7. Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis Available: http://www.virusmyth.net/aids/reappraising. Accessed 14 November 2006.
8. National Institute of Allergy and Infectious Diseases (2003) The evidence that HIV causes AIDS. Available: http://www.niaid.nih.gov/factsheets/evidhiv.htm. Accessed 17 July 2007.
9. AIDS Truth (2007) Debunking AIDS denialist myths. Available: http://www.aidstruth.org/debunking-denialist-myths.php. Accessed 17 July 2007.
10. Maggiore C (1997) What if everything you thought you knew about AIDS was wrong? Studio City (CA): Health Education AIDS Liaison. 126 p.
11. Gerhard S (2001) HIV-positive women birthing outside the system. Mothering Magazine. Available: http://www.healtoronto.com/mothering1001a.html. Accessed 17 July 2007.
12. Ribe J (2005) Autopsy report of Eliza Jane Scovill. Available: http://www.ratbags.com/rsoles/comment/maggiorecoroner.pdf. Accessed 17 July 2007.
13. ABC News (2005) Did HIV-positive mom’s beliefs put her children at risk? Available: http://abcnews.go.com/Primetime/print?id=1386737. Accessed 17 July 2007.
14. Duesberg P (1987) Retroviruses as carcinogens and pathogens: Expectations and reality. Cancer Research 47: 1199–1220. Find this article online
15. Farber C (2006) Out of control: AIDS and the corruption of medical science. Harper’s Magazine. Available: http://www.harpers.org/archive/2006/03/0080961. Accessed 17 July 2007.
16. Farber C (2006) Serious adverse events: An uncensored history of AIDS Hoboken (NJ): Melville House. 345 p.
17. Culshaw R (2006) Why I quit HIV. Available: http://www.lewrockwell.com/orig7/culshaw1.html. Accessed 17 July 2007.
18. Al-Bayati M (1999) Get all the facts: HIV does not cause AIDS Dixon (CA): Toxi-Health International. 200 p.
19. Dr. Rath Health Foundation (2005) The end of the AIDS epidemic is in sight!. Available: http://www4.dr-rath-foundation.org/THE_FOUNDATION/press_release20050615.htm. Accessed 17 July 2007.
20. Watson J (2006) Scientists, activists sue South Africa’s AIDS ‘denialists’ Nat Med 12: 6. Find this article online
21. Wright M (2000) The contradictions and paradoxes of AIDS orthodoxy. Available: http://www.virusmyth.net/aids/data/mwparadox.htm. Accessed 17 July 2007.
22. Clerc O (2001) Modern medicine: A neo-Christian religion. The hidden influence of beliefs and fears. Continuum Magazine. Available: http://www.virusmyth.net/aids/continuum/article3.htm. Accessed 17 July 2007.
23. Duesberg P (1995) Infectious AIDS: Have we been misled? Berkeley: North Atlantic Books.
24. Moore J, Nattrass N (2006) Deadly quackery. The New York Times. Available: http://www.nytimes.com/2006/06/04/opinion/04moore.html. Accessed 17 July 2007.
25. [No authors listed] (1993) List of scientists skeptical of HIV causation of AIDS. Available: http://www.virusmyth.net/aids/group.htm. Accessed 17 July 2007.
26. Farber C (1992) Fatal distraction. Spin Magazine. Available: http://www.virusmyth.net/aids/data/cffatal.htm. Accessed 17 July 2007.
27. [No authors listed] (2006) Harpers astonishes the world with the extent of AIDS skulduggery. Available: http://www.paradigmoverthrow.com/blog/harpers-astonishes-the-world-with-the-extent-of-aids-skulduggery.htm. Accessed 17 July 2007.
28. Duesberg P (1989) Human immunodeficiency virus and acquired immunodeficiency syndrome: Correlation but not causation. Proc Natl Acad Sci U S A 86: 755–764. Find this article online
29. Holtgrave D (2005) Causes of the decline in AIDS deaths, United States, 1995–2002: prevention, treatment or both? Int J STD AIDS 16: 777–781. Find this article online
30. Harrison-Chirimuuta R (1997) Is AIDS African? Available: http://www.virusmyth.net/aids/data/rcdisson.htm. Accessed 17 July 2007.
31. Duesberg P (1992) AIDS acquired by drug consumption and other noncontagious risk factors. Pharmacol Ther 55: 201–277. Find this article online
32. [No authors listed] (2006) Denying science. Nat Med 12: 369. Find this article online
33. Bogart L, Thorburn S (2005) Are HIV/AIDS conspiracy beliefs a barrier to HIV prevention among African Americans? J Acquir Immune Defic Syndr 38: 213–218. Find this article online
34. National Science Board (2004) Science and technology: Public attitudes and understanding. Available: http://www.nsf.gov/statistics/seind04/c7/c7s2.htm. Accessed 17 July 2007.

All journal content, except where otherwise noted, is licensed under a Creative Commons Attribution License.

Mbeki sets the Times straight

August 18th, 2007

Writes longwinded statement that firing was for group disloyalty

Defends health minister and broad AIDS policy and fires back at press with words and a lawsuit

Real message is “I’m in charge”, not activists or media

lionroars.jpegIn the aftermath of press criticism of the firing of the overreaching deputy health minister, South Africa’s President Thabo Mbeki has written a long explanatory statement for the ANC newsletter which wraps his real message in code that possibly only South Africans can interpret accurately.

“I have, during the period you served as Deputy Minister of Defence,
 consistently drawn your attention to the concerns raised by your
 colleagues about your inability to work as part of a collective, as the
 Constitution enjoins us to.

For the same reason, I have also discussed
 this matter with you as Deputy Minister of Health.

 “You traveled to Madrid despite the fact that I had declined your
 request to undertake this trip. It is clear to me that you have no 
intention to abide by the constitutional prescriptions that bind all of 
us. For this reason I suggested to you that you should resign.

” It is clear that you do not accept my advice. This leaves me no choice 
but to relieve you of your duties.”

….

As I said in my 8 August
 letter, the central matter I raised with the former Deputy Minister is 
the issue of the collective responsibility of everybody who serves in
 the National Executive.
I would never have raised this with Ms
 Madlala-Routledge when I spoke to her on 7 August and in the 8 August 
letter, maliciously, with no factual basis. 

I am certain that Ms Madlala-Routledge will recall the instances when I
 spoke to her while she served as Deputy Minister both at Defence and at
 Health, to assist her to understand and respect her obligation to honour 
the fact that she was part of a collective that has a responsibility to
 abide by the decisions of the ANC and the government.

…

However, some, both within our country and internationally, have raised
 an ill-founded and ill-intentioned hue and cry about the dismissal of Ms
Madlala-Routledge….

Some in our country and others elsewhere in the world, including the
 media, have acclaimed Ms Madlala-Routledge as a great heroine, before
 and after her dismissal, on the basis that she seemed to demonstrate 
intellectual and personal “courage” by defying the obligation to speak 
and act as part of a collective. In this regard, in her 10 August press
conference, she made a point of emphasising her obligation to be
 accountable to the media.



Collective responsibility



With regard to all this, I must make the point absolutely clear, without
 equivocation or qualification, that while the ANC serves as government,
in any of the three spheres of government, freely elected by the people,
 it will ensure that its members respect the principle and practice of
 collective responsibility.

…

I refer to our leadership because like others who have decided to
 campaign on the basis of the concocted assertion about “centralisation
 of power in the Presidency”, Ms Madlala-Routledge may entertain the 
illusion that she stayed in government as long as she did on the basis 
of decisions taken by the President, solely and exclusively. 


If this is the case, she, and everybody else, will have to learn the
 basic lesson that the national democratic revolution cannot, and will
 not be advanced on the basis of fabrications….

Contrary to what some have suggested, Ms Madlala-Routledge, like other
 members of the National Executive, has never been denied the right to
 speak her mind both in the Cabinet Committee and the Cabinet meetings.


This also relates to instances when Deputy Ministers have differed with
 their Ministers. Any suggestion to the contrary would be, to speak 
plainly, a blatant lie.

 Similarly, we must underline and emphasise the point that government
 policies are government policies. There is no government policy that
 belongs to individual Ministries or Departments, or even the Presidency.
…

In an article in “The Independent”, Ms Madlala-Routledge said: “I can’t
 say what reason the President had for dismissing me. But I know that the
 Health Minister, back in the driving seat, wanted to reassert her ideas.
We have made progress recently, and I would be saddened and disappointed 
if we were now to be taken back to a time when people were confused
 about Aids treatment.



“I am certain now, that if our Health Minister goes back to talking
 about garlic and beetroot, she will face only ridicule. I am not, I must
 stress, attacking the traditional African medicines that she is keen to 
champion. They have a place in health care.

” But we are dealing with a modern disease. And as with any modern
 disease, we have to subject whatever we propose as a cure, to the most
 rigorous scientific testing…

It is also important for us to hear Mr
 Mbeki’s voice, encouraging people, leading, and showing them that
 HIV/Aids, with treatment, can be managed.”



South Africa, HIV & AIDS



The principal journalist responsible for the many shameless lies told in
”The Independent” seems to be one Katherine Butler, the newspaper’s
 Foreign Editor. It is perfectly obvious that she did not even bother to
 study our government’s 2000-2005 and 2007-2011 HIV/AIDS/STD Strategic
Plans, (NSPs), and their implementation.

….

Despite all the foregoing, and strangely, including the financial
 resources our government and parliament have provided to give substance 
to our NSPs, all of which stand up to any and all international
 comparisons, one of the journalists at the Madlala-Routledge press
conference, who, we must assume, is not familiar with any of the history
 we have indicated, said our country is faced with an ‘international PR
 crisis with regard to HIV and AIDS!’

…

Mbeki stands out

If you read it all through it generally seems to be a massive putdown of the cheeky deputy health minister for her blatant disloyalty and presumption, and an equal putdown of the newspapers such as the British Independent which were equally presumptuous in describing her as putting South African HIV∫AIDS policy on a new track more in line with Mbeki’s activist critics than his comprehensive policy and planning initiatives over the last few years.

All in all, as far as we can judge, this is a round rebuttal of anybody that thinks Mbeki has given in to the forces of scientific darkness that are urging the discredited standard paradigm on South Africa so forcefully, with the disgracefully ignorant support of the New York Times editorial board. As Comments here have noted this week, this is good news for the African babies who are otherwise in line for doses of AZT that are body weight equivalent to the high doses that killed as many as 300,000 Americans in the years before 1995.

It is a strange situation that the only battleground where the paradigm is being challenged is in the most developed country in Africa, the continent that became the new market for AIDS drugs once the US was fully supplied, even though its “AIDS” had nothing in common with the shape and symptoms of the supposed epidemic in the US.

Thus we have, in effect, the South African President telling the New York Times to get lost – and knowing more about the science than the editors and readers of that otherwise still great newspaper.

Mbeki maintains broad support, broad policy

In this stance he is not isolated, however, but as he emphasizes, in his long time caution about AIDS and rational unwillingness to base South African policy on the narrow base of an uncritical acceptance of the HIV paradigm, he has the collective support of the leaders of his party and his Cabinet.

Contrary to what some have suggested, Ms Madlala-Routledge, like other
 members of the National Executive, has never been denied the right to
 speak her mind both in the Cabinet Committee and the Cabinet meetings.


This also relates to instances when Deputy Ministers have differed with
 their Ministers. Any suggestion to the contrary would be, to speak 
plainly, a blatant lie.

 Similarly, we must underline and emphasise the point that government
 policies are government policies. There is no government policy that
 belongs to individual Ministries or Departments, or even the Presidency.


Our government is not made up of a federation or coalition of ministers,
or a Presidential autocracy.

As prescribed by our Constitution, and in terms of the practice we have 
entrenched since 1994, all government policies are approved by the 
Cabinet. This includes the legislation that the National Executive
 submits to the National Legislature. 
Accordingly, the President and the rest of the Cabinet take full
 responsibility even for some of the contested draft legislation 
currently being considered by our National Parliament.

 In this context I must also emphasise that there is not even one
 important policy and programmatic initiative that our government has
 taken since 1994 that has not been based on decisions taken by the
 constitutional structures of the ANC.

The fantasy of Ms Madlala-Routledge and her media and activist supporters that she has led Mbeki and his government into giving up this caution and blindly following HIV∫AIDS thinking seems to have been misplaced.

There remains one significant political leader who is aware of the exceptionally questioned status of the global HIV∫AIDS paradigm, and the repeated challenge to its validity and contradiction of its claims in the top scientific literature.

That is to say, one significant politician who has informed himself rather than trust the New York Times, which has turned a blind eye to the credentials of the critics and the substantial nature of the criticism for two decades.

Evidently Mbeki is retaining a firm grip on the helm and with the full support of his Cabinet is maintaining a broad approach which takes full responsibility for the welfare of his people.

He shows that responsibility – unlike the US government – by taking into account the full range of information available, including the now plain fact that there is reason for massive doubt that the NIAID and its lapdog the New York Times have endorsed the right paradigm for twenty years.

Meanwhile he has defended his Health Minister Manto Tshabalala-Msimang from scurrilous reports of her “behavior” ie drinking while in hospital a while back:

In its 12 August edition the “Sunday Times” dramatically presented on
 its front page a story about how Minister Tshabalala-Msimang allegedly
 behaved while receiving treatment in a hospital in Cape Town, a few
 years ago. Through her lawyers, the Minister has threatened to take 
legal action against the newspaper. Accordingly we cannot comment on
 this matter.

 However, the government Presidency has issued a statement to say that
 this newspaper report does not justify dismissing the Minister, as some
 have suggested.
Among other things, the statement said: “The Presidency
 notes that the latest allegations levelled against the Minister of
 Health appear to be consistent with attempts by some in the media and 
elsewhere, to demean the person of the Minister…

”The Presidency would like to reassure all South Africans of the 
integrity of the public health system as led by Minister Manto
Tshabalala-Msimang and the Cabinet collective.”


Here is the latest report on that allegation where the Times is refusing to hand over the documents it says it was relying on, and Manto says she is suing:

The minister must “explain on what basis” the documents should be returned, Sunday Times editor Mondli Makhanya said, after a deadline set by the minister for the return of the documents had passed.
Makhanya said the newspaper had written to the minister, saying the onus was on her to explain why documents and notes she was requesting should be returned.
He said as far as the Sunday Times was concerned there was no reason to give her anything because the story about her drinking was true.
“The minister needs to tell us what it is in the story that is garbage?” he said.
“The story that ran on Sunday is 200 percent accurate.

Sunday Times adamant about Manto
JOHANNESBURG – The Sunday Times refused on Tuesday to return documents detailing Health Minister Manto Tshabalala-Msimang’s alleged drinking in hospital.
The minister must “explain on what basis” the documents should be returned, Sunday Times editor Mondli Makhanya said, after a deadline set by the minister for the return of the documents had passed.
Makhanya said the newspaper had written to the minister, saying the onus was on her to explain why documents and notes she was requesting should be returned.
He said as far as the Sunday Times was concerned there was no reason to give her anything because the story about her drinking was true.
“The minister needs to tell us what it is in the story that is garbage?” he said.
“The story that ran on Sunday is 200 percent accurate.
“It is thoroughly, thoroughly researched. Everything is accurate.”
Makhanya said he was “not saying anything” about whether the paper was in possession of Tshabalala-Msimang’s medical records.
He said legal action remained just a “threat”.
In any case to be successful in court she would have to disprove the story, which Makhanya insisted was accurate.
A retraction was not under consideration, he said.
It would be “terrible” for media freedom if the paper had ceded to her demands.
After the deadline passed on Tuesday afternoon, “We’ll take it from there,” said Makhanya.
Tshabalala-Msimang said she would proceed with legal action after the newspaper failed to return her medical records.
“The newspaper has failed to comply with the demand to return these medical records.
“The minister has therefore directed her legal team to proceed with the litigation against the Sunday Times,” said the minister’s spokesman, Sibani Mngadi, in a statement on Tuesday afternoon. –Sapa
Manto set to sue
JOHANNESBURG – Health Minister Manto Tshabalala-Msimang is proceeding with legal action against the Sunday Times, after the newspaper failed to return her medical records by a Tuesday afternoon deadline.
“The newspaper has failed to comply with the demand to return these medical records.
“The minister has therefore directed her legal team to proceed with the litigation against the Sunday Times,” said the minister’s spokesman, Sibani Mngadi, in a statement on Tuesday afternoon. –Sapa
Manto willing to go legal for documents
JOHANNESBURG – Legal action will be taken if the Sunday Times does not return medical documents belonging to the Health Minister, her spokesman said on Tuesday.
Sibani Mngadi said the Sunday Times had until about 5.30pm on Tuesday to return Health Minister Manto Tshabala-Msimang’s medical documents.
If this deadline was not adhered to, the minister would definitely seek court assistance to have her medical records returned to her.
“We are prepared for this,” he said.
Mngadi said the minister had sent both a faxed and hand-delivered copy of her demands to the Sunday Times on Monday afternoon.
He said the minister believed the Sunday Times was in “gross violation” of the National Health Act in obtaining her medical records.
Mngadi said he was “very much concerned” at the “arrogance” of Sunday Times editor Mondli Makhanya during interviews he had given on Monday.
Tshabalala-Msimang’s demands followed after the Sunday Times ran a story on August 12 about her alleged alcohol binges during a hospital stay two years ago.
In a statement issued on Monday the minister dismissed the newspaper story as “false, malicious and in contravention of the law”.
“The minister calls upon the Sunday Times to, within 24 hours, hand over to her all records concerning her hospitalisation, medical treatment and condition (including the notes containing such information as well as the comments of various “doctors” in respect of such hospitalisation, treatment and condition),” the ministry said.
The statement also called upon the Sunday Times to “retract malicious, untrue and injurious statements referred to in the report”.
Comment from the Sunday Times was not immediately available. – Sapa.
Manto snitch faces disciplinary action
JOHANNESBURG – The health professional who leaked Health Minister Manto Tshabalala-Msimang’s medical records to the Sunday Times will face disciplinary action, the Health Professionals Council of SA said on Tuesday.
“This is a flagrant violation of the long established ethical rule of the medical profession, namely, to preserve and maintain patient confidentiality,” the HPCSA said in a statement.
The council said they would not hesitate to take “the most stringent” disciplinary action against any health professional who allowed the Sunday Times to obtain the Minister’s records.
The HPCSA also urged the Sunday Times to return Tshabalala-Msimang’s records to her.
Earlier, the minister’s spokesman said legal action would be taken if the Sunday Times did not return medical documents belonging to her.
Sibani Mngadi said the Sunday Times had until about 5.30pm on Tuesday to return Health Minister Manto Tshabala-Msimang’s medical documents.
Mngadi said the minister had sent both a faxed and hand-delivered copy of her demands to the Sunday Times on Monday afternoon.
Tshabalala-Msimang’s demands followed after the Sunday Times ran a story on August 12 about her alleged alcohol binges during a hospital stay two years ago.
In a statement issued on Monday the minister dismissed the newspaper story as “false, malicious and in contravention of the law”.
“The minister calls upon the Sunday Times to, within 24 hours, hand over to her all records concerning her hospitalisation, medical treatment and condition (including the notes containing such information as well as the comments of various “doctors” in respect of such hospitalisation, treatment and condition),” the ministry said.
Comment from the Sunday Times was not immediately available. – Sapa.

Last updated
15/08/2007 11:33:51 As an observer from faraway Manhattan we have to say that in all these stories from Africa there is a certain naivete and simplicity in the comments and statements people make which remind us that we are dealing with a continent that has far to go before it catches up with Western levels of social camouflage.

Here is the complete Mbeki letter at the ANC:LETTER FROM THE PRESIDENT



Who are our heroes and heroines?



On 8 August, I wrote to the then Deputy Minister of Health, Nozizwe
Madlala-Routledge, relieving her of her duties in government. In this 
letter I said: 
”This letter serves to inform you that, acting in terms of the 
provisions of clause 
93 of the Constitution of the Republic of South Africa, I have decided
 to relieve you of your duties as Deputy Minister of Health with effect
 from today.



“All of us who serve our people through the national government took an
 oath or made a solemn affirmation to respect and uphold the
 Constitution. This same Constitution calls upon us to, among other
 things, work collectively to develop and implement national policies.

”I have, during the period you served as Deputy Minister of Defence,
 consistently drawn your attention to the concerns raised by your
 colleagues about your inability to work as part of a collective, as the
 Constitution enjoins us to.

For the same reason, I have also discussed
 this matter with you as Deputy Minister of Health.

”You traveled to Madrid despite the fact that I had declined your
 request to undertake this trip. It is clear to me that you have no 
intention to abide by the constitutional prescriptions that bind all of
us. For this reason I suggested to you that you should resign.

” It is clear that you do not accept my advice. This leaves me no choice 
but to relieve you of your duties.”



A hue and cry


Ordinarily, I would not make any further comment on this matter.
 However, some, both within our country and internationally, have raised
 an ill-founded and ill-intentioned hue and cry about the dismissal of Ms
Madlala-Routledge. As part of this, all manner of fabrications have been
 peddled that relate to a whole variety of issues that bear on the work
 both of the ANC and our government.



Nozizwe Madlala-Routledge also chose to convene a press conference to
give her the possibility to ‘tell her side of the story’, during which
she claimed that all she had ever done was to “speak truth to power”,
presumably to present herself to the media as part of the so-called
Fourth Estate, which is fond of using this phrase to define its social
role.



In her comments, among others, she chose to make various observations
about the functioning of the Ministry and Department of Health, the 
government in general, the meeting the Deputy President and I had with
her on 7 August, and the kind of leaders the December 2007 National
Conference of the ANC should elect.



With regard to this last issue, a journalist asked Ms Madlala-Routledge
why in the last two years she has expressed her seemingly dissenting
 views publicly, rather than within the structures of the ANC, which our
movement requires of its members. She responded more or less precisely 
in these terms: “The fax I sent to the President to say I am not 
resigning I sent from Luthuli House, (the ANC Headquarters building). 
Albert Luthuli, Oliver Tambo, Govan Mbeki, Archie Gumede…Lilian Ngoyi,
Dora Tamana, and the Freedom Charter taught us the values I uphold. The 
ANC taught us to speak out!…As we go towards December, I am going to
 be campaigning hard to get a leader or leaders (elected by the ANC
National Conference) I think will be brave to stand up for the truth,
for the values my organisation, the ANC, stands for…I am going to work
 very hard in my branch, in my district, my Province (KZN), and all over,
to make sure that we succeed to unite the ANC, that is very important -
to unite the ANC – and choose a leader who the country will support.”



Naturally, members of the ANC have asked what Ms Madlala-Routledge meant
 when she made these remarks. They have asked why she has suggested that
 the current leadership of the ANC has divided the ANC, and why she 
suggests it does not have the courage to stand up for the truth, why she
 suggests that our leadership has no regard for the values of our 
movement, and why she suggests that the leader of the ANC is not
 supported by our country.



Undoubtedly the ANC will deal with this matter as prescribed by its
 Constitution, its normal procedures, its conventions and traditions, and
 our current challenges.

Who’s in, who’s out?

 We have, in the past, dropped people who had served in government in
 ministerial positions. This has also happened at the level of Provincial
 Government.

In no instance have the members of the ANC thus affected
 ever decided that they should engage in a media and public campaign, as
 Ms Madlala-Routledge has chosen to do.

 And indeed, none of the similar interventions affecting other members of
the ANC serving in government, including local government, have aroused 
the media frenzy generated by the dropping of Ms Madlala-Routledge.



The strange and disturbing assertions and developments we have heard and
seen, since the dismissal of Ms Madlala-Routledge, strongly suggested
that we must make some comments in this regard, which explains the
 reason for this Letter. I began the Letter by citing my letter to Ms
Madlala-Routledge.

The question at issue is therefore very simple. As I said in my 8 August
 letter, the central matter I raised with the former Deputy Minister is 
the issue of the collective responsibility of everybody who serves in
 the National Executive.
I would never have raised this with Ms
 Madlala-Routledge when I spoke to her on 7 August and in the 8 August 
letter, maliciously, with no factual basis. 

I am certain that Ms Madlala-Routledge will recall the instances when I
 spoke to her while she served as Deputy Minister both at Defence and at
 Health, to assist her to understand and respect her obligation to honour 
the fact that she was part of a collective that has a responsibility to
 abide by the decisions of the ANC and the government.



In this regard, I must also say that, of course, government can detail 
the many instances when Ms Madlala-Routledge wilfully ignored or defied 
this obligation.



The Spanish trip



To justify her trip to Spain, Ms Madlala-Routledge, supported by some in
 the media, has argued that some Ministers and Deputy Ministers have
 travelled out of the country without receiving authorisation, written or
 otherwise. The fact of the matter is that Ms Madlala-Routledge has
 absolutely no way of knowing this.

In any case, the point at issue is
 that Ms Madlala-Routledge defied a written decision that she should not
 travel to Spain.

 If she was looking for a precedent to argue that she should not have 
been dismissed from the National Executive, she would have been better 
served if she provided even one example of a Minister or Deputy Minister
 who travelled even after permission to travel had been denied, as she
 did. Personally, I know of no other such incident since 1999.



Because the ANC has always sought to build rather than destroy, for many
years our leadership agreed to keep Ms Madlala-Routledge in government,
 determined further to develop her as a true cadre of our movement,
 committed to serve the people as a disciplined member of our movement.
 It is clear that in this specific case we failed.

 I refer to our leadership because like others who have decided to
 campaign on the basis of the concocted assertion about “centralisation
 of power in the Presidency”, Ms Madlala-Routledge may entertain the 
illusion that she stayed in government as long as she did on the basis 
of decisions taken by the President, solely and exclusively. 


If this is the case, she, and everybody else, will have to learn the
 basic lesson that the national democratic revolution cannot, and will
 not be advanced on the basis of fabrications.

 There is nothing exceptional about the Constitutional requirement for
 members of the National Executive to act as a collective. This applies
 even to the lowliest of community-based organisations. Defiance of this
 very elementary rule would expose any organised social formation to
 chaos and anarchy. This includes the ANC. If it were tolerated in
government, it would inevitably lead to a slide to the disastrous
 condition of a failed state.

Some in our country and others elsewhere in the world, including the
 media, have acclaimed Ms Madlala-Routledge as a great heroine, before
 and after her dismissal, on the basis that she seemed to demonstrate 
intellectual and personal “courage” by defying the obligation to speak 
and act as part of a collective. In this regard, in her 10 August press
conference, she made a point of emphasising her obligation to be
 accountable to the media.



Collective responsibility



With regard to all this, I must make the point absolutely clear, without
 equivocation or qualification, that while the ANC serves as government,
in any of the three spheres of government, freely elected by the people,
 it will ensure that its members respect the principle and practice of
 collective responsibility.



None of the members of the ANC deployed in government will be treated by
 our movement as heroes and heroines on the basis of “lone ranger”
 behaviour, so-called because of their defiance of agreed positions and
 procedures of our movement and government.



In the 95 years of our existence as a movement, no member of our
 organisation became a hero or heroine because of actions that would
 condemn our movement to the plague of chaos and anarchy. At the same 
time, throughout its history, to date, our movement has insisted on the 
need to respect the right of every member freely to express his or her
 view within our constitutional structures.



Indeed, during her press conference, even Ms Madlala-Routledge stated 
that when she has attended meetings of our National Executive Committee
 (NEC), she observed that members of the NEC, and other participants, 
enjoyed the freedom to speak their minds.

 Contrary to what some have suggested, Ms Madlala-Routledge, like other
 members of the National Executive, has never been denied the right to
 speak her mind both in the Cabinet Committee and the Cabinet meetings.


This also relates to instances when Deputy Ministers have differed with
 their Ministers. Any suggestion to the contrary would be, to speak 
plainly, a blatant lie.

 Similarly, we must underline and emphasise the point that government
 policies are government policies. There is no government policy that
 belongs to individual Ministries or Departments, or even the Presidency.


Our government is not made up of a federation or coalition of ministers,
or a Presidential autocracy.

As prescribed by our Constitution, and in terms of the practice we have 
entrenched since 1994, all government policies are approved by the 
Cabinet. This includes the legislation that the National Executive
 submits to the National Legislature. 
Accordingly, the President and the rest of the Cabinet take full
 responsibility even for some of the contested draft legislation 
currently being considered by our National Parliament.

In this context I must also emphasise that there is not even one
 important policy and programmatic initiative that our government has
 taken since 1994 that has not been based on decisions taken by the
 constitutional structures of the ANC.

During these years, to date, the
 people of South Africa have elected the ANC to serve as the ruling
 party. Members of the ANC deployed in government have consistently
worked in a manner that respects the popular mandate given to their
movement.



HIV, AIDS & super-heroines



In the determined effort to market Ms Madlala-Routledge as some
”super-heroine”, her admirers have attributed our government policy and
 programmes on HIV and AIDS to her. 
Thus the extraordinarily absurd claim has been made that her dismissal
 from the National Executive threatens the very survival of the
 government (and ANC) programme on HIV and AIDS.


In this regard, and as an example of what I am talking about, the
 British newspaper, “The Independent”, even felt entitled and obliged to
 tell a litany of blatant untruths to promote a deliberately negative 
agenda about the ANC and our government, which Ms Madlala-Routledge,
 consciously or unwittingly, has seemed very determined to advance.



Among other things, the British newspaper, “The Independent” wrote, (on
 10 August): 
”Thabo Mbeki’s stance on Aids has left South Africa with the world’s
 worst HIV epidemic. Yesterday, he silenced the woman fighting to end the
 suffering of millions… The fight against Aids in South Africa, the
 epicentre of the global pandemic, has been dealt a devastating blow.
President Thabo Mbeki stunned and outraged campaigners yesterday by 
sacking the country’s deputy health minister, the woman credited with
 ending a decade of Aids denialism at the heart of the South African
 political leadership…



”The sacked minister, Nozizwe Madlala-Routledge, is an outspoken critic
 of President Mbeki and his Health Minister, Manto Tshabalala-Msimang and 
the way they have handled the epidemic. She was the co-architect of an 
ambitious new five-year plan to accelerate the rollout of free,
life-saving Aids drugs, tripling the numbers on treatment by 2011. That
plan could now be in jeopardy…



“‘He (Mbeki) has once again shown his contempt for those seeking
scientific approaches to Aids,’ said Professor Nicoli Nattrass of the
University of Cape Town. 
’This is a dreadful error of judgement. It indicates that the President
still remains opposed to the science of HIV,’ the Treatment Action
Campaign (TAC), South Africa’s biggest Aids advocacy group, said
yesterday.



“‘It’s an absolute disgrace,” said Mike Waters, the opposition
 Democratic Alliance’s health spokesman. ‘The fact is for the first time
 we had a deputy minister with a clear direction in the fight against
 Aids. Both the President and the Minister are denialists, while the
 deputy minister has her feet stuck in reality.'”



In an article in “The Independent”, Ms Madlala-Routledge said: “I can’t
 say what reason the President had for dismissing me. But I know that the
 Health Minister, back in the driving seat, wanted to reassert her ideas.
We have made progress recently, and I would be saddened and disappointed 
if we were now to be taken back to a time when people were confused
 about Aids treatment.



“I am certain now, that if our Health Minister goes back to talking
 about garlic and beetroot, she will face only ridicule. I am not, I must
 stress, attacking the traditional African medicines that she is keen to 
champion. They have a place in health care.

” But we are dealing with a modern disease. And as with any modern
 disease, we have to subject whatever we propose as a cure, to the most
 rigorous scientific testing…

It is also important for us to hear Mr
 Mbeki’s voice, encouraging people, leading, and showing them that
 HIV/Aids, with treatment, can be managed.”



South Africa, HIV & AIDS



The principal journalist responsible for the many shameless lies told in
”The Independent” seems to be one Katherine Butler, the newspaper’s
 Foreign Editor. It is perfectly obvious that she did not even bother to
 study our government’s 2000-2005 and 2007-2011 HIV/AIDS/STD Strategic
Plans, (NSPs), and their implementation.



Had she, and her Editor, done so, they would, for instance, have found
 this comment (in the 2007-2011 Plan), which she would have been free to
challenge with facts, 
that:



“In 1992, the National AIDS Coordinating Committee (NACOSA) – (led by 
the ANC) -was launched with a mandate to develop a national strategy on
 HIV and AIDS. Cabinet endorsed this strategy in 1994… Much was done to
 implement the recommendations of the NACOSA Plan review. These include
 the appointment of provincial AIDS coordinators, the establishment of
 the Inter-Ministerial Committee on AIDS, launch of Partnerships against
 AIDS by the Deputy President in 1998, development of the Department of
Education HIV and AIDS policy for learners and educators, development of
 other national policies, including the Syndromic management of STIs, the
 establishment of the South African AIDS Vaccine Initiative (SAAVI) in
1998, the establishment of SANAC, the establishment of the national 
interdepartmental committee on HIV and AIDS, as well as the development
 of a Strategic Framework for a South African AIDS Youth Programme.”



The 2000-2005 Plan said: “The development of this strategic plan was 
initiated by the Minister of Health, Dr Manto Tshabalala-Msimang in July
 1999 in response to President, Mr Thabo Mbeki’s, challenge to all
 sectors of society to become actively involved in initiatives designed 
to address the HIV/AIDS epidemic. It began with a meeting in July 1999
 to review the current HIV/AIDS prevention, treatment, and care efforts
 in South Africa.



“The meeting was attended by representatives of faith-based
 organisations, people living with HIV infection and AIDS, human rights
 organisations, academic institutions, the civil military alliance, the
 Salvation Army, the media, organised labour, organised sports, organised
 business, insurance companies, women’s organisations, youth
 organisations, international donor organisations, health professionals
 and health consulting organisations, political parties, and relevant 
government departments.



“After priority areas for future efforts were discussed and agreed upon,
 a committee was charged with developing a five-year HIV/AIDS and STD
 Strategic Plan. Task teams were established to review current goals and
 objectives for the designated priority areas. The priority areas are
 prevention; treatment, care and support; legal and human rights; and
 monitoring, research and evaluation.



“In addition, the Minister of Health held bilateral meetings with
 several important sectors including traditional leaders, faith-based
 organisations and business to obtain their views and to discuss ways to
 facilitate their active participation.”



Further, the 2007-2011 Plan says: “The HIV & AIDS and STI Strategic Plan
 for South Africa (NSP), 2007-2011, flows from the National Strategic
plan of 2000-2005, the Operational Plan for Comprehensive HIV and AIDS
 Care, Management, and Treatment
(CCMT) as well as other HIV and AIDS strategic frameworks developed for
 government and sectors of civil society in the past five years. It
 represents the country’s multi-sectoral response to the challenge with 
(sic) HIV infection and the wide-ranging impacts (sic) of AIDS.”



Despite all the foregoing, and strangely, including the financial
 resources our government and parliament have provided to give substance 
to our NSPs, all of which stand up to any and all international
 comparisons, one of the journalists at the Madlala-Routledge press
conference, who, we must assume, is not familiar with any of the history
 we have indicated, said our country is faced with an ‘international PR
 crisis with regard to HIV and AIDS!’



Vavi, Waters & Madlala-Routledge



The fact of the matter is that personally, Ms Madlala-Routledge had very
little to do with both the NSPs we have mentioned, regardless of the 
fabrications that she and her admirers choose to manufacture. These
driven admirers include the General Secretary of COSATU, Zwelinzima
Vavi, who, not surprisingly, joined the chorus of the praise-singers of
 Ms Madlala-Routledge, boldly saying (according to the SABC), with
 absolute contempt for the facts, but absolute loyalty to a particular
 agenda: “I think the firing of that minister – who everybody in the 
country accepted was one of the most efficient, hardworking ministers we
 have in the Cabinet – sends a message…that we know of so much dead
wood that remains untouchable in government as ministers, many of them 
dying on duty…says basically, if you’re working hard and are an
independent thinker, you will get the chop.”



(As Head of State and Government, I know of no Minister or Deputy
Minister, with which echelon of South Africans I interact virtually
 everyday, who is not an independent thinker and a hard worker, who
 behaves like a sheep and a mindless sycophant. Given my constitutional
 and political responsibilities, defined by our Constitution and
 statutes, I am quite ready to listen to any contrary view in this
regard, regardless of its origin. On the various occasions I have met Vavi formally and informally, he has never raised this issue. Neither
 has COSATU, a genuinely valued ally of the ANC, which Vavi has served as
General Secretary for some years, ever raised this issue in its numerous 
interactions with the ANC and government! 
Basing itself on its experience about Vavi’s many public and negative 
statements, which I assume he will continue to make, the ANC, a devoted
ally of COSATU, must surely come to the conclusion that its historic
ally, COSATU, has determined that it will principally communicate with
 us, the ANC, through public statements made by its General Secretary!)



The “Mail and Guardian” quoted Vavi as saying: “In the absence of any
 other convincing explanation, we then conclude that she
 (Madlala-Routledge) was fired because of her views on HIV/Aids, which
 were not shared by the president and Minister Manto Tshabalala-Msimang.
 It is very sad because this means the sheep mentality of following the
leader will persist. It will deepen the culture of sycophancy among
 government ministers and officials.

”But all we can do is pay tribute to her. Thanks to her, government now
 has a five-year comprehensive HIV/Aids plan. Thanks to her there is
unity between government and civil society and it is also thanks to her
that we no longer have the mixed messages, and the spirit of Aids
denialism is behind us.”


Again not surprisingly, the Democratic Alliance (DA) backed what Vavi
said. In a statement on 10 August headed “Madlala-Routledge fired for
speaking the truth” -speaking truth to power? – Mike Waters, DA
spokesperson on health said: “The far more likely explanation (for her
dismissal) is that (Ms Madlala-Routledge) was fired for speaking the
truth. The former Deputy Minister has been outspoken on the following
issues:

* Government’s performance with regard to HIV/Aids;
* The nature of government’s response to the HIV/Aids pandemic; and,
* The situation at Frere Hospital.”



The Endgame?



In its 12 August edition the “Sunday Times” dramatically presented on
its front page a story about how Minister Tshabalala-Msimang allegedly
behaved while receiving treatment in a hospital in Cape Town, a few
years ago. Through her lawyers, the Minister has threatened to take
legal action against the newspaper. Accordingly we cannot comment on
this matter.

However, the government Presidency has issued a statement to say that
this newspaper report does not justify dismissing the Minister, as some
have suggested.
Among other things, the statement said: “The Presidency
notes that the latest allegations levelled against the Minister of
Health appear to be consistent with attempts by some in the media and
elsewhere, to demean the person of the Minister…

”The Presidency would like to reassure all South Africans of the
integrity of the public health system as led by Minister Manto
Tshabalala-Msimang and the Cabinet collective.”



In the recent past the ANC, the government and our people as a whole
have had to contend with elaborate and sophisticated disinformation
campaigns intended to destabilise the ANC, the government, our democracy
and country, not disconnected from similar anti-ANC campaigns during the
apartheid years.
The more recent campaigns presented themselves through
the “hoax e-mail” and “browse report” incidents.

Time will tell what happened that gave the “Sunday Times” the right to
tell the story it told, whether right or wrong, about what might have
happened in Minister Tshabalala-Msimang’s “private space” in hospital.
All of us, up to now, assumed that we had a Constitutional and common
sense entitlement to treat this “hospital space” 
as being subject to the “privacy and dignity” human right and privilege
to which all our citizens, including Ministers, are Constitutionally
entitled.



Whatever the endgame in this regard, we, and the overwhelming majority
of our people, will have been painfully alerted to the fact that not
 everybody in our country and abroad, is happy that the ANC enjoys the
 confidence of the masses of our people. 
Equally, others are unhappy that, contrary to the predictions of the 
doomsayers about African countries, we have managed the transition from
 white minority rule to non-racial, democratic rule as well as we have,
thus making the statement in practice that cannot be disproved with
facts, that categorically, there exists no genetic fault that condemns 
Africa and Africans forever to be defined as a failed continent and
 civilisation.


Is it the case that to win the approval of the loudest voices in the
world of the contemporary global communication system we must behave in
a manner that is consistent with their stereotypes? Who will determine
 who our heroes and heroines will be?

 – Thabo Mbeki


———————————————————-


This is from the issue of ANC Today available from the ANC web site at:
http://www.anc.org.za/ancdocs/anctoday/2007/at32.htm

__,_._,___

Times sets Mbeki straight

August 15th, 2007

Anonymous editorial writer redraws the picture in HIV∫AIDS to NIAID specs

But who will step up and contradict at this stage?

lion.jpegNot content with an almost perfect record over the last two decades in promoting the HIV∫AIDS paradigm as if it was invested in it in some as yet unrevealed way, the Times has stepped forward today to put the lionhearted Mbeki in his place for getting rid of the presumptuous and scientifically ignorant deputy health minister, Nozizwe Madlala-Routledge, who has been peddling the John P. Moore brand of nonsense about the AIDS challenge in Africa for too long.

But this is hardly surprising, of course, since the Times itself and its reporters, led by CDC grad Larry Altman, has been playing precisely the same uninformed role ever since it began reporting on the HIV∫AIDS paradigm and its social consequences twenty years ago.

Presumably the financial squeeze at the Times, which recently resulted in the cutting down of the spread of its pages from a magisterial 27 inches to a more modern and unassuming 24 inches to fit the Procustian bed of overriding financial considerations in the Web-Murdoch era, has the reporters of the greatest newspaper in the world on short rations, and prevents any of them at long last bothering to read the debunking scientific literature on the disputed, in fact blatantly incredible theory of HIV∫AIDS. But surely they might spend an hour or two with one of the 25 or so popular introductions to the issue in book form that have come from well informed authors on the invalidity of the paradigm, most recently Bialy, Farber, Culshaw and Bauer.

Of course, the editorialist who wrote this backwards pointing screed is not to blame for mouthing what has always been the party line at the Times, if he/she is surrounded by reporters such as Nicholas Wade and Larry Altman who simply ignore Duesberg and the dissent. Small wonder he/she thinks that the alternative view of AIDS from a highly productive scientist and long time National Academy member supported by many thousands of working professional level minds is “crackpot”.

The Times’ own survival is at stake, if it remains thoughtless

But one would think that a newspaper which by now must have got the message from the Web and its blogs, which so often tend to know better than newspaper reporters these days because they can draw on so many more individual minds, many of which are well read and even expert in the fields they cover, that the only way for it to survive is to be more professionally well informed and researched and fact checked than ever before, and for its reporters and editors to apply their professional minds to the material they cover, rather than just process it from the In basket to the Out basket, would do a better job at understanding just what is going on in South Africa, and why Mbeki is resisting being steamrollered.

Do they really expect the President to roll over like the media lapdogs of the AIDS press around the world led by the New York Times when faced with the mediocre scientists who lead this bandwagon, and the lynch mob emotionalism of the ignorant activists, when the health of his people is at stake, and when he – unlike the reporters and editors of the Times – actually informs himself of the alternative view, which he has done ever since he called together the South African panel to investigate the matter before the Durban AIDS Conference at the beginning of this century, which had the very clear outcome of showing that the objections of the dissenters had no scientific rebuttal?

The degree of irresponsibility shown by the Times in this affair will be its ever lasting embarrassment and shame, and the shame of the media world that follows its lead every day, when the scientific literature it daily ignores is finally brought to the attention of the public and politicians, as every buried truth sooner or later is.

But whether that is soon, or much delayed, depends on the courage and commitment of the very few people in the world who are prepared to fight this battle, and no doubt to the great delight of John P. Moore, it looks as if there are fewer and fewer that have the inclination and resources to do so.

How many of them are prepared to write to the Times to complain, and write an expert and persuasive Op-Ed to counter this kind of thing, and answer in public John P. Moore’s misleading diatribe last year? How many are prepared to expose themselves to public ridicule, and perhaps endanger their employment and finances?

Very few, we imagine.

The rope awaits – is your neck ready?

noose.jpegIn a world where even Mbeki has to take into account the ignorant counter attacks of the Times editorial page, and even the perceptive and principled editor of Harpers cannot afford to back up his writer in the affair for very long, and where even a distinguished scientist with the Nobel in hand who has long been a major player in science cannot afford to invest his reputation any more in speaking up for sense in HIV∫AIDS, and where even Celia Farber, the most successful and literate reporter on dissent in the field, has taken a sabbatical, and where even an independent scholar with a very fine mind who wrote an irrefutable inside account of the twisted science politics of this affair can find himself separated from a scholarly institution in another country on account of his fight for scientific integrity in this field, and where even one of the finest scientists of our generation has been cut off from public funding for more than two decades for his leadership stand for scientific sense in the face of what has become a universally credited fairy tale, what hope is there that there is still a voice somewhere that is willing to speak up and persuade the Times to give him or her a platform which if credited by its readers will bring its own record into grave disrepute?

Anybody else willing to put their head in a noose?

August 14, 2007
New York Times Editorial
Firing an AIDS Fighter

What is it about South Africa’s devastating AIDS epidemic that President Thabo Mbeki just doesn’t want to understand? Mr. Mbeki has catastrophically failed to face up to his country’s greatest challenge.

For years, he associated himself with crackpot theories that disputed the demonstrable fact that AIDS was transmitted by a treatable virus. He also insisted that he knew nobody with AIDS, even though nearly 20 percent of South Africa’s adult population are estimated to be living with H.I.V. And he suggested that antiretroviral drugs were toxic, and he encouraged useless herbal folk remedies instead. As a result, thousands of South Africans have needlessly sickened and died.

Now Mr. Mbeki has fired one of the few effective AIDS fighters in his administration, Deputy Health Minister Nozizwe Madlala-Routledge.

Ms. Madlala-Routledge provided a brief interlude of sanity and seriousness after the health minister — who recommended beetroot and garlic therapy — fell ill last fall. Over the next nine months, Ms. Madlala-Routledge promoted an ambitious but attainable goal of cutting the number of new H.I.V. infections in half and treating 80 percent of people in need by 2011.

But after her boss, the beetroot and garlic advocate, returned to work early this summer, that new seriousness was shoved aside. And, last week, so was the woman responsible for it.

The official explanation for Ms. Madlala-Routledge’s firing was that she did not have official approval for a trip she made to Spain to attend an AIDS conference. The more likely reason was the visit she made to Frere Hospital in the Eastern Cape Province in July where, ever outspoken, she condemned the abominable conditions there as a national emergency.

Unlike other African countries, South Africa has the financial resources and the medical talent to successfully take on its H.I.V./AIDS epidemic. What it lacks is a president who cares enough about his people’s suffering to provide serious leadership. Only two more years remain in Mr. Mbeki’s presidential term. Unless he finally starts listening to sensible advice on AIDS, he will leave a tragic legacy of junk science and unnecessary death.

Poisoning African mothers

August 11th, 2007

Why is Africa testing nevirapine on breast feeding mothers?

Will South Africa hold out? Risks include death

A drug that achieved less than placebo, except for destroying the liver

skeletonsuit1.jpgIn March 2006, investigative AIDS reporter Celia Farber published a damning piece in Harpers magazine which exposed the corruption of NIAID administered research on a particularly nasty AIDS drug, nevirapine, a potentially deadly concoction aimed at preventing the harmless transmission of HIV from mother to baby in the womb.

The intensively checked article quoted the vicious side effects the drug is capable of bestowing on unlucky patients, up to and including death, and recounted the attempts of NIAID officials at manipulating the results of a Uganda study to suggest it was more safely effective than it was at preventing the transmission of HIV from mother to foetus than a placebo, which it wasn’t.

skeletonfire.jpgHafford 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 non-complainer, 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.”

(For those who haven’t read this seminal expose of the skeletons under the suits of AIDS officials and researchers, here is the relevant excerpt:

Excerpt from Out of control: AIDS and the corruption of medical science

skeletonsuit.jpgJoyce 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 be 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 bad 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 non-complainer, 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 sub-acute 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 lawsuit.” (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,11. 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 band density signal “positive.” The most stringent criteria (four bands) are upheld in Australia and France; the least stringent (two bands), in Africa, where an HIV test is not even required as part of an AIDS diagnosis. The U.S. standard is three reactive bands. It has been pointed out that a person could revert to being HIV negative simply by buying a plane ticket from Uganda to Australia. 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.22. 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.

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 back, “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 be 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 fourteenth 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 2000.33. “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.” 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 available across Africa.44. 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.

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 be disciplined. Soon he discovered just how bad 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 Carré’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.55. 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 non-nucleoside 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.”

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.66. 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 born, 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). 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 be 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 newborns 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 non-compliance 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 underweight 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 sub-investigators “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.77. 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. 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 “re-monitoring 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.88. 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. 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, re-monitored, 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.”99. At this point the story grows ever more complicated, as Fishbein supported Luzar in a sexual-harassment claim against Kagan.

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 ironclad 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.1010. 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.

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 1987.1111. 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 retrovirus, 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.

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 Farber article ended with a long and accurate rundown of Berkeley retrovirologist and cancer researcher Peter Duesberg’s debunking reviews of HIV as a cause of AIDS, leaving most readers with a clear impression that the field needed a radical reassessment of its paradigm, as well as its research ethics.

It evoked an energetic response from Dr Robert Gallo, well known for his seminal triumph in first discovering HIV in the mail from Luc Montagnier of the Pasteur Institute, and AIDS activists in New York and South Africa whose strenuous resistance to paradigm review is typically funded by companies who make and sell AIDS drugs.

The lengthy self-justification was put up at AIDSTruth.org, a site run by John P. Moore, who researches the effects of microbicides on HIV transmission among macaques at Weill Cornell in New York City, and it can be studied there for its many flaws, which were carefully detailed in a long answer to every point, one by one, which can be seen at the Reappraising AIDS site of the Committee for the Scientific Reappraisal of HIV∫AIDS.

Here is their introduction, if you want to read it:

Correcting Gallo: Rethinking AIDS Responds to Harper’s ‘Out of Control’ Critics

In its March, 2006 issue, Harper’s magazine published “Out of control: AIDS and the corruption of medical science”, an article by Celia Farber which described the death of one woman in a US-based clinical trial of Nevirapine in pregnant HIV-positive women, and the shoddy, corrupt or perhaps outright fraudulent trial of the same drug in Uganda. She described the coverup that occurred, and raised important questions about the effectiveness and safety of HIV/AIDS research. For brevity we will refer to this as “the Farber article”.

Shortly after this article was published, on March 3rd to be exact, a document started circulating entitled “Errors in Celia Farber’s March 2006 article in Harper’s Magazine”. Half of its authors were researchers: The lead author was Robert Gallo, MD, who claims to have discovered HIV. Others were microbiologist John Moore PhD, of Cornell University , Jeffrey Safrit PhD, senior program officer for the Elizabeth Glaser Pediatric AIDS Foundation (which receives money from the Nevirapine manufacturer) and a medical professor, Daniel Kuritzkes MD. The remaining four are activists for AIDS drug treatment, HIV vaccines and medical marijuana. We will refer to this as “the Gallo document”.

After the Rethinking AIDS response the website “AIDSTruth.org” wrote that they “are aware that the AIDS denialist group, Rethinking AIDS, has finally prepared what they deem to be a rebuttal of our exposure of the errors perpetrated by Celia Farber in her Harper’s Magazine article. We have looked over the AIDS denialists’ response. It is characteristically superficial and silly, further exposing the Rethinking AIDS group’s misunderstanding of the science of HIV/AIDS. We will not be responding further to it. The AIDStruth website will continue to post, at periodic intervals, information that is relevant to understanding how HIV infection causes AIDS and how AIDS can be treated with anti-retroviral drugs.”

We would be happy to enter into a constructive debate but this response to our detailed scientific survey indicates that they are unwilling or, more likely, unable to respond to our challenges with substantive science of their own.

The Gallo document claims to have noted 56 errors in the Farber article. The purpose of this website is to address all of these. For each supposed error, relevant text from the Farber article is given, followed by the error description from the Gallo et al document, and then our response, including references identified as “RA”.
Our analysis of the Gallo et al document attacking the Celia Farber article in the March, 2006 issue of Harpers magazine is broken down into the following sections. In each file a quotation from the Farber article is marked as “Farber”, the entire text of the Gallo document is marked as “Gallo” and our response is marked as “RA” (Rethinking AIDS). When we supply a section of references they are marked “Refs.”
breastfeed.jpgOn nevirapine, the following was the exchange. Note that the conclusion is that not only does nevirapine not contribute any significant lowering of the rate of HIV transmission from mother to foetus to newborn (the oft repeated assertion is false, it is clear) but in more than one study doing nothing ie taking a placebo achieved better results: there was lower transmission than when nevirapine, with all its sickening and killing potential, was used.

“The Tanzania Trial of Vitamins was conducted between 1995 and 2003 among 1078 HIV-1-positive women who were pregnant at enrollment to ascertain the effect of vitamin supplements on MTCT, pregnancy outcomes, and other survival and health endpoints…Antiretroviral medications were not available in Tanzania at the time of the study…Of the 925 live births that occurred in the group of women considered for analyses, HIV status at birth was known for 838; of these, 60 (7.2%) were positive.” [2]

By comparison, the HIVNET 012 study in Uganda gave the rate of HIV transmission for nevirapine as “8.2% at birth” and “11.9%” at 6 weeks [3]. The latter figure is similar to the 6-week rate of 11.1% in the placebo group of another large clinical study in Tanzania that did not involve antiretrovirals [4]. Furthermore, a large prospective study in South Africa, in which “no woman received antiretroviral therapy,” reported that the 3 month rate was only 14.6% “for those exclusively breastfed for 3 months” [5]; this is only slightly higher than the 13.1% for nevirapine at 3 months (3). In Kenya, the 3 month HIV transmission rate with nevirapine “was 18.1%, similar to the 21.7% before the intervention” [6].


http://www.rethinkingaids.com/GalloRebuttal/Farber-Gallo-30.html

Rethinking AIDS
The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis

Item #30: Nevirapine and a Study with 561 People

Farber

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.
Gallo

Farber quotes Turner referring to a study of 561 people.

We are not sure what the 561 person study is that Turner refers to. No reference is supplied by Farber. We have given references above demonstrating that transmission is generally in the 25% region after a few months.
RA

Turner is referencing an African study published in 1998 that stated that “Presence of HIV-infection was assessed in 158 children [of HIV-positive mothers]…Overall, 19 children were diagnosed as HIV-infected [12%, even though there was no access to antiretroviral therapy or other interventions] ” [1]
AT

The website aidstruth.org, run by mainstream AIDS researchers, published an accusatory article by Nathan Geffen and Jeanne Bergman that notes correctly that this Ladner research was interrupted by the tragic civil war in Rwanda. They unfortunately then leap to the conclusion that, if this missing data was known, “The actual figure for perinatal HIV transmission was almost certainly much higher [than 12%]”.
VT

Dr. Valendar Turner, the main target of this piece, has responded effectively at theperthgroup.com/LATEST/Geffen.html.
RA

Additional research by us uncovered another study that produced very similar results, an HIV transmission rate of 7.2% at birth, in a much more stable African country, Tanzania. No war interrupted this trial. Consequently, data on HIV status on birth was available for 838 of 925 mothers:

“The Tanzania Trial of Vitamins was conducted between 1995 and 2003 among 1078 HIV-1-positive women who were pregnant at enrollment to ascertain the effect of vitamin supplements on MTCT, pregnancy outcomes, and other survival and health endpoints…Antiretroviral medications were not available in Tanzania at the time of the study…Of the 925 live births that occurred in the group of women considered for analyses, HIV status at birth was known for 838; of these, 60 (7.2%) were positive.” [2]

By comparison, the HIVNET 012 study in Uganda gave the rate of HIV transmission for nevirapine as “8.2% at birth” and “11.9%” at 6 weeks [3]. The latter figure is similar to the 6-week rate of 11.1% in the placebo group of another large clinical study in Tanzania that did not involve antiretrovirals [4]. Furthermore, a large prospective study in South Africa, in which “no woman received antiretroviral therapy,” reported that the 3 month rate was only 14.6% “for those exclusively breastfed for 3 months” [5]; this is only slightly higher than the 13.1% for nevirapine at 3 months (3). In Kenya, the 3 month HIV transmission rate with nevirapine “was 18.1%, similar to the 21.7% before the intervention” [6].

In the study of nevirapine and AZT in Uganda [3], 120 of “the 616 assessable babies,” or 19.5% , were left out of the 3 month analysis (see section, “Primary efficacy analysis”). This proportion is only slightly less than the 22% (60 of 275) who were missing from follow-up in the Ladner study [1] due to civil war in Rwanda.

The main point, that the Gallo document ignores, is that trials without a placebo cannot conclude that either active treatment A (e.g. AZT) or active treatment B (e.g. Nevirapine) is better than doing nothing (i.e. a placebo). It could be argued that in the Tanzanian trial [2], which was conducted by Harvard researchers, the rate of HIV seropositivity in infants was reduced due to the provision of vitamin supplements. But, if that is the case, it is shocking that less effective toxic drugs are preferred over cheap and non-toxic vitamins (which also have other benefits unlike drugs intended to be specific for HIV).
Refs

1. Ladner J et al. Chorioamnionitis and pregnancy outcome in HIV-infected African women. J Acquir Immune Defic Syndr. 1998 Jul 1; 18(3): 293-8.
2. Villamor E et al. Wasting during pregnancy increases the risk of mother-to-child HIV-1 transmission. J Acquir Immune Defic Syndr. 2005 Apr 15; 38(5): 622-6.
3. Guay L. A. et al. HIVNET 012 randomized trial. Lancet 354:795-802, 1999.
4. Baylin A. et al. Effect of vitamin supplementation to HIV-infected pregnant women on the micronutrient status of their infants. Eur. J. Clin. Nutr. 59:960-968, 2005. (See Table 1.)
5. Coutsoudis A et al. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa. Lancet 354:471-476, 1999.
6. Quaghebeur A. et al. Low efficacy of nevirapine (HIVNET012) in preventing perinatal HIV-1 transmission in a real-life situation. AIDS 18:1854-6, 2004.
Reasonable people who read all this material surely concluded that AIDS drug research was highly suspect until reviewed and reformed (one prominent player who evidently concluded that is President Clinton, according to his remarks to this writer last year) and that with its potentially horrific side effects and complete ineffectivennss nevirapine was the last drug one wanted to give pregnant women. Indeed, as we recall it is or was not dispensed in the States for that very reason.

Meanwhile it seems that nothing or healthy nutrients have a better effect.

skeleton2.jpgIn a classic example of how the HIV∫AIDS paradigm based government-media-science -health-corporate-charity system surrounds any threatening invasion of truth cells with an army of neutralising and counter asserting antibodies, and eventually expels them from the body politic, all this revelation was stifled by media silence or one-sided dismissal and eventually dispensed with, the coup de grace being administered by the New Yorker article recently by Michael Specter (see earlier post) which blithely discounted it all as passe and reasserted the established line.

Now Henry H. Bauer, one of the world’s experts in resistance to paradigm change, whose just published book, The Origin, Persistence and Failings of HIV∫AIDS Theory (McFarland, $35) is a comprehensive and unusually cool and penetrating reappraisal of the scene, showing readers a record number of overlooked impossibilities in the current conventional wisdom, has commented on the last NAR post (supporting Mbeki in his fight against scientific illiteracy) by drawing our attention to a shocking fact – shocking to those familiar with the scientific literature, that is, even if the Harper’s article, which the full review proved totally accurate, is discounted for some reason.

breastgood.jpgNevirapine is being tested around Africa as a preventive for HIV transmission from mothers to newborns in breastfeeding. Only South Africa has made an effort to hold out and prevent such a trial taking place, but it looks as if the activists are about to prevail.

Trials of nevirapine in babies are already underway elsewhere in Africa. A trial in Kampala, Uganda, involves 125 newborns at Mulago hospital, and a second at a clinic in Chitungwiza, Zimbabwe, has around 75 infant participants.

A third trial is expected to begin soon in Tanzania. But without the fourth — the South African trial — there was a risk that the project would not have enough participants to render it statistically significant.

Here is the full SciDev.Net report in all its horrid detail:South Africa: HIV Trial Gets Long-Awaited Go Ahead

SciDev.Net (London)

9 August 2007
Posted to the web 10 August 2007

Sharon Davis And Christina Scott

After years of legal wrangling and controversy, authorities finally approved an anti-HIV drug trial. Sharon Davis and Christina Scott report.

A clinical trial investigating ways to prevent newborns from contracting HIV through breast milk is set to proceed in South Africa, following a court judgement overruling the apparent reluctance of the country’s drugs regulators to let the trial go ahead.

South Africa’s Medicines Control Council (MCC) finally approved the trial last week (30 July) after a protracted battle between the MCC and paediatric HIV/AIDS researchers that ended in court.

The situation highlights problems in scaling up HIV/AIDS research in South Africa. The Sydney Declaration at the recent International AIDS Society conference in Australia (22-28 July) called for an increase in research in the developing world (see Scientists: Don’t neglect HIV/AIDS research).

The trial

Research presented at the conference indicated that breastfeeding by HIV infected mothers accounts for one third of all mother-to-child HIV transmissions in the developing world.

“Many HIV-infected women in South Africa and other African countries do not have the luxurious choice of breastfeeding alternatives, and would still choose to breastfeed despite knowing the risks of HIV transmission to their babies through breast milk,” said Daya Moodley, from the Nelson Mandela School of Medicine at the University of KwaZulu-Natal (UKZN) in Durban, South Africa.

In the developed world, formula milk provides a safe alternative to breastfeeding. But bottle-feeding is a risky option in many parts of Africa with poor access to clean water or electricity, and can trigger severe gastrointestinal illnesses in infants.

A US$7.5 million trial, sponsored by the US-based National Institutes of Health (NIH) and led by Moodley and her team at UKZN, aims to test the effectiveness of the antiretroviral (ARV) drug nevirapine as a treatment to block HIV infection in babies breastfed by HIV positive mothers. Nevirapine has been registered with the MCC since April 2000 for the treatment of HIV in adults, adolescents and children with HIV/AIDS.

Three hundred and fifty babies of HIV-infected mothers will be enrolled in the trial. Half the newborns will be given nevirapine and half a placebo for six months or until they stop breastfeeding. The researchers will then monitor the children for signs of HIV infection until 18 months of age. The trial has a double-blind design, meaning neither the participants or researchers know who is receiving which treatment.

South African studies into the safety of nevirapine for babies were completed in 2000 after approval about a year earlier by the MCC.

Yet it was only last week that the MCC approved the trial.

“The MCC is supposed to make a decision within three months of submission by researchers,” said Quarraisha Abdool Karim of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) and co-principal investigator of the global HIV Prevention Trials Network leadership group.

“This is important research. In KwaZulu-Natal and many rural areas, formula feeding is not an option. This delay in research targeted at reducing risk in some of the most vulnerable populations is outrageous,” she told SciDev.Net.

Safety concerns

The dispute between the MCC and the researchers has run for four years. The researchers first applied for MCC approval in November 2003, and the application was eventually rejected in December 2004. The MCC continued to oppose the trial despite several court orders and its own appeals committee approving the trial in February 2006.

Gratification

The MCC’s main concern was the use of a placebo in the trial as a comparison for nevirapine.

Peter Eagles, chairperson of the MCC, told SciDev.Net two weeks ago (27 July) that the MCC is worried about infants in the placebo arm of the trial being exposed to HIV through breastfeeding.

But Pretoria High Court judge Willie Hartzenberg, dismissing the MCC’s application for leave to appeal previous court verdicts (3 July), found the MCC’s allegations that the trial would lead to the infection of babies with HIV to be unsound. He noted that the clinical trial would not place any mother or child in a position worse than they would have been without the trial.

Moodley said, “There is a misunderstanding that women will be forced to breastfeed in the trial. There is no threat of coercion of women to breastfeed and participate in the trial.” Only HIV positive mothers who elect to breastfeed despite the risk of mother-to-child transmission will be enrolled in the trial.

The MCC has also questioned the use of nevirapine to prevent mother-to-baby transmission of HIV. The council told South African newspaper The Argus (30 July) that it has rejected the findings of the HIVNet012 study conducted in Uganda — regarded by researchers as the ‘pivotal study’ on nevirapine for single-dose use to prevent mother-to-baby HIV transmission. “We are no longer able to continue accepting HIVNet as a basis for registering nevirapine for single-dose use in preventing HIV transmission from mother to child in South Africa,” Peter Eagles was quoted as saying.

According to Moodley, “The local and international scientific committee, funding agencies and support staff involved in the clinical trial have been preparing intensively to ensure that we will be able to provide clear scientific evidence on the efficacy and safety of the drug regimen in children in the trial.”

“This clinical trial, like other drug trials, includes intensive laboratory and clinical monitoring for potential side effects and benefits of nevirapine in children,” she adds.

Hoosen ‘Jerry’ Coovadia, of the UKZN medical school and one of the research team, said, “The South African government has been rightly worried about research which is inappropriate for the developing world. They have accused external agencies of abusing vulnerable populations.”

“But here is a study specifically addressing a problem of predominantly African children, which would be of benefit to many poor children in the developing world,” he told SciDev.Net.

“[The trial] will help reduce a substantial proportion of the 300,000 children globally who are infected each year through HIV infected breast milk. [The MCC] held us back on something which could have saved lives.”

Further delays

Following the Pretoria High Court hearing, Judge Hartzenberg ordered the MCC to approve the trial immediately (3 July). The judge stated that the actions of the MCC were “obstructive” and said that the medical evidence refuted the council’s allegations that the research would encourage HIV infection in newborns.

But weeks after the court’s decision, Maryann Francis, a spokesperson from the UKZN, confirmed that the clinical trials were still on hold (24 July). She said the MCC had recently requested additional documentation — including informed consent paperwork, insurance certificates, ethics committee approvals and financial declaration of sponsorship from the NIH — before the trials at Durban’s Prince Mshiyeni Hospital could proceed.

Peter Eagles told SciDev.Net that the MCC’s request for more paperwork was legitimate because, since the council decided not to approve the trial, they “did not request the normal documentation required” at the time. However, the researchers say copies of the documentation were supplied earlier and have repeatedly gone missing at the MCC.

Coovadia said they sent the paperwork demanded by the MCC to the State Attorney on 26 July.

That same week Peter Eagles said the council was still considering further legal action, seeking to oppose the decision by Judge Hartzenberg, despite being refused permission to appeal. “We are not happy with the [judge’s] decision, and our lawyers are looking into this,” he told SciDev.Net.

But last week the MCC decided to approve the trial. It is not known what prompted the MCC to take the decision after a month’s delay following the court verdict. The MCC did not respond to queries about this.

The situation in South Africa

The MCC’s stance has led to claims of unscientific behaviour from HIV/AIDS health workers and activists. There are fears that MCC scientists have caved in to pressure to adopt the stance of South Africa’s ruling African National Congress party, denying that HIV is the cause of AIDS and refuting the scientific consensus on the use of ARV drugs.

Although South Africa has one of the highest HIV/AIDS infection rates in the world, president Thabo Mbeki has gone on record as saying that he knows no one with HIV. South Africa’s health minister, Manto Tshablala-Msimang, has encouraged people to tackle the disease by eating beetroot, lemons and olive oil. The South African health department has also repeatedly raised concerns about the effectiveness and cost — as well as the alleged toxicity — of ARVs.

HIV/AIDS health workers and activists are particularly concerned at the MCC’s failure to act against unproven ‘cures’ that have not gone through safety and efficacy tests, but are nevertheless peddled by a number of businesses and individuals. These include Matthias Rath, a German physician operating in South Africa who advocates herbs and vitamins as a viable alternative to ARVs. The MCC did not respond to queries about these allegations.

Nathan Geffen of the South African AIDS activist non-governmental organisation, the Treatment Action Campaign, says the MCC has refused to act against the “illegal distribution of medicines” by a number of other businesses and individuals profiting from unproven herbal “pseudo-cures”.

“Yet in [the case of the nevirapine trial], the MCC has acted against the advice of experts and its own appeal committee and attempted to block an ethical trial of a proven medicine with the potential to save the lives of many children,” Geffen told SciDev.Net.

Trials of nevirapine in babies are already underway elsewhere in Africa. A trial in Kampala, Uganda, involves 125 newborns at Mulago hospital, and a second at a clinic in Chitungwiza, Zimbabwe, has around 75 infant participants.

A third trial is expected to begin soon in Tanzania. But without the fourth — the South African trial — there was a risk that the project would not have enough participants to render it statistically significant.

Daya Moodley and her team hope to begin the trial within two months. “Our struggle was not intended for the financial gain of this project but the mere fact that we would provide important evidence of a way of protecting thousands of children from HIV if breastfed by their HIV-positive mothers.”
breastfed.JPGWhy is this wrong? One reason is that we already have a study from Durban which showed in 1999 that women with HIV who were breastfeeding transmitted at lower rates than women with HIV who did not breast feed, rates lower or comparable to the rates later claimed for pregnant women who were being given nevirapine (in a study without proper placebo control, as is usual in AIDS drug research).

In other words, women who breastfeed already lower their rate down to or below the rate for women who are given nevirapine when pregnant.

We are merely quoting the scientific literature, of course, which here is Coutsoudis A et al. Influence of infant-feeding patterns on early mother-to-child transmission of HIV-1 in Durban, South Africa. Lancet 354:471-476, 1999.

But this may seem irrelevant to the enthusiastic agitators and media reporters of HIV∫AIDS, since the scientists never bother to mention it.

breast-baby-strap-514web.jpgWe think that they would think again if their own wives and sweethearts were faced with the choice of nevirapine or nothing, when told that the scientific papers show that nothing is at least as good and often better.

After all, is achieving nothing or worse worth the risk of liver failure and death?

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.

Somehow we don’t think that those who rush to try this drug out on black people in socially remote (to them) regions of the fabled dark continent would hurry to test it on their own near ones and dear ones.

Not to mention that breastfeeding is something which should be encouraged in Africa, where it helps to cure the nutritional deficits that newborns are otherwise subject to in poorer communities. One hardly wants to discourage mothers from breastfeeding by claiming that they might transfer HIV to their babies unless they take a poisonous drug which increases the chances of doing so.

Even on the dark fantasy continent of HIV∫AIDS that cannot make any sense at all.

Naive SA Minister sacked

August 10th, 2007

Mbeki gives mainstream yapper the royal boot

AIDS activists scream, but evidently Mbeki not one of them yet

mbeki1.jpgWell, well, well. It turns out that Thabo Mbeki, the intellectually energetic leader of South Africa who has tried to maintain his independence and objectivity in AIDS in the face of the global propaganda tsunami, has not given up his fight for clarity in the matter of AIDS policy.

The annoying deputy health minister Nozizwe Madlala-Routledge, whose uncritical promotion of standard dogma in HIV∫AIDS smacked of nothing but the worst kind of goody-goody opportunism, has finally been fired.

Her uncritical swallowing of the Washington-media-activist-drug company line that drugs will cure “AIDS” in South Africa the modern way, and that old fashioned, low tech nourishing food, especially certain nutrient bearing vegetables, is merely a secondary line of defense in fighting the impact of filth, disease and starvation on the weak immune systems of the poor, seems finally to have proved too irritating to the only world leader who seems capable of looking into the question for himself.

idiot.jpgSo Mbeki, who has adopted a policy of allowing drugs to reach the so-called “AIDS” victims of Suth Africa in expanding quantities in recent years, even though we suspect he would rather not until the Western medical community publicly sorts out the science and its dissent, finally freed himself of this yapping terrier with its teeth clamped on his trouser cuff.

As the sole political leader in the world who has been sophisticated enough to perceive that top scientists may mislead policy makers, not to mention themselves, we hope that Mbeki continues to struggle for rational reassessment in this arena, and uses what leeway he has to get rid of those who can’t or won’t think critically about this vital topic.

aids-highway2.gifEven if he is forced like other African leaders to accept that the “AIDS” label is the quickest way to win foreign aid for building up his health infrastructure, there is no need to sell out completely to a paradigm fueled by every motive except scientific objectivity, despite the constant media and activist barrage he is subjected to, such as this dimwittedly presumptuous cartoon (above left, click to resize).

JOHANNESBURG, Aug 10 (AFP)
Sacked S. African minister hints at plot to remove her

South Africa’s sacked deputy health minister, Nozizwe Madlala-Routledge, suggested Friday that her immediate boss had set her up for dismissal.

Madlala-Routledge, who had questioned the government’s health policy, was axed by President Thabo Mbeki on Wednesday for undertaking an “unauthorized” trip to an AIDS conference in Madrid.

In a radio interview on Friday, she pointed a finger of blame at her former boss, Health Minister Manto Tshabalala-Msimang, with whom she had differences of opinion over policy.

“I will say that when I spoke in the National Council of Provinces two years ago…the minister of health had said to me…’I’ll fix you’ and maybe she has fixed me,” Madlala-Routledge said.

Tshabalala-Msimang has been a target of criticism both at home and abroad over her approach to AIDS, earning the sobriquet “Dr Beetroot” for touting the use of vegetables to help combat the disease.

The minister is seen as very close to Mbeki, who attracted flak some years ago for questioning the link between HIV and AIDS.

Madlala-Routledge is believed to have incurred the president’s wrath when she recently exposed abysmal health facilities at a government hospital in relatively underdeveloped Eastern Cape province.

In her radio interview, she said she had not sought to slight Mbeki by taking the trip to the conference Spain.

“I acted in good faith in the belief that our president had approved the trip,” she said. “I was just doing my job.”

Madlala-Routledge’s sacking has been condemned by opposition parties and AIDS lobby groups, but Mbeki spokesperson Mukoni Ratshitanga said the president was not bound to explain her dismissal.

“It is a world-wide convention that heads of states do not give reasons for appointments and dismissals,” Ratshitanga told AFP Friday.

“This has nothing to do with democracy at all. He is not obliged to explain his action over this matter,” he said.

Some 5.41 million South Africans are estimated to be HIV-positive, including 257,000 children under the age of 14.

The action points up the irony that the only influential political leader in the world prepared to take on the inconsistencies and incredibilities of the world HIV∫AIDS paradigm is African, when all his peers on the continent, like their Western counterparts in science and media, are only too glad to feed at the trough and wear blinkers to prevent themselves seeing any signs that something is wrong, even as the scientific and popular literature indicating this accumulates to unprecedented proportions.

Meanwhile, the HIV∫AIDS meme continues to spread fantasy, violence and death in his country, as the following report notes at the end if our interpretation is correct:

South African AIDS activists outraged over axing of deputy health minister:

South African AIDS activists outraged over axing of deputy health minister
The Associated Press
Published: August 9, 2007

JOHANNESBURG, South Africa: South Africa’s deputy health minister, one of its most respected women politicians, lost her job on the eve of the nation’s Women’s Day.

Nozizwe Madlala-Routledge was credited with revamping a beleaguered campaign against AIDS, earning the respect of AIDS activists who had blasted her boss, Health Minister Manto Tshabalala-Msimang, for her promotion of garlic and lemons as a remedy of AIDS and her open mistrust of antiretroviral medicines. President Thabo Mbeki fired Madlala-Routledge late Wednesday following reports that she had gone to Spain to attend an AIDS conference without his permission.

Madlala-Routledge’s aides told a newspaper earlier this week that there had been a mix up in dates and she had already arrived in Spain by the time she received word from the president she should not go. Since then she has made no comment, but AIDS activists said Thursday she would address a press conference Friday.

A two-paragraph statement from the presidency, released just before midnight, gave no reason for the dismissal.

Opposition parties and AIDS activists reacted to the dismissal with shock and outrage Thursday.
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“This is a dreadful error of judgment that will harm public health care and especially the response to the HIV epidemic,” the Treatment Action Campaign said in a statement. “It indicates that the President still remains opposed to the science of HIV and to appropriately responding to the epidemic.”

Patricia De Lille, leader of the small Independent Democrats party, noted the dismissal came “just hours before the dawn of our 13th Women’s Day,” calling it “an insult to every single South African woman who has the courage to stand up for the truth.”

Mbeki — whose own record fighting has been criticized by AIDS activist — is a staunch ally of Health Minister Tshabalala-Msimang.

Tshabalala-Msimang was ill for nine months and has only recently resumed her duties. During the health minister’s illness, Madlala-Routledge mended fences with the activists in the Treatment Action Campaign and the mainstream medical community and was one of the driving forces behind a new five year plan which has made reducing the number of new HIV infections one of its main targets, and aims to extend treatment to 80 percent of those with AIDS by 2011.

Doctors, trade unionists and international organizations like UNAIDS celebrated that South Africa had finally emerged from an era of mistrust and confusion over AIDS.

But when Tshabalala-Msimang returned to work in June after a liver transplant, her first public gesture was to snub South Africa’s national AIDS conference on the grounds that her deputy had been given a more prominent speaking role than her.

“If full control of the AIDS program is now back in the hands of health minister Manto Tshabalala-Msimang, we can expect an end to the optimism and vision of recent months, and a progressive new approach, and a return to the dark ages of denialism,” said Mike Waters, health spokesman for the main opposition party, the Democratic Alliance.

Madlala-Routledge and Tshabalala-Msimang are among several women prominent in South African politics. Mbeki was hailed when he appointed Phumzile Mlambo-Ngcuka as deputy president and the country has a number of women at the helm of key ministries, such as foreign affairs.

The South African parliament also has the highest proportion of women legislators in Africa due to the ruling ANC’s policy that 33 percent of its members should be women.

But despite the gains made to improve conditions for women in the last decade, millions are still battling poverty, discrimination and abuse.

About 75 percent of African women under 30 are jobless while in 2002 women held only 14 percent of positions at top management level, with black women holding only 2 percent of these positions.

Women also suffer the most from the HIV/AIDS pandemic and bear the brunt of the country’s high rate of murder and rape with a staggering 52,617 women raped in the last year.

The recent murders of three lesbians showed that South Africa was celebrating National Women’s Day in a climate of violent homophobia and sexism, the New York-based Human Rights Watch said Thursday.

Last month the bodies of Sizakele Sigasa and Salome Masooa, were found with fatal bullet wounds in a field in Soweto. Sigasa had been an activist for the rights of people living with HIV/AIDS as well as lesbian, gay, bisexual and transgender people’s rights.

While police have refused to speculate on the motive for the murders it is feared that the two women were the latest in the growing number of lesbians killed for their sexual orientation.

“Despite legal commitments to equality for all, lesbians in South African townships are still targeted for rape and murder,” Jessica Stern, researcher with the Human Rights Watch, said in a statement.

The South African government will look more closely at crimes against women, Mbeki said at a Women’s Day event Thursday, the South African Press Association reported. Mbeki said nothing about Madlala-Routledge’s dismissal.

Brit bus driver tried to help Libyan nurses

August 10th, 2007

Torture officially acknowledged by Quaddafi’s son, as little known story of dissident help revealed

Is such generosity always a waste of time?

quaddafis-son.jpgThe inhospitable treatment of the Bulgarian nurses and Egyptian born doctor while they languished in jail for eight years in Tripoli is now confirmed by none other that the unpleasant looking son and heir of Quaddafi, Seif al-Islam Gadhafi, 36, who has according to the BBC report today( Fri Aug 10) acknowledged to Al Jazeera TV that they were tortured, though he claimed it was merely with “electricity” and threats their families would be attacked if they didn’t confess to injecting 400 babies with the “AIDS virus” HIV. The rest is “lies”, he said.

Seif’s denials are useless, however, since the readers of the New York Times know the details already from widespread news reports of interviews with the abused detainees. The nurses have told how they were hung up by their arms until they lost all feeling in those limbs, and were kicked mercilessly as they lay on the floor afterwards. We haven’t seen confirmation that they were raped, though.

The doctor has detailed the procedures followed in his case. According to Doctor Recounts Imprisonment in Libya, he was spun on an iron bar like a roasting chicken, his testicles electrocuted, set upon by police dogs, and he was told he was being injected with the “AIDS virus”.

When, in the end, he was magnanimously told that he could stay in Libya, unlike the nurses, who were handed over to Bulgaria to continue their imprisonment, he declined, and he is now a Bulgarian citizen. All have been pardoned by the Bulgarian president, and presumably plan another lawsuit, which in this case, unlike an earlier one complaining of torture, will now present Seif the president’s son as a reluctant defense witness as taped on Al-Jazeera.

Hersee travels to Libya

All this catastrophic tragi-comedy of course was posited on the Western medical superstition, contradicted endlessly by the scientific literature, that HIV causes illness of any kind, a truth which no doubt is unlikely to be broached to the nurses and doctor, who have enough psychological stress to handle with nearly nine years of torment not even justified under the conventional wisdom.

They may have heard this news, however, since one of the oddities of the trial was the generous behavior of Mike Hersee, a Luton, Bedfordshire, England bus driver who helped found HEAL of London and is a confirmed denier of the conventional wisdom in HIV∫AIDS. He offered to help in the Libyan defense by advising the nurses’ lawyers how and why the whole idea of HIV as the cause of any illness was suspect at a profound level, according to all the science.

Hersee won himself an invitation to Tripoli, and seems to have appreciated his visit to the country and finding that not all Libyans are witch hunting opportunists, prepared to sacrifice the lives of foreigners who come to help their country if their murky politics so dictates. His story of the affair is now published in a new online gay magazine from Britain, with the unfortunate name of Hot, Wild and Free, under the title Liberated in Libya? The editors hope the AIDS goon squad can be tempted into debate:

Five Bulgarian nurses (Valya Chervenyashka, Snezhana Dimitrova, Nasya Nenova, Valentina Siropulo, and Kristiyana Valtcheva) and one Palestinian doctor (Ashraf al-Hajuj) had been sentenced to death by firing squad for infecting more than 400 children with HIV at the al-Fateh Hospital in Benghazi in 1998. The Libyan Supreme Court ordered a retrial after international outrage at the unfairness of the original proceeding. During that trial, Luc Montagnier of the Pasteur Institute in Paris and Vittorio Colizzi of Rome’s Tor Vergata University analyzed the viruses from the children, concluding that they had mostly been infected before the health care workers ever arrived in Libya. However on July 11 2007 Libya’s Supreme Court upheld the 2004 death sentences. In a surprise turn of events the medics have since been released.

The following article is intended to provoke reaction and encourage debate. The question is not only who are the real victims in this story but also what is the truth about HIV/AIDS?

The essential hopelessness of contradicting conventional medical and scientific wisdom in a courtroom emerges from the story, even though Hersee was only trying to play an advisory role, not match his credentials against Libyan authorities, however misguided they might be. After all, Luc Montagnier himself had earlier testified in vain that the Virus was present among the babies before the Bulgarians came into the country.

Let the doctor have the last word. “I know the country very well and how they work,” he said. “There is no law beyond the officers themselves.”

Little does he know that his remark may well apply to the state of medical science itself, at least in the field which formed his torture chamber. But this kind of news is probably too much ever to be absorbed by people who have been through so much.

But then, that reason to keep quiet applies to all the dissent on this vexed topic.

Libya ‘tortured’ Bulgarian medics (BBC):
Saif al-Islam Gaddafi (20 May 2005)
Saif al-Islam Gaddafi said some of the medics’ allegations were lies
Libyan leader Muammar Gaddafi’s son has said the six Bulgarian medics who were imprisoned for deliberately infecting children with HIV were tortured.

Saif al-Islam Gaddafi told Al Jazeera TV that Libyan investigators tortured the medics with electric shocks and threatened to target their families.

But Mr Gaddafi denied his country would face legal action for mistreating them.

The five nurses and a Palestinian-born doctor served eight years in detention before being freed by Libya last month.

The release was made possible by a deal struck in Tripoli on improving Libya-EU ties, following years of negotiations.

‘Negligence’

In an interview with the Arabic news channel on Wednesday, Mr Gaddafi admitted the medics had been tortured into confessing.

“Yes, they were tortured by electricity and they were threatened that their family members would be targeted,” he said.

“But a lot of what the Palestinian doctor has claimed are merely lies.”

Dr Ashraf Alhajouj, the Palestinian-born medic, told Dutch TV last month that Libyan authorities had drugged him, given him electric shocks by attaching electrodes to his genitals, and set police dogs on him.

He also said they had tied his arms and legs to a metal bar and spun him repeatedly, like a chicken on a rotisserie.

Mr Gaddafi also confirmed that some of the children had been infected with HIV before the medics arrived in Libya, something which international scientists say they have proven. One case was reported after their arrest.

“There is negligence, there is a disaster that took place, there is a tragedy, but it was not deliberate,” he said.

Libyan courts had based their rulings on conflicting reports implicating the medics, he added.

The medics have always maintained their innocence and were pardoned on their return by Bulgarian President Georgi Parvanov.


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