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March 22, 2004 | by  | in Features |
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Alive & Well?

AIDS is big business. The US Government has recently launched a five-year, $15b package to fund research and development into HIV/AIDS prevention and treatment in at risk (developing) countries. Countless other billions are spent each year by pharmaceutical companies in the race to find the next big breakthrough in the battle against the disease. The cause attracts rich and powerful patrons: The Bill and Melinda Gates foundation is one of the major contributors to the UNAIDS initiative. For a time, red ribbons were as de rigueur on the red carpet as bling-bling and hair extensions. Over 20 years on from the discovery of AIDS and then HIV, there is no vaccine, no cure and it’s still regarded as an epidemic. This would suggest that there is an enormous amount about it that is still unknown, yet the average layperson in the developed world, at least, probably knows more about it than any other fatal illness. It’s highly contagious. It’s transmitted via body fluids. HIV positive pregnant women will likely pass it on to their children. Men who have sex with men are at extremely high risk. It’s killing Africa. An HIV positive test result is, for now, a death sentence. HIV causes AIDS.

What if the accepted wisdom is wrong? What if, as a growing number of so-called AIDS dissidents – HIV-positive people, virologists, doctors, journalists, even rock stars – argue, what we think we know about HIV and AIDS is actually entirely off-track? Is the AIDS establishment committing, as the dissidents argue, the biggest (and most expensive) medical blunder in history?

A confession: this feature began as a piece about AIDS dissidents. Preliminary reading suggested that maybe they have a point – and, as a member of the indie media, Salient should look into it. And stir, of course, always stir. The more I read, though, the more I thought I must have been missing something. The bulk of the dissident literature certainly doesn’t read like propaganda – in fact, the Establishment seems needlessly dismissive, writing them off as akin to Holocaust deniers, enough said, without direct argumentation. The rationality of the dissenters, their credentials, was enhanced, not diminished by this kind of reaction. But – a huge sticking point – how could so many people get it so wrong, and why would so many people with only commercial interests mortgage the ranch on something so apparently flawed? Instead, I took a step backward. Despite knowing what everyone who’s done 6th Form Health knows, I knew very little about the history of HIV/AIDS, so set about trying to find out about that. It’s a cool story – theft, corruption, conspiracy theories, mud-slinging and back-stabbing. It’s necessarily incomplete – it originates, after all, a little over 20 years ago, and try writing your life-story in less than 4000 words – but shows that, dissenter or not, a healthy dose of cynicism never goes amiss.

Acquired Immune Deficiency Syndrome (AIDS) was first identified, according to the UNAIDS Q & A (Basic facts about the HIV/AIDS epidemic and its impact), in 1982 in the United States, following a year after “the first cases of unusual immune system failure were identified among gay men.” In the year before Human Immunodeficiency Virus (HIV) was isolated, three modes of transmission were defined – sexual contact, blood transfusion and mother-to-child. Doctors Robert Gallo had been researching retroviruses in the hope that he would discover a viral cause for some types of cancer, when he called a triumphant international press conference with Margaret Heckler, the then- US health and human services secretary. He had, he announced, isolated the retrovirus that causes AIDS. Gallo’s discovery was what would later be known as HIV, and later still, “the AIDS virus”. Not only had he discovered the virus, however, he’d also discovered a test for it. Within 24 hours, banner headlines were touting Gallo as a miracle worker – his discovery the greatest thing since sliced bread spawned penicillin.

Controversy soon followed. Luc Montagnier, of France’s Pasteur Institute (IP), claimed that Gallo had used a blood sample sent by him. Not only that, but according to Christine Maggiore, founder of Alive and Well AIDS Alternatives, Gallo had not yet published any of his research – meaning that the Heckler press conference was peremptory to any kind of examination of the research by his peers, as would usually be expected. Accounts of what took place next vary, but an investigation took place, and in the Report from the Subcommittee on oversight and investigations Committee on Energy and Commerce, highlights showed that

A substantial body of circumstantial evidence assembled and reviewed during the Subcommittee’s investigation shows that at the very inception of their seminal experiments, the Laboratory of Tumor Cell Biology (LTCB) scientists knew or had reason to know that the virus they were working with and claimed as their own was the IP virus… . The Gallo et al. patent was issued in record time… At the time the Gallo et al. patent issued, the IP patent patent application, submitted over four months prior to the submission of the Gallo et al. patent application, had not been touched… The differential handling of two applications for the same invention [the HIV isolate test] has never been satisfactorily explained.

Gallo was not charged with anything criminal, however his reputation was damaged; it has been claimed that he was overlooked for a Nobel prize because of this. He now shares the patent for the initial test with Montaigner of the Pasteur institute. Montaigner has since subscribed to the idea that HIV alone isn’t the cause of AIDS. In 1994, Gallo was exonerated on appeal.

And it seemed that subsequent research bore out Gallo’s findings. The machine was in action and it seemed that the only thing more contagious than the virus itself was hysteria about it. President Clinton was quoted in the Washington Post, April 30, 2000 as saying that the rates of HIV/AIDS in Africa were a “threat to US national security… spurred by US intelligence reports that looked at the pandemic’s broadest consequences… particularly in Africa… [and] projected that a quarter of southern Africa’s population is likely to die of AIDS.” Originally seen as a ‘gay’ disease, HIV developed a stigma that took some time to shake. Misinformation about its level of contagion further fuelled the hysteria: schools refused to accept HIV-positive students for fear they’d pass it on, despite proof very intimate contact was required. The “gay” stigma was pilloried in UK TV show Brass Eye, in a mock-talk show: an HIV-positive guest is introduced as having contracted the virus through an infected blood transfusion. He corrects the host, saying that he actually contracted it from a male sex partner, to which the host replied, “oh, you have the bad AIDS.”

Gay rights groups worldwide took on HIV/AIDS as pet cause, campaigning for rights and education from a very early stage. The Reader’s Companion to American History claims that “AIDS made political mobilization a matter of life and death. With a large majority of the cases striking male homosexuals, the gay community in short order created a host of organizations, such as the Gay Men’s Health Crisis in New York City, to provide services and assistance to those infected. Local and national gay civil rights groups also grew in size and number, as the community sought to increase funding for research and education and to win protection against discrimination. A personal and social tragedy of immense proportions, AIDS paradoxically strengthened the political arm of the gay movement.” The combination of homosexuality, fatal illness and children was a potent one for Hollywood, and a number of movies for big and small screen were made in short order – including And the Band Played On, featuring Alan Alda as Robert Gallo and, most glitteringly, Tom Hanks’ Philadelphia. It’n not just the AIDS establishment that has such glamorous support, however; the Foo Fighters have lent their star power to Alive and Well AIDS Alternatives, holding fund- and awareness-raising concerts for the cause. Nate Mendell (bass); “I grew up in punk bands with a healthy distrust for the government… I think the thing that personally got me involved – I didn’t have any experience with people who were HIV positive – was that basically I was outraged that what seemed to be a fairly straightforward scientific hypothesis against the current hypothesis [about HIV causing AIDS] was being ignored.”

Throughout all of this, the battle to develop pharmaceutical treatments was waging. AZT [STANDS FOR…?], dubbed by Christine Maggiore, founder of Alive and Well, in her book What if Everything You Thought You Knew About AIDS was Wrong? as a “drug waiting for a disease”, was one of the first treatments given to HIV positive patients. Writes Maggiore, “AZT is a chemical compound that was developed – and abandoned – over 30 years ago as a potential chemotherapy treatment for cancer.” It was abandoned due to the adverse side-effects – including but not limited to diarreah, dementia, lymphoma, muscle wasting and T cell depletion, all of which are AIDS-defining illnesses. Advances in treatment have been made, however, on two fronts: they really do seem capable of prolonging life, and they’ve become much cheaper, as evidenced in George W. Bush’s State of the Union address in January of last year, “AIDS can be prevented. Anti-retroviral drugs can extend life for many years. And the cost of those drugs has dropped from $12,000 a year to under $300 a year — which places a tremendous possibility within our grasp. Ladies and gentlemen, seldom has history offered a greater opportunity to do so much for so many.”

Treatment is one of the really divisive issues. While those helming AIDS research are touting the advances in treatment and funding, dissenters like Christine Maggiore claim to have lived without traditional treatment since positive HIV diagnosis in otherwise perfect health. Enter our old friend Dr. Peter Duesberg, virologist. He is seen as one of the leading lights in the dissenters’ cause – he, after all, is a man of science, working in the field of retroviruses, and previous research partner of Dr. Robert Gallo. Duesberg and Maggiore argue that HIV doesn’t cause AIDS – that, in fact, it is the treatment cocktails commonly prescribed to HIV patients that, ironically, bring on immune system deficiency faster. Why?

Well, argue Maggiore and Duesberg, if HIV doesn’t, if fact cause AIDS, there must be some other link from one to the other. An HIV-positive patient is (very simplistically) determined to have progressed to full-blown AIDS when they develop any one of a number of symptoms, diseases or viruses. An HIV positive patient with pneumonia, for example, will now be deemed to have AIDS. An HIV-negative patient with pneumonia only, of course, has pneumonia. AIDS itself isn’t a disease; it’s HIV plus an indicator. Fine. Duesberg also points to differing statistics in African and American/European cases: As at 2000, WHO’s statistics showed that (as written in a letter to Clinton from Mbeki), “In Africa 23 million HIV-positives generate per year 75,000 AIDS patients, ie. 1 AIDS case per 300 HIV-positives. But in the US, 0.9 million HIV-positives now generate per year about 45,000 AIDS cases, ie. 1 AIDS case per 20 HIV positives.” This is a staggering differene – and the difference is, of course, treatment. “This hypothesis”, argues Duesberg (www.duesberg.com),

…offers a simple explanation for the “heterosexual” distribution of AIDS in African people… . Malnutrition, parasitic infections and poor sanitation do not discriminate between the sexes. By contrast, American AIDS could be caused by recreational drugs consumed by millions and anti-HIV drugs prescribed to about 200,000 including 150,000 still health HIV-positives (1998). The non-random, 85%-male epidemiology of American AIDS reflects the male prerogative on hard recreational drugs (heroin, cocaine) and the wide-spread use of drugs as male homosexual stimulants.

Duesberg (whom Gallo claims he can’t think about without “shrieking”) believes that the way to eradicate AIDS is to eliminate hard drug use – clean needle programs miss the point, he argues, although admirable, it is prolonged use of the drugs themselves that lead to opportunistic infections taking hold. Isn’t it sexually transmitted, too? Beyond shadow of a doubt, argue AIDS researchers – though booms in other STIs seem to show that people aren’t really practicins safe sex, although HIV hasn’t risen at the same rate. Studies of sex workers in the States in the early 90s showed that those who used IV drugs. Incedence amongst those who didn’t abuse was significantly lower (Wall Street Journal 17 March 1993).

More recent UN literature, however, points to different sub-groups of HIV, peculiar to specific forms of transmission. Not only do these account for discrepancies among drug- and non-drug-users, but alos between men and women and homo- and heterosexuals. “The genetic variability of HIV poses special problems for HIV diagnosis, treatment and HIV vaccine development”, continues the UNAIDS brief, which would seem to answer a lot of questions, so, according to the UN, does HIV cause AIDS?

Historically, haemophiliacs provided the strongest body of evidence for HIV being the cause of AIDS. The health status of haemophiliacs has been tracked for more than a century, providing important base-line informtionwhich clearly links the advent of HIV infection with the subsequent development of AIDS… . Monkeys that are inoculated with SIV DNA (the simian version of HIV) become infected and develop AIDS… . Laboratory tests show that HIV infects exactly the same type of white blood cells that become depleted in people with AIDS. Drugs that block HIV replication in test tubes have been shown to reduce viral load in people with HIV and delay progression to AIDS.

Moving into the 21st Century, HIV/AIDS has really moved away from being a gay issue, and become the new epidemic of developing nations; in particular, sub-Saharan Africa. Diagnosis of AIDS in Africa, up until very recently, has been sketchy at best. Instead of using blood tests, more often than not, AIDS was diagnosed by symptom: according to World Health Organisation at the end of the 80s, these could include weight loss over 10%, chronic diarrhea for more than a month, fever for more than a month, persistent cough, shingles, chronic or persistent herpes and cryptococcal meningitis. All of these are also symptoms of living in extreme poverty, which is, of course, the biggest killer in developing nations South African President Thabo Mbeki, in the opening address of 13th International AIDS Conference in July 2000, stated, “The world’s biggest killer and the greatest cause of ill health and suffering across the globe, including South Africa, is extreme poverty.” And none of these symptoms would result in an AIDS diagnosis in the western world without a positive HIV blood test result. AIDS dissenters point to steady, and even falling, diagnosed cases in Africa in order to prove that AIDS is not, in fact an epidemic. However, The UN estimates have been revised recently for the former reason: The latest UNAIDS update on Sub-Saharan Africa claimed,“
Figures released in Zimbabwe this year have been interpreted to suggest that national adult HIV prevalence has dropped from the end-2001 estimate of 34% to 25% and that the country is turning its epidemic around. Unfortunately, there appears to be no basis for this view. The new figure represents a statistical correction of the 2001 estimate, which had relied on antenatal data that included a significant proportion of testing irregularities.” This necessity for statistical correction may prove the first point of the dissenters over misdiagnosis, but does explain why numbers are apparently dropping – which pulls the rug out from under the theory that it isn’t an epidemic.

That said; is a $15b dollar plan aimed solely at AIDS research for the developing world really top priority? One of the biggest grant that has been given under this plan so far is of $64 million to the University of Maryland School of Medicine. The grant will be used, according to the Institute of Human Virology (IHV) website,

…by the University of Maryland Institute of Human Virology to provide care, treatment and counselling to people living with AIDS in Africa and other developing countries… . The grant… will enable the consortium to nearly double the delivery of anti-HIV drugs to HIV-infected persons in parts of Africa, the Caribbean and Latin America.

The head of the IHV is none other than Dr Robert Gallo, continuing his battle in the field. The IHV website doesn’t outline what form counselling will take, however the consortium mentioned is a “five-member faith-based consortium, led by Catholic Relief Services.”

Surely, with this kind of funding and expertise behind it, the search for a vaccine mustn’t be far from over? There’s an urban legend that says that the cure for the common cold is being withheld in order to keep the pharmaceuticals in business, so can one be so crass as to imply that the same kind of logic may be slowing the development of a vaccine down? There’s more money in treatment than a vaccine, as reported in Worth magazine in 1996, in an interview with Gallo: “A vaccine would do even more, of course. It would prevent HIV infection. But in the past few years, Bristol-Myers Squibb, Merck, Genentech, and a number of smaller biotech companies have slashed AIDS-vaccine research… worried they’d be forced to sell their vaccines for peanuts in the third world… accelerated the move towards safer bets – which mean therapies, not vaccines.” Projects such as that undertaken at the IHV however, still keep the search for a vaccine pre-eminent.

Have they put their eggs in the wrong basket? Is it possible that so much brainpower, money and time is completely misdirected? Duesberg remains convinced this is so. And he faces a granite wall of brainpower and money, meaning it’s likely that although he retains tenure at Berkley, funding will not be forthcoming any time soon. This, in itself, has to be a bad thing; until a vaccine or cure is discovered, surely no stone should be left unturned, especially one as pre-eminent as he once was?
For some reason, HIV/AIDS seems inextricably tied to money and populism, which would cast a film of doubt over any cause, no matter how worthy. Dissidence or complete faith in the theories mean very little when the reality is still fatal.

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