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Rapid Responses: Rapid Responses published:
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HIV/AIDS is indeed a colossal catastrophe
- David Rasnick (8 November 2003)
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What is there in a name?
- Maulik V Baxi (8 November 2003)
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The catholic church and AIDS
- Frank J.J. Conijn (12 November 2003)
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Re: The catholic church and AIDS
- Chinyelu K. Lee (19 November 2003)
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AIDS a Disaster? Or AIDS Science
- David R Crowe (20 November 2003)
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AIDS a Disaster? Or AIDS Science
- Peter J Flegg (21 November 2003)
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Re: HIV/AIDS is indeed a colossal catastrophe
- Ed Rybicki (21 November 2003)
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Ed Rybicki chose not to refute any of the facts
- David Rasnick (23 November 2003)
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Full support for BMJ Rapid Responses
- Etienne de Harven (23 November 2003)
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Re: Full support for BMJ Rapid Responses
- Mike Foley (24 November 2003)
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Holy Rollers
- Peter Morrell (26 November 2003)
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HIV: hypotheses and theories.
- Peter J Flegg (29 November 2003)
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Reframing AIDS from within
- Mark Griffiths (29 November 2003)
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Immunisation against H.I.V.
- Paul.D. Hooper, Isle of Wight PO38 2LE (7 December 2003)
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Re: Immunisation against H.I.V.
- Alexander H Huw (8 December 2003)
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Using Padian is Making This All Too Easy. What the AIDS Denialists Need is NEW MATERIAL.
- Tony Floyd (9 December 2003)
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Re: Re: HIV/AIDS is indeed a colossal catastrophe
- Eleni Papadopulos-Eleopulos, Valendar F Turner, John Papadimitriou, Barry Page, David Causer, Helman Alfonso (11 December 2003)
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Re: Re: Immunisation against H.I.V.
- Mark Griffiths (11 December 2003)
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Re: AIDS a Disaster? Or AIDS Science
- David R Crowe (14 December 2003)
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Reframing or Inflaming?
- John P Heptonstall (21 December 2003)
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An apparently missing control experiment on HIV/AIDS
- Etienne P. de Harven, Dr. Christian Fiala (14 March 2004)
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Re: Ed Rybicki chose not to refute any of the facts
- Ed P Rybicki (17 March 2004)
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Re: An apparently missing control experiment on HIV/AIDS
- Eleni Papadopoulos-Eleopulos, Valendar F Turner, John Papadimitriou, Barry Page, David Causer, Helman Alfonso, Sam Mhlongo, Todd Miller, Christian Fiala (23 March 2004)
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Re: Re: An apparently missing control experiment on HIV/AIDS
- Brian T Foley (28 May 2004)
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David Rasnick, Visiting Scholar UC Berkeley Berkeley, CA 94720
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Dear Editor, The article "Reframing HIV and AIDS" says "In just over two decades, the epidemic has already killed over 23 million people" and cites "UNICEF. HIV/AIDS: The big picture 2003" as the source. UNICEF also says that over 40 million people are living with HIV/AIDS. Where do these numbers come from? South African author Rian Malan went in search of the source of these frightening numbers and recorded his findings in 2001 where he documented the lack of evidence for claims of an AIDS emergency in Africa (1). If AIDS is indeed devastating and depopulating Africa and other parts of the world then there should be hard evidence that would slap anybody in the face and wouldn't need to read about it in BMJ and the New York Times. People in the Middle Ages new all about the Plague without the benefit of a CDC, WHO, NIH, MRC or CNN. If there really was an AIDS emergency the people of the world would demand governments to do something about it immediately or they would throw the rascals out. Instead, we read in journals, official reports and newspapers that Africans, Asians, Indians, etc. are in denial and must wake up to the AIDS emergency that they are in. AIDS is truly a disaster of colossal proportions but not for the reasons given in headlines. The contagious/HIV hypothesis is the biggest scientific, medical blunder of all time--and is easy to prove (2, 3). "Can Africa be saved?" the cover of Newsweek asked as far back as 1984 (4), reflecting the old Western belief that Africa is doomed to starvation, terror, disaster and death. This was repeated two years later in an article in the same journal in a story about Aids in Africa. The title set the scene: "Africa in the Plague Years" (5). It continued: "Nowhere is the disease more rampant than in the Rakai region of south- west Uganda, where 30 percent of the people are estimated to be seropositive." The World Health Organisation (WHO) confirmed "by mid-1991 an estimated 1.5 million Ugandans, or about 9% of the general population and 20% of the sexually active population, had HIV infection" (6). Similar reports were repeatedly published during the last 15 years, declaring as much as 30% of the population doomed to premature death, with dire consequences for families and society as a whole? The predictions announced the practically inevitable collapse of the country in which the world-wide epidemic supposedly originated. Today, however, one reads little about Aids in Uganda because all the prophesies have proved false, as evidenced in the ten-year census of September 2002 (7). Summing up, the Uganda Bureau of Statistics says, "Uganda's Population grew at an average annual rate of 3.4% between 1991 and 2002. The high rate of population growth is mainly due to the persistently high fertility levels (about seven children per woman) that have been observed for the past four decades. The decline in mortality reflected by a decline in Infant and Childhood Mortality Rates as revealed by the Uganda Demographic and Health Surveys (UDHS) of 1995 and 2000-2001, have also contributed to the high population growth rate." In other words, the already very high population growth in Uganda has further increased over the past 10 years and is now among the highest in the world (8). Even if Uganda has so far escaped the apocalypse that was predicted in 1984, the popular media continue to inform us that the whole of Sub- Saharan Africa has suffered massive devastation and depopulation as a result of two decades of AIDS. Notwithstanding the claims of the media, it is extremely difficult to document an Africa AIDS catastrophe that some have compared to the European plague of the Middle Ages. A new AIDS epidemic was claimed to have emerged in Sub-Saharan Africa in 1984 (9-14). In sharp contrast to its America and European namesakes, the African AIDS epidemic is randomly distributed between the sexes and not restricted to behavioral risk groups (15-17). The African epidemic is also a collection of long-established, indigenous diseases, such as chronic fevers, weight loss (alias "slim disease"), diarrhea and tuberculosis (18-23). In addition, the African AIDS-defining diseases differ from the American/European AIDS diseases significantly in their prevalence among AIDS patients. For example, the predominant American/European AIDS disease, Pneumocystis carinii pneumonia, is almost never diagnosed in Africans (24, 25). According to the WHO, the African epidemic increased from 1984 until the early 1990s, similar to the American/European epidemics, but has since leveled off to generate about 75,000 cases annually ((26) and back issues). (By way of comparison, the plague epidemic of London in 1665 had eliminated 1/3 of the population with plague-specific symptoms in a few weeks to months [29] and the flu epidemic of 1918 eliminated 20 million in one season (27). By 2001, Africa had reportedly generated a cumulative total of 1,093,522 AIDS cases (26). But, during this period the population of Sub- Saharan Africa had grown (at an annual rate of about 2.6% per year) from 378 million in 1980 to 652 million in 2000 (28). Therefore, a possible, above-normal loss of 1 million lives to AIDS is statistically hard to verify for two reasons: 1) the loss would be dwarfed by the overwhelming, simultaneous gain of 274 million people (the equivalent of the population of the USA), and 2) the African AIDS-defining diseases are indistinguishable from conventional African morbidity and mortality (2). Because of the many epidemiological and clinical differences between African AIDS and its American/European namesake, and because of the many uncertainties about the statistics on African AIDS (29), both the novelty of African AIDS and its relationship to American/European AIDS have recently been called into question (1, 29-36). Indeed, all available data are compatible with a perennial African epidemic of poverty-associated diseases under the new name AIDS (19, 22). Because the WHO decided in 1985 to accept AIDS diagnoses without an HIV-test, there is no reliable documentation for even an HIV epidemic in Africa (29, 37). Such presumptive diagnoses were approved because the cost of the HIV-antibody test is prohibitive for most Africans. As a result, there are huge discrepancies in African AIDS statistics. For instance, based on WHO information, the Durban Declaration claimed in 2000 that, "24.5 million...are living with HIV or AIDS in Sub-Saharan Africa". However, the WHO had reported no more than 81,565 new cases AIDS for the whole African continent in that year (obtained by subtracting the cumulative total of 794,444 in 1999 from the cumulative total of 876,009 in 2000) (38, 39). African AIDS is assumed to be sexually transmitted. The assumptions 1) that HIV is sexually transmitted and 2) there are "24.5 million...living with HIV or AIDS in Sub-Saharan Africa" (40) produce a sexual paradox. The fact that mainstream HIV researchers have agreed that it takes on average 1000 unprotected sexual contacts with HIV- positive partners to transmit HIV (36, 41, 42) means that an extraordinary degree of sexual promiscuity is necessary in order to sustain a sexually transmitted AIDS epidemic. Therefore, the level of sexual promiscuity in Africa must be significantly greater than that in the USA and Europe where the promised heterosexual AIDS epidemics never materialized (43). Thus, in order to produce an African AIDS epidemic on the scale repeatedly reported in the New York Times, by the WHO and UNAIDS requires massive, random sexual promiscuity, far beyond that seen in the USA and Europe. The number of random sexual contacts needed to spread a sexually transmitted HIV epidemic in Sub-Saharan Africa is a straight forward calculation. Since only 1 in 26 (24.5 million per 652 million) of Sub-Saharan Africans was HIV-positive in 2000, each of the 24.5 million must have had an average of 1000 x 26 = 26,000 sexual contacts to reach the 1000 HIV-positive contacts needed to acquire HIV and to spread an epidemic. It strains credulity to accept that poor, hungry Sub-Saharan Africans are engaging in such levels of sexual promiscuity. Indeed, the evidence is strongly against it. A recent thorough epidemiological study of sexual transmission of HIV in Africa found the same "low rates of heterosexual transmission [of HIV], as in developed countries [and] no correlation between the percent of adults...reporting non-regular sexual partners...and HIV prevalence" (36). These and other anomalies led Brewer et al. to "propose that existing data can no longer be reconciled with the received wisdom about the exceptional role of sex in the African epidemic" (44). Thus, either the assumption of the Durban Declaration that HIV is sexually transmitted, or its claim that 24.5 million are HIV-positive, or both are flawed. Nevertheless, we continue to read in newspapers and hear on television that 25 million people have died of AIDS, and there are upwards of 40 million people infected with HIV-and most of these are said to be in Africa. South Africa is the richest country in sub-Saharan Africa and has the most reliable statistics on the continent. Statistics South Africa (Stats SA) reports a constant growth in the population of South Africa from 38 million in 1994 to 43 million in 2001 (45, 46). Furthermore, the rise in the number of deaths from all causes during the same period was also constant, growing as the population grows-but no faster. The latest antenatal screening survey in South Africa (47) also failed to support the hypothesis that HIV is sexually transmitted but instead confirms the conclusion of Brewer et al. that, "HIV is not transmitted by 'sex'" (44). The survey included testing pregnant women for syphilis and antibodies to HIV in order to see how the two diseases were correlated by geographical location and over time. But, there was no correlation. On the contrary, KwaZulu-Natal, which is leading when it comes to HIV, has the lowest rate of syphilis in all provinces. Western Cape, on the other hand, had the highest rate of syphilis in 2000 but the lowest HIV prevalence. Northern Cape had the highest rate of syphilis in 2001 but the third lowest prevalence of HIV antibodies in that year. Paradoxically, then, there is an inverse geographical correlation between syphilis and HIV although both are said to be transmitted by heterosexual intercourse. An even more extraordinary result is the divergence over time between an increasing prevalence of antibodies to HIV and a declining rate of syphilis. This is also difficult to understand given the assumption that both are sexually transmitted. A recent study in Uganda produced similar results. The intention of the study had been to reduce HIV incidence by mass treatment of STDs with conventional antibiotics. The rationale behind the study was that reducing STDs (which was assumed to be a co-factor in the transmission of HIV) should reduce the transmission of HIV. However, the result of the study was paradoxical. While the investigators were very successful in significantly reducing STDs, their intervention had "no [effect] on incidence of HIV-1 infection..." (48). The data from Thailand show that these paradoxical results are not peculiar to Africa. Even though Thailand is said to be severely hit by a heterosexually transmitted HIV-epidemic, we find yet again the same scenario presented by South Africa and Uganda. Bangkok has the highest rate of STDs but low HIV prevalence. Conversely, the so called Golden Triangle of northern Thailand has the highest rate of HIV but the second lowest STD morbidity of all regions. And, even within the different provinces of the Northern Region there is a negative correlation between HIV and syphilis (49). The conclusion from these observations is obvious: HIV cannot be heterosexually transmitted. African AIDS numbers are based on HIV-antibodies in pregnant women. Before 1998, two HIV-antibody tests had been performed for the South African surveys: one screening test and a confirmation test on the positive samples. The second test was skipped from 1998 onwards, except in Western Cape, even though generally it is the accepted standard to do at least two tests. Furthermore, the manufacturer of the HIV-antibody test that was used in the surveys specifically warns that, "non-specific reactions may be seen in samples from some people who, for example, due to prior pregnancy...have antibodies to the human cells or media in which HIV -1 is grown for manufacture of the EIA" (50). In other words the test, which may show false positive reactions in women with "prior pregnancy", is being used in pregnant women without further confirmation or adjustment. The insert that comes with the antibody test also warns that, "at present there is no recognized standard for establishing the presence or absence of HIV-1 antibody in human blood." This probably explains why "Studies from seven African countries over the last 15 years show rates of HIV incidence during antenatal and/or post-partum periods exceeding what could be expected solely from sexual transmission" (51). Yet, these problematic, unconfirmed results from pregnant women are then used to estimate the frequency of HIV in the general population (52) and eventually the whole of Sub-Saharan Africa. Thus, there is no evidence that HIV is spreading through sexual intercourse (or any other way) in Africa or anywhere else. Combined with the evidence that Africa is not currently being devastated and depopulated by an AIDS epidemic, the inability to document a sexually transmitted epidemic of HIV shows that a future HIV-caused AIDS apocalypse in Africa is unlikely. David Rasnick, Member of the Presidential AIDS Advisory Panel of South Africa References 1. Malan, R. AIDS in Africa in search of the truth. In: Rolling Stone, Vol. 22 November, pp. 70-72, 74-78, 80, 82, 100, 102, 2001, http://www.whatisaids.com/rollingstone.htm 2. Duesberg, P., Koehnlein, C., and Rasnick, D. The chemical bases of the various AIDS epidemics: recreational drugs, anti-viral chemotherapy and malnutrition. J. Biosci., 28: 383-412, 2003. 3. Duesberg, P. H. and Rasnick, D. The AIDS dilemma: drug diseases blamed on a passenger virus. Genetica, 104: 85-132, 1998. 4. Anonymous Can Africa be saved? In: Newsweek, pp. cover, 1984, 5. Nordland, R., Wilkinson, R., and Marshall, R. Africa in the Plague Years. In: Newsweek, pp. 44-46, 1986, 6. The Aids Support Organisation and WHO The inside story. 1995. 7. Anonymous Results from the Population Census from September 2002. Entebbe, Uganda: Uganda Bureau of Statistics, 2002. 8. United Nations Population Fund The State of World Population 2001, Demographic, Social and Economic Indicators. 2001. 9. Piot, P., Quinn, T. C., Taelman, H., Feinsod, F. M., Minlangu, K. B., Wobin, O., Mbendi, N., Mazebo, P., Ndangi, K., Stevens, W., and et al. Acquired immunodeficiency syndrome in a heterosexual population in Zaire. Lancet, 2: 65-69, 1984. 10. Van de Perre, P., Rouvroy, D., Lepage, P., Bogaerts, J., Kestelyn, P., Kayihigi, J., Hekker, A. C., Butzler, J. P., and Clumeck, N. Acquired immunodeficiency syndrome in Rwanda. Lancet, 2: 62-65, 1984. 11. Bayley, A. C. Aggressive Kaposi's sarcoma in Zambia, 1983. Lancet, 1: 1318-1320, 1984. 12. Seligmann, M., Chess, L., Fahey, J. L., Fauci, A. S., Lachmann, P. J., L'Age-Stehr, J., Ngu, J., Pinching, A. J., Rosen, F. S., Spira, T. J., and Wybran, J. AIDS-an immunologic reevaluation. N. Engl. J. Med., 311: 1286-1292, 1984. 13. Quinn, T. C., Mann, J. M., Curran, J. W., and Piot, P. AIDS in Africa: an epidemiological paradigm. Science, 234: 955-963, 1986. 14. Quinn, T. C., Piot, P., McCormick, J. B., Feinsod, F. M., Taelman, H., Kapita, B., Stevens, W., and Fauci, A. S. Serologic and immunologic studies in patients with AIDS in North America and Africa: the potential role of infectious agents as cofactors in human immunodeficiency virus infection. JAMA, 257: 2617-2621, 1987. 15. World Health Organization Global AIDS surveillance, Part II. Weekly epidemiological record, 76: 390-396, 2001. 16. Duesberg, P. H. HIV is not the cause of AIDS. Science, 241: 514- 516, 1988. 17. Blattner, W. A., Gallo, R. C., and Temin, H. M. HIV causes AIDS. Science, 241: 514-515, 1988. 18. Duesberg, P. H. AIDS acquired by drug consumption and other noncontagious risk factors. Pharmacology & Therapeutics, 55: 201-277, 1992. 19. Konotey-Ahulu, F. I. D. AIDS in Africa: Misinformation and disinformation. Lancet, ii: 206-207, 1987. 20. Pallangyo, K. J., Mbaga, I. M., Mugusi, F., Mbena, E., Mhalu, F. S., Bredberg, U., and Biberfeld, G. Clinical case definition of AIDS in African adults. Lancet, ii: 972, 1987. 21. Colebunders, R., Mann, J., Francis, H., Bila, K., Izaley, L., Kakonde, N., Kabasele, K., Ifoto, L., Nzilambi, N., Quinn, T., van der Groen, G., Curran, J., Vercauten, B., and Piot, P. Evaluation of a clinical case definition of Acquired Immunodeficiency Syndrome in Africa. Lancet, i: 492-494, 1987. 22. Konotey-Ahulu, F. I. D. Clinical epidemiology, not seroepidemiology, is the answer to Africa's AIDS problem. BMJ, 294: 1593- 1594, 1987. 23. Konotey-Ahulu, F. I. D. What is AIDS? Watford, England: Tetteh- A'Domenco Co., 1989. 24. Goodgame, R. W. AIDS in Uganda-clinical and social features. N Engl J Med, 323: 383-389, 1990. 25. Abouya, Y. L., Beaumel, A., Lucas, S., Dago-Akribi, A., Coulibaly, G., N'Dhatz, M., Konan, J. B., Yapi, A., and De Cock, K. M. Pneumocystis carinii pneumonia. An uncommon cause of death in African patients with acquired immunodeficiency syndrome. Am Rev Respir Dis, 145: 617-620., 1992. 26. World Health Organization Global situation of the HIV/AIDS pandemic, end 2001 Part I. Weekly epidemiological record, 76: 381-384, 2001. 27. Fenner, F., McAuslan, B. R., Mims, C. A., Sambrook, J., and White, D. O. The Biology of Animal Viruses. New York: Academic Press, Inc., 1974. 28. U.S. Bureau of the Census International Data Base World population by region and development category: 1950-2025. Washington, DC: U.S. Department of Commerce, Bureau of the Census, 2001. 29. Fiala, C. AIDS in Africa: dirty tricks. In: New African, pp. 36- 38, 1998, 30. Hodgkinson, N. AIDS: the failure of contemporary science. London, UK: Fourth Estate, 1996. 31. Shenton, J. Positively False: exposing the myths around HIV and AIDS. London/New York: I. B. Tauris, 1998. 32. Stewart, G. T., Mhlongo, S., de Harven, E., Fiala, C., Koehnlein, C., Herxheimer, A., Duesberg, P., Rasnick, D., Giraldo, R., Kothari, M., Bialy, H., and Geshekter, C. The Durban Declaration is not accepted by all. Nature, 407: 286., 2000. 33. Gellman, B., S. African President Escalates AIDS Feud. Washington Post A01, 2000 34. Fiala, C., de Harven, E., Herxheimer, A., Kohnlein, C., Mhlongo, S., and Stewart, G. T. HIV/AIDS data in South Africa. Lancet, 359: 1782, 2002. 35. Ross, E. Sub-Saharan Africa, Kenyia and the Malthusian paradigm in contemporary development thinking. In: M. Pimbert (ed.), Reclaiming Knowledge for Diversity, pp. in press: Routledge or Earthscan, 2003. 36. Gisselquist, D., Rothenberg, R., Potterat, J., and Drucker, E. HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission. Int J STD AIDS, 13: 657-666, 2002. 37. World Health Organization Provisional WHO clinical case definition for AIDS. Weekly Epidemiological Records, March, 7, (10): 72- 73, 1986. 38. World Health Organization Global AIDS surveillance, Part I. Weekly Epidemiological Record, 75: 379-383, 2000. 39. World Health Organization Global AIDS surveillance, Part I. Weekly Epidemiological Record, 74: 401-404, 1999. 40. The Durban Declaration The Durban Declaration. Nature, 406: 15- 16, 2000. 41. Padian, N. S., Shiboski, S. C., Glass, S. O., and Vittinghoff, E. Heterosexual transmission of human immunodeficiency virus (HIV) in Northern California: results from a ten-year study. Am. J. Epidemiol., 146: 350-357, 1997. 42. Jacquez, J. A., Koopman, J. S., Simon, C. P., and Longini Jr., I. M. Role of the primary infection in epidemics of HIV infection in gay cohorts. J. Acquired Immune Deficiency Syndromes, 7: 1169-1184, 1994. 43. Fumento, M. The myth of heterosexual AIDS: how a tragedy has been distorted by the media and partisan politics, p. 463. Washington, DC: Regnery Gateway, 1990. 44. Brewer, D. D., Brody, S., Drucker, E., Gisselquist, D., Minkin, S. F., Potterat, J. J., rothenberg, R. B., and Vachon, F. Mounting anomalies in the epidemiology of HIV in Africa: cry the beloved paradigm. International Journal of STD & AIDS, 14: 144-147, 2003. 45. Statistics South Africa Causes of death in South Africa 1997- 2001. 2002. 46. Statistics South Africa South African Statistics 2000. 2000. 47. Makubalo, L. E., Netshidzivhani, P. M., Mulumba, R., Levin, J., du Plessis, H., Ratsaka, M., Mahlasela, L., Mudzanani, L., Johnson, C., and Shikweni, F. Summary Report:NATIONAL HIV AND SYPHILIS SERO-PREVALENCE SURVEY IN SOUTH AFRICA. Pretoria, South Africa: Directorate: Health Systems Research, Research Coordination and Epidemiology, 2001. 48. Wawer, M. J., Sewankambo, N. K., Serwadda, D., Quinn, T. C., Paxton, L. A., Kiwanuka, N., Wabwire-Mangen, F., Li, C., Lutalo, T., Nalugoda, F., Gaydos, C. A., Moulton, L. H., Meehan, M. O., Ahmed, S., and Gray, R. H. Control of sexually transmitted diseases for AIDS prevention in Uganda: a randomised community trial. Rakai Project Study Group. Lancet, 353: 525-535, 1999. 49. Chitwarakorn, A. e. a. Sexually Transmitted Diseases in Asia and the Pacific. Region 10, Chiang Mai, Thailand: Ministry of Public Health, AIDS Division, HIV/AIDS Situation in Thailand, 1998. 50. Abbott Laboratories Diagnostics Division Human Immunodeficiency virus type 1 HIVAB HIV-1 EIA. Abbott Park, IL: Abbott Laboratories, 1997. 51. Gisselquist, D., Rothenberg, R., Potterat, J., and Drucker, E. HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission. Int J STD AIDS, 13: 657-666, 2002. 52. Ntsaluba, A. National HIV and Syphilis Sero-Prevalence Surveyof women attending Public Antenatal Clinics in South Africa 2000. pp. 13 pages. Pretoria, South Africa: Ministry of Health, Director-General for Health, 2000. Competing interests: None declared |
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Maulik V Baxi, Final Year Medical Student, Medical College and Shri Sayaji General Hospital, Baroda The Maharaja Sayajirao University of Baroda, Baroda - 390 001 India
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Awarding the ongoing epidemic of AIDS a title of disaster is long awaited formula. In fact it was already predicted this would have to be addressed as a disaster some day.(1) There are some stages a disaster usually has(2): -Stage of planning: Before the strike of disaster, you can prepare for survival should it come. -Stage of impact: This is when it happens actaully. -Stage of rescue: Immediately after disaster, this stage is important in saving lives. -Stage of rehabilitation: This is the stage where those left to face the ruined environment, get help to become self-reliant again. These four stages are seen going on together in case of AIDS. The future depends upon how the first and the last stages are managed. The balance of these stages in case of AIDS is so delicate that even a small mistake in identifying one loophole will greatly increase the burden of the disease. And this small mistake may mean some more thousand people loosing their lives. Now that WHO has already suggested this to be addressed as a global health emergency, there arises a need of tackling this emergency also, not just by making drugs available to few millions or taking steps towards prevention in another few millions, but by creating a multipronged approach for control of HIV/AIDS under one coordinating umbrella organization. References: (1)Kiragu K. Youth and HIV/AIDS: Can we avoid Catastrophe? Population Reports, series L, Number 12. The John Hopkins University Bloomberg School of Public Health, Population Information programme, Baltimore. Fall 2001. (2)Park K. Textbook of Preventive and Social Medicine. (17th Ed.) Banarasidas Bhanot Publishers, Jabalpur. p.376 Competing interests: Maulik Baxi is Associate editor of Asian Student Medical Journal and Director, Taxila - Centre for Medical Reforms and Research |
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Frank J.J. Conijn, Editor, Physical Therapist's Literature Update Amsterdam, The Netherlands
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Editor,
In the fight against AIDS, we should never forget the (highly) detrimental effect of the proclamations of the conservative christian church(es). That might be proved to be the strongest causative factor, next to the reluctance by authorities to implement information and prevention campaigns. Frank Conijn Editor, Physical Therapist's Literature Update Competing interests: None declared |
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Chinyelu K. Lee, Doctoral Candidate - Political Science Yale University - 06512
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Christian churches are not perfect. Stigmatization for religious reasons have been well documented. However, it unfair and probably incorrect to claim that "conservative" churches were the causal factor in the explosion of this epidemic. Churches are one of many groups that were involved in the stigmatization of persons with HIV/AIDS. While they are immensely important to the social fabric of many developing nations, do we really want to suggest that their stigmatization has had more of an effect than similar behavior by national, regional, and local government officials. What about the stigmatization that comes from the indigenous religions, where "sin" is subsituted for some other form of unclean spirit. Looking to lay the blame for the spread of HIV/AIDS at the feet of churches or anyone else is counterproductive. The disease is here and local churches, which provide a substantial portion of the health care in developing nations, are at the forefront of the struggle, particularly in non-urban areas. Stigmatizing churches, a group with vast networks, truly local organizations with experience delivering healthcare, and a genuine desire to help the most vulnerable populations, is probably the least productive activity that can be engaged in by a pundit from the North. Competing interests: None declared |
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David R Crowe, President, Alberta Reappraising AIDS Society 2636 Toronto Cr NW, Calgary, AB, T2N 3W1, Canada
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It is hard to know whether AIDS is a disaster unless you know which definition of AIDS is being used. Is this WHO AIDS (e.g. Bangui definition or variants?) or US AIDS circa 1981 or 1987 or 1993 or is it Canadian AIDS? All are different. WHO AIDS (no HIV test, 3 of the following 4 symptoms: cough, fever, diarrhea, weight loss > 10%) could be just malnutrition converted into a supposedly infectious disease. I was prompted to write because of the Nature article about the BMJ rapid responses on AIDS. Those who believe in HIV=AIDS=Death are in the important positions of power in medical science, and can stop research with an alternative perspective from being published. BMJ rapid responses are way for the debate to occur. It is sad that the debate has to occur outside the mainstream of peer-reviewed scientific publications. But the solution is not to stop the rapid responses? It is to open up scientific journals to alternative views of AIDS, Mad Cow disease, West Nile Virus, SARS and others. There is much contradictory evidence, as Gisselquist et al documented in recent papers on HIV transmission in Africa. But even in that work that shocked many, there was no consideration of the possibility that the "epidemic" of AIDS in Africa is actually an epidemic of the use of tests that are not very accurate, and that the epidemic might be entirely virtual. Competing interests: None declared |
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Peter J Flegg, Consultant Physician Blackpool FY3 8NR
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David Crowe apparently finds it hard to know if AIDS is a disaster, and wonders if the epidemic is "entirely virtual". I will ignore the insult this implies to the millions who are suffering or who have so far died, and focus on the reason he gives for querying its existence - namely the AIDS case definition itself. As he indicates, there have been different definitions, which have changed over the last 20 years, but with good reason(1). Some are case definitions derived for surveillance purposes in areas of the world where there are fewer resources and laboratory facilities available to arrive at definitive diagnosis. Other changes are merely the result of refinements in case definition to account for evolving clinical and laboratory markers. I would be the first to admit that "AIDS" is not a very useful definition, nor is any disease diagnosis an exact science, but the ability to estimate AIDS cases provides important epidemiological information essential for devising a coherent strategy to tackle HIV on a global basis. If the definitions have changed, or vary slightly between countries, what of it? Are we now to conclude that coronary artery disease does not exist because the definitions for myocardial infarction and acute coronary syndromes have altered? Try telling the widow that her husband's chest pain was only a "virtual heart attack" because some authorities use a troponin T assay and others a Troponin I assay for myocardial damage and see how far you get. David Crowe is incorrect to indicate that medical science believes in the HIV=AIDS=DEATH scenario. This thinking went out of the window 15 years ago. If he means that medical scientists believe HIV infection can result in immunodeficiency and all which that entails, he is also wrong. We do not believe it (this implies faith); instead we know it to be true. (1) http://www.who.int/hiv/strategic/surveillance/definitions/en/ Competing interests: None declared |
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Ed Rybicki, Professor in Microbiology University of Cape Town, Rondebosch, 7701 South Africa
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Those of us in the "orthodox" camp in South Africa - the vast majority of scientists working on or associated with HIV/AIDS - would agree whole-heartedly with the sentiment that HIV/AIDS is a colossal catastrophe. It is heartening that our government agrees with us enough to have consented to a massive anti-retrovirals rollout, that will undoubtedly prolong the lives and improve the quality of life of thousands of South Africans. It is most frustrating, therefore, to read David Rasnick's recent "Rapid Response" in which he claims that "there is no evidence that HIV is spreading through sexual intercourse (or any other way) in Africa or anywhere else. Combined with the evidence that Africa is not currently being devastated and depopulated by an AIDS epidemic, the inability to document a sexually transmitted epidemic of HIV shows that a future HIV- caused AIDS apocalypse in Africa is unlikely." And yet again, despite its dissolution at least 18 months ago, he claims to be "Member of the Presidential AIDS Advisory Panel of South Africa". BMJ does itself and its readers a disservice by allowing this charlatan a public voice. The next thing that happens is that he will quote his unrefereed contributions to your journal as statements of scientific truth - much as he refers to journalist Rian Malan's article on HIV statistics in South Africa in that noted peer-reviewed journal "Rolling Stone" (Malan, R. AIDS in Africa in search of the truth. In: Rolling Stone, Vol. 22 November, pp. 70-72, 74-78, 80, 82, 100, 102, 2001, http://www.whatisaids.com/rollingstone.htm)in his BMJ letter! Yet again, Rasnick's contribution is full of half-truths, misstatements, shaky extrapolations and downright untruths. And yet again, he has been given a platfrom to promulgate his disbelief. Enough, already! Ed Rybicki Competing interests: Working on HIV vaccines |
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David Rasnick, Visiting Scholar Dept. MCB UC Berkeley, CA 94720
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Dear Editor, Ed Rybicki chose not to refute any of the facts or arguments I have presented regarding the lack of evidence for the contagious/HIV hypothesis of AIDS. He merely recites the catechism of AIDS dogma. In addition, he doesn't check his facts. He says, "And yet again, despite its dissolution at least 18 months ago, [Rasnick] claims to be 'Member of the Presidential AIDS Advisory Panel of South Africa'". I am indeed still a member of the Presidential AIDS Advisory Panel because it has not been disbanded. Just weeks ago, in fact, president Mbeki said publicly that he is still waiting on this very panel to conclude its deliberations and present a report on its findings. Prior to the recent Cabinet decision to make anti-HIV drugs available throughout South Africa, on the eve of the 53rd Session of the World Health Organization's Regional Committee for Africa convened in Johannesburg, September, 2003, Mbeki posed these questions to the 37 Ministers of Health and delegates from 46 African countries: "Do we know what is it that is killing the people of Africa? Do we have a good sense of the health challenges facing them? And are we therefore in a position to conceptualise strategies and advise African Heads of State and Government on appropriate responses?" The Cabinet's decision on the anti-HIV drugs was not the president's. He has not changed his mind on those drugs. If Rybicki had read the Cabinet's decision, he would have seen that inclusion of the anti-HIV drugs was a minor component of the comprehensive plan to beef-up the healthcare infrastructure throughout SA. However, this is not reported in newspapers. Mbeki's government is using the hoopla around HIV drugs to improve healthcare generally. One benefit of all the fuss around the Cabinet's decision is that AIDS will most likely not be a campaign issue in the upcoming national elections early next year. Mbeki's second term in office will be very interesting. David Rasnick, PhD Member of the Presidential AIDS Advisory Panel Competing interests: None declared |
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Etienne de Harven, emerit.prof(Pathol),Toronto 06530 St-Cezaire, France
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I simply wish to indicate my full support to David Rasnick and to David Crowe responses to L. Stabinski's et al. paper. In medical science, when research is restricted to one single hypothesis (in this case the HIV=AIDS hypothesis), and when, twenty years later, that research has resulted in no curative treatment, no vaccine, and no verifiable epidemiological prediction it is most urgent to courageously admit that the hypothesis was wrong! "Errare humanum est sed diabolicum perseverare..." Competing interests: None declared |
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Mike Foley, Consultant Anaesthetist James Cook University Hospital, Middlesbrough, UK
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I have noticed that falling from a height can result in serious injury or death. The only hypothesis which I have developed is that this is due to a force,which I don't really understand but call 'gravity'. Despite years of research I have been unable to cure this untoward consequence of gravity or come up with a vaccine to prevent it. Does Prof de Harven agree that it is time to courageously abandon my single hypothesis or would he advise me otherwise? Competing interests: None declared |
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Peter Morrell, Hon Research Associate, History of Medicine, Staffordshire University, UK
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Sir, Two quotes by esteemed scientists might help Mike Foley to clarify what science means by a hypothesis. “The essence of science is that it is always willing to abandon a given idea, however fundamental it may seem to be, for a better one; the essence of theology is that it holds its truths to be eternal and immutable. To be sure, theology is always yielding a little to the progress of knowledge, and only a Holy Roller in the mountains of Tennessee would dare to preach today what the popes preached in the Thirteenth Century, but this yielding is always done grudgingly, and thus lingers a good while behind the event.” [1] On this basis, the HIV supporters like Foley [2] come closer to what Mencken calls Holy Rollers in their failure to conform to his view that science is a fluid and evolving set of beliefs. Indeed, they seem to regard the HIV hypothesis as an “eternal and immutable” truth. Such an attitude can also be seen to yield only unwillingly to “the progress of knowledge.” [1] It yields only grudgingly, as Mencken says. By contrast, those who cast doubt on the HIV hypothesis are shown to conform to the more openly evolving and critical view of true science. Likewise, when Bronowski says, “the essence of science: ask an impertinent question, and you are on the way to a pertinent answer,” [3] then again we can see which group comes closest to any trace of impertinence as opposed to those who slavishly adhere to the established theory. Sources [1] H.L. Mencken (1880–1956), Minority Report, no. 232, Knopf (1956). [2] BMJ e-letter, Re: Re: Full support for BMJ Rapid Responses, Mike Foley, 24 Nov 2003 http://bmj.bmjjournals.com/cgi/eletters/327/7423/1101#41398 [3] Jacob Bronowski (1908–1974), The Ascent of Man, ch. 4 (1973). Competing interests: None declared |
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Peter J Flegg, Consultant Physician Blackpool, UK, FY3 8NR
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"The essence of science is that it is always willing to abandon a given idea, however fundamental it may seem to be, for a better one". How right Peter Morell is to remind us of this. If he knows of a better idea as to what causes AIDS other than HIV, I am waiting to hear of it. Until then, I see no reason to abandon the HIV "hypothesis". To paraphrase Karl Popper(1), where one is faced with a choice of theories, it is appropriate to accept the one that has the most supporting evidence. HIV as a cause for AIDS fulfils these criteria admirably. The fact that "disbelievers" refuse to accept this stems from their reliance on their own discredited criteria of scientific validity, and because they have set themselves up to be the arbiters of what constitutes sufficient evidence. Popper went further, however: he also suggested that we should attempt to disprove theories, i.e. show if they can be falsified. Is it not instructive how the HIV "theory" remains intact despite the so-called evidence from the disbelievers, and yet their own pet theories as to what causes AIDS cannot pass muster (AZT, degenerate lifestyles, stress, malnutrition etc.)? Why is it that their opinions on these remain immutable in the face of each new piece of evidence to the contrary? As a supporter of the HIV "hypothesis", I can assure him that the science of HIV evolves exactly according to the principles he claims he espouses. Of course we are willing to alter our opinions in the face of new evidence – this is happening continually. As one example, we can look at one of the clinical correlates of AIDS, namely Kaposi’s sarcoma. Initial theories, which on the face of it had a reasonable evidence base but were never wholly convincing, were rejected when new evidence implicated other factors. Hence we have seen "causes" such as inhaled nitrates, HIV itself and CMV fall by the wayside with proper application of the scientific method, which now implicates HHV-8 as the cause. Ironically, the very fact that our views can change is one of the main reasons that "disbelievers" have been so vocal in their accusations. Hear them cry: "Last year you said CMV; now you say HHV-8! Can’t you make up your mind? You obviously know nothing!" If one scientist proposes that HIV may be curable, and several years later admits that this claim was premature (this finding being based largely upon his own research), the disbelievers proclaim he has been "discredited", and therefore that all his work must be invalid! This is forever the way of the dissident. They are rightly at liberty to ask Bronowski-style "impertinent questions", but why do they always refuse to accept pertinent answers? Perhaps Peter Morrell should study some of the alternative claims for an AIDS hypothesis more closely. He will find that it is their proponents who are immutable in the face of new evidence, and not the orthodox HIV researchers. (1) Popper, K. The Logic of Scientific Discovery. 1934. Competing interests: None declared |
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Mark Griffiths, Independant researcher Pierrelatte, France
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Dear Editor I was diagnosed HIV positive in 1986, and live well today with absolutely no anti-retrovirals or chemical treatment since my diagnosis. I have been blessedly aware of alternative theories about the causes of AIDS since then. I am delighted to discover that the BMJ has opened its doors to a global, unblinkered debate on a subject which has long been censored or ridiculed by journals like Nature and other industry supported journals world-wide. Most of the efficient immune-boosting non-toxic treatments have been rigorously buried by the orthodoxy since Gallo & Heckler's infamous political media conference in 1984. Lord Baldwin of Bewdley did once voice his vision of the scandal of censored, viable natural treatments and effective educational programmes for HIV positives in the House of Lords journal Hansard. Some five years ago in my adopted France, certain scientists and health practitioners, looking for non-official solutions for their patients, were attacked and silenced. Their laboratories were closed, their patients arrested, interrogated like drug addicts and their supplements confiscated, making the French Cathar inquisition seem like an Enid Blighton story! I would be delighted if your readers could discover HIV positive people, living outside the official system, and what they have to say. Even scientists like Luc Montagnier have come round to the point of view that immune boosting, non-toxic treatments must become an officially supported part of AIDS politics. This is even more pertinent for Africa. To the best of my knowledge, and I have diligently studied the common points of people surviving AIDS since 1981, our principal wisdom has been avoiding official treatments. A London based group have created a website to appeal for a new start to AIDS politics and treatments. http://www.altheal.org For the first time since 1984, an historic symposium will be held in the European Parliament at Brussels (8 Dec), which will permit dissidents and orthodoxy to express their opinions. Competing interests: None declared |
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Paul.D. Hooper, Retired G.P. Selborne, Pyle Shute, Chale,, Isle of Wight PO38 2LE
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Two hundred years ago Edward Jenner showed that innoculation with Cowpox gave immunity to Smallpox; the disease of one species giving immunity to the disease of another species. I wonder if any thought has been given to innoculating people with the Simian Immunosuppressive Virus in order to give immunity to the Human I.Virus. But perhaps I am way behind the times. Competing interests: None declared |
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Alexander H Huw, Writer/artist WC1N 1PE
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Paul.D. Hooper, et al. ask: "Two hundred years ago Edward Jenner showed that innoculation with Cowpox gave immunity to Smallpox; the disease of one species giving immunity to the disease of another species. I wonder if any thought has been given to innoculating people with the Simian Immunosuppressive Virus in order to give immunity to the Human I.Virus. But perhaps I am way behind the times." Like 'HIV', so-called 'SIV' has never been truely isolated and has never been proven to be a 'retrovirus'. Indeed, 'retroviruses' do not exist. Dr Robert Gallo and Prof Luc Montagnier announced the 'discovery' of a 'retrovirus' fully aware that there was no proof for it. Gallo and Montagnier published electron micrographs of a few particles which they claimed are a 'retrovirus' and are 'HIV'. But the photographs did not prove the particles were a virus. Virologists Dr Stefan Lanka states: "The rules demonstrating the existence of HIV (and retroviruses in general) were never adhered to by those who devised them nor were they ever validated." (Continuum Vol.4, No.3) 'Retroviruses' (as a source of reverse transcription) have never been proven to exist as biological entities. All 'retroviruses' ('HIV', 'SIV', 'BIV', 'FIV', 'MIV') are hypothetical constructs. 'Retroviruses' are an over-determination of the phenomenon of reverse transcription first discovered in 1970 by Howard Temin whilst studying the Rous Sarcoma Virus. Reverse transcription is a normal process of cells associated with cellular repair mechanisms particularly of the cell membrane. Reverse transcription is not a property unique to hypothetical 'retroviruses' - it also occurs in hepatitis viruses as well as most mammalian and plant cells. There is no Universal gold standard 'HIV' test tp prove 'HIV' positivity. The 'HIV' antibody test does not detect a 'virus' but an assortment of proteins that are non-specific to the hypothetical 'HIV'. The proteins that are used in the 'HIV' test are merely the biological outcome of stressed white blood cells used in the lab. In 'Bio/Technology', June 1993, 'Aids' analyst, Dr Eleni Eleopulos exposed the non-specificity and unreliability of the 'HIV' 'antibody test'. Dr Eleopulos's critique supports the argument for the banning of the misleading 'HIV' tests. There can be no Gold Standard 'HIV' test because there is no Gold Standard 'HIV' isolate. On each continent there are different criteria for 'HIV' positivity and 'Aids' definition. All evidence of 'HIV' positivity must be confirmed by pure culturing of a patient's lymphocytes and detection of whole, sell-free viral particles; so far this has never been achieved. 'HIV' is termed a 'lentivirus' ('slow virus'): lentiviruses are not known to be sexually transmitted. The hypothetical 'HIV' is not sexually transmitted: cell-free viral particles have never been found directly in semen. In 'American Journal of Epidemiology' (Vol. 146, No.4), Nancy S. Padian et al reported: "We estimate that HIV infectivity for male-to-female transmission is low, approximately 0.0009 per contact, and that infectivity for female-to-male transmission is even lower." Moreover, Dr David Ho admits that 99.8 per cent of putative 'HIV particles' are non-infectious; the remaining 0.2 per cent of 'viral particles' , being defective, are not capable of replication. As a transmittable entity, 'HIV' could not survive in nature. This indicates that what we are calling 'HIV' is a misinterpreted, non-transmissible, endogenous epiphenomenon that should never have been classed as a virus. 'HIV' is an artefact of cell-culture invented by Dr Robert Gallo. The phenomena collectively known as 'HIV' are non-specific: reverse transcriptase is non-specific; PCR is non-specific; Viral Load is non- specific. Each property relating to 'HIV' can be shown to pertain to the cells used in co-cultivation experiments. No particle of 'HIV' has ever been obtained pure, free of contaminants; nor has a complete piece of 'HIV' RNA (or the transcribed DNA) ever been proved to exist. Dr John Papadimitriou states: "They have not proven that they actually have detected a unique, exogenous retrovirus. The critical data to support that idea have not been presented. You have to be absolutely certain that what you have detected is unique and exogenous, and a single molecular species....the proper controls have never been done. ('Aids: The failure of contemporary science', Neville Hodgkinson, Fourth Estate, 1996, page 375). Dr Eleopulos and her colleagues argue that the greatest ingle obstacle to understanding and solving 'Aids' is 'HIV'. 'HIV' imprinting has become unconsciously internalised on such a global scale that people will not be able to accept the brute reality that 'HIV' and 'SIV' do not exist. Competing interests: None declared |
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Tony Floyd, Medical Student Newcastle University, Newcastle Australia
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Nancy Padian's article(1) has, yet again, (yawn), been misquoted in an attempt to add credibility to arguments against the prevailing theory on HIV/AIDS. I say 'arguments' because Rasnick publishes with Duesberg and other respondents seem to be supporters of the Dr Eleopulos group. Duesberg is a retrovirologist and has never doubted that HIV exists, he just doesn't think it is a bad thing. If the two groups had more common ground they might carry more weight. But that's another story... From David Rasnick on 8 November 2003: > The fact that mainstream HIV researchers have agreed that it takes on average 1000 unprotected sexual contacts with HIV- positive partners to transmit HIV (36, 41, 42) The reference given as '41' is the very same Padian paper, available here. As has been pointed out before it is entirely invalid to extrapolate the results of this study into some sort of estimate of how many sexual contacts one might need to contract HIV. Reasons include: 1. All participants were aware that they were with a HIV-positive partner. 2. They all new that they were part of a study examining transmission. 3. It (might be) safe to assume that none of the participants wanted to be infected. 4. The group studied are all from a wealthy country which was saturated with AIDS education. 5. Condom use increased substantially during the study period. 6. Anal sex decreased substantially during the study period. 7. The whole world does not live in North Carolina. As you have claimed that HIV researchers have 'agreed' to this figure of a thousand contacts can you please advise which studies make this claim as the ones that you have provided in no way agree on a figure that might be applied to 'unprotected' contacts. From Alexander H Huw on 8 December 2003: > Nancy S. Padian et al reported: "We estimate that HIV infectivity for male-to-female transmission is low, approximately 0.0009 per contact, and that infectivity for female-to-male transmission is even lower." When and where did she publish that? In her paper(1) she did report findings from her Northern Carolina group as:
"Male-to-female transmission was approximately eight-times more efficient than female-to-male transmission and male-to-female per contact infectivity was estimated to be 0.0009"
You might say that only a few words have been changed, however taking numbers that the authors, for obvious reasons, never claimed to be applicable to the rest of the world and giving them new meaning is just a little deceptive don't you think? Such use of 'evidence' has come the attention of other respondents(2):
"The misquoting of journal articles to suit personal hobby horses seems to be a standard tactic in the electronic age."
If you checked your sources a little more carefully rather than parroting eachother you might have a better chance of being noticed in more than an unedited forum.
References:
(1) Padian NS. Shiboski SC. Glass SO. Vittinghoff E. Heterosexual transmission of human immunodeficiency virus (HIV) in northern California: results from a ten-year study. American Journal of Epidemiology. 146(4):350-7, 1997 Aug 15. [Abst ract] (2) Alan Carson. 'Re: JAMA citation.' BMJ Rapid Response. 5th December 2003 Competing interests: None declared |
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Eleni Papadopulos-Eleopulos, Biophysicist Department of Medical Physics, Royal Perth Hospital, Western Australia, 6001, Valendar F Turner, John Papadimitriou, Barry Page, David Causer, Helman Alfonso
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One of the reasons why Ed Rybicki (Rapid response “Re: HIV/AIDS is indeed a colossal catastrophe”, 21st November 2003) did not refute David Rasnick’s arguments (Rapid response “HIV/AIDS is indeed a colossal catastrophe,” 8th November 2003) may be the following: While David Rasnick’s well documented arguments are based on epidemiological evidence, Ed Rybicki is a microbiologist working on HIV vaccines. However, given Ed Rybicki’s credentials, he is extremely well qualified to help us with one of our long standing questions regarding HIV. Would he please tell us whether in 1983 Montagnier discovered HIV? Yes or no? If yes what is the evidence in Montagnier’s paper which proves such a virus exists? If no, who in his view is the discoverer of HIV and what is the evidence which convinces him this is the case? Competing interests: None declared |
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Mark Griffiths, Independant researcher Pierrelatte 26700 (Fr)
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Dear Sir As a layman (HIV positive since 1986) with a minimum amount of medical knowledge, I used to believe that vaccination introduced a small quantity of an infectious agent into our bloodstream in order to stimulate our immunity against that agent. Why have the fundamental, traditional laws of virology disintegrated into Orwellian AIDS-speak to justify the inability of retrovirologists to justify their hypotheses and the resulting ongoing fruitless research? This research has contributed zero benefit to public health, and made a fortune for industry over the last twenty years. If virology was to retain its credibility, a vaccine against HIV/AIDS would have the immunising effect of rendering a person "HIV positive". The arrogance of the current medical paradigm denies the right of the individual to choose (or even be fully informed about) his diagnosis and treatment, and his potentially positive involvement in his own healing process. In any other domain this would be considered a breach of fundamental human rights, but AID$ seems to be a law unto itself. How long will we allow this madness to continue? Yours, not blinded by "AIDS-speak" Competing interests: None declared |
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David R Crowe, President, Alberta Reappraising AIDS Society Box 61037, Kensington PO, Calgary, AB, T2N 4S6, Canada
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Peter Clegg claims that AIDS definitions only vary slightly between countries. This is simply not true. The US AIDS definition (1993) allows someone to be diagnosed with AIDS without any disease, simply on the basis of low CD4 counts (or skewed CD4/CD8 ratios) plus a positive HIV test. In the CDC's 1997 surveillance report, more than 60% of new AIDS diagnoses were in this category. The CDC has not reported this information since then. In Africa, by contrast, and other places where the WHO definition is used, relatively generic symptoms (fever, cough, diarrhea, weight loss) are necessary, but no HIV test! In summary, the 1993 US AIDS definition can be satisfied by test without illness, and the African definition by illness without tests. It is hard for me to comprehend how this can be considered a slight variation. The use of the word AIDS has a very powerful effect on scientists and lay people alike, but unfortunately not enough people know that it can have several very different meanings. Quoting Lewis Carroll's Alice "The question is whether you can make a word mean so many different things". Competing interests: None declared |
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John P Heptonstall, Director of The Morley Acupuncture Clinic and Complementary Therapy Centre Leeds LS27 8EG
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Sir The authors obviously take the facts as given by WHO and UNAIDS verbatim, is that healthy? The AIDS 'debate', when encouraged, is fascinating. In addition to attempting to keep up with the 'debate' I have recently been informed by two excellent articles (bibliography at end) and share points I have deduced with BMJ readers. I welcome correction and answers where appropriate but feel certain there are serious problems with AIDS and HIV statistics as created by WHO and UNAIDS that makes them completely unreliable:- 1. TB can trigger a false positive with the HIV test so how does one differentiate between a person with TB who is not HIV+ and one who actually has HIV; and does this not affect international AIDS statistics as they are dependent on HIV test results? 2. Pregnancy can trigger false positives with HIV tests so how does one differentiate between a pregnant woman with HIV and one without; and does this not affect international AIDS statistics that are almost completely dependent on HIV tests of blood of pregnant women? 3. According to their AIDS statistics, WHO and UNAIDS state that Africa is in the grip of a pandemic of AIDS with over 20,000,000 Africans affected by the plague. The two bodies define AIDS in Africa according to the Bangui Definition - that if one has 2 major and one minor symptom (eg weight loss, chronic diarrhoea with say coughing, then one has AIDS. Certain countries, eg Tanzania,have gone even further and accept one major and one minor symptom (eg. fever with weight loss) as denoting AIDS - and do not use HIV testing to facilitate their statistics. If an African is suffering from malaria, or TB, or dysentery, or SLIM - which are endemic in Africa and cause the same symptoms that WHO and UNAIDS have decided denote AIDS, how does one differentiate between AIDS and these disorders? 4. In Africa, many poor counries have little medicine to treat endemic diseases like TB, malaria, dysentery, SLIM and if AIDS is diagnosed they do not 'waste' their precious stocks of medicines on the 'AIDS' patient suspected to be 'concurrently suffering from' TB or dysentery or malaria or SLIM. How then does one resist the potentially resistible mortality for those Africans who are wrongly diagnosed with AIDS? 5. Less than 50% of Africans have safe drinking water. More than 60% have no sanitation, Most villages have no sewage systems so animal and human faeces abound in drinking water causing the endemic chronic parasitic and bacterial infections that cause diseases that are defined by symptoms also defined by Bangui as AIDS. Is not the Bangui definition irresponsible in Africa? Would not the bangui definition be more responsible if used after Africans had their water and sanitation improved to acceptable standards? 6. In 1999 the UNAIDS Commission recommended African Finance Ministers to redirect billions of dollars from their health infrastructure and rural development into AIDS - condoms, safe sex and deadly drugs - is that not irresponsible when the eradication of AIDS and, more importantly the endemic diseases caused by lack of sound health infrastructure, sanitation, rural development and drugs for endemic diseases, are more urgently needed by Africans? 7. It is said that the WHO and UNAIDS statitsics for AIDS in South Africa relied heavily on HIV testing of blood samples finding 4,000 HIV+ results for pregmant women; it then extrapolated to reach a figure of about 5,000,000 South Africans suffering from AIDS (using the Epimodel in Geneva) including the young, old, men, women and children. The HIV test manufacturers state that pregnancy and those endemic diseases that ravage the females' homeland all create positive HIV test results. Are the WHO/UNAIDS statistics accurate or irresponsibly inaccurate? 8. Figures from WHO/UNAIDS stated there were 2.2 million cumulative AIDS deaths in Uganda, yet the Ugandan Ministry of Health had a total record of only 56,000 deaths. 9. To the end of 2001, official government bodies' figures for cumulative AIDS deaths in the developed world could only account for about 7% of the total 28 million deaths WHO and UNAIDS declared had occurred through AIDS. Apparently Russia could account for only 5% of WHO/UNAIDS alleged figures, India only 2%, and China only 1%. What is going on at WHO and UNAIDS, who or what is responsible for such gross inaccuracies? 10. If WHO and UNAIDS figures are so inaccurate, and create unnecessary fear amongst poor communities that should have other priorities for spending the litte assets they hold, would that not play into the hands of unscrupulous drugs companies that wish to extend HIV testing into these poor countries and acquire those assets through the purchase of very toxic drugs that would be given to poverty stricken people, especially pregnant women and their children, who would know no better - drugs such as Nevirapine, banned in the USA but already being delivered to Africa by drugs companies and that could be foisterd on unsuspecting mothers who have false positive HIV tests or 'flawed' Bangui diagnoses? 11. The media continues to declare that WHO and UNAIDS statistics suggest that Africa is dying of AIDS, that countries are depopulating because of the pandemic, yet many such countries are actually shown as increasing in population. Botswana was said in 1993 to have an estimated population of 1.4 million, and today under 1 million and reducing, yet Botswanas own reports say its population is growing at 2.7% p.a. 12. The Epimodel for Africa estimated 9.6 million cumulative AIDS deaths by 1997 rising to 17 millions by 2000. It estimated 250,000 AIDS deaths in South Africa for 1999. To validate this in an African setting an MRC sponsored team accessed South Africa's death reports and reported in 2001 there had been 339,000 adult deaths in 1998, 375,000 deaths in 1999, and 410,000 deaths in 2000. The MRC conclusion supported the model of a rapidly increasing mortality; but the Epimodel estimated 250,000 AIDS deaths in 1999 - the MRC showed 375,000 deaths from all causes leaving fewer than expected for 'all cause'. A new model was used, ASSA 600, and this yielded a 143,000 AIDS deaths total for 1999 leaving only 232,000 deaths from all other causes. The team suggested that all other causes of death had been in decline since 1985 (despite cholera and malaria epidemics, poverty increase, drug resistant killer diseases flourishing and the state health system reportedly in terminal decline). The MRC report was published in June 2001. ASSA 2000 then replaced ASSA 600 and produced an even lower estimate of 99,000 AIDS deaths for 1999; since ASSA 2000 was scrapped a further estimate lowered the figure by another 10% - so much for WHO/UNAIDS estimate of 250,000! 13. AIDS modelling has declared South African universities rampant with infection with 1 in 4 undergraduates expected to die of AIDS within 10 years. Real samples suggest an on-campus prevalence about 1.1%. South African banks tested 29,000 staff for HIV as models suggested 12% rates. Real tests showed about 3%. Prisons test infections for HIV and the rate in Grahamstown jail was only 2-4%, with only 2 deaths from AIDS in 7 years. Recorded prison rates are about 2.3% yet the media has reported estimates of as much as 60%. 14. The World Bank claimed African teachers to be dying of AIDS faster than being replaced and the BBC reported that 1 in 7 (14%) of Malawian teachers would die in 2002. Bennell, a Health Policy Analyst, found the all causes death rate amongst teachers in Malawi to be under 3%. In Botswana figures appear to be 3 times lower than extimates and in Zimbabwe 4 times lower. 15. If these figures and trends are accurate are WHO and UNAIDS deceiving themselves and the global public; and if so is the worst may be over for Africa in that the pandemic is levelling off or even declining in worst hit areas? 16. If UNAIDS and WHO are so incredibly wrong, why do they persist in the apparent deception - and could it have anything to do with their allegiance to international pharmaceutical giants and 'AIDS industry' bodies? 17. 350 million Africans get malaria each year but do not appear to have the right to anti-malarial treatment. 2 million get TB annually yet AIDS spending is 90 times higher than TB spending and there is little left over for treating pneumonias, cancers, parasitics, bacterials or diabetes. What scientific or political justification could there be for this? Bibliography Johannesburg magazine, The Individualist (July 2003); Africa - Treating Poverty with Toxic Drugs by Liam Scheff The Spectator (London) December 14th 2003; Cover Story; Africa Isn't Dying of AIDS, as told by Rian Malan in Cape Town. Regards John H. Competing interests: None declared |
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Etienne P. de Harven, Emerit.Prof.Univ of Toronto 06530 Saint Cézaire, France, Dr. Christian Fiala
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An apparently missing control experiment on HIV/AIDS It appears that a most crucial, control experiment has been omitted, in 1983, when the team at the Pasteur Institute in Paris published their historical paper on the alleged “isolation” of HIV (LAV) (1). The problem is as follows: Isolation of HIV (LAV) has been claimed on the basis of observations made from complex, mixed cell cultures of different origins, hyperstimulated by PHA and by TCGF. The cultures were supplemented with human lymphocytes isolated from umbilical cord blood, and the paper was illustrated with an excellent electron microcopy (EM) picture showing unquestionably typical retrovirus particles budding from the surface of an infected lymphocyte. This illustrated infected cell was clearly identified by the authors of the paper as a cord blood lymphocyte. However, the authors interpreted this picture as evidence for the infection of these lymphocytes by an exogenous retrovirus, presumably originated from the lymph node of a pre-AIDS patient. More importantly, this interpretation has been one of the key elements leading the authors to claim success in having “isolated” HIV (LAV). However, it was well known, for almost 30 years, that the human is the most striking reservoir of endogenous human retroviruses (HERVs). EM evidence for the presence of retoviruses in human placenta was clearly demonstrated by Sandra Panem in 1978 (2), i.e. 5 years before the Pasteur group published their historical paper (1). The human placenta being very rich in endogenous retroviruses, we have all reasons to believe that lymphocytes from the cord blood are similarly carrying this defective endogenous retrovirus. Moreover, it is well established that human endogenous retroviruses (HERVs) can be forced, under the influence of various growth factors, to express themselves as complete viral particles, Budding on cell surfaces (3). How can we exclude, therefore, that the EM picture published by the Pasteur group in 1983 (1) simply demonstrates the activation of endogenous retroviruses of cord blood lymphocytes, and do not in any way demonstrates an exogenous infection of these lymphocytes by AIDS patient material? Can any BMJ reader help to identify a laboratory where one could perform the following, short, non-expensive, control experiment that is obviously missing? The experiment will be as simple as this: 1) Isolate lymphocytes from human umbilical cord blood, 2) Place these lymphocytes in cell cultures, exposing the cells to exactly the same growth factors (PHA and TCGF) as those used in the 1983 experiments, in absence of any other cellular elements; 3) Prepare these lymphocytes sequentially, for transmission electron microcopy; 4) Search, by EM, for budding retroviral particles on the surface of these cultured lymphocytes. I am personally convinced that if positive results are obtained (i.e. budding retrovirus on stimulated cord blood lymphocytes in the total absence of any AIDS patient material), a profound reappraisal of the 1983 Pasteur paper will appear imperatively necessary. I would be happy to contribute as an advisor and as an electron microscopist, anytime, anywhere. Conflict of interest: None Etienne de Harven, MD Emerit Prof (Pathology) University of Toronto, 06530 Saint Cézaire sur Siagne, France E-mail: <pitou.deharven@wanadoo.fr> References 1)Barré-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vézinet-Brun F, Rouzioux C, Rozenbaum W, Montagnier L. Isolation of a T-lymphotropic retrovirus from a patient at risk for acqueired immune deficiency syndromed (AIDS). Science 220, 20 May 1983, pp 868-871. 2) Panem S. C type virus expression in the placenta. Curr Top Pathol 1979; 66:175-189. 3) Löwer R. et al. The virus in all of us: characteristics and biological significance of endogenous retrovirus sequences<<<; proc Natl Acad Sci USA 1996; 93 : 5177-518 Competing interests: None declared |
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Ed P Rybicki, Professor in Microbiology Univ of Cape Town, Rondebosch 7701, South Africa
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I have chosen not to refute "facts" as put forward by Dr Rasnick, because I have come to the conclusion that debating him is like wading in mud: tiring, unsatisfactory, and eventually a pretty dirty business. The single uncontestable fact is that he clings to the supposed respectability conferred by his FORMER membership of a now-defunct South African Presidential advisory panel, of which none of the orthodox members take any pride in their FORMER association. I know several of these personally, and they are not under the impression that its activities are ongoing. Why Dr Rasnick is, is not clear. Perhaps his personal correspondence with Mr Mbeki bears him out? As for other "facts" concerning HIV that Dr Rasnick keeps promulgating: well, sir, you are an unregenerate denialist, and history will prove it so. If there is any justice, and an "HIV crimes" comission is ever set up, your name will be high on the list - as malign propagandist in chief. Life is too short to have truck with fools, so I will not enter into any further correspondence on this issue. Competing interests: Working on HIV vaccines |
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Eleni Papadopoulos-Eleopulos, Biophyscist Royal Perth Hospital, Western Australia, Valendar F Turner, John Papadimitriou, Barry Page, David Causer, Helman Alfonso, Sam Mhlongo, Todd Miller, Christian Fiala
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Re: An apparently missing control experiment on HIV / AIDS In his rapid response, “An apparently missing control experiment on HIV / AIDS”, 14 March 2004, with respect to Montagnier’s 1983 paper, Etienne de Harven wrote: “…the paper was illustrated with an excellent electron microcopy (EM) picture showing unquestionably typical retrovirus particles budding from the surface of an infected lymphocyte.” The presence of buds on cell surfaces does not prove that the buds represent retrovirus particles. These buds may be nothing else but cellular protrusions resulting from localised contraction of the actin- myosin system induced by the oxidizing agents to which the cell cultures are subjected. (1) That is, although buds are characteristic of retroviral particles, they are not specific. According to Montagnier et al “That this new isolate was a retrovirus was further indicated by its density in a sucrose gradient, which was 1.16…” (2) However, we know now in the material which banded at 1.16gm/ml, the “purified virus”, Montagnier and his colleagues could not find any particles with the “morphology typical of retroviruses”. (3) This means that even if the cell-free particles originated from buds on the cell surface neither the buds nor the cell free particles could have had anything to do with either an endogenous or exogenous retrovirus. Etienne wrote: “It appears that a most crucial, control experiment has been omitted, in 1983, when the team at the Pasteur Institute in Paris published their historical paper on the alleged “isolation” of HIV (LAV) … Can any BMJ reader help to identify a laboratory where one could perform the following, short, non-expensive, control experiment that is obviously missing? The experiment will be as simple as this: 1) Isolate lymphocytes from human umbilical cord blood, 2) Place these lymphocytes in cell cultures, exposing the cells to exactly the same growth factors (PHA and TCGF) as those used in the 1983 experiments, in absence of any other cellular elements; 3) Prepare these lymphocytes sequentially, for transmission electron microcopy; 4) Search, by EM, for budding retroviral particles on the surface of these cultured lymphocytes. I am personally convinced that if positive results are obtained (i.e. budding retrovirus on stimulated cord blood lymphocytes in the total absence of any AIDS patient material), a profound reappraisal of the 1983 Pasteur paper will appear imperatively necessary. I would be happy to contribute as an advisor and as an electron microscopist, anytime, anywhere.” Such an experiment has already been carried out. Budding retrovirus -like particles have been reported in “non-HIV infected” cord blood lymphocytes as well as many other cells used for “HIV isolation”.(4) References 1. Papadopulos-Eleopulos E, Turner VF, Papadimitriou JM, Causer D. (1996). The Isolation of HIV: Has it really been achieved? Continuum 4:1s-24s. www.virusmyth.net/aids/data/epreplypd.htm 2. Barre-Sinoussi F, Chermann JC, Rey F, Nugeyre MT, Chamaret S, Gruest J, Dauguet C, Axler-Blin C, Vezinet-Brun F, Rouzioun C, Rozenbaum W, Montagnier L (1983) Isolation of a T-Lymphotrophic Retrovirus from a patient at Risk for Acquired Immune Deficiency Syndrome (AIDS). Science 220:868-871. 3. Tahi D. (1998). Did Luc Montagnier discover HIV? Text of video interview with Professor Luc Montagnier at the Pasteur Institute July 18th 1997. Continuum 5:30-34. 4. Dourmashkin, R.R., O'Toole, C.M., Bucher, D. and Oxford, J.S. 1991.The presence of budding virus-like particles in human lymphoid cells used for HIV cultivation. p.122. In:Vol. I, Abstracts VII International Conference on AIDS,Florence. Competing interests: None declared |
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Brian T Foley, HIV Researcher Los Alamos National Lab, Los Alamos, NM 87545
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The Perth group wrote:
“… Such an experiment has already been carried out. Budding retrovirus -like particles have been reported in “non-HIV infected” cord blood lymphocytes as well as many other cells used for “HIV isolation”.(4) …” In the interest of fairness, it should be pointed out that the authors of (4) clearly state that the retrovirus-like particles are distinguishable from HIV-1 particles by EM alone (5) and that serological and other molecular methods also readily distinguish them.
In (5) the authors state:
REFERENCES:
4. Dourmashkin, R.R., O'Toole, C.M., Bucher, D. and Oxford, J.S. 1991.
5. Dourmashkin RR, Bucher D, Oxford JS.
Competing interests: None declared |
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