2.0 Introduction
      It is widely accepted that AIDS originated in Africa and was carried to the USA by Haitian immigrant workers. According to the Weekend Guardian dated 13.6.93, the AIDS epidemic in the West began in the late 1970s among gay men in San Francisco. This was the Mecca of the gay liberation movement and, as 9,000 gay men moved there, it also became the epicentre of the AIDS earthquake. In its bath-houses and sex clubs, gay men claimed to have 1,000 - 10,000 sexual partners in a lifetime. Drug abuse was as prevalent among this group as promiscuity.
      By the early 1980s, sporadic European cases of AIDS were being reported, and panic began. Faced with a range of new immunodeficiency diseases (including ME), of which AIDS was the most lethal, Western society looked to the scientific community to come up fast with both the cause and the cure of AIDS.
      Scientists responded to public pressure with a simple answer:
"HIV causes AIDS"
      A simple answer was just what was needed - clear, neat, concise, easy to comprehend. This is how it happened.

      2.1 The first controversy - Who discovered HIV?
In 1963 John F. Kennedy committed the USA to putting a man on the moon within a decade and it was done.
      When Richard Nixon came to office, he felt obliged to make a similar promise of scientific advance. In the State of the Union address on 22.1.71 he made a huge commitment to curing cancer. Billions of dollars were poured into cancer research, mainly aimed at identifying viruses as the causes of cancers. Viruses have been shown to cause cancer in animals. They are very specialized viruses - oncogenic retroviruses. Retroviruses contain RNA, not DNA, as their genetic material, and therefore depend on the enzyme Reverse Transcriptase to convert the code contained as RNA, into DNA, the form in which it can be replicated. If the virus contains an oncogene, it makes the host cell divide too much, causing cancer. 1970 was a key year, during which:
      - Howard Temin and David Baltimore discovered Reverse Transcriptase (Nobel Prize 1975).
      - Peter Duesberg and Peter Voigt discovered oncogenes.
According to Jad Adams (1989), p38, cancer research was awash with money, but despite the investment, it was largely unsuccessful. By the mid 1980s, disillusion had set in.
      After some false starts in 1980, Robert Gallo of the National Cancer Institute (NCI) (the chief proponent of the theory that HIV is the single cause of AIDS) published the discovery of the Human T-cell leukaemia virus (HLTV) in 1981. He claimed that it caused a type of leukaemia similar to a disease of African macaque monkies. Peter Duesberg, Professor of Molecular Biology at Berkeley, part of the "Virus causation of cancer" research programme, refuted his claim. By the mid 1980s, Gallo had found two retroviruses associated with T-cells, which may have been implicated in the causation of two kinds of cancer. He called them HTLV1 and HTLV2.
      It was in 1982 that Gallo became involved in AIDS, perhaps because of falling cancer research funding. He was in contact with Don Francis at the Center for Disease Control (CDC), and his co-worker Max Essex. Francis postulated a retrovirus as the cause of AIDS. In July 1982, Luc Montagnier, from the Pasteur Institute in Paris, visited Gallo's laboratory.
      In April 1983, Montagnier submitted a paper to "Science", entitled "Isolation of a T-Lymphotropic Retrovirus from a patient at risk of AIDS". The virus had been isolated from the lymph nodes of a 33 year old Parisian homosexual fashion designer who was feeling unwell, in December 1982. He claimed more than 50 sexual partners per year, and travelled a great deal, including visits to N. America. He had been in New York in November 1979. Laboratory tests showed him to be suffering from a variety of opportunistic infections, including some STDs. Jad Adams points out what everyone else chooses to forget. This man did not in fact develop full-blown AIDS. Instead, he subsequently recovered fully and was still alive in July 1988. At the suggestion of Gallo, Montagnier included the sentence "The virus appears to be a member of the human T-cell leukaemia virus (HTLV) family". The paper was published on 20th May 1983.
      On 12th December 1983, Gallo submitted to "Science" a paper entitled "Antigens on HTLV-infected cells recognised by Leukaemia and AIDS Sera are related to HTLV Viral Glycoprotein". This paper was published on 11th May 1984.
      On 14th December 1983, Abraham Karpas, another former leukaemia researcher, working at the Department of Haematological Medicine at Cambridge University, had a paper accepted by "Molecular Biology in Medicine". In this paper appeared the first electron microscope pictures of a retrovirus isolated from an AIDS patient. However, because Karpas omitted to claim it as a "novel virus", the paper attracted little attention. The virus was named Lymphodenopathy Associated Virus (LAV).
      By management of media, Gallo gradually changed Human T-cell Leukaemia Virus to Human T-cell Lymphotropic Virus (also HTLV), as leukaemia research merged into AIDS research.
      On 23rd April 1984, Margaret Heckler, U.S. Secretary for Health and Human Services, announced to a grateful world that Dr. Robert Gallo had discovered the virus that causes AIDS. She claimed for the USA the discovery as yet another major achievement in the advancement of science. But later that year, nucleic acid sequencing studies were used to compare HTLV 1, 2 and 3 and LAV. Controversy arose between Gallo and Montagnier, the latter claiming that Gallo's "discovery" was in fact cultures grown from samples supplied by Montagnier. The dispute was temporarily resolved in 1987 when both parties agreed to publish a false joint public statement (Adams (1989) p60). However, motivated by nationalism, kudos and financial gain (to be derived from the development of HIV antibody test kits), the dispute over patents reared its head again in April 1992. Falsification of a key document and confusion over the origin of cultures at Gallo's laboratory came to light during the court case. Gallo was found guilty of fraud in his patent application and was thoroughly discredited (Culliton (1992) and Maddox (1992)). Montagnier's team at the Pasteur Institute in Paris was recognised as having discovered HIV.

      2.2 The second controversy - Does HIV cause AIDS?
Meanwhile, in May 1986, the International Committee on Taxonomy of Viruses agreed that HTLV3 and LAV were identical and should be renamed Human Immunodeficiency Virus (HIV). This nomenclature is based on identifying:
      1 The species affected (Human)
      2 The effect (Immunodeficiency)
      3 The type of microbe (Virus).
By this time, several laboratories had isolated the virus from AIDS patients, but Jad Adams argues that being there does not prove a causal relationship. It neglects the possibility of an intervening variable, e.g. lifestyle, which could cause both the presence of the virus and the propensity to develop AIDS. So the name of the virus may be misleading. According to Adams and Root-Bernstein, the cause of AIDS is likely to be a complex interaction of many factors. To say that HIV causes AIDS is simplistic.
      Adams perceives fashions in epidemiology, as in other walks of life. In the nineteenth century, bacteria were sought as the causative agents in contemporary diseases (e.g. typhoid, cholera, TB). Similarly, having controlled bacteria through the use of vaccination and antibiotics, in the twentieth century, we look to the as yet unconquered virus as the probable cause of modern diseases.
      The Koch Postulates are generally accepted as the rules proving causality of disease by a micro-organism. They state:
      1 The organism must be found in all cases of the disease.
      2 It must reproduce the original disease when introduced into a susceptible host.
      3 It must be found in a host so infected. (Merriam-Webster, 1965; Weiss and Jaffe, 1990).
In the case of HIV and AIDS, none of these is satisfied.
      1 There are many well documented cases of fatal AIDS in which there was no trace of HIV, by any known test.
      2 When HIV is grown in culture, it behaves very differently from its assumed behaviour in patients, rapidly causing infected and unaffected cells to agglutinate. There is no parallel in vivo. It is ethically impossible to inject HIV into a human, but when it is injected into chimpanzees, our nearest primate relations, AIDS never develops. The chimps remain healthy (Root-Bernstein (1993) p97, AIDS 1992 Educational Video, Jad Adams p88 and Times 26.4.92).
      3 Untestable (see 3 above).
Despite this evidence, a substantial proportion of the scientific community continues to adhere to the hypothesis that HIV is the single causative agent of AIDS, and HIV research attracts funding of $4 billion p.a. in the U.S.A. and 150 million p.a. in Britain (Times 26.4.92). It is noteworthy that Root-Bernstein (1993), p95, considers Koch's postulates irrelevant, where damage to the immune system is caused by the multiple effect of simultaneous infection with a variety of microbes. He draws an analogy with the multiple depressive effect of mixing alcohol and medication.
      As early as 1986, Peter Duesberg, a leading virologist at the University of Berkeley, California, once central to the retrovirus research establishment, began to spear-head an attack on the conventional wisdom. He calls for a radical rethink of AIDS, and founded the "Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis". The first issue of the group's magazine, "Rethinking AIDS", was published in June 1992. The editor is Dr. Harvey Bialy, scientific editor of "Biotechnology", a sister publication to Nature. The magazine has 500 subscribers, including many eminent figures, such as:
      Charles Thomas - Professor of Biological Chemistry at Harvard.
      Kary Mullis - inventor of the polymerase chain reaction (PCR) technique for genetic testing (lecture in Westminster, 31.5.94).
      Gordon Stewart - emeritus Professor of Public Health at Glasgow University.
      Professor S. Root-Bernstein - Associate Professor of Physiology at Michigan State University and prize-winning researcher in immunology.
      Duesberg argues forcibly that HIV is only weakly infectious, and that AIDS is caused by other, mainly non-infectious factors. Abstracts of his three key papers are attached at Appendix 5. His evidence is as follows:
      HIV destroys T-Lymphocytes slower than the body regenerates them and is therefore not capable of significantly damaging the immune system.
      10% of all American AIDS patients are from abnormal health groups:
      Heterosexual i.v. drug users
      Male homosexuals who use oral aphrodisiacs and psycho-active drugs
      Babies of drug-addicted mothers
      Recipients of blood transfusions
      91% of all American AIDS patients are male (therefore the disease is unlikely to be spread by heterosexual intercourse)
      Every year the incubation period for HIV to develop into AIDS is extended as the expected epidemic fails to materialize. It is now > 10 years in many cases
      50% of American AIDS cases are not tested for HIV. Diagnosis is made on the basis of their disease symptoms. Of those who are tested, 5% never show any sign of HIV infection.
      Many other factors/conditions known to suppress immune function are present in AIDS patients, e.g.
      Immune reaction to semen following anal intercourse
      Use of recreational drugs, e.g. Amyl Nitrites (Poppers)
      Repeated prescriptions of antibiotics (for STDs associated with promiscuity)
      Opiate drugs (e.g. heroin)
      Repeated blood transfusions
      Malnutrition (caused by bowel dysfunction in homosexuals, drug use, poverty, anorexia nervosa)
      Multiple infections by micro-organisms (e.g. syphilis)
      Infection with specific viruses, e.g. Cytomegalovirus
      Epstein-Barr virus
      Hepatitis B virus (HBV)

      Retroviruses (of which HIV is one) are notoriously weak and unlikely to cause disease
      Babies born to healthy HIV positive mothers are born healthy and usually remain healthy
      Only 5% incidence of HIV infection by professionals working on AIDS who became involved in blood contact accidents, and of these only one case of AIDS developing
      More than tenfold variation between the HIV infection : AIDS incidence ratio for different risk groups
      Dramatic variation of diseases in AIDS cases between different risk groups
e.g. Kaposi's Sarcoma is linked to nitrite inhalation
      TB is linked to i.v. drugs
      Leukopenia, anaemia and nausea is linked to AZT
      American AIDS symptoms are different from European
      American and European symptoms are different from African

Having dismissed HIV as the cause of AIDS, Duesberg attributes the syndrome to:
      1 The use of recreational drugs (mainly amphetamines and nitrites (poppers) in the USA and Europe (note the report in the TES 6.5.94 [Times Education Supplement] of the exceptionally high incidence of AIDS in Edinburgh, linked to drug use).
      2 More recently to the side effects of AZT developed by Burroughs Wellcome to fight AIDS. AZT is prescribed for HIV antibody positive individuals as well as those with AIDS. This drug was originally used in chemotherapy, to fight cancer. By interfering with DNA replication, it interferes with normal cell division and therefore has devastating side effects.
      3 In Africa a combination of protein malnutrition (leading to wasting) coupled with poor sanitation, leading to bowel infections/diarrhoea parasitic infection i.e. the normal diseases that afflict poverty-stricken communities.
      By May 1992, dissent in the AIDS scientific community had reached such proportions that an "Alternative AIDS Symposium" was convened in the Netherlands, and attracted considerable publicity. One of the speakers was Montagnier himself, whose position had shifted substantially during the decade since his discovery of HIV. Neville Hodgkinson quotes him in the Sunday Times of 26.4.92:
      "We were naive. We thought this one virus was doing all the destruction. Now we have to understand the other factors in this."
      Montagnier had first announced his new position at the Sixth International AIDS Conference in San Francisco in 1990 (seven years after his original discovery) where he had been largely ignored.
      Considerable evidence against the "HIV causes AIDS" hypothesis comes from studies of haemophiliacs infected with the virus through injection of contaminated Factor VIII. There is greater correlation between the onset of AIDS and the length of treatment with blood transfusions (which involves the use of immunosuppressive drugs) than with HIV infection. According to Johnson (1993), "AIDS" symptoms in haemophiliacs do not appear when they are given highly purified substitutes for Factor VIII. This suggests that what has been diagnosed as "AIDS" in haemophiliacs may be due to impurities in the clotting factor, rather than to HIV. Moreover, whereas it was originally thought that some wives of HIV infected haemophiliacs, who tested HIV antibody positive (having contracted the virus from their husbands through heterosexual intercourse) had developed AIDS, subsequent statistical analysis concluded that the morbidity rate among these women was no higher than the national average for their age groups. They were mainly older women, and their symptoms were generally pneumonia (not uncommon as a fatal illness for that age group), with no weight loss, Kaposi's Sarcoma or other typical AIDS-related diseases.
      Another interesting group is prostitutes. It was thought that they were the "link" group, likely to transmit AIDS from i.v. drug users and homosexuals (high risk groups) to the population at large. In fact, this has not happened. Non drug-using prostitutes have repeatedly been found to be unaffected by AIDS, in a number of studies (Root-Bernstein, 1993). Root-Bernstein argues powerfully (p7) that HIV is not transmitted by sexual promiscuity per se and should not be classified as a STD.
      In summary, there are currently three hypotheses regarding the cause of AIDS:
      1 HIV alone causes AIDS (the ruling model)
As time goes by, statistical evidence from epidemiological studies increasingly undermines this theory.
      2 HIV + cofactors cause AIDS (Montagnier and others)
HIV predisposes the body to susceptibility should other predisposing conditions exist. This model is gaining momentum in the scientific community.
      3 HIV does not cause AIDS, but is merely a marker of "at risk" individuals (Duesberg and others). HIV is a harmless passenger, transmitted in groups who are at risk of contracting AIDS for other reasons, e.g. recreational drugs. Increasingly this model appears to explain the epidemiological evidence that is emerging as time passes.
Root-Bernstein (1993), p114, summarises the various scenarios neatly (Appendix 6).

      2.3 The third controversy - What is HIV?
Whether or not HIV alone, or with cofactors, causes AIDS, we should discover all we can about the virus per se.
      It is unquestionably a retrovirus (requiring the enzyme Reverse Transcriptase to convert its genetic code from RNA into DNA, the form in which it can replicate). There is an army of such viruses living as parasites in man, and in general they are non-pathogenic. Considerable research has been directed at studying the structure of the virus. Much is known, and there is little controversy about this. A major problem in finding a cure or vaccine and indeed for the body's immune system in producing antibodies to the virus, is that it has a high rate of mutation. Two major races of the virus have been identified as HIV1 and HIV2.
      The most controversial question is how and where the virus first infected humans.
      It is widely accepted that the virus arose in Africa, and an in depth study by Louis Pascal (1991) is the most detailed work carried out in this area (see Appendix 7 for Brian Martin's introduction to Pascal's article). Eva Snead was the first person to point out the similarity between HIV and SV40, a common infection in Macaque monkeys, and to suggest that HIV resulted from contaminated Polio Vaccinations grown on monkey tissues. Pascal developed Snead's hypothesis by postulating that the recently discovered (1985) SIV rather than SV40 was the culprit. SIV (Simian Immunodeficiency Virus) is a common infection of Macaque, Rhesus and African Green monkeys. (It is noteworthy that both Pascal and Snead belong to the "HIV causes AIDS" camp.) Brian Martin (1993) studied the scientific community's reception of Pascal's hypothesis.
      According to Altman, AIDS began in Central Africa (Rwanda, Burundi and Zaire). Kinshasa (formerly Leopoldville) is now one of the worst HIV-hit areas of Africa. Pascal notes that the first live polio vaccination campaigns were launched in 1958 in precisely this area of Africa. The polio vaccine was administered orally to thousands of young children (whose immune systems are notably less resistant than in adults) by syringe, and may easily have entered the lungs as well as the gut. The attenuated, live polio virus, used in the vaccination programme, was grown in rhesus monkey kidney and was known to be contaminated with another unknown monkey virus at the time it was used. Post hoc rationalisation suggests this virus may well have been SIV. Pascal's concern is that across the world, there are many well documented cases of contamination of cell cultures, the most scandalous being that of HeLa (cervical cancer cells from Henrietta Lacks, who died of the disease), which is known to have spread throughout medical research programmes spanning the U.S.A., Europe and what was the U.S.S.R. by cross-contamination of samples. A documentary on Channel 4 and the book by Michael Gold, "A Conspiracy of Cells", describe how this contamination may invalidate the results of vast amounts of research. Pascal reasons that if the AIDS pandemic arose through a vaccination programme, then other major epidemics may arise in the future for the same reason. In fact, concern is mounting that vaccines are (in Eva Snead's words) soups of a variety of organisms, which we inject willy-nilly into our newly born babies. Hiram Caton is critical of Pascal's article, on the grounds that entry via the lungs is unlikely and that, via the oral route, the virus could not have crossed the gut wall to enter the blood-stream. He points to similar avenues of research by Lecatsas and Kyle (Appendix 8), which explore other possible routes by which SIV could have been transmitted from monkeys to man, e.g.:
      - Someone with bleeding gums eating under-cooked monkey meat
      - A monkey bite
      - Development of malaria vaccine
      - Development of smallpox vaccine
      - Treatment, with intra-muscular injection of oral polio vaccine, of homosexuals suffering from Herpes
      Andrew Tyler explored the possible monkey to man transmission routes in his article in the Independent Magazine 19.9.92. He makes the point (p30) that African vaccination programmes are often chaotic, and conducted with minimal equipment. For example, syringes and needles are used repeatedly, causing cross-infection.
      Root-Bernstein (1993), p2, traces the pre-history of HIV, citing cases of AIDS long before the 1970s. So, he concludes, either HIV is not the cause of AIDS or HIV was introduced into man much earlier than we thought. This would match suggestions that attempts to develop a malaria vaccine earlier this century, which involved injecting monkey blood into human volunteers, could have been the route of transmission (see recent press coverage - Table 1, Hawkes, Times 4.4.94).
      In fact, we simply don't know how HIV arose, and probably never will.

      2.4 The fourth controversy - What is AIDS?
We aren't sure who discovered HIV. We aren't sure where it came from. We don't know if it causes AIDS. Do we know what AIDS is?
      Duesberg and Adams (Sunday Times 31.5.92) argue strongly that we don't. We lack a clear and constant definition of AIDS. (The CDC definition is given in Appendix 9, a copy of Root-Bernstein (1993), p58). Acquired Immune Deficiency Syndrome is just that. It is not a disease but a condition which, by suppressing the body's immune system, lays it open to a variety of diseases. Symptoms vary dramatically, not only between individual patients, but also between the various "at risk groups" and between different regions of the world.
      A young post-graduate researcher at Cambridge (who has just been granted a further four years' funding) told me that "HIV is a very complex virus. It does not show itself in the same way in any two patients". It seems he is looking down the wrong end of the telescope. Instead of trying to explain the diversity of the symptoms in terms of one causative microbe, maybe he should be asking whether there might be multiple causes of the diseases.
      Some anomalies are deftly pushed aside by the Health Education Authority's 1992-up-dated HIV/AIDS video, widely used in school health education programmes. I transcribe below some of the text.
      "The disease [misnomer] is extremely variable and there is no "average" course of development. In some people, symptoms similar to 'flu or glandular fever occur at about the time that antibodies appear. Then many years may elapse when the virus is hidden in cells. [Incidentally, this runs contrary to all that is generally accepted in medicine, namely, that for a disease to be caused by a micro-organism, that micro-organism must be shown to infect the body a short while before the disease symptoms arise. The intervening incubation period is generally measured in weeks or at most in months (see section 2.2 above).]
      Symptoms which may occur intermittently during the latent period include:
            Swollen lymph glands
            Wasting/weight loss
            Persistent night sweats
            A variety of skin and mouth conditions
When the AIDS phase is reached, opportunistic infections are as follows. They can sometimes occur in people not infected with HIV though this is rare and the effects are usually less severe.
- TOXOPLASMA affects the brain and eye
- CRYPTOSPORIDIUM causes diarrhoea
- HERPES infects mouth, anus and genitals
- CYTOMEGALOVIRUS mounts a generalized attack on the light-sensitive retina of the eye
- MYCOBACTERIA e.g. T.B. (increasingly) affecting lungs and other organs
- CRYPTOCOCCUS - causes meningitis
- PNEUMOCYSTIS - causes pneumonia
The most common cancer, Kaposi's Sarcoma, was a rare and slow growing cancer of the blood vessels in the skin. It is much more aggressive in AIDS patients, and appears in the digestive system too.
      [2] In the early days of AIDS, almost half the homo- and bisexual men with AIDS also had Kaposi's Sarcoma. Now, its incidence is declining in these groups.
      [3] Non-Hodgkins Lymphoma also occurs in AIDS. Its incidence is increasing.
      [4] HIV attacks a variety of cells including the brain and muscle cells. Symptoms range from mild to severe dementia. The heart can also be affected.
      [5] In some parts of Africa, weight loss (wasting) is very severe. Therefore it is called "Slims disease".
      [6] Which conditions appear varies from person to person."

Let us take the passages in bold print in turn:-
      [1] If we define AIDS as a set of symptoms in a person with HIV, then it cannot occur in a person without HIV, or if AIDS does occur in people without HIV, HIV cannot be the sole cause.
      [2] A clear definition is needed. It would be nonsense to say "The incidence of heart disease in Down's Syndrome is declining."
      [3] As for [2]
      [4] These symptoms are very similar to syphilis, in which disease Kaposi's Sarcoma can also occur. Do these patients have syphilis? Are they even tested for syphilis, a bacterial disease?
      [5] Malnutrition, common throughout the third world, causes extreme weight loss.
      [6] Then we need a definition of AIDS. Is it:
(a) a defined and unchanging range of disease conditions in HIV carriers? Apparently not - see [2] and [3] above.
(b) a defined and unchanging range of disease conditions in individuals regardless of their HIV status?
(c) any disease that occurs in an HIV carrier?
Probably - see [2] and [3] above.
      The CDC surveillance definition of AIDS has expressly included HIV negative cases, according to Maver (Rethinking AIDS - March 93).
      Root-Bernstein (1993), p 67, discusses how the definition of AIDS has been revised over time. The effect of each revision, has been to dramatically increase the size of the group included, lending weight to the public perception of an escalating epidemic.
      Supporters of the "HIV + cofactors causes AIDS" school would argue that the cofactors influence the actual disease state, HIV predisposing the body to disease.
      Duesberg argues strongly that the classification of AIDS patients has led to a state of total confusion and massive misdiagnosis. Symptoms among homosexual men bear strong resemblances to other sexually transmitted diseases. Symptoms among haemophiliacs may be attributed to their haemophilia and/or its treatments. Symptoms among wives of haemophiliacs and their death rate is in line with average demographic trends. Symptoms in Africa are those normally associated with poor communities in the third world and, in fact, recent epidemiological analysis of Europe suggests that AIDS remains largely confined to disadvantaged groups in society, whose diet, hygiene and lifestyle are poor.
      HIV testing throughout the African continent is rare and AIDS diagnosis is based solely on symptoms (Dispatches Channel 4, AIDS in Africa, 23.3.93). There are many documented cases of AIDS diagnosis in which subsequent testing for HIV was negative and, conversely, ever increasing numbers of HIV antibody positive individuals who continue to live healthy lives.
      A clear, universal definition of AIDS is urgently needed. Misdiagnosis, particularly in Africa, may be causing death on a massive scale. Once diagnosed as having AIDS, patients are ostracised by their village, considered beyond help, and left in solitude to die, as the lepers of old. "Dispatches" offered such individuals treatment - antibiotics for ulcers and lung infections, dietary supplements for weakness and wasting, and the patients recovered. The programme suggests that African states cannot attract Western aid for their age-old or war-related problems of famine and poverty, but the WHO is pumping money into programmes to fight the AIDS epidemic. If this money were diverted to more conventional and cost effective treatments of symptoms rather than AIDS prevention programmes, much more good would be done. Thus, economics could be the driving force behind the desire to impose an AIDS epidemic onto Africa:
      - firstly, nations can more easily attract aid for AIDS prevention and treatment than for the endemic diseases of the continent and
      - secondly, multinational pharmaceutical companies are anxious to develop and market inexpensive "dip stick" HIV tests to the African continent and to introduce AZT to Africa (Shenton, 1993).
      The most poignant story of what is going wrong in Africa was published in the Sunday Times on 3.10.93 (see Chapter 3, Table 1).
      "The 1990 Triennial (1989-1991) AIDS notification baseline: a world review by country and WHO region" (Appendix 10) shows that Africa has the highest incidence of AIDS. Perhaps this simply reflects the general disease level on that continent, compared with the rest of the world.

      2.5 The fifth controversy - Is the test for HIV reliable?
Robert Maver (1993) points out that prior to 1985 virtually no one was tested for HIV. Statistics for AIDS pre-1985 were based entirely on diagnosis of symptoms.
      The dispute between Gallo and Montagnier (see 2.1 above) was caused in part by the patent rights to the HIV tests, which they rightly saw as becoming big business.
      According to the 1992 LEA AIDS video:
"Several laboratory procedures are now available to test for HIV infection. - The most common is the antibody test. The main problem is the delay between infection and the appearance of antibodies, normally less than 3 months.
- Antigen tests are more complex. They test for HIV protein directly.
- HIV can also be grown in cell culture."
      In practice, none of the tests is very reliable. Duesberg argues that the HIV antibody test is a nonsense. Antibodies to a virus infection indicate that the body is effectively fighting the infection and, since HIV is a weak retrovirus, which only advances slowly from helper-T-cell to helper-T-cell, an individual with high levels of antibody to HIV should not be particularly at risk of disease caused by it (if such there be).
      Marilyn V. Savant (1993) has done a statistical analysis of the two most widely used HIV antibody tests, known as
            - ELISA
            - Western Blot
      She concludes that in mass testing of the heterosexual community at large, there are likely to be five times as many false positives as real positives. The implications for the life-style and life insurance prospects for the individual whose tests are false positives are appalling.
      The local Health Promotion Unit advises that if a negative result is obtained by the HIV antibody test for an individual, who appears to be highly at risk, and/or is demonstrating symptoms of AIDS, the individual is offered the antigen test. However, the reliability of this test is recognised as being substantially lower. It appears that doctors are trying to fit the symptoms and conditions to the conventional wisdom rather than looking objectively at the test results in a particular case.
      Math (1992) points out that the whole subject of antibody testing is hugely complex. Test design depends on identifying an antibody to target. In fact, there is a range of antibodies produced by the body as a reaction against different parts of the HIV virus. The relative strengths of these reactions and hence the levels of the various antibodies varies significantly between populations. He compares levels in homosexual men, haemophiliacs and African heterosexuals, classed as HIV antibody positive by conventional tests, and finds significant differences.
      It is known that many disease conditions, such as influenza and malaria, can produce false positive results in HIV tests (Times 4.4.94). Several of these conditions are most prevalent in Africa, where the major AIDS epidemic is alleged to have occurred. Dr Harvey Bialy claims that false positives obtained by the hugely inaccurate ELISA HIV test, used to randomly sample for HIV in Africa, has led to massively exaggerated figures about infection levels on that continent (Dispatches, Channel 4, AIDS in Africa, 23.3.93).
      Root-Bernstein (1993), p49, quotes examples of cases where HIV has disappeared from an individual and offers two possible explanations. Either it is possible to recover from HIV infection or tests are inaccurate.

      2.6 The sixth controversy - How efficacious is AZT?
In the late 1980s, fear of a global and devastating AIDS epidemic put pressure on the medical research establishment to come up with a cure fast, and offered a huge crock of gold to the drug manufacturer who won the race. The difficulties were enormous. The virus cannot easily be attacked because it lies within cells, its genetic material embedded in the nucleic acids of the nucleus. Infected cells cannot be targeted for destruction by so-called "magic bullet" drugs or irradiation because there are too many, distributed throughout the body. The best approach was to target the point at which reverse transcriptase directs DNA production from viral RNA. At this point, DNA-like compounds can be introduced to slow and confuse the process.
      Zidovudine, brand name AZT, and its derivatives appeared the most promising group of compounds to work like this. It had been used in chemotherapy to retard cancers, by blocking DNA replication, but because DNA replication is required for healthy cell division (e.g. in maintaining the body, growth of hair, skin and nails and for healing) as well as cancerous cell division, it had devastating side effects. These effects are most detrimental in children, who are still growing.
      Initially, AZT was trialled in dying AIDS patients, and the manufacturers, Burroughs Wellcome, claimed that it slowed the advance of the diseases. Cautious optimism from such trials encouraged its prescription for HIV antibody-positive individuals desperately fearful that they would succumb to AIDS and willing to try any remedy to delay that fearful day. Trials in HIV antibody positive, symptom-free individuals were undertaken, even in children, without recourse to the normal legal restrictions on drug development because of the perceived urgency. With patients dying, the development of a cure could not be withheld pending the results of the normal 2 year to 10 year animal toxicity trials. Doubts about the efficacy of AZT in AIDS patients were first raised by Fischl, Richman and Grieco (1992) but were largely ignored. In early 1992 doubts were being raised about the longevity of HIV antibody positive individuals treated with AZT compared with untreated individuals. The Lancet (Feb 1992), p421, has an editorial under its "Noticeboard", entitled "Doubts about Zidovudine". It begins:
      "Debate about the efficacy and safety of zidovudine (AZT) is being stifled by a medical and scientific community that continues to display a striking arrogance over those it claims to serve, says a UK television documentary (Dispatches, Channel 4) screened this week. These criticisms have been the subject of intense discussion in the USA, where several AIDS organisations are now campaigning against the more widespread prescription of zidovudine to symptom-free HIV-positive individuals. Help groups have even been established to enable HIV-positive patients gain the confidence to come off their medication."
      During the remainder of February and March 1992, the Lancet carried a series of papers exposing AZT.
      When the story broke in the mass media (see Chapter 3), shares in Burroughs Wellcome plummeted. It is precisely at that time that I attended a key conference jointly organized by the Wellcome Trust and Association for Science Education and sponsored by the BMA at the Wellcome H.Q. opposite Euston Station. The event was heavily sponsored (price for teachers £25). The proceedings were not published until January 1994. In the same week as the conference, Duesberg's views about the role of HIV in causing AIDS started to be reported by Neville Hodgkinson in the Sunday Times. The reports were largely dismissed as trivial, by Anderson and other key speakers at the conference, who simply mentioned in passing "irresponsible reports in the gutter press". (See also Chapter 4 for the sponsorship of educational material by the Wellcome Trust.)
      Duesberg is the most severe critic of AZT (see section 1.2 above). While it is now accepted that
      - AZT does not delay the onset of AIDS in HIV antibody positive individuals, and that
      - AZT is of dubious value in the treatment of AIDS patients,
he alone claims that AZT may actually be the cause of AIDS in many healthy HIV antibody positive people taking the drug, because of its interference with cell division, which adversely affects health.

      The Rt. Hon. Michael Howard Q.C., M.P., Secretary of State for the Environment, in an address to the Institute of Directors, Pall Mall, on 8.2.93, stated:
      "I want to tell you briefly of a research project in the AIDS field published in 1992. It was conducted by the Bastyr College of Natural Health Sciences in Seattle, Washington. It was a one year open trial of 16 men with AIDS-related complex on a regime that comprised dietary and lifestyle counselling, nutritional supplementation, psychotherapy and hydrotherapy, with the alternative of homeopathic or herbal treatment. The results, with no patients progressing to AIDS, no patients dying, and in fact some clinical improvement observed, compared more favourably with anything that had been achieved in the orthodox, pharmaceutical field. It was not in any way a tightly controlled trial, and the numbers were small. But does anyone imagine that if the agent involved had been a drug it would not, in the present climate, have been pursued by pharmaceutical money for all it is worth? Leads have been followed up on far less when the incentives were there. So far as I am aware, the Bastyr College is still looking for funds to proceed with stage 2"

      2.9 Summary
There is a tendency among the laity to assume that science advances by consensus, building progressively like Lego, brick by brick. The reality is quite different. From the earliest AIDS research a decade ago to the present, controversy rages among scientists over every aspect of HIV and AIDS. At first the debate was contained and Duesberg maintains that he was actively suppressed, so that the public at large, including the teaching profession, was, until quite recently, wholly unaware of dissent from the simple, conventional establishment message. Fields (1994) makes a plea for funding to be made available to enable new avenues of research about AIDS to be opened up, since the present, heavily focussed approach is simply not coming up with any answers.
      In the next chapter we shall see how the controversies have come to light, and are published in the mass media.

Click here to move to the next chapter, Chapter 3: Media Coverage of HIV and AIDS

To select any chapter, click below:-


Click here to return to main index

HTML Rae West First uploaded 98-02-14 .