[11] In their
1988 paper in the British Journal of
Haematology, entitled, 3’-Azido-3’-deoxythymidine
inhibits proliferation in vitro of human haematopoietic progenitor cells,
Dainiak et al reported their
investigation of “the mechanism by which cytopenias develop [i.e.
cell depletion, which is]…a serious, dose limiting toxicity of AZT therapy…”
Observing that “Anaemia [during AZT therapy] appears to be due to bone marrow
suppression [and] nearly one half of patients treated with AZT for
[HIV]-associated disease develop transfusion-dependent anaemia due to bone
marrow depression”, they concluded from their study that “AZT is a potent
inhibitor of haematopoiesis in vitro,
and that erythroid progenitors are particularly sensitive to its action. These
results may explain the marrow hypoplasia that occurs during AZT administration
in vivo.”
[12] AZT
reaches and can destroy foetal bone marrow too. In the May 1998 issue of the
Pediatric Infectious Diseases Journal,
Watson et al at the University of
Rochester Medical Center in New York reported the case of an HIV-negative baby
born to a positive mother who had been treated with a HAART cocktail of AZT,
3TC and a protease inhibitor, suffering “high output congestive heart failure
secondary to profound anemia.” The paediatricians excluded “infection,
nutritional deficiencies, congenital leukemia and congenital red blood cell
aplasia in the child” and considered the “cause of the life-threatening anemia
in our infant…to be in utero erythroid marrow suppression by one or more of the
antiretroviral agents administered to the mother.”
[13] Martin
alleges that “toxicity in most cases is reversible.” This optimistic jive was
flatly contradicted by Mir and Costello just a year after AZT was approved.
They reported their concern in the Lancet
in 1988 that “bone marrow changes in patients on zidovudine seem not to be
readily reversed when the drug is withdrawn. These findings have serious
implications for the use of zidovudine in HIV positive but symptom-free
individuals.”
[14] Writing
in AIDS in 1997, Kelleher et al noted, “Lack of strong evidence
exists for sustained immune reconstitution by current therapies [comprising AZT
and other drugs, and AZT may] unmask silent opportunistic infections.” Not only
can AZT “unmask silent opportunistic infections”, it can exacerbate clinically
conspicuous ones. Havlir and Barnes reported in February 1999 in the New
England Journal of Medicine that
HIV-positive tuberculosis patients treated with [AZT-based] ‘antiretroviral
therapy’ developed “paradoxical worsening of disease…in up to 36 percent of
[them], characterized by fever, worsening chest infiltrates on radiograph, and
peripheral and mediastinal lymphadenopathy…[whereas] only 7 percent of patients
who received antituberculosis therapy but not antiretroviral therapy had
paradoxical reactions.” On 18 September 2000, Reuters released a report Doctors
describe AIDS patients’ medical paradox. It could have been written by a
deadpan standup comedian: “Some AIDS
patients whose ravaged immune systems have been boosted by taking cocktails of
powerful medicines [not even the manufacturers claim this] have been suffering
a surprising increased susceptibility to infections, researchers said on
Monday. Scientists at Thomas Jefferson University in Philadelphia labeled as a
medical paradox their discovery that AIDS patients whose conditions had been
improving [according to surrogate markers, not actual health] thanks to
treatment with drug cocktails had been coming under attack from opportunistic
infections that ordinarily should not have been much of a problem. In a study
published [in September] in the journal Annals
of Internal Medicine, the researchers said the sometimes-fatal ‘immune
reconstitution syndrome’ stemmed from an inflammatory reaction by the newly
strengthened immune system to bacteria or viruses already present in the
patient. The researchers said the causes of the syndrome were unknown. The
researchers said they were startled by the fact that the infections were
affecting patients who had been benefiting from so-called highly active
antiretroviral therapy (HAART) involving the use of combinations of powerful
anti-HIV (human immunodeficiency virus) medicines. The doctors described
learning of patients with a typical infection suffered by those with HIV -
mycobacterium avium infection… ‘No one is exactly sure what to do against this
syndrome yet,’ DeSimone said... More than a year ago, researchers began to see
patients with HIV, the virus that causes AIDS, developing infections at times
that caught them off guard. The Jefferson doctors said they decided to search
the medical literature and speak with colleagues to learn whether others had
seen similar developments. They said doctors at other hospitals mentioned
infections such as CMV retinitis, an AIDS-related blindness...” A subject to
which we will return later. In the case of children, apart from being poisonous
to their blood cells, McKinney et al
found that AZT didn’t alleviate their secondary infections. In their paper
A multicenter trial of oral zidovudine in
children with advanced human immunodeficiency virus disease published
in the New England Journal of Medicine in 1991, they reported, “Although
no control group was available for direct comparison, the improvement in the
children in this study closely paralleled the observations in controlled
studies of adults receiving zidovudine… Children treated with zidovudine
continued to have bacterial and opportunistic infections.” Of the eighty eight
children in the study, “One or more episodes of hematologic toxicity occurred
in 54 children (61 percent) and neutropenia (neutrophil count, <0.75X10^9
per liter) in 42 (48 percent).” So why prescribe it?
[15] Martin’s
happy claim that AZT cocktails afford “long-lasting beneficial effects” was
refuted in November 1997, when Lemp et al
reported in the Journal of Acquired
Immune Deficiency Syndrome and Human Retrovirology that with HAART (Highly
Active Antiretroviral Therapy), “the treatment benefit is temporary and confers
no long-term survival advantages.” Obviously. How could it possibly? Would you
nurse your wilting pot-plant with weed-killer? In the clever age, whatever
happened to common sense? At last some lay folk are waking up; Steven Gendin
wrote an article in the January 1999 issue of the AIDS-drugs-promoting rag POZ,
candidly entitled If the virus doesn’t get you, the drugs you
take will. He’s seen enough of his friends fade away on AZT to know. In
July 2000 he went himself at the age of 34, dead of heart failure - which we
will examine below.
[16] That AZT
is entirely ineffective as a therapy was borne out clearly by the large-scale
Concorde trials in Europe, reported by the Coordinating Committee in the
Lancet in April 1994: “A total of
172…participants died [169 while taking AZT, 3 while on placebo] …The results
of Concorde do not encourage the early use of zidovudine in symptom-free
HIV-infected adults.” Embarrassingly
for Wellcome, and disastrously for its share prices, the fabulous results of
the chaotic American study that had preceded FDA approval of AZT couldn’t be
reproduced. The drug was found to have no clinical benefits. Predictably,
“Representatives of the Wellcome Foundation who were also members of the
Coordinating Committee…declined to endorse this report” and insisted on
gerrymandering the reach of its grim conclusions. Even so, the adverse implications
of the trial for AZT could not be avoided. One glaring finding was that AZT’s
“severe side-effects”, even in cases of patients on low doses quashed any
apparent therapeutic value as suggested by raised CD4 cell-counts - about which
the Committee noted that the results “also call into question the uncritical
use of CD4 cell counts as a surrogate endpoint for assessment of benefit from
long-term antiretroviral therapy.” Emphasising the worthlessness of CD4 cell
counting in Annals of Internal Medicine
in 1996, Fleming and DeMets described it as being “as uninformative [an
indication of immune status] as a toss of a coin.” Not that anyone took any
notice. Today, patients terrified by their doctors’ mournful announcements of
their low cell counts - still taken as a signal of collapsing health and
imminent demise - are urged to start with ‘antiretrovirals’ like AZT, following
which the prophesy will be faithfully fulfilled. For example, Harrigan et al
reported in AIDS in July 2000 that “Triple therapy for
HIV-infected patients… do not have any unique effects on CD4 cell counts
independent of reductions in plasma viral load”, according to Reuters;
“The data appear to contrast
with recent evidence suggesting that such regimens are able to maintain an immunologic
benefit even after plasma viral rebound… The team examined the correlation
between CD4 cell counts and plasma viral load over 52 weeks using data from 3
randomized clinical trials… The studies compared dual nucleoside therapy with
triple combination therapy that included a protease inhibitor, with or without
a nonnucleoside reverse transcriptase inhibitor. The data presented in these
randomized double-blinded trials suggest that the specific antiretroviral
regimen used neither increases nor decreases the strength of the correlation
between the change in CD4 cell count and the change in plasma viral load.” CD4
cell counting continues to the present day, as if it means anything. And the
evidence mounts against multi-drug therapy, a topic deferred for a later look.
[17]
Notwithstanding the dark clouds looming over AZT at the end of the Concorde
trials, Wellcome released ebullient press statements quite at variance with the
negative findings that the trial overseers were later to report in the
Lancet. But the company could hardly endorse a finding and broadcast to the
world that a flagship money-spinner didn’t live up to its billing. To obfuscate
the drug’s demonstrated therapeutic irrelevance, and keep a good thing going
for the company’s bottom line, Wellcome pulled a sharp move. To protect its
delinquent product, it immediately threw its support behind a new gimmick
called ‘combination therapy’. Henceforth the dose was slashed in half or more,
and AZT was to be marketed as a drug combined with others - all equally
ineffective on their own, as if to mix two or three toxic duds would be to
conjure them miraculously into a medicinal marvel. It’s a treatment approach
that is now falling to pieces, as we’ll see when we review the recent
literature about HAART cocktails later on. But before we leave the subject of
mixing your drinks, just in is a paper by Havlir et al in the July 2000 issue
of the Journal of Infectious Diseases warning for heaven’s sake don’t take
AZT and 4TC together. Reuters Health
reported: “Combination treatment with zidovudine and stavudine results in worse
outcome than treatment with stavudine alone, according to the results of a
48-week multicenter study…The researchers conclude that stavudine and
zidovudine should not be used together in any antiretroviral regimen.” Now you
tell us.
[18] In fact, not only was
AZT found to be useless at the end of the Concorde trials, it turned out to be
positively harmful: Phillips et al
reported in a letter to the New England
Journal of Medicine in March 1997 that “Extended follow-up of patients in
one (AZT) trial, the Concorde study, has shown a significantly increased risk
of death among the patients treated early.” In another paper in that year,
Impact of treatment changes on the
interpretation of the Concorde trial, White et al highlighted in AIDS that
“participants of open-label ZDV [AZT] still had four to five times the
incidence of ARC/AIDS/death of participants on blinded therapy [of which approximately
half were on AZT and half on placebo] … The unadjusted hazard of ARC/AIDS/death
was 4.6 times higher for participants [in the deferred group] who had received
ZDV...after adjustment for latest CD4 this became 1.6 … There was a suggestion
of a benefit in terms of [slower] progression to ARC, AIDS or death [with AZT],
no effect on progression to AIDS or death, and a suggestion of an increase in
mortality.” Walker summed it up in his essay HIV, AZT, big science & clinical
failure, “…the Concorde trial
results showed conclusively that asymptomatic antibody-positive individuals who
took AZT, died more quickly and in greater number than those simply affected by
AIDS-defining illnesses.” As Marginal
structural models to estimate the causal effect of zidovudine on the survival
of HIV-positive men in the September 2000 issue of Epidemiology by Hernan et al
suggested too: “Our analysis included the
2,178 men who attended at least one visit between visits 5 and 21 while HIV positive,
and who did not have an
AIDS-defining illness and were not on antiretroviral therapy at the first eligible visit.
By the end of the follow-up (media duration-69
months), 1,296 men had initiated zidovudine treatment and 750 had died”,
from which the researchers drew the
dazzling conclusion of “a detrimental
effect of zidovudine.”
[19] The
negative Concorde trial results were entirely on par with those of an earlier
French trial. In 1988 in the Lancet,
Dournon et al had published a study
of AZT, conducted at the Claude Bernard Hospital in France. It was wider and
longer than the American Fischl trial that had preceded FDA approval, and at
the end of it the researchers found AZT to be “disappointing.” They noted, “The
bone marrow toxicity of AZT and the frequent need for other drugs with
haematological toxicity meant that the scheduled AZT regimen could be
maintained in only a few patients… by six months, these values [i.e. initial
modulation of p24 antigen levels] had returned to their pretreatment levels and
several opportunistic infections, malignancies and deaths occurred” - by nine
months, about a third dead, another third very sick. But most significantly for
the idea that AZT exerted an anti-HIV effect, “full-dose AZT for 2 months did
not eliminate antigenemia in patients with pretreatment p24 levels of 200 U/ml
or higher...[so] in AIDS and ARC patients, the rationale for adhering to
high-dose regimens of AZT, which in many instances heads to toxicity and
interruption of treatment, seems questionable.” It bears emphasising that the
dose was 200mg every four hours, the standard officially recommended dose, and
the same as the dose given during the pre-approval Fischl trial in the US, yet
the reported outcome was completely different.
[20] It is
worth quoting at length from the Claude Bernard Hospital AZT trial report
because it is very illuminating: “AZT was started at full dose in 260 patients,
64 with ARC and 196 with AIDS. In 58 of these patients, AZT had to be stopped
at least once for a minimum of 7 days. In 142 other patients, dosage was
reduced by half because of leucopenia (79), leucopenia and (32), anaemia (20),
rash (3), vomiting (3), headaches and insomnia (2), myalgia (2), or hepatitis
(1). 3 patients reduced the dose with no medical reason. Later on, progression
of toxicity led to suspension of AZT (for at least 7 days) in 85 of the 142
patients whose treatment had been reduced to half dose. Thus AZT was stopped at
least once in 143 (55%) patients who began the full-dose regimen. Because of
their initial haematological status 105 (28.8%%) patients were treated from the
start with half-dose AZT – toxicity led to cessation of treatment in 71 (67.6%)
cases.”
[21] One
can’t help wondering whether the fact that the French trial was performed
independently, and beyond the reach and control of the drug’s manufacturer,
might not have had something to do with it. Indeed, Professor David Warrell, UK
chairman of the Concorde trials, commented on Wellcome’s efforts to skew the
final Concorde report as follows: “What we learnt I suppose, and we shouldn’t
have been surprised, is that when the wrong result is produced for a famous and
flourishing company on which a great deal of financial expectation rests, the
company’s representatives are going to be under a great deal of pressure, and
the interpretation of those results is going to be ‘stressed’; there is going
to be an attempt perhaps to blunt the message, to modify, to make a more mellow
conclusion from results which seem to be inescapable in their implications.”
[22] Martin’s
absurd statement that AZT and 3TC “improves quality of life” is just stale
advertising propaganda quoted mindlessly from some glossy ad. The trouble that
doctors have with patient ‘non-compliance’ is notorious, due to the
intolerable, excruciating ‘side effects’ that most people experience on these
drugs. Numerous papers have detailed these problems, most recently for example,
Nicholson: Managing side-effects:
practical advice on dealing with side-effects of antiretroviral therapies in AIDS Treatment Update, October 1998. In
1994, Lenderking et al of the Harvard
School of Public Health, reporting their Evaluation
of the Quality of Life Associated With Zidovudine Treatment in Asymptomatic
Human Immunodeficiency Virus Infection in the New England Journal of
Medicine, found “a reduction in the quality of life due to severe side
effects of therapy” and the “severe adverse events” it caused, which were
“life-threatening in some cases.” Without intended irony, AIDS expert Dr. Lori
Swick pointed out in The Toronto Star
in September 1999 that “One of the major barriers to effectively treating HIV
is that most people do not feel sick at the time they are offered anti-HIV
medications. In fact, it is only after starting the medications that they begin
to feel sick.” Well, of course. Jerry Cade MD, who serves on the US
Presidential Advisory Council on HIV/AIDS agrees. In the April 2000 edition of A+U, an AIDS magazine in the US, he
stated, “In the face of extreme drug side effects, some patients … are becoming
extremely ill from the medications.” On 12 July 2000 Business Today quoted AIDS don Anthony Fauci, director of the US
National Institute for Allergies and Infectious Diseases telling the 13th International AIDS Conference in
Durban about the desirability of interrupting the ‘antiretroviral’ treatment
with ‘drug holidays’: “The patients in the study are absolutely delighted to
spend half their time off therapy… Clearly, even our
most vigorous efforts to eradicate (the virus) had been unsuccessful.” The report
went on, “Most patients have a difficult time staying on their anti-HIV drugs because the
effect wears off or the side effects become intolerable. Side effects can
include everything from fever to headaches, from nausea to anemia. Many
patients therefore cannot take the drugs... A separate study reported Tuesday
by Scott Holmberg of the U.S. Centers for Disease Control and Prevention shows
how intolerable treatments can be.” GlaxoWellcome however would prefer you sick
without a break until you go. Its PRODUCT INFORMATION release for Combivir (AZT
and 3TC) states, “Patients should be advised of the importance of taking
COMBIVIR as it is prescribed” i.e. “One COMBIVIR tablet…twice a day.”
[23] The
truth of the matter is that AZT makes you feel like you’re dying. That’s
because on AZT you are. How can a deadly cell-toxin conceivably make you feel
better as it finishes you, by stopping your cells from dividing, by ending the
vital process that distinguishes living things from dead things? Not for
nothing does AZT come with a skull and cross-bones label when packaged for
laboratory use.
[24] These
are some of AZT’s ‘side effects’ listed by its manufacturer: Body as a Whole:
abdominal pain, back pain, body odor, chest pain, chills, edema of the lip,
fever, flu syndrome, hyperalgesia; Cardiovascular: syncope, vasodilation;
Gastrointestinal: bleeding gums, constipation, diarrhea, dysphagia, edema of
the tongue, eructation, flatulence, mouth ulcer, rectal hemorrhage; Haemic and
Lymphatic: lymphadenopathy; Musculoskeletal: arthralgia, muscle spasm, tremor,
twitch; Nervous: anxiety, confusion, depression, dizziness, emotional lability,
loss of mental acuity, nervousness, paresthesia, somnolence, vertigo;
Respiratory: cough, dyspnea, epistaxis, hoarseness, pharyngitis, rhinitis, sinusitis;
Skin: acne, changes in skin and nail pigmentation, pruritus, rash, sweat,
urticaria; Special senses: amblyopia, hearing loss, photophobia, taste
perversion; Urogenital: dysuria, polyuria, urinary frequency, urinary
hesitancy.
[25] A
typical encounter with “A world of antiretroviral experience” promised children
in an AZT advertisement in the Lancet
in 1991 was described in an article by Gayle Melvin, KIDS WITH AIDS,
run in several newspapers in the US and Canada in
September 1998: “Robert Swanson’s medicines came with horrible side effects:
nausea, diarrhea and blinding headaches… Robert would secretly skip a dose of
medicine. ‘I’d find his pills all over the place, in his room, in the dirty
clothes’, Britten says… ‘When you think of medicine, you think of something
that makes you better, but I don’t feel better when I take it,’ Robert says.
‘I’d rather feel good and let the virus take over than feel bad and take the
medicine.’ …Tina [takes] AZT,…ddC and Viracept, a protease inhibitor…three times
a day. Then she waits to get sick. ‘My head will start to hurt all over, like a
pounding. I get dizzy. Sometimes I throw up,’ she says in her sweet, girlish
voice. She gets sick every time? ‘Every time’, says Tina… As they go through
their teens, these children face [the] challenges [of] taking responsibility
for their…often debilitating medical regimen.”
[26] Gay playwright Larry Kramer, founder of prominent
AIDS-activist group ACT-UP, was interviewed on WebMD on 7
January 2000. As he made plain, he’s not opposed in
principle to drug treatment for AIDS diseases; on the contrary he said, “I have
felt it…important, … to concentrate all my energy on fighting for a cure,
fighting for drugs.” He had many revealing observations from the ground about
current therapies, mostly AZT-based ‘cocktails’: “I think, for those of us who
follow the literature, the medical literature…what’s appearing more and more,
is terribly frightening reports that the proteases, the cocktails simply are
not working in a larger and larger percentage of people, and that these new
drugs that are coming out right, left, and centre have such horrendous side
effects that people simply are beginning to refuse to take them…We’re finding
out, for instance, that 50 percent of people who take certain drugs die from
liver disease rather than AIDS, because the drugs are so harsh on the
liver… unfortunately, …most of the
activists, the AIDS activists, who speak for us now are so in the pockets of
the bureaucracy of the drug companies …, that they have become almost fascist
in ramming their treatment notions down the rest of us. The research that is
done today is pretty much dictated by a small handful of pea brains called
Treatment Action Group, TAG, which has a stranglehold on what is researched, what
the drug companies release, how it’s tested, and … the guidelines [for] all of
this poison… we really must start putting pressure on the pharmaceutical
companies to make us drugs that don’t have such horrible side effects... And
more and more people I know are refusing to take drugs at all, which is very
interesting. They’d rather just not feel that sick. …And the other thing that
nobody pays any attention to is that we
simply do not have any data - sufficient data - to know which of these drugs
works and in which combination. The drug company makes the drug, unleashes it
on the world, goes on to merrily develop another poison without continuing to
test the stuff that’s out there. There is no database that is worth anything…
If after only two years, the combination therapies are beginning to make people
so sick and kill them, how are you supposed to take them for the rest of your
life? Get real… I said to a friend of mine, David Sanford, who’s editor of the
Wall Street Journal, who has AIDS, and
who just feels so awful from all of these drugs, and I said ‘why don’t you get
out there and say I feel awful from all these drugs?’ …I think it’s very
interesting that I am hearing about more and more patients who are simply
stopping taking the medicine. They’re just too uncomfortable.” Also
participating in the interview was Dr. Richard Marlink, senior research
director and lecturer at the Department of Immunology and Infectious Diseases
at the Harvard School of Public Health, and executive director of the Harvard AIDS
Institute. He heartily agreed with Kramer’s concern that “the fact that that
database does not exist anywhere” and thought it was “a national crime.”
[27] The extreme liver toxicity of AZT mentioned by
Kramer has long been observed, and it has recently been formally acknowledged
again. In 1989, in Annals of Internal
Medicine, Dubin et al found Zidovudine-induced hepatotixicity: “We
report a patient who experienced acute cholestatic hepatitis on initial
exposure to and rechallenge with zidovudine and, as a result, was unable to
receive further therapy with the drug... Seven days [after starting AZT
therapy] the patient presented with a 2-day history of intermittent fevers and
abdominal discomfort... Seven days [after re-starting AZT therapy once the initial
symptoms resolved] the patient again experienced fever, right upper quadrant
pain, nausea, and headache... One month later [after discontinuing AZT] the
liver function tests had almost completely returned to normal and remained
without significant abnormalities.” In 1990, during a stint at Mount Sinai
School of Medicine, Professor Allen Arieff reported several cases of fatal
lactic acidosis among patients treated with AZT. Reports of AZT-generated liver
disease were also fielded by the National Institutes of Health. The numerous
cases turned up by FDA epidemiologist Joel Freiman led to the FDA demanding
that Burroughs Wellcome issue an advisory to leading infectious disease
specialists in the US about the danger that AZT treatment posed to the liver. Which
it did in 1993. It went unheeded.
Perhaps because the AZT PRODUCT INFORMATION advisory still says, “There
are insufficient data to recommend dose adjustment of Retrovir in patients with
impaired hepatic function.”
[28] On 19 November 1999 Reuters Health reported that “Liver
disease has become the leading cause of death among HIV patients at a
Massachusetts hospital, [according to] a report issued on Friday...[by] Dr.
Barbara McGovern, a professor at Tufts University School of Medicine and a
member of staff at Lemuel Shattuck Hospital in Jamaica Plains, Mass. The
findings were reported…at the annual meeting of the Infectious Diseases Society
of America in Philadelphia. McGovern said HIV patients who take a powerful
combination of AIDS drugs called highly active antiretroviral therapy (HAART)
were at particular risk because of the drug’s potential toxicity to the liver.
One-third of HIV patients with underlying liver disease at Lemuel Shattuck have
had to stop taking HAART.” In the same month, in their paper HIV Treatment-Associated Hepatitis,
Orenstein and LeGall-Salmon reported in The
AIDS Reader that “Severe hepatitis has been reported with all of the
currently available classes of antiretroviral agents.”
[29] In a case report
published in August 2000 in Infections in
Medicine entitled Lactic Acidosis
Secondary to Nucleoside Analog Antiretroviral Therapy, Khouri and Cushing explain why drugs in the AZT class hammer the
liver: “There are several reports of lactic acidosis and microvesicular
steatosis-associated nucleoside analog toxicity in HIV-infected patients… The
patients were treated with zidovudine and had a high mortality rate… Seven
reports have described the syndrome of lactic acidosis in 25 patients with
HIV/AIDS… Of the total, 21 were receiving treatment with zidovudine, and 1 was
receiving treatment with stavudine, lamivudine, and indinavir. Sixteen (64%) of
the patients were female, and 18 (72%) died… The nucleoside analog
antiretroviral agents…inhibit mitochondrial DNA (mtDNA) polymerase in cell
culture…. Zalcitabine, stavudine, zidovudine, and didanosine all have an effect
on mtDNA synthesis… Inhibition of mtDNA can lead to a variety of metabolic
abnormalities. These are largely the result of a derangement in pyruvate
metabolism. After formation by glycolysis, pyruvate is metabolized in the
mitochondria by pyruvate dehydrogenase (PDH) to acetyl coenzyme A (CoA).
Pyruvate may be reduced to lactate by lactate dehydrogenase, and it may also be
used in gluconeogenesis… Inhibition of mtDNA causes a disorder of oxidative
phosphorylation by making the mitochondrial respiratory chain dysfunctional and
unable to break down acetyl CoA. This dysfunction shifts pyruvate metabolism
toward the other pathways, reduction to lactate and gluconeogenesis. The lactate
cannot be cleared as rapidly as it is being produced, and the resultant excess
causes an acidosis. The increased gluconeogenesis causes hyperglycemia. Even
though the inhibition of polymerase g makes the respiratory chain
dysfunctional, PDH is fully functional and makes acetyl CoA. The overproduction
of acetyl CoA, without utilization in the respiratory chain complex, pushes it
out of the mitochondria and into the cytoplasm, where it serves as a substrate
for fat production… Inability to metabolize acetyl CoA also leads to increased
circulating levels of the ketones acetoacetate and b hydroxybutarate… Suggested
mechanism and manifestations of mitochondrial dysfunction. (A) The nucleoside
analog antiretroviral agents inhibit mitochondrial DNA (mtDNA) polymerase g in
cell culture. Inhibition of mtDNA makes the mitochondrial respiratory chain
dysfunctional and unable to break down acetyl coenzyme A (CoA). This shifts
pyruvate metabolism toward the other pathways, reduction to lactate and
gluconeogenesis. The lactate cannot be cleared as rapidly as it is produced and
the resultant excess causes an acidosis. (B) The increase of pyruvate leads to
increased gluconeogenesis in the liver, resulting in secondary diabetes
mellitus. The gluconeogenesis stimulates insulin production. (C) The
overproduction of acetyl CoA without utilization in the respiratory chain
complex pushes it out of the mitochondria to the cytoplasm, where it serves as
a substrate for fat production. (D) The overproduction of lactate causes lactic
acidosis. The gluconeogenesis causes the secondary diabetes mellitus and
hyperinsulinemia, the hyperinsulinemia causes insulin resistance, and fat
synthesis causes fatty liver and weight gain…. The predicted clinical
manifestations of mitochondrial dysfunction are fatigue from decreased levels
of adenosine triphosphate production, lactic acidosis, ketoacidosis, secondary
diabetes mellitus, and fatty liver and weight gain caused by hyperglycemia.”
[30] As for
the fabled power to prevent pregnant women transmitting HIV to their foetuses
that Martin claims for AZT, Bennet warned in Mandatory testing of pregnant
women and newborns: a necessary evil? in AIDS/STD Health Promotion
Exchange 1998
that “At present, data regarding the effects of ZDV (AZT) use on vertical
transmission rates are inconclusive and incomplete. In addition, the long-term
effects of ZDV use during pregnancy and after birth on the woman and any
resulting child are yet to be discovered. The possibility has not yet been
ruled out that this ‘risk-reducing’ measure may not be effective and may prove
detrimental to the health of both mother and child.”
[31]
Bennet’s caveat has moved from the hypothetical to the tragically real. In
February 1999, French researcher Stephane Blanche announced at the Sixth
Conference on Retroviruses and Opportunistic Infections that the drug had
apparently killed two babies in an AZT trial that he and colleagues were
conducting. Both had fallen sick at four months and had died of mitochondrial
dysfunction and neurological defects - conditions ordinarily very rare. In
September 1999, in his research team’s paper in the Lancet entitled Persistent
mitochondrial dysfunction and perinatal exposure to antiretroviral nucleoside
analogues, he reported: “We analysed observations of a trial of tolerance
of combined zidovudine and lamivudine and preliminary results of a continuing
retrospective analysis of clinical and biological symptoms of mitochondrial
dysfunction in children born to HIV-1-infected women in France.... Eight
children had mitochondrial dysfunction. Five, of whom two died, presented with
delayed neurological symptoms (epilepsy, massive cortical necrosis, cortical
blindness, spastic tetraplegia, cardiomyopathy and muscle weakness) and three
were symptom-free but had severe biological or neurological abnormalities. Four
of these children had been exposed to combined zidovudine and lamivudine, and
four to zidovudine alone. No child was infected with HIV-1... Our findings
support the hypothesis of a link between mitochondrial dysfunction and the
perinatal administration of prophylactic nucleoside analogues… Further
assessment of the toxic effects of these drugs is required.” On the same theme,
in the same issue of the Lancet,
Dutch researchers Brinkman et al
published a paper recording their view that AZT-class drugs “are much more
toxic than we considered previously.” Discussing the body-wasting
characteristic of AZT-treated patients, they point out that “The layer of
fat-storing cells directly beneath the skin, which wastes away…is loaded with
mitochondria… [O]ther common side effects of [AZT and like drugs are] nerve and
muscle damage, pancreatitis and decreased production of blood cells… all
resemble conditions caused by inherited mitochondrial diseases.” In July 1999,
ahead of publication of Blanche et al’s
report, the Committee on Safety of Medicines in the United Kingdom issued a
warning to doctors “about the risk of mitochondrial dysfunction in infants born
to HIV infected mothers treated with zidovudine (AZT) to prevent vertical
transmission” according to the AIDS information service, www.aidsmap.com: “The warning comes in
advance of the publication of data from a French study in which it was
discovered that 8 out of approximately 200 infants developed mitochondrial
dysfunction following exposure to zidovudine, with or without 3TC treatment,
for the prevention of vertical transmission of HIV infection.” And without
giving further details, on 3 February 2000 Laurie Garrett reported in Newsday,
“But two babies have died
recently in the United States as a result of AZT-induced destruction of their
mitochondria, vital components of all human cells....” Nonetheless, “surprising
to outside observers was Mbeki’s decision to deny the use of AZT, which is very
cheap, to block the transmission of the virus from mother to baby even though
the drug was offered at a dramatically discounted rate.”
[32]
Blanche’s hypothesis that AZT - a well-established mitochondrial poison in
adults - damaged mitochondria in utero
found support in Gerschenson et al’s
paper in May 2000 in AIDS Research and
Human Retroviruses, reporting Fetal
mitochondrial heart and skeletal muscle damage in Erythrocebus patas monkeys
exposed in utero to 3'-azido-3'-deoxythymidine: “3’-azido-3’-deoxythymidine
(AZT) is given to pregnant women positive for the human immunodeficiency virus
type 1 (HIV-1) to reduce maternal-fetal viral transmission. To explore fetal
mitochondrial consequences of this exposure, pregnant Erythrocebus patas
monkeys were given daily doses of 1.5 mg (21% of the human daily dose) and 6.0
mg (86% of the human daily dose) of AZT/kg body weight (bw), for the second
half of gestation. At term, electron microscopy of fetal cardiac and skeletal
muscle showed abnormal and disrupted sarcomeres with myofibrillar loss. Some
abnormally shaped mitochondria with disrupted cristae were observed in skeletal
muscle myocytes. Oxidative phosphorylation (OXPHOS) enzyme assays showed
dose-dependent alterations. At the human-equivalent dose of AZT (6 mg of AZT/kg
bw), there was an approximately 85% decrease in the specific activity of NADH
dehydrogenase (complex I) and three- to sixfold increases in specific activities
of succinate dehydrogenase (complex II) and cytochrome-c oxidase (complex IV).
Furthermore, a dose-dependent depletion of mitochondrial DNA levels was
observed in both tissues. The data demonstrate that transplacental AZT exposure
causes cardiac and skeletal muscle mitochondrial myopathy in the patas monkey
fetus.”
[33] American researchers
(Culnane et al), who in January 1999
had claimed in the Journal of the
American Medical Association that AZT appeared to be safe for babies, were
incredulous when Blanche dropped his conference bombshell. Which is odd,
because a month earlier a paper in AIDS
by Lorenzi et al at Hopital Cantonal Universitaire in Geneva
reported that “Following combination antiretroviral therapy administered during
pregnancy, most HIV-positive mothers and about half of their children developed
one or more adverse events.” Of thirty babies, “the most common adverse event
was prematurity (ten infants), followed by anaemia (eight). The investigators
also noted two cases of cutaneous angioma, two cases of cryptorchidism, and one
case of transient hepatitis. Two infants…developed… intracerebral
hemorrhage…[and one,]…extrahepatic biliary atresia.”
[34] None of this is really
surprising since as early as 1990, Gillet et
al had reported in the Journal of
Gynecology, Obstetrics, and Biological Reproduction that “concentrations of
[AZT] in the liquor and in the fetal blood [of six aborted human foetuses] were
higher or equaled those found in the maternal blood.” They reiterated
accordingly, “The drug remains contra-indicated in pregnancy.” Not least
because the FDA categorises AZT as a ‘C’-class drug for safety in pregnancy.
With such drugs, it warns, “Safety in human pregnancy has not been determined,
animal studies are either positive for fetal risk or have not been conducted,
and the drug should not be used unless the potential benefit outweighs the
potential risk to the fetus.” Stahlmann and Klug concurred in Antiviral Agents: Nucleoside and
Non-nucleoside Analogues in Kavlock and Dastron’s text, Drug Toxicity in Embryonic Development.
Advances in Understanding Mechanaisms of Birth defects: Mechanisting
Understanding of Human Development Toxicants: “Sufficient data regarding
the safety of zidovidine in human pregnancy are not available.”
[35] In their paper
published in Mutation Research in
1997, Genotoxicity and Mitochondrial
Damage in Human Lymphocyte Cells Chronically Exposed to AZT, Argawal and
Olivero reported that “AZT induces significant toxic effects in humans exposed
to therapeutic doses… Cytogenetic observations on H9-AZT cells showed an
increase in chromosomal aberrations and nuclear fragmentation when compared
with unexposed H9 cells [and] the mechanisms of AZT induced cytotoxicity in
bone marrow of the patients chronically exposed to the drug in vivo may involve both chromosomal and
mitochondrial DNA damage.” This might explain Kumar et al’s 1994 report in the Journal
of Acquired Immune Deficiency Syndrome and Human Retrovirology of a
shocking number of therapeutic and spontaneous abortions, and, in the case of
live births, a ten per cent
abnormality rate among one hundred and four cases of pregnant women treated
with AZT in a hospital in India. The grotesque birth defects included holes in
the chest, abnormal indentations at the base of the spine, misplaced ears,
mis-shapen faces, heart defects, extra digits and albinism. Such birth defects
are not unknown among Western children exposed to AZT in the womb either;
interviewed in Zenger’s magazine in
September 1999, Mary Caffrey, a nurse in the Paediatric Division of the
University of San Diego Medical Center, said reassuringly about AZT-generated
birth defects, “I know we’ve seen some webbed fingers...but these birth defects
are cosmetic and don’t interfere with life.” The almost trebled birth defect
rate in the state of New York among babies exposed to AZT in the womb was
reported by Newschaffer et al in July
2000 in the Journal of the Acquired
Immune Deficiency Syndrome. The epidemiologists researched Prenatal Zidovudine Use and Congenital
Anomalies in a Medicaid Population “in 1932 liveborn deliveries from 1993
to 1996 to HIV-infected women in the state of New York (NYS), U.S.A. Prevalence
of anomalies in the cohort was compared with that of a general NYS population.
Within the cohort, adjusted odds of any anomaly were compared by receipt of ZDV
and by trimester of first prescription.” They found that “The adjusted
prevalence of any anomaly in the study cohort was 2.76 times greater than in
the general population … Children of study women who were prescribed ZDV had
increased adjusted odds of any anomaly… Children of HIV-infected women in this
cohort had a greater prevalence of major anomalies than did the general NYS
population...” Doesn’t the doctor’s Hippocratic promise not to administer
poison apply anymore?
[36] The
danger for developing foetuses posed by the administration of AZT to pregnant
mothers was underscored in 1997 by Ha et
al in the Journal of Acquired Immune
Deficiency Syndrome and Human Retrovirology in their paper entitled Fetal, infant, and maternal toxicity of
zidovudine (AZT) administered throughout pregnancy in Macaca nemestrina.
The researchers reported, “The AZT animals [Macaque monkeys given AZT during
pregnancy] developed an asymptomatic macrocytic anemia, but hematologic
parameters returned to normal when AZT was discontinued. Total leukocyte count
decreased during pregnancy and was further affected by AZT administration.
AZT-exposed infants were mildly anemic at birth. AZT caused deficits in growth,
rooting and snouting reflexes, and the ability to fixate and follow near
stimuli visually.” The latter indications of neurological damage were
anticipated in their 1994 paper in the same journal, Fetal toxicity of zidovudine in Macaca nemestrina: preliminary
observations. They found that “AZT-exposed infants took three times as many
sessions (6) as controls (2) to meet criterion on Black-White Learning, a
simple discrimination task (and were)…significantly [worse in locating] the
reward…” That’s not all they found either: “Postnatal weight increase was
significantly lower in AZT-exposed infants… Hemoglobin dropped significantly in
the AZT-treated animals after treatment began and remained low until the end of
the study... Platelet counts increased significantly in AZT-treated animals
during the treatment period but returned to control levels before the end of
the study... The mechanism for the elevation of platelet count in AZT-treated
animals is unknown… The hematological toxicities reported here are consistent
with those seen in 500 mg/day AZT-treated humans.” Incredibly, Connor et al in their piece (discussed in my
first essay) Reduction of Maternal-Infant
Transmission of Human Immunodeficiency Virus Type 1 with Zidovudine Treatment,
the pitiful albeit hugely popular paper in the New England Journal of Medicine in 1994 propounding the
administration of AZT to pregnant women, rely on Ha et al’s just-mentioned
1994 monkey research report for the comforting conclusion, “Based on these
findings, we predict that there would be no significant toxic effects of
prenatal AZT exposure (100 mg/dose; 500 mg/day) in humans.” In the light of all
that was already known about the acute toxicity of AZT, and it would be
reinforced by later studies, what better illustration of Erasmus’s foresight in
the 16th century that the dullest, most ignorant and incautious
doctors would become the superstars of the AIDS age, and that for their
experiments on pregnant women with cell-poisons they’d be not abjured but celebrated.
On trial, no doubt, they would defend their science in radical ideological
terms like the doctors at Nuremberg. The evil they perceived called for
ruthless measures to root out, and in such struggles conventional civilised
restraints on medical experiments on humans fall by the way.
[37] AZT is
as poisonous to children as it is to the unborn: In a study in the US, designed
by Dr. Janet Englwood, and sponsored by both the National Institute of
Allergies and Infectious Diseases and the National Institute of Child Health
and Human Development, eight hundred and thirty nine HIV-positive children were
divided into three groups and treated with AZT, ddI and a combination of both
respectively. The ‘AZT alone’ wing of the study had to be called off abruptly
in February 1995 due to the “more rapid rates of…bleeding and biochemical
abnormalities” exhibited by the children in this group. For the reason, here’s
a clue. In 1997, Benbrick et al
reported a study by researchers at several French institutions in the Journal of Neurological Science;
comparing AZT with other similar nucleoside analogue drugs used in AIDS
treatment, they found that although “all [such drugs] exert cytotoxic effects
on human muscle cells and induce functional alterations of mitochondria…AZT
seemed to be the most potent inhibitor of cell proliferation.”
[38] Consonant with these
findings, in 1997 in the journal Clinical
Infectious Diseases, Heresi et al
reported fungal infestations (PCP) which developed in the lungs of two
HIV-negative babies, born healthy, whose mothers had been treated with AZT
followed by the babies themselves for six weeks. No mystery about it. Under the
entry ‘Retrovir’ (AZT’s trade name), The
Physician’s Desk Reference hints
delicately, “It was often difficult (in AZT clinical trials) to distinguish
adverse events possibly associated with administration of Retrovir from
underlying signs of HIV disease or intercurrent illnesses.” In similar terms,
the 16th edition of the manual USP
DI: Drug Information for the Health Care Professional published in 1996 by
the United States Pharmacopeial Convention states that “it is often difficult
to differentiate between the manifestations of HIV infection [again presumed]
and the manifestations of zidovudine. In addition, very little placebo
controlled data is available to assess this difference.” To put a point on it,
AZT itself can cause AIDS-defining illnesses. Its critics have been saying so
for years. What else is one to make of Buchbinder et al’s finding reported in AIDS
in 1994 that “Only 38% of the HLP (healthy long-term (>10 years)
positives) had ever used zidovudine or other nucleoside analogues, compared
with 94% of the progressors”? Or Washington University’s Assistant Professor of
Medicine Dr Carl Fichtenbaum’s observation about Mycobacterium avium complex
disease in his article I Hear You
Knockin’ in the magazine Research
Initiative Treatment Action: “Mycobacterium avium complex disease is one of
the most common OI’s [opportunistic infections] in persons with advanced HIV
disease. It has been observed in 15 to 40% of persons with HIV infection. The
incidence of MAC began rising in 1987 in persons with AIDS. From 1981 to 1987,
5.3% of persons with AIDS reported to the CDC had MAC disease. Of note, the
incidence increased from 5.7% in 1985-86 to 23.3% in 1989-90. Thus, MAC disease
has become one of the most frequent OI events occurring in individuals with
CD4+ lymphocyte counts <50 cells/mm3.” Funny how the disease incidence
suddenly ballooned coincidentally with the introduction of AZT as an AIDS drug
in 1987.
[39] In a
remarkable illustration of how AIDS doctors miss the grisly evidence of the
iatrogenic cause of their patients’ disease right in front of their eyes,
Swanson et al published a report in AIDS in 1990 entitled
Factors influencing outcome of treatment
with zidovudine of patients with AIDS in Australia: “Zidovudine was
reasonably well tolerated in this study... 27% [remained] on full dose at the
end of the first year of therapy. The full daily dose (1.2 g) was received by
68 patients (24%) for the entire duration of their time on therapy. Of these
full-dose patients, six died within 6 weeks of commencing therapy...172
patients (56%) developed a new AIDS-defining condition during therapy; 130
patients [42%] developed the condition more than 6 weeks after commencing
zidovudine therapy... Anemia was the most frequently reported adverse
experience during zidovudine therapy. Transfusions were reported necessary for
155 patients (50%) while on zidovudine, 91 patients (representing 29% of the
total) required transfusions on more than one occasion.” With a similar
detached Josef Mengele tone, in Prolonged
zidovudine therapy in patients with AIDS and advanced AIDS-related complex,
Fischl et al reported a year earlier
in the Journal of the American Medical
Association, “58% of all subjects with AIDS and AIDS-related complex
receiving zidovudine experienced granulocytopenia of grade 3 or higher...
Serious anemia occurred in 32% of all subjects receiving zidovudine...and could
be typically managed by dose attenuation, temporary dose interruption of
zidovudine therapy and/or red blood cell transfusions... 12% of subjects...had
an episode of thrombocytopenia after the initiation of zidovudine therapy...
Ten patients had liver enzyme levels elevated...and were managed with dose
attenuations or interruptions of zidovudine therapy... One report of a grand
mal seizure, two events associated
with cardiac dysfunction, and five reports of myopathy were the only new
serious potentially drug-related adverse events reported during extended
periods of zidovudine administration.”
[40] In the June 1999 issue
of the New England Journal of Medicine,
Learmont et al reported the
interesting case of eight “transfusion recipients…infected with…HIV-1…from a
single donor before 1985… Since then, two subjects died of causes unrelated to
HIV-1 infection. The [cause of] death of one other subject, in 1987 [is
indeterminate, and the five other] recipients are still asymptomatic 14 to 18
years after infection and have not received antiretroviral therapy.” Wonder of
wonders. Likewise, in the July 1999 issue
of the Journal of Medical
Virology, Candotti et al’s study
of sixty eight ‘long term non-progressors’ mentioned coincidentally that none
were on “antiretroviral therapy”. This tallies with the observation of prominent
AIDS researcher Dr Jay Levy, Professor
of Medicine at the University of California at San Francisco, in the
Lancet in 1998 that “long-term survivors of HIV” have all avoided
‘antiretrovirals’. Similarly Dr
Donald Abrams, Professor of Medicine and director of the AIDS program at San
Francisco General Hospital, noticed in 1996: “I have a large population of
people who have chosen not to take any antiretrovirals... I’ve been following
them since the very beginning... They’ve watched all of their friends go on the
antiviral bandwagon and die.” In the same year and in the next, two papers in
the Journal of Infectious Diseases
took a formal look at the curious relationship between keeping off ‘antiretroviral
therapy’ and staying alive. Hogervorst et al noted that “None of the LTAs [long term asymptomatics]
received any antiviral drugs during the study; however, 3 [of 6] rapid
progressors…were treated with zidovudine…[and] a rapid progressor was treated
with didanosine during the study.” Montefiori et al found similarly: “LTNPs [Long-term non-progressors] were
defined as having documented HIV-1 infection for >7 years, CD4 cell counts
of >600 cells/cubic mm, and no symtpoms related to HIV-1 infection. With the
exception of [two of nineteen] patients, no patients had ever received
antiretroviral therapy.”
[41] In 1997, The
Canadian Pharmaceutical Association warned in its Compendium of Pharmaceuticals, “The long-term consequences of
in-utero and infant exposure to zidovudine are unknown. The long-term effects
of early or short-term use of zidovudine in pregnant women are also unknown.”
Likewise, the US Centers for Disease Control’s April 1998 Guidelines for the Use of Antiretroviral Agents in Pediatric HIV
Infection cautioned, “Data from clinical trials that address the
effectiveness of antiretroviral therapy in asymptomatic infants and children
with normal immune function are not available… The theoretical problems with
early therapy include the potential for short- and long-term adverse effects,
particularly for drugs being administered to infants aged <6 months, for
whom information on pharmacokinetics, drug dosing, and safety is limited…[and]
clinical trial data documenting therapeutic benefit from [antiretroviral
therapy] are not available.”
[42] However, in his paper
in AIDS in May 1999, Rapid disease progression in HIV-1
perinatally infected children born to mothers receiving zidovudine monotherapy
during pregnancy, Professor de Martino, Coordinator of the Italian Register
of HIV Infected Children at the Department of Paediatrics, University of
Florence in Italy reported that “Comparison of HIV-1-infected children whose
mothers were treated with ZDV with children whose mothers were not treated
showed that the former [AZT treated] group had a higher probability of
developing severe disease (57.3%…versus 37.2%)…or severe immune suppression
(53.9%…versus 37.5%…) and a lower survival [rate] (72.2%…versus 81.0%…).” De
Martino’s findings accorded with a report in 1996 by the American National
Institute of Child Health and Human Development regarding the clinical outcome
of AZT treatment of HIV-positive babies: “In contrast with anecdotal clinical
observations and other studies indicating that zidovudine favorably influences
weight-growth rates, our analysis suggests the opposite [and] our findings
suggest that the widely held view that antiretroviral treatment improves growth
in children with HIV disease needs further study.” In June 2000, De Souza et al published consistent findings in AIDS concerning the Effect of prenatal zidovudine on disease progression in perinatally
HIV-1-infected infants. Their objective was to “determine the influence of
prenatal zidovudine (ZDV) prophylaxis on the course of HIV- 1 infection in
children by comparing the clinical outcome of infants born to HIV-
1-seropositive mothers who did versus those who did not receive ZDV during
pregnancy. METHODS: Medical records of HIV-1-seropositive mothers and their
infants were reviewed retrospectively. Participants were divided according to
maternal ZDV use: no ZDV (n = 152); ZDV (n = 139). The main outcome measure was
rapid disease progression (RPD) in the infant, defined as occurrence of a
category C disease or AIDS-related death before 18 months of age. RESULTS: HIV
vertical transmission rates were significantly different (no ZDV versus ZDV: 22.3% versus 12.2%; p =
.034). Among infected infants, the RPD rate was 29.4% in the no ZDV group
compared with 70.6% in the ZDV group (p = .012), and prematurity was
significantly associated with a higher risk of RPD (p = .027). CONCLUSIONS: The
rate of RPD was significantly higher among perinatally infected infants born to
HIV-infected mothers treated with ZDV than among infected infants born to untreated
mothers…” The following month, in the July 2000 issue of the Journal of Infectious Diseases, Kuhn et al reported likewise in their study of 325 HIV-positive children
born between 1986 and 1997 until death or diagnosis with AIDS: Disease progression and
early viral dynamics in human immunodeficiency virus-infected children exposed
to zidovudine during prenatal and perinatal periods. Their findings were
summarised by Reuters Health: “Among
infected children who did not receive ART before AIDS diagnosis, 44% developed
AIDS or died before age 12 months when they were exposed to prenatal or
perinatal zidovudine. However, among HIV-infected infants not exposed to
zidovudine prophylaxis, rate of death or progression to AIDS was only 24%…
Zidovudine exposure before birth or perinatally appears to accelerate disease
progression in HIV-infected infants, but this can be counteracted by early
treatment with multidrug antiretroviral therapy (ART).” Blind to her own findings, and like De
Martino, Blanche, De Souza and pals, all AZT adherents to the end, Kuhn bubbled
to the reporter that AZT is “obviously and absolutely the primary thing that
must be done” to prevent ‘HIV transmission’ to infants. As long as you follow
up with more metabolic poisons: “The data showed that those receiving ART
subsequent to zidovudine prophylaxis were in fact not compromised in any way.”
She speculated that “more rapid disease progression in infants who become
infected despite zidovudine prophylaxis may be due to an as-yet-unidentified
factor in mothers.” As if AZT itself isn’t enough to do the trick. Karen Emmons
reported in similar vein in her jolly piece in the San Francisco Examiner on 31 May 1999, Thailand wins a round against HIV: “Of the children who were born
HIV-positive in Bangkok in the past four years and received the combination
drug treatment [AZT and ddI]…one-fourth died in their first year, about 33
percent by their second year, 40 percent by age 3, and then the mortality
tapered off.” This is a medical victory? On these data, a critical journalist
might have reported an iatrogenic drug disaster.
[43] That’s just what some observers think AIDS in the US
largely to have been, and if one looks at the CDC’s AIDS mortality figures read
against the frequency of AZT use there, it’s not hard to see why. AIDS deaths
trebled between 1988 and 1989 with the recommendation that AZT be given to
asymptomatic HIV-positives; they rose steadily by 1994/5 to fifteen times what
they had been prior to the introduction of AZT as an AIDS drug in 1986/7, and
then fell precipitously - by 1997 to less than half of the 1994/5 death rate
following the slashing of the recommended dose by two thirds, and the
abandonment of AZT-monotherapy in favour of ‘combination therapy’, still toxic
but not as immediately so. At the first meeting of President Mbeki’s
International AIDS Advisory Panel of orthodox and dissident AIDS experts
convened in Pretoria over 6 and 7 May 2000, Dr. Claus Koehnlein, a German physician
on the panel, told journalist Celia Farber, “I remember vividly the early
years, and seeing those AZT patients, and they just had no bone marrow left and
that was it …we killed a whole generation of AIDS patients with AZT. Especially
in the early high doses of 1200 and 1500 milligrams. That was just murder.” On
3 February 2000, in an article Experts
Warn Against Using AZT On Pregnant Women, the Inter Press Service reported
him making similar points at an AIDS conference in New Delhi, India: “Since AZT
can directly cause several of the 30 AIDS-indicator diseases which form the
basis for AIDS diagnoses in the U.S, it logically follows that AZT can cause
AIDS when administered to an asymptomatic HIV-positive individual... In his
experience, most HIV-positive patients who were placed on AZT rapidly suffered
immune-deficiency and developed symptoms which were commonly ascribed to AIDS.
And most of the cases he knew of resulted in death. Koehnlein described AZT as
a ‘highly toxic and worthless drug approved by the U.S Food and Drug
Administration on the basis of fraudulent research and which continues to be
promoted in spite of being responsible for tens of thousands of deaths’.” In
fact there was no argument about it when during the AIDS Advisory Panel’s deliberations
at the first meeting another panelist, pharmaceutical biochemist Dr David
Rasnick, said that AZT had “killed a lot of people.” He reported to our
amazement during a tea break, “That was quite openly stated and nobody
disagreed with it. I would put the figure at least tens of thousands killed, at
the doses they were giving people in the early years.” Pharmacologist Dr Andrew
Herxheimer, Emeritus Fellow of the Cochrane Centre in the UK and WHO advisor on
essential drugs for developing countries, was on the panel too, invited for his
expertise on drug toxicity. He told medical documentary producer Joan Shenton,
“I think zidovudine was never really evaluated properly and that its efficacy
has never been proved, but its toxicity certainly is important. And I think it
has killed a lot of people. Especially at the high doses. I personally think it
not worth using alone or in combination at all.” The peculiar part of it is
that having been found to be too poisonous and ineffective as a monotherapy for
adults by 1994, AZT should thereafter be commended as such for babies in utero. For people in ‘developing
countries’ like South Africa at any rate: On 30 January 1998, the CDC advised
in its Morbidity and Mortality Weekly
Report that “when considering treatment of pregnant women with HIV
infection, antiviral monotherapy is now considered suboptimal for treatment;
combination drug therapy is the current standard of care.” About which we’ll
chat in a moment.
[44] One would think that
this mountain of toxicity data would give pause to doctors plying the drug on
pregnant women, but apparently not in the debased scientific atmosphere of the
AIDS era. One wonders whether the First Precept of the Nuremberg Code -
informed consent - formulated after the Nazi medical experience, is ever
observed with such dangerous experimental treatment. Any bets on whether these
women are told, for instance, of Olivero et
al’s report in 1997 in the Journal of
Acquired Immune Deficiency Syndrome and Human Retrovirology bluntly headed AZT is a Genotoxic Transplacental Carcinogen
in Animal Models? The researchers reported that “In newborn monkeys and
mice, AZT was incorporated into DNA of many fetal tissues… AZT appears to be a moderately-strong
transplacental carcinogen… [and in] adult mice, lifetime AZT administration
induces vaginal tumors at a 10-20% incidence.” Or of the same researchers’
other paper in 1997 in the Journal of the
National Cancer Institute entitled Transplacental
effects of 3’-azido-2’,3’-dideoxythymidine: tumorigenicity in mice and
genotoxicity in mice and monkeys? In the light of earlier rodent studies
which found AZT “to be carcinogenic in adult mice after lifetime oral
administration”, the research team, all scientists with the US National Cancer
Institute, were concerned to assess “the transplacental
tumorigenic and genotoxic effects of AZT in the offspring of…mice and…monkeys
given AZT orally during pregnancy.” Pregnant mice and monkeys were given AZT in
the second halves of their gestational terms. After exposure to the drug in the
womb, the offspring of these animals were not further treated. By one year of
age, the mice exposed to AZT in utero “exhibited statistically significant,
dose-dependent increases in tumor incidence and tumor multiplicity in the
lungs, liver, and female reproductive organs. AZT incorporation into nuclear
and mitochondrial DNA was detected in multiple organs of transplacentally
exposed mice and monkeys. Shorter chromosomal telomeres were detected in liver
and brain tissues from most AZT-exposed newborn mice but not in tissues from
fetal monkeys.” The researchers concluded, “AZT is genotoxic in fetal mice and
monkeys and is a moderately strong transplacental carcinogen in mice examined
at 1 year of age. Careful long-term follow-up of AZT-exposed children would
seem to be appropriate.” Since “AZT is unequivocally a transplacental genotoxin
and carcinogen [and] given transplacentally to mice, benzopyrene produced lung
and liver tumour multiplicities similar to those observed [with AZT]”, the researchers
recorded their concern that “the current practice of treating HIV-positive
women and their infants with high doses of AZT could increase cancer risk in
the drug-exposed children when they reach young adulthood or middle age.”
[45] Following the
publication of these findings, GlaxoWellcome’s lawyers raced to hedge the
company against legal claims arising from the development of cancers in such
children, by amending its PRODUCT INFORMATION sheet under the section PRECAUTIONS: Information for Patients:
Carcinogenesis, Mutagenesis, Impairment of Fertility. On 4 March 1998, to
the sentence “The long-term consequences of in utero and infant exposure to
Retrovir are unknown” was added the phrase “including the possible risk of
cancer.” And the Olivero studies were deemed ominous enough to warrant mention
in a substantial new paragraph.
[46] But as AIDS journalist
Laurie Garrett reported in Newsday on
3 February 2000 (apparently quoting Kevin De Cock of the US Centres for Disease
Control), “Nobody is keeping track of the thousands of women and babies who
have received AZT or nevirapine to see what - if any - side effects might turn
up in the HIV-negative among them years after taking the drugs.”
[47] Nor does it seem very
likely that HIV-positive pregnant women will be told of Olivero et al’s
paper in AIDS in January 1999,
reporting the research of a major collaborative investigation by several
institutions in the US, overseen by the National Cancer Institute. In view of
the 1997 animal research findings mentioned above, the researchers were
concerned to establish whether their observations applied to humans, that is,
whether AZT administered to HIV-positive pregnant women was incorporated into
their DNA and that of their babies. It was found that it was. The ramifications
of this for the potential human carcinogenicity of AZT were conveyed in the
researchers’ recommendation that “the biologic significance of ZDV-DNA damage
and potential subsequent events, such as mutagenicity, should be further
investigated in large cohorts of HIV-positive individuals [because]…these data
raise the possibility that the presence of extensive ZDV incorporation into
human DNA may be cumulative, with potential long-term consequences such as
mutagenicity and tumorigenicity.” At the 1st National AIDS
Malignancy Conference held in the US in 1997, Olivero emphasised that
“pound-for-pound” the doses of AZT they gave to the animals were close to doses
given to HIV-positive pregnant women - in fact the monkeys were given less.
[48] And it
sure would be surprising were these women - advised to go on a bracing ‘short
course’ of AZT treatment - to be told about the findings reported in Mutation Research in July 1999: 3’-azido-3’-deoxythymidine transplacental
perfusion kinetics and DNA incorporation in normal human placentas in similar
terms perfused with AZT by Olivero and Poirier of the Laboratory of
Cellular Carcinogenesis and Tumor Promotion, US National Cancer Institute, and
Parikka and Vahakangas of the Department of Pharmacology and Toxicology,
University of Oulu, Finland. Concerned because “transplacental exposure studies
demonstrated that AZT is a moderate to strong transplacental carcinogen in mice
[and] the consequences of transplacental AZT exposure to the fetus remain
unknown”, the researchers investigated “the extent and kinetics of AZT transfer
across the human placenta.” They reported, “Since AZT crosses the human
placenta and becomes rapidly incorporated [within 2 hours of AZT perfusion]
into DNA of placental tissue in a dose-dependent fashion, [this suggests] that
even short exposures to this drug might induce fetal genotoxicity… In previous
studies AZT has been shown to produce both large-scale DNA damage and point
mutations. Skin tumors induced in mice by transplacental AZT initiation and
subsequent topical promotion had mutations in Ha-ras Exon I codons 12 and 13,
but these mutations were not observed in liver and lung tumors from mice given
the same exposure. The fact that the recommended treatment involves AZT use for
the last 6 months of pregnancy, suggest that human fetuses may also sustain
AZT-DNA damage… the consequences of any fetal exposure to a nucleoside analog,
in utero, remain unknown and a long-term
follow up of children prenatally exposed seems to be appropriate.” It certainly
would - in the light of Poirer et al’s new paper currently in press for
publication in the Journal of Acquired
Immune Deficiency Syndrome and Human Retrovirology in 2000:
Incorporation of 3’-azido-3’-deoxythymidine
(AZT) into fetal DNA, and fetal tissue distribution of drug, after infusion of
pregnant late-term rhesus macaques with a human- equivalent AZT dose.
And Diwan et al’s report in Toxic
Applied Pharmacology (Vol. 15) in 1999: Multiorgan
transplacental and neonatal carcinogenicity of 3’-azido-3’-dideoxythymidine in
mice.
[49]
Protagonists for the supply of AZT to HIV-positive pregnant women base their
fervent case on the finding that the babies of these women given AZT are less likely
to be born HIV-positive than those of mothers not so treated. In the popular
view, this evinces successful AZT interdiction of HIV transmission from mother
to child (on the fallacious assumption that the mere presence of antibodies
invariably signifies an active rather than a defeated infection). But since the
CDC reported in its Morbidity and
Mortality Weekly Report on 30 January 1998 that AZT causes “only a
minimal…reduction in maternal and antenatal HIV/RNA copy number”, i.e.
the ‘viral load’ in HIV-positive mothers, reduced levels of ‘HIV antibodies’
reportedly observed in the blood of infants exposed to AZT in utero
are better and more obviously explained in terms of AZT’s
broad cellular toxicity: In common with all chemotherapeutic agents, AZT is
particularly deadly to rapidly dividing cells like lymphocytes - which generate
antibodies. By inhibiting lymphocyte replication in mothers and their foetuses
or neonates, AZT reduces antibody production generally, thus giving rise to a
lower number of reactive ‘HIV antibody test kit’ results among neonates exposed
to AZT in the womb or after birth. As Separation Scientific’s manual for its DB
HIV Blot 2.2 antibody test tells us, “infants may test positive for HIV-1 due
to passive transfer of maternal antibodies which may persist for several
months” so anxiously testing them after birth with HIV antibody test kits is
perfectly futile. And you can’t properly use PCR tests ‘to test for the virus
itself’ as one sometimes hears, because the manual for the only such test
licensed by the FDA for use in clinical practice, the Roche Amplicor HIV-1
Monitor Test (for measuring‘viral load’) warns that it is “not intended to be
used as a screening test for HIV-1 or as a diagnostic test to confirm the
presence of HIV-1 infection.” As for
so-called qualitative PCR HIV tests, they are so notoriously non-specific that
Roche admonishes that its Amplicor HIV-1 Test, a ‘qualitative assay’, is “For
research use only. Not for use in diagnostic procedures.” In the Practising
Midwife in 1999, Chrystie
confirmed in an article Screening of
pregnant women: the case against that “Those laboratories which undertake
HIV screening and confirmation assays understand fully the technical problems
associated with PCR and other amplification assays and it is precisely for
those reasons that PCR is NOT used as a confirmatory assay (as discussions with
any competent virologist would have informed them).” Rich et al reported Misdiagnosis
of HIV infection by HIV-1 plasma viral load testing: A case series in Annals
of Internal Medicine in 1999:
“Plasma viral [RNA] load tests were neither developed nor evaluated for the
diagnosis of HIV infection…Their performance in patients who are not infected
with HIV is unknown.” The text-book excuse for this is contamination, but An
AIDS Case in the appendices to this
debate reveals much more challenging problems with ‘HIV-PCR testing’. One day
it will occur to some bright young doctor to test babies born to HIV-negative
mothers for ‘HIV antibodies’. Or a group of spinsters in a poor rural reserve.
Or underfed prepubescent children there. He or she is likely to be in for a
shock at how many are HIV-positive. And that might serve as a spur to a long
overdue re-examination of the real meaning of reactive ‘HIV antibody’ test
results. But that’s a scandal on which we had best not get started in this
discussion of AZT. Whatever ‘HIV-positive’ actually signifies, one can only
wonder at doctors’ eagerness to feed this poison to HIV-positive pregnant women
in the light of Semba et al’s study of the effects of Vitamin A
administration to such women, published in 1993 in Archives of Internal
Medicine. Mothers given Vitamin A had less
HIV-positive babies than the control group, and the results were better than
those achieved in the Connor AZT study, ACTG 076 published a year later in
the New England Journal of Medicine. But
then Western medicine has always been partial to the violent option. Or maybe
it’s just that there’s no role for doctors or money to be made from providing
food-aid and vitamins to the poor.
[50] The dangers of AZT for babies and neonates have
fallen on deaf ears at the Perinatal AIDS Unit of the Chris Hani-Baragwanath
Hospital in Johannesburg. Dr James McIntyre dismissed this critique thus: “I
have read the piece with interest, although little agreement with your
arguments (sic).” Which I suppose is
why he felt no compunction about pitching for AZT (for a pleasing fee no doubt)
from the pulpit of an awesome temple - pillars and everything - set up by
GlaxoWellcome in the centre of the Exhibition Hall at the Durban AIDS
Conference on 10 July 2000. Despite Mbeki’s cautionary message about AZT in
October 1999, paediatrician Dr David Johnson gushed on television two months
later, “When used for mother to child transmission, it’s an absolute lifesaver.
It saves, has the potential to save millions and millions of babies.” But Dr
Glenda Gray, director of the unit, takes the cake. She told the Washington
Post on 16 May 2000, “If they’re
not going to provide us with AZT then the best thing that the government can do
is to ask us to strangle them all at birth.” The kind of remark one might
expect from someone whom I watched covering her mouth and giggling like a
school-girl, uncomprehending as Professor Manu Kothari from Seth Gordhandas
Sunderdas Medical College, King Edward Memorial Hospital, Mumbai, India addressed the second meeting of the AIDS Advisory
Panel and bestowed it with insights of the most rousing profundity.
[51] We seem to be face to face with a replay of the
Diethylstilbestrol debacle, but far worse. A synthetic oestrogen-like hormone,
DES was heartily prescribed to pregnant women “for routine prophylaxis in ALL
pregnancies... 96 per cent live delivery with desPLEX in one series of 1200
patients - bigger and stronger babies, too. No gastric or other side effects
with desPLEX - in either high or low dosage.” So puffed a typical advertisement
in a medical journal in 1957:
To quote Nora Cody speaking
in Bethesda, US at the National DES
Research Conference in July 1999, “30 years ago today DES was still being
prescribed to pregnant women in this country and, indeed, around the world. By
1969 scientists had studied this scientific substance for over three decades.
Over and over, they had found cancer in laboratory animals. In the famous
Dieckmann study in 1953, they had discovered that DES was completely
ineffective in preventing miscarriage and in fact more harmful than a placebo.
Yet for all of this scientific inquiry, there was a fundamental failure, and
DES showed us the terrible potential for human tragedy from scientific
discovery.” Hundreds of thousands of people were exposed to DES in utero,
leading to a variety of
adverse health consequences especially among women. These included an elevated
risk of developing clear cell adenocarcinoma of the vagina or cervix (a rare
cancer virtually non-existent in non-exposed women of similar age), an
increased incidence of structural changes in their reproductive organs (virilisation),
an increased risk for infertility, and a higher risk for ectopic pregnancy,
miscarriage, and preterm labor and delivery. New York attorney Ron Benjamin,
specialising in toxic torts and defective drug liability, told me over the
telephone in May 2000 that he had recently pulled $13m from a jury in a DES
injury case he had handled. I predict an avalanche of claims against
GlaxoWellcome arising from AZT poisoning that will prove as uncontainable as
the run of asbestosis claims which nearly brought down Lloyds of London – as
reported in Time in February 2000.
[52] Reporting to the US Surgeon General in 1970, the Ad
Hoc Committee on the Evaluation of Low Levels of Environmental Chemical
Carcinogens recommended that “Any substance which is shown conclusively to
cause tumors in animals should be considered carcinogenic and therefore a
potential cancer hazard for man… No level of exposure to a chemical carcinogen
should be considered toxicologically insignificant for man. For carcinogenic
agents a ‘safe level for man’ cannot be established by application of our
present knowledge...” Have the rules changed? Is AZT too big to ban -
under the Delaney Amendment outlawing
potentially carcinogenic drugs in the US? Or are the rules about exposing
patients to likely carcinogens just relaxed a bit when they are female and
pregnant? Or black or gay?
[53] For those of us who
like to trust that medical experts in high places know what they are doing and
think straight, the following statement by Dr. Ellen Cooper, Principal
Researcher of the Women and Infants Transmission Study in the US, might come as
a bit of a shock. Quoted in Mothering
magazine in September/October 1998, she said, “We don’t know what the long-term
effects of AZT use during pregnancy might be, but so far we have seen virtually
no adverse effects in the short term... Not one single tumor. Not one... I mean
[the children] have cancers, lymphomas, and other problems like that...but
there’s no reason to link those cancers to AZT.” Her reticence about coming to
terms with the horror she helped spawn makes sense, seeing that she was a
director of the FDA on the panel that approved AZT.
[54] The
likely carcinogenicity of AZT, demonstrated by recent studies, is actually no
news at all. Way back in December 1986, a review of numerous AZT studies
entitled Review & Evaluation of
Pharmacology & Toxicology Data was submitted to the US Food and Drug
Administration by its in-house toxicology analyst Dr Harvey Chernov. He
reported - apart from the observation that AZT was toxic to bone marrow and
caused anaemia in all species of experimental animal, and humans too - that AZT
“was found weakly mutagenic in vitro in the mouse lymphoma cell system.
Dose-related chromosome damage was observed in an in vitro cytogenetic
assay using human lymphocytes”, and AZT was
found to be active in the Cell Transformation Assay, a stock test for
carcinogenic potential. He emphasised, “This BALB/c-3T3 neoplastic
transformation assay was performed according to standard operating procedure.
Concentrations
of AZT as low as 0.1 mcg/ml reduced the number of cells in culture after a
3-day exposure. A statistically significant increase in the number of aberrant
‘foci’ was noted at concentration of 0.5 mcg/ml. This behaviour is
characteristic of tumor cells and suggests that AZT may be a potential
carcinogen. It appears to be at least as active as the positive control
material, methylcholanthrene.” As Chernov explains it, “A test chemical which
induces a positive response in the Cell Transformation Assay is presumed to be
a potential carcinogen.” Naturally he advised the FDA against approving AZT,
but his report was buried. Indeed, it had to be flushed out of the FDA’s files
by resort to the machinery of the federal Freedom of Information Act some years
later. In 1994, in Cancer Research,
Olivero et al published more
AZT-rodent carcinogenicity findings: Vaginal
epithelial DNA damage and expression of preneoplastic markers in mice during
chronic dosing with tumorigenic levels of 3'-azido-2',3'-dideoxythymidine (AZT):
“…we have found positive correlations
between the dose of AZT administered to female CD-1 mice, the incorporation of
AZT into vaginal DNA, the hyperproliferation of the vaginal epithelial basal
layer, and the aberrant expression of alpha-6 integrin toward the epithelial
suprabasal strata of the vagina, a target organ for carcinogenesis in mice.
These results suggest that there is an ordered progression of abnormal events
leading to tumorigenesis in vaginal epithelial tissues.”
[55] Chernov’s bleak
predictions for the human carcinogenicity of AZT have since come true. But
you’d never know it reading the tortured spin of AZT promoters Broder et al
in their piece, Clinical Pharmacology of 3'-Dideoxythymidine
and Related Dideoxynucleosides, published in the New England Journal of
Medicine in 1989. Conceding that “it is of
particular concern that the drug may be carcinogenic or mutagenic” and “its
long term effects are unknown”, the authors state, “zidovudine may be
associated with a higher incidence of cancers in patients whose
immunosurveillance mechanisms are disturbed simply because it increases their
longevity.” Just muse on that as a vignette illustrating the quality of
reasoning exhibited by AIDS scientists, and then before you dry your eyes,
consider this - from the same illustrious peer-reviewed journal: In 1988, in
their paper Effect of
continuous intravenous infusion of zidovudine (AZT) in children with
symptomatic HIV infection, Pizzo et al claimed that AZT boosted the IQ of
twenty one HIV-positive children by fifteen points. “Transfusion was required
in 14 patients because of low levels of hemoglobin. Dose-limiting neutropenia
occurred in most patients who received doses of 1.4 mg per kilogram per hour or
more… Regardless of the starting dose, nearly all patients had a transient drop
in their neutrophil counts within 10 days of the initiation of AZT therapy… The
major limitation of the therapy was hematologic toxicity both the hemoglobin
concentration and the white-cell count… In three of the five children who died,
evidence of a response to AZT, particularly neurodevelopmental improvement, was
present at the time of death.” In declaiming these AZT-boosted
“neurodevelopmental” improvements, the excited researchers had the decency at
least to mention that the kids made brainy by AZT also happened to die. But not
Burroughs Wellcome, which seized on and punted this garbage as a selling hook
for AZT when advertising it in the Lancet:
“Helping keep HIV disease at bay in children. Generally well tolerated;
Improved cognitive function…”
[56]
Actually, AZT doesn’t make you clever, it makes you stupid. You may have heard
of ‘AIDS-dementia’. It’s like ‘neuro-syphilis’ - which no one gets anymore, now
that penicillin has taken over from arsenic and mercury salts to kill syphilis
spirochaetes. (The Oxford Companion to
Medicine admits, “…nearly all the late symptoms of syphilis were really due
to mercury poisoning.”) To be told by a doctor that you’re about to die would
knock the best of us off the psychological rails. Certainly I’ve seen this in
three AIDS-based cases I’m conducting. At the least of it, the diagnosis per se
can precipitate a health
collapse, as a glance at Ader, Felten and Cohen’s text, Psychoneuroimmunology
reveals. And the widow of my colleague killed
by AZT can confirm. Bacellar et al
reported in the journal Neurology in
1994 that “the risk of developing HIV dementia among those reporting any
antiretroviral use (AZT, ddI, ddC, or d4T) was 97% higher than among those not
using this antiretroviral therapy… In addition, the findings of our analysis
seem to confirm previous observation of a neurotoxic effect of antiretroviral
agents…linked…to the development of toxic sensory neuropathies, usually in a
dose-response fashion.” Remember the sensory and mental disturbances mentioned
above on the package blurb as being among AZT’s ‘side effects’? You know, the
ones caused by the poisoning of your nerves and brain? Which caused a client of
mine, among other unpleasant things, to lose his sense of taste. Heald et al
mentioned some of them in their
paper in AIDS in 1998, Taste and smell complaints in HIV-infected
patients. In a discussion of mitochondrial myopathy, Robbin’s Pathologic Basis
of Disease mentions
mitochondrial encephalomyopathy. The Concise
Oxford Medical Dictionary tells us that encephalomyopathy is “extensive
destruction of nerve cells throughout the nervous system [causing] widespread
disease of brain and spinal cord.”
[57] In the May 1999 issue
of Clinical Infectious Diseases, Fichtenbaum
et al at the Washington University
School of Medicine described the cases of three patients who developed
progressive multifocal leukoencephalopathy after four to eleven months of
HAART. Despite a change in their treatment, the research team “observed no
improvement [in two of the cases]… Neurologic deterioration continued, and
[the] patients died within 2 months.” They concluded that the condition can
“develop while using HAART” notwithstanding test results suggesting “a good
virologic response to antiretroviral therapy.” That the drugs themselves caused
the brain and neurological damage, they didn’t consider. Apparently Fichtenbaum
and his portly pals found the logical leap too wide to hazard. But not Research
Initiative Treatment Action in
their piece headed Just Sweat it Out:
Physical therapy’s role in the HIV pandemic under the chapter The Nervous
System and Physical Therapy:
“Peripheral neuropathy pain, which occurs in 40 to 60% of people with AIDS, is
one of the most common causes for referral to physical therapy and is often one
of the most neglected. Symptoms of peripheral neuropathy include burning,
numbness, and/or a tingling sensation of the extremities. Lower extremity
involvement is more common than upper extremity involvement. Problems with
ambulation, balance, and compensatory low back pain are also commonly
associated with peripheral neuropathy.” Since there isn’t a jot of evidence
that HIV attacks nerve cells, but ample evidence that nucleoside analogues like
AZT, 3TC, d4T, ddI and ddC do, the article concedes that “peripheral neuropathy
may be directly related to [such] pharmacological agents…”
[58] If it’s not good for
your head, AZT is not great for your heart either. Lipshultz pointed out in the
New England Journal of Medicine in 1998
that “possible mechanisms [for heart muscle disease among HIV-positive
patients] include cardiotoxicity as a result of antiretroviral therapy...” And
in their paper in Nature Medicine in
1995, Mitochondrial toxicity of antiviral
drugs, Lewis and Dalakas mention heart disease among the many
manifestations of drug toxicity caused by ‘antiviral’ nucleoside analogues
(ANAs) like AZT, noting that “the prevalent and at times serious ANA
mitochondrial toxic side effects are particularly broad ranging with respect to
their tissue target and mechanisms of toxicity: Haematalogical; Myopathy;
Cardiotoxicity; Hepatic toxicity; Peripheral neuropathy.” On 24 February 2000,
in a report Zidovudine causes
cardiomyopathy in animal model,
Reuters Health mentioned Lewis et al’s
rodent study findings that “Pathological changes occurred in the hearts of all
the animals following 35 days of AZT treatment”, namely the “structural and
functional changes of mitochondrial cardiomyopathy.” Nothing new. In 1992 in
Annals of Internal Medicine Herskowitz et al published
Cardiomyopathy Associated with Antiretroviral Therapy in Patients with
HIV Infection: A Report of Six Cases: “Symptomatic congestive heart failure
has been described as part of the spectrum of human immunodeficiency virus
(HIV)-related cardiac disease [but] studies have failed to show HIV genomic
material in endomycocardial biopsy samples taken from patients with
HIV-associated mycocarditis and clinically established congestive heart
failure. Other etiologies should be considered, such as drug-induced
cardiotoxicity, as suggested by the recent finding of zidovudine-induced
cardiomyopathy in rats and zidovudine-induced skeletal myopathy in humans.”
Lewis et al confirmed Herskowitz’s
apprehensions in Circulation Research
two years later, their findings summed up in the title: Cardiac Mitochondrial
DNA Polymerase-y Is Inhibited Competitively and
Noncompetitively by Phosphorylated Zidovudine. In the August 2000 issue
of European Journal of Medical Research,
Rickerts et al investigated the Incidence of myocardial infarctions in
HIV-infected patients between 1983 and 1998: the Frankfurt HIV-cohort study
and found “The incidence of MI in HIV
infected patients increased in our cohort after the introduction of HAART.” In
the same month, in the International
Journal of STD & AIDS, Koppel et
al reported “A significant number of the HAART patients had very high
levels of Lp(a) and various combinations of increased lipid values associated
with considerably increased risk for CHD [coronary heart disease]. The
elevation of Lp(a) did not relate to any other clinical or laboratory parameter
than to LDL-cholesterol.” On the other hand, in September 2000, the New
England Journal of Medicine
published a study by Lipshultz et al.
Reuters reported: “New tests of the GlaxoWellcome AIDS drug
AZT show that, unlike infant monkeys exposed to the drug, it does not damage
the heart of human newborns… The drug… had been shown to cause some heart
abnormalities in infant monkeys whose mothers had been exposed to it while
pregnant. Studies in children have produced mixed results.” The study involving
185 babies found that, “infants born to HIV-infected women and exposed to
zidovudine were no more likely to have abnormal [hearts]...than were infants
who did not have zidovudine treatment.” Of course, biopsies of cardiac tissue
weren’t taken to determine whether it had suffered the same kind of damage seen
in adults and in animal studies. The children’s hearts were not conspicuously
harmed. Which is not saying very much. Especially since cardiomyopathy was one
of the abnormalities in AZT-exposed babies reported by Blanche et al in
the Lancet in September 1999. But the curious thing about the Lipshultz
report is the wide press it enjoyed in the newspapers and in discussion forums
on the internet, unlike a host of other recent negative findings about AZT. As
if it decisively vindicated AZT from the dense surrounding countryside of
papers returning adverse data.
[59] It would appear that
AZT and chemically related drugs can blind you too. In the Journal of Infectious
Diseases in March 1999, Karavellas and Plumm reported their investigation of
“the likelihood of the development of a new ocular inflammatory syndrome
(immune recovery vitritis, IRV), which causes vision loss in AIDS patients with
cytomegalovirus (CMV) retinitis, who respond to HAART. We followed 30
HAART-responders with CD4 cell counts of >/=60 cells/mm3. Patients were
diagnosed with IRV if they developed symptomatic vitritis of >/=1+ severity
associated with inactive CMV retinitis. Symptomatic IRV developed in 19 (63%)
of 30 patients…over a median follow-up from HAART response of 13.5 months…
These data suggest that IRV develops in a significant number of
HAART-responders with CMV retinitis...” It’s amazing. Some ‘successfully’
treated AIDS patients go blind. A brand-new disease construct comes into being:
‘Immune Recovery Vitritis’. Roche hawks its ‘anti-CMV medication’, with
advertising directed specifically at gay men whose sight has been wrecked by drug
damage to their ocular nerves. In an echo of the Japanese Clioquinol disaster,
cytomegalovirus is blamed for the blindness, not the HAART drugs,
notwithstanding their well-established neuro-toxicity.
[60] During a polio-like
epidemic in the sixties in Japan, Subacute Myelo-Optico-Neuropathy or SMON
caused blindness, paralysis and death in thousands of cases. The Japanese
medical research establishment approached the crisis on the footing that some
new unknown infectious agent was responsible. Echo-, Coxsackie- and
lenti-viruses were put in the dock in turn. Professor Shigeyuki Inoue at Kyoto
University’s Institute for Virus Research claimed that a virus he had
identified (coincidentally in the same herpes-class as the common-place and
generally harmless cytomegalovirus) was the cause of SMON, and it was accepted
as such in the 1974 edition of the American textbook, Review of Medical
Microbiology. With modern medicine’s bias to
germs as the causes of disease, entirely overlooked was the possibility that the
epidemic was caused not by a contagion but by a toxin - until the
epidemiological anomalies became uncontainable for the viral culprit theory.
Finally, an anti-diarrhoereal drug, Entero-Viaform containing Clioquinol was
found to be the cause. Inadequately tested, it turned out to be neuro-toxic.
When it was banned, the plague ceased, and in the litigation that followed its
manufacturer Ceiba-Geigy was taken to the cleaners.
[61] But back to cancer. Pluda
and colleagues, all researchers with the US National Cancer Institute, no less,
reported in 1990 in Annals of Internal
Medicine that on AZT, your chances of developing lymphoma relative to the
rest of the population went up 50 fold: “The estimated probability of
developing [Non-Hodgkins] lymphoma [in patients taking AZT alone, or in
combination] by 30 months of therapy was 28.6% and by 36 months, 46.4%.” The
authors considered “a direct role of therapy itself” for the development of the
disease, and warned, “Zidovudine can act as a mutagen.” On 20 July 2000
Associated Press released a piece by
Emma Ross entitled AIDS Treatments
Studied, mentioning a Danish research report in the same month in the Lancet.
Examining the cases of 7300
European HIV patients, she said the study (by Ludgren et al) had found that the
percentage contracting “non-Hodgkins
lymphoma had quadrupled since the [HAART] drugs were introduced six years ago.”
Of course the rest of her story had a different spin, but it is the data, not opinions,
that count.
[62] In the light of these reports, is it truthful for
AZT manufacturer GlaxoWellcome to persist with the assertion, as it does in its
AZT package insert that, “It is not known how predictive the results of rodent
carcinogenicity studies may be for humans”? After all, “At doses that produced
tumors in mice and rats, the estimated drug exposure [for mice] …was [only
about] 3 times…the estimated human exposure at the recommended therapeutic dose
of 100 mg every 4 hours.” And how frank is GlaxoWellcome in disposing of
Chernov’s positive Cell Transformation Assay findings with the bald
unelaborated statement in the same package insert, “In an in vitro mammalian cell transformation assay, zidovudine was
positive at concentrations of 0.5 µg/ml and higher”? How many doctors, let
alone patients, appreciate from this that as little as half a millionth of a
gram per millilitre of AZT came up positive in a standard drug-industry
screening-test for potential drug carcinogenicity? And what risks for patients
this portends?
[63] In AIDS in May 1999, Grulich et
al reported a 16-year study of cancer incidence among people given an AIDS
diagnosis in New South Wales, Australia. The researchers noted that among more
than 3600 AIDS diagnoses, fully one quarter of the patients had developed
cancers including those of lung, skin and lip, leukaemia and Hodgkins Disease -
none of which are ‘AIDS indicator diseases’. “There was an increased incidence
of several other forms of cancer, some of which are known to occur at increased
rates in transplant recipients who have received immunosuppressive therapy.”
Presumably these patients had been dosed according to the standard
‘antiretroviral’ treatment protocol - AZT alone or in combination with related
drugs. All of which, like ‘immunosuppressive therapy’, are destructive of the
cells of the immune system. They observed: “The incidence of Hodgkin’s Disease
increased significantly at the time of AIDS diagnosis.” Since the disease sets
in after the diagnosis is made and the treatment begins, the sensible doctor
might wonder about the medicine. Such enquiry might be stimulated by Zietz
et al’s paper in June 1999 in the New England Journal of Medicine
reporting An unusual cluster of cases of
Castleman's disease during highly active antiretroviral therapy for AIDS.
Most patients with this “rare… lymphatic hyperplasia…disease” typically present
with “multicentric lymphadenopathy… an interfollicular predominance of plasma
cells… and progressive systemic symptoms or with a more localized, indolent
disease that can often be cured by local excision.” In the four cases reported,
the patients suffered “Fever, weakness, generalized enlargement of lymph nodes,
and marked polyclonal gammopathy… [and three] died within a week after the diagnosis.”
Speculating about the possible causes - the virus HHV-8 is tentatively mooted -
the authors note that in all cases “symptoms of multicentric Castleman’s
disease started after the initiation of highly active antiretroviral therapy…”
Sure they did. Just as Simone et al
reported in Annals of Internal Medicine
in September 2000: Inflammatory Reactions
in HIV-1-Infected Persons after Initiation of Highly Active Antiretroviral
Therapy: “Inflammatory reactions involving opportunistic infections,
AIDS-associated malignant conditions, and other noninfectious diseases have
recently been described in patients infected with HIV-1. These conditions often
appeared shortly after the introduction of HAART and were associated with
pronounced reductions in plasma HIV-1 viral load and increases in CD4(+)
T-lymphocyte counts.” In other words the drugs seem to fix your symptomless HIV
but make you very sick. Only in the AIDS age!
[64] In October 1998, at a
conference in the US sponsored by the World Health Organization, experts from
all over the world convened under the aegis of the International Agency for
Research on Cancer to examine the potential carcinogenicity of AZT. At the end
of their colloquium, AZT was classified a “possible human carcinogen.” The
panel would doubtlessly have put it less tentatively had many of the most
significant research reports on AZT-carcinogenicity mentioned in this review
been published before the conference and not after it. Like this one:
[65] In February 1999,
researchers with the National Toxicology Program of the Department of Health
and Human Services in the US delivered a report entitled TR-469 Toxicology and Carcinogenesis Studies of AZT (CAS No.
30516-87-1) and AZT/a-Interferon
A/D B6C3F1 Mice (Gavage Studies). They concluded, “Under the conditions of
these 2-year gavage [oral force feeding] studies there was equivocal evidence
of carcinogenic activity of AZT in male mice based on increased incidences of
renal tubule and harderian gland neoplasms in groups receiving AZT alone. There
was clear evidence of carcinogenic activity of AZT in female mice based on
increased incidences of squamous cell neoplasms of the vagina in groups that
received AZT alone or in combination with -interferon A/D. Hematotoxicity
occurred in all groups that received AZT. Treatment with AZT alone and AZT in
combination with -interferon A/D resulted in increased incidences of epithelial
hyperplasia of the vagina in all dosed groups of females.” Under the heading
GENETIC TOXICOLOGY, the investigators reported, “AZT is mutagenic in vitro
and in vivo. It induced gene mutations in Salmonella typhimurium strain
TA102. AZT induced sister chromatid exchanges in cultured Chinese hamster ovary
cells. In vivo studies with male mice
administered AZT by gavage showed highly significant increases in
micronucleated erythrocytes in bone marrow and peripheral blood after exposure
periods that ranged from 72 hours to 14 weeks.” How many studies will it take?
[66] Debunking Martin’s
claims as to the efficacy of AZT for “post-exposure prophylaxis” would take
more space than the joke warrants. Put it this way. There are no smart-bomb
drugs for viruses, especially retroviruses like HIV, claimed by ‘AIDS experts’
not merely to infect our cells but to actually get into our DNA. As Nobel
laureate retrovirologist and former director of the US National Institutes of
Health, Dr. Harold Varmus put it in June 1998, “Trying to rid the body of a
virus whose genome is incorporated into the host genome may be impossible.” Any
honest, competent GP will tell you that viruses are beyond medicine’s reach.
With viral diseases you take it easy and hope for the best. Presuming of course
you have the disease you’ve been told you do, but just what HIV antibody test
results really tell is another story, and what an unbelievable scientific
shambles it is. In its PRODUCT INFORMATION advisory, GlaxoWellcome says about
claims for AZT as a preventative drug for “post-exposure prophylaxis”:
“Patients should be advised that therapy with Retrovir has not been shown to
reduce the risk of transmission of HIV to others through sexual contact or
blood contamination.” In their paper in AIDS
in August 2000, Post-exposure prophylaxis
with highly active antiretroviral therapy could not protect macaques from
infection with SIV/HIV chimera, Le Grand et al pointed out that, “To
date, only one study has reported that
zidovudine (ZDV) alone may protect from occupational post-exposure infection
with an efficacy estimated at 81%. [Cardo et
al of the Centers for Disease
Control and Prevention Needlestick Surveillance Group: A case-control study of
HIV seroconversion in health care workers after
percutaneous exposure in New England
Journal of Medicine 1997.] However, a retrospective case-control study is
not the optimal design for assessing the efficacy of such strategies, thus
limiting the significance of this observation.” In their experiment on macaques
monkeys to determine the efficacy of post exposure prophylaxis following
deliberate infection, they found that it didn’t work: “This is the first
demonstration that post-exposure prophylaxis of HIV transmission with a
therapeutic design recommended in humans could not protect macaques from
experimental challenge with a pathogenic lentivirus closely related to HIV-1.”
[67] Overlooked by just
about everyone is a fundamental biochemical reason why AZT can never in
principle be a prophylactic agent to prevent HIV infection. It is rudimentary
that HIV is a retrovirus, so the experts tell us. And that retroviruses have
RNA not DNA at their core. RNA differs from DNA in that in place of thymidine,
it has uracil as one of its nucleotides. AZT, (a fake thymidine stand-in) is
claimed by the experts to disrupt the formation of proviral DNA by substituting
itself in place of natural thymidine. But only after it has infected the cell
does the process start, the ‘AIDS experts’ tell us, in which HIV is reverse
transcribed into DNA; which enters cellular DNA as ‘provirus’; which is then
transcribed into viral RNA; which orchestrates the formation of new viral
particles; which bud off the cell membrane and go off to infect other cells. It
is therefore only after infection - on this conventional model of infection and
treatment - that AZT can be antagonistic to HIV, by inhibiting replication. AZT
cannot be absorbed into cell-free HIV before it has infected target cells. As
GlaxoWellcome’s www.treathiv.com site
tells us, “All anti-HIV medications attack the virus inside the CD4 cell where
the virus is trying to make copies of itself” - in other words, after
infection.
[68] Wait, says the AIDS
expert. CD4 cells have a limited life span. If AZT prevents HIV replication for
the few days that the cell is alive, it can prevent new HIV particles from
being formed until the cell and the virus die together. Mull on the sense of
that theory. Think how many millions of CD4 cells that AZT (suitably
metabolised to make this possible) will have to enter to prevent HIV
replicating in each one. You might wonder: If all or most of one’s millions of
CD4 cells need to absorb AZT to stave off HIV replication, will they be harmed?
GlaxoWellcome’s suggestion that AZT is overwhelmingly more specifically
antagonistic to HIV and other retroviruses than human cells just isn’t true.
Several studies have found this – reviewed and confirmed in 1995 by Chiu and
Duesberg, reporting in Genetica their
investigation of The toxicity of
azidothymidine (azt) on human and animal cells in culture at concentrations
used for antiviral therapy: “AZT, a chain terminator of DNA synthesis
originally developed for chemotherapy, is now prescribed as an anti-human
immunodeficiency virus (HIV) drug at 500 to 1500 mg/person/day, which
corresponds to 20 to 60 µM AZT. The human dosage is based on a study by the
manufacturer of the drug and their collaborators, which reported in 1986 that
the inhibitory dose for HIV replication was 0.05 to 0.5 µM AZT and that for
human T-cells was 2000 to 20.000 times higher, i.e. 1000 µM AZT. This suggested
that HIV could be safely inhibited in humans at 20 to 60 µM AZT. However, after
the licensing of AZT as an anti-HIV drug, several independent studies reported
20 to 1000-fold lower inhibitory doses of AZT for human and animal cells than
did the manufacturer’s study, ranging from 1 to 50 µM. In accord with this,
life threatening toxic effects were reported in humans treated with AZT at 20
to 60 µM. Therefore, we have re-examined the growth inhibitory doses of AZT for
the human CEM T-cell line and several other human and animal cells. It was
found that at 10 µM and 25 µM AZT, all cells are inhibited at least 50% after 6
to 12 days, and between 20 to 100% after 38 to 48 days. Unexpectedly, variants
of all cell types emerged over time that were partially resistant to AZT. It is
concluded that AZT, at the dosage prescribed as an anti-HIV drug, is highly
toxic to human cells.” As Martin Walker put it in his essay describing
Burroughs Wellcome’s AZT marketing campaign, HIV, AZT, big science &
clinical failure, “After almost four
years of licensed use, it was accepted that AZT had a 1,000 times higher
toxicity than had been quoted by Burroughs Wellcome in the Data Sheet
Compendium or cited in the Physicians Desk Reference in 1986. At an end
cost of £10,000 per
patient per year, Wellcome attempted to keep the dosage as high as possible. By
1993, however, dosages per day had been reduced by most doctors from 1,200 mg
to 500mg.” There’s another problem with the use of AZT as a prophylactic agent:
Although GlaxoWellcome describes AZT as an “antiviral agent active in vitro
against retroviruses including
…HIV”, it also points out in its package insert that “The HIV infection is
unlikely to be completely eradicated by zidovudine treatment because the viral
genome is integrated into the host DNA.” So, on this model, once the few days
or weeks of prophylactic drug treatment to inhibit HIV replication is ended,
HIV is free to take off and replicate unhindered. Of course if you stay on the
medicine indefinitely, it’s going to be tickets for you because as South
African-born Dr Joseph Sonnebend has seen in his physician’s practice in New
York, “AZT is incompatible with life.”
[69] Schmitz et
al’s paper Side effects of AZT prophylaxis after occupational exposure to
HIV-infected blood in Annals of
Hematology in 1994 might dampen the ardour of AZT “post-exposure
prophylaxis” proponents: AZT was supplied to fourteen health care workers
“exposed to HIV contaminated blood through needle sticks and similar
accidents.” Three abandoned the treatment early because of its unendurable
toxicity. Eleven held the course for a month. Four of them developed severe
neutropenia. One developed a lung infection. The study itself was called off
early before more harm was done. Robbins’ pathology text explains, “The
symptoms and signs of neutropenias are those of bacterial infections [and] the
most severe forms of neutropenias are produced by drugs.” Hello? In the same
year an article in AIDS
Scan by Tokars et al on AZT
prophylaxis (discussing a paper in Annals
of Internal Medicine 118; 1993) reflected the findings of the US CDC:
“Adverse symptoms, most commonly nausea, malaise or fatigue, and headache, were
reported by 75% of workers using zidovudine; 31% of workers did not complete
planned courses of zidovudine because of adverse events.” And in a third report
in the same year, Modern Medicine of
South Africa carried an article by Robinson (discussing a paper in March
1993 in Clinical Infectious Diseases)
headed Don’t start AZT prophylaxis for
health care workers exposed to HIV. It reported, “No studies show that
zidovudine prophylaxis is effective… Anecdotes suggest that prophylactic
zidovudine does not prevent infection despite prompt and intensive
administration. Zidovudine is known to have a number of potential toxicities…
25% of workers who take zidovudine report intractable nausea, vomiting,
headaches and other effects severe enough to force them to stop their
prophylaxis… zidovudine…has unproven efficacy, has defined toxicity, and has
unknown future risk.” In the Lancet in February
2000, Parkin et al provide fresh
confirmation of all this in their paper Tolerability
and side-effects of post-exposure prophylaxis for HIV infection. More than
a third of the recipients of AZT-based combination antiretroviral therapies
experienced “intolerable side-effects” like “uncontrollable vomiting”, and
severe diarrhoea, described by the researchers as “potentially serious.”
[70] Following the rape in
1999 of prominent South African AIDS journalist Charlene Smith, an intense
debate has raged in the local media about whether the State ought to provide
AZT and related drugs to rape victims. However, the US Centers for Disease
Control, the fons et origo of most
conventional wisdom about AIDS, is not on the side of its protagonists. In CDC
Update, dated 29 Sept 1998, it
warned, “Potential benefits must be weighed against the risks of drug toxicity
[and] the difficulty of compliance with the regimen… Because post-exposure is
an experimental therapy of unproven efficacy, it should only be prescribed with
the informed consent of the patient, after explanation of the potential
benefits and risks. Antiretroviral therapy should never be used routinely…”
This advice was based on the conclusions of a conference of experts convened to
examine the matter on 24-25 July 1997 in Atlanta. The report of this External
Consultants’ Meeting on Antiretroviral Therapy for Potential Nonoccupational
Exposures to HIV recorded that “no data currently exist about the effectiveness
of such therapy for these types of exposures... There are no human studies of
antiretroviral drug therapy for sexual, drug use, or other non-occupational
exposures to HIV... Potential benefits have to be weighed against the
significant health risks and costs associated with this therapy for
nonoccupational exposures. First, these medications can have severe side
effects… Second, efficacy is unknown... This therapy should never be routine.
It is… complicated…[and] is NOT a ‘morning-after pill’.”
[71] Even GlaxoWellcome –
not ordinarily shy to exploit anxious and vulnerable new markets – discourages
rape victims from swallowing AZT; its South African medical director Dr Peter
Moore warned on the television programme Carte
Blanche on 7 November 1999 that AZT was “not registered” and “not
recommended” for ‘anti-HIV prophylaxis’ following rape. This is surprising
honesty from a company whose representatives have lied repeatedly to the South
African public since President Mbeki directed on 28 October 1999 that the
safety of AZT be investigated on the basis that “there is a large volume of
scientific evidence...that [AZT] is harmful to health. These are matters of
great concern to the government as it would be irresponsible for us not to heed
the dire warnings which medical researchers have been making.” In the Josef
Goebbels tradition of public relations, GlaxoWellcome protested that there is
no cause for concern about AZT, that there is nothing new in the medical
literature to warrant questioning its safety, that there has been no litigation
about it, and that AZT has brought “quality of life to millions of AIDS
sufferers around the world.” Just like Arbeid
Macht Frei. Perhaps GlaxoWellcome’s directors actually believe the
propaganda churned out by their spin departments, like National Party
politicians during apartheid, unreached by adverse reports raining in. One gets
this impression from an exchange between Minister of Health, Dr Manto
Tshabalala-Msimang and medical director of GlaxoWellcome SA, Dr Peter Moore in
South African investigative film journalist Vivienne Vermaak’s expose, The truth
on AZT, shown on e-TV on 12
December 1999. Moore’s simpering performance on television was a pathetic
sight, especially set against Dr Tshabalala-Msimang’s curt rebukes:
Moore: We find it unusual
that these allegations of safety aspects on AZT have suddenly arisen in South
Africa. They have not surfaced in any other country around the world, in over a
100 countries where the drug is registered. There is no other regulatory body
at the level of the Medicines Control Council which is reviewing AZT because of
safety concerns.
Tshabalala-Msimang: If it is
the first time, then somebody has to start.
Moore: I have never seen
that [skull and crossbones] label before [on bottles of AZT supplied by Sigma
Corporation to research laboratories].
Voiceover: How does Glaxo
respond to new research, which claims the drug causes cancer, birth defects and
deaths?
Moore: I’m not aware of the
data you just mentioned to me.
Voiceover: We asked Glaxo to
comment on the finding that almost all long-term HIV survivors do not take any
anti-AIDS drugs.
Moore: Yes, I haven’t seen
those statistics, so I can’t comment on them.
Tshabalala-Msimang: I don’t
know what literature they read… Look, GlaxoWellcome knows exactly. And each and
every one of us, if we want to find that information, it is easily available.
Voiceover: The scientific
debate is whether AZT kills the cells or not.
Moore: No, it does not kill
the cell. What it does, it stops the HIV from replicating. So, the virus is in
the cell, it cannot replicate and it is digested by the organelles within the
cell. [This is a novel explanation!]
Voiceover: Others disagree,
adding the drug cannot target specific enzymes.
Professor Ruben Sher: Now
reverse transcriptase is also present in many other functions of the body. So
although we were assured originally that it acted only on the HIV reverse
transcriptase because it was specific to HIV, it would seem that it is not
quite the truth.
Moore: … I disagree with you
that those trials were not properly conducted. They were done according to good
clinical guidelines and they were accepted by authorities like the Food and
Drug Administration. But I think what we have to do; we have to move away from
those original monotherapy trials… GlaxoWellcome is not killing people with its
anti-retroviral medicines. GlaxoWellcome is not exploiting any individuals for
commercial benefit and your third allegation was that GlaxoWellcome is lying.
GlaxoWellcome is a reputable company. We do not lie to people. We do not lie to
researchers, we do not lie to scientists, we do not lie to physicians and we do
not lie to patients.
Tshabalala-Msimang: What it
does, it suppresses the immune system. The very system we want to boost… I
wouldn’t take AZT, I would not.
[72] South Africa’s ‘AIDS
experts’ and other medical notables, in a stupendous display of professional
indolence and ignorance, have simply echoed Glaxo’s line. In these straitened
times, one can understand; they wouldn’t want to put a major research sponsor’s
nose out of joint. Here’s a sample:
“But immunologist Malegapuru
Makgoba, president of the Medical Research Council (MRC) describes the grounds
of Brink’s argument as ‘nonsensical’. He adds, ‘I’ve read nothing in the
scientific or medical literature indicating that AZT should not be given to
people’.” (Nature November 1999.)
“The enormous impact of
antiretrovirals on HIV/Aids… have increased life expectancy and improved the
quality of life of many Aids sufferers in the developed world… Good scientific
evidence exists to show that AZT…reduce[s] mother to child HIV transmission.
The benefits of treatment appear to outweigh the risks.”
“…I do not intend to engage in nonsensical debates on
AZT… I find the issues you raise a total waste of energy but perhaps more
exciting for ignorant people in the field.”
William Makgoba Phd,
president of the South African Medical Research Council.
There is “no new evidence in
the medical literature in the last year on the adverse effects of AZT.”
Dr Salim Abdool Karim, director:
HIV Prevention and Vaccine Research, Medical Research Council, Professor in
Clinical Public Health, Columbia University, and chairman: Scientific Programme Committee, 13th International AIDS Conference,
Durban.
“We’re making a laughing
stock of ourselves. Government is discrediting the drug because it doesn’t want
to pay for it. But it’s backfiring, because there is no evidence. . . they will
find nothing.”
Dr Ruben Sher, HIVCare International.
It’s all “complete nonsense …it’s like believing the
earth is flat.”
Dr Peter Cooper, head of Paediatrics, Johannesburg
Hospital and University of the Witwatersrand.
“There is no question in the minds of scientists that the
government contributes to a climate that raises the possibility
that…antiretrovirals are toxic.”
Professor Jerry Coovadia, Head of the Department of
Paediatrics, Natal University, chairman of the 13th International
AIDS Conference, Durban..
“There’s no medical or
scientific reason whatsoever for the MCC to review the material. I’m sure the
MCC will come out with a balanced report, but it’s nauseating that they’re even
looking at it.”
Professor Gary Maartens,
head of the HIV/Aids Unit, Groote Schuur Hospital, Cape Town.
[73] Best keep Gary’s sick-bag
handy for when you read what his fellow AIDS dignitaries overseas reckon about
AZT:
“AZT…is mildly toxic.”
Dr Mark Wainberg, former
president of the International AIDS Society, Professor of Medicine, McGill
University, and Head of AIDS Research at the Jewish General Hospital in
Montreal. (In April 2000, the AIDS gauleiter
proposed that an exemplary sprinkling of us troublemakers for the AIDS business
should be “locked up” to quell our complaints.)
“To combat a fatal disease, it is perfectly acceptable to
use drugs slightly more toxic than an aspirin.”
Dr Joseph Perriens, Head of the Care and Support Program of the United
Nations AIDS program in Geneva.
“I
read over your article. It is quite clear… that you are a fully fledged member
of the Duesberg conspiracy…This places you outside the boundaries of scientific
discussion on HIV and AIDS, so I shall not correspond with you further.
Instead, efforts will be made to minimize the damage you could cause to public
health in South Africa if you were to persuade gullible politicians that your
arguments have merit.”
Dr John Moore, Aaron Diamond AIDS Research Institute, New York.
“The positive results of
treating people with anti-retrovirals such as AZT is overwhelming… Yes, there
are side effects, but the balance of the equation is so clearly positive…
[The government’s decision not to provide the drug is a] mistake from a
humanistic perspective. Those who failed to manage the epidemic properly would
be judged harshly by history… President Mbeki, don’t let this be your legacy.”
Dr David Ho, scientific
director and chief executive officer, Aaron Diamond Aids Research Institute,
New York.
[74] On the other hand our
National Minister of Health, Dr Manto Tshabalala-Msimang who evidently took the
trouble to read this debate, has been commendably responsive to the tocsins
sounded about AZT in the medical literature:
“In a speech last week to
the National Assembly, Health Minister Manto Tshabalala-Msimang said that the
drug might be toxic and might cause some forms of cancer.” (New York Times,
November 25, 1999.)
“We have to be
very cautious… so that we do not look back 10 to 15 years down the line and
find that we had exposed…our people to a dangerous drug.”
“We have to be very cautious, very sensitive”
“There is no
substantial data that AZT stops the transmission of HIV from mother to child.
There is too much conflicting data to make concrete policy.”
“Could you with a clear conscience introduce those toxic
drugs to a woman and her child? I say no.”
“Until we are convinced that
the drug AZT is safe, as a responsible government we will not move in that
direction.”
“There is a lack of
information on how the drugs affect these children over time.”
“I would not [take AZT]; I wouldn’t.”
“I don’t…subscribe to the theory
of just giving medicine and not looking at a woman... her whole health status,
because the last thing that I’d like to see is for a medical person to give a
particular woman an injection and you never see that woman again. You don’t
know what complications are there. You don’t know what the side-effects are.”
“As to rape victims, I have engaged in a dialogue with
GlaxoWellcome, and checked their policy documents. Nowhere does GlaxoWellcome advocate
using AZT to prevent the transmission of HIV to rape victims.”
“AZT is a confirmed carcinogen.”
“The fact is that some of the mice [given AZT] have
contracted cancer. It attacks bone marrow. It is very toxic.” To which South
African AZT campaigner Charlene Smith, offered the glittering retort, “Stop
giving AZT to the damn mice and start giving it to people.”
[75] Such is the logic of
this doyenne of South African AIDS activists, and darling of the Mail and
Guardian. Week after week, its
editor Philip van Niekerk excoriates Mbeki in venomous editorials and front
page headlines for doubting the quintessentially European suggestion that the
African rural destitute, the constituency closest to Mbeki’s heart, are mating
randomly to death. Former health advisor Dr Ian Roberts told Newsday on
3 February 2000 that “up to
40 percent of all women of reproductive age are infected with HIV in rural
parts of KwaZulu-Natal.” What HIV-positive signifies or doesn’t we’ll look at
another time.
[76] In the Washington Post on 4 June 2000, Smith
reviled Mbeki as “chief undertaker” for denying AZT to rape victims, and
claimed, “For years Mbeki has argued - erroneously and dangerously - that AZT itself
is toxic.” In truth, Mbeki’s AZT safety concerns were only announced a few
months previously. Anyway, where’s the dangerous error? Wasn’t AZT designed to
kill human cells? None other than the president and chief executive officer of
The International Association of Physicians in AIDS Care, Dr Jose Zuniga,
appreciates how dangerous this stuff is: “Our association does not advocate
universal access to antiretrovirals because in many cases there is no
infrastructure to introduce the drugs safely.” Likewise, Dr Stefan Vella,
current president of the International AIDS Society has warned of “the dangers
of parachuting drugs” into countries without an adequate health infrastructure
because “you may do more harm than good.”
[77] In her Washington Post article Smith then tells
a whopper: “In three recent major drug trials in South Africa, antivirals
proved startlingly effective in rape victims if given within 72 hours of being
raped and for 28 days thereafter. Not one of the hundreds of victims became HIV-positive.”
News to me. To the MRC’s AIDS research boss Dr Karim too: “As far as I know,
there have been no trials of any antiretrovirals for rape. I would be very
surprised if these did indeed take place.” But suppose a register was kept of
rape victims given AZT, and none were HIV-positive after the treatment. Unless
the experiment was conducted with a placebo wing, it would be impossible to
draw any sensible conclusions from it. Is the reasoning so elusive? Had the
victims taken a Disprin or drunk Jeyes Fluid the result would have been the
same in any event. Because in the longest and largest epidemiological study yet
conducted to determine the infectivity of HIV, Padian et al reported in 1997
in the American
Journal of Epidemiology that it takes an average of about 1000 sexual acts
for an HIV-seronegative woman to convert to HIV-positive when keeping company
with a seropositive man. And a cool 8000 hits the other way round. In South
Africa, it seems, the poorer you are, the luckier you get. Like in Hlabisa, a
socially conservative, impoverished rural backwater. It’s one in three
HIV-positive there, the experts say. Trouble is, any sociologist knows that
it’s the elites who get around the most, not the economic losers. Houston, we
have a problem.
[78] In an empathetic note
to Smith posted on 19 April 1999 to an internet discussion conducted by the
Mail and Guardian, Aiden Gregg at Yale
pointed out that given South African HIV infection numbers bandied about like
“one in ten”, together with Padian’s low HIV infectivity finding, a woman raped
in this country has a one in ten thousand chance of becoming HIV-positive,
whereas going on AZT brings about certain poisoning, to a greater or lesser
extent, patient to patient. Smith retorted with a slew of miserable non-sequiters,
“It is so easy to speak when it is not your life at risk, isn’t it? I have two
children I love. I have a worthwhile life. I fought to live during the rape.
And by taking these drugs I am still fighting to live.” To which a judge might
respond, “After you have composed yourself, would try again to answer the
question.” Pietermaritzburg AZT promoter Yvonne Spain (also missing the point
of this debate) told me that Smith had said to her that taking the drug was the
only thing that had “kept her sane.” Who knows?
[79] It’s a hard thing to
say, but the disconcerting thing about her Survivor’s
Story, is that Smith’s hysterical aversion to defilement with Africa’s sex
plague seemed to rank above the pain of the invasion. A dominant feature of her
account is her frantic endeavour to find chemical absolution: “I keep saying to
them and the police, I’ve got to get AZT fast so that I don’t get HIV… I tell
her I am fine I just need AZT… I refuse to comply with anything until I get
AZT… the doctor comes out, I tell him the time that has lapsed since the rape
and that I need AZT fast… And if I have HIV? I pray that I don’t, but I believe
all of this happened for a purpose, God sent me this challenge, I have to turn
this evil into good and that too is why I am speaking out.”
[80] Bobbing and weaving,
Smith rudely rebuffed a request by Lynn Gannett in New York to speak out with
details of the mysterious alleged AZT-rape trials, and hissed, “The lunatic
fringe in the AIDS community will not silence me.” Honey, we’re not trying to,
but in your campaign, do you think you could stick to the facts? Because your
crazy imagination is causing problems: On 14 June 2000, the South African Press
Association reported that on the previous day, “President Thabo Mbeki…questioned
Leader of the Opposition and Democratic Party leader Tony Leon’s contention
that pharmaceutical company GlaxoWellcome had offered AZT to rape victims at a
reduced price. Replying to debate on the presidency’s budget vote, Mbeki said
no company in the world was licensed to provide AZT for that purpose. Earlier
in the debate, Leon had quoted rape victim Charlene Smith as saying that if
Mbeki had taken up an offer from the company to provide the drug at the lowest
cost in the world, and made it available to rape victims, 10,000 rape survivors
would have received the drug. Leon also quoted Smith as saying the company had
offered the drug at R200 for 28 days’ supply. Mbeki said AZT was not a vaccine
and not used in these circumstances. ‘GlaxoWellcome would not have made the
offer for AZT to be used in that regard,’ he said. ‘The company had not applied
for a licence and no clinical study had been conducted on the use of AZT for
rape victims’.”
[81] On her website www.speakout.org.za Smith sells AZT
hard. In the teeth of GlaxoWellcome’s disavowal of AZT for HIV prophylaxis
after sexual exposure, she urges otherwise, and advises women that if the pills
are taken “preferably ONE TO TWO HOURS AFTER THE RAPE, the more effective they
will be. These drugs are your first priority after a rape. However, you will
first have to be tested immediately after the rape to test whether or not you
are already HIV+ (this will only show if you were HIV+ before the rape, as
almost a third of women reaching rape clinics already are). If you are already
HIV+ it is dangerous to go onto the antiretrovirals after rape, because it is
likely that they will make you ill and will interfere with your effective
medical care when you get full blown AIDS.” GlaxoWellcome can’t be pleased with
that last bit. But it sure will like the next from its unpaid sales-lady: Don’t
you worry yourself about the scary toxicity warnings in bold type upper case
lettering at the head of GlaxoWellcome’s PRODUCT INFORMATION advisories for AZT
and 3TC, Smith counsels. The manufacturer is exaggerating. What’s more, as the
chilly hemlock does you in, and you can unmistakably feel it, relax, it’s only
in your head: “These drugs have side effects, but those side effects are not nearly
as bad as the package insert leads us to believe they could be – anticipate
nausea, a dry mouth, forgetfulness ... however, some of these symptoms are also
those of Post Rape Trauma Syndrome.” My colleague, killed by a single month’s
course of AZT and 3TC treatment, told his law-firm partner before he died, “I
think the medicine is killing me.” A textbook case of HIV-antibody test-kit
cross-reactivity, he had registered positive, and was prescribed the drugs to
“extend [his] life.” He commenced taking the treatment in good health, and
immediately became severely ill on it.
Within months he died in diapers, wasted away to a skeleton. And he
didn’t have Smith’s trauma to confuse the cause.
[82] Under the heading,
“Should pregnant women take these drugs?”, Smith feigns uncertainty: “If you
are pregnant at the time, you should consult a physician about the use of
antiviral drugs for post-exposure treatment.” As if he’d know. In truth, Smith
already has the answer. Why she conceals it from desperate women who might read
her website for advice is difficult to understand. By doing so she exposes
pregnant women to a repetition of Amy Brown’s tragedy. In October 1999, Smith
herself had reported Brown’s experience of AZT in the Mail and Guardian.
Five months after being raped she came up
positive to an HIV antibody test. “I was eleven weeks pregnant and the doctor
said Retrovir [AZT] and 3TC are not approved for pregnancy but you have to take
it. I lost the baby a week later.” Any wonder? Like Methotrexate, another
chemotherapeutic drug employed clinically as an abortifacient, AZT is a
cytostatica, an antimitotic agent. It inhibits foetal cells from dividing and
growing. And ending cell replication is exactly what AZT was designed to do.
Nothing more, nothing less. This is why Gill et al claimed success in their
use of AZT against blood cells in a
study reported in the New England Journal
of Medicine in 1995, Treatment of
adult T-cell leukaemia-lymphoma with a combination of interferon alfa and
zidovudine. This study is tricky to reconcile with the claim in
GlaxoWellcome’s PRODUCT INFORMATION on AZT, to put such concerns to bed, that
“human cell lines showed little growth inhibition by zidovudine except at [high
concentrations].” And with the fact that in the same breath the advisory warns
obliquely that this ‘antiretroviral’ drug slaughters red and white blood cells,
wrecks muscle tissue and hammers the liver.
[83] It’s curious that Smith
ducks the question of AZT’s safety for the unborn and passes the buck to the
quack. Because few lines earlier she had scowled, “DO NOT rely on a general
practitioner for HIV/AIDS advice in South Africa, most are criminally ignorant
about the necessary drugs and treatment.” No arguing with that. If after all
this you are left thoroughly mixed up by Dr Smith, why, don’t hesitate to
“PHONE FOR HELP. GlaxoWellcome HIV/AIDS Helpline (0800 110 605) can answer
questions or provide information on HIV infection and AIDS.” The folk who’ll
answer are not doctors, much less virologists, but you can rely on them to
explain everything nicely. And for friendly, unbiased advice on whose expensive
merchandise to buy too, of course.
[84] So I asked the
GlaxoWellcome HIV/AIDS Helpline, “Should rape victims take AZT?” “Absolutely,”
Colleen told me, “before the HIV gets into the memory cells.” “But,” I queried,
“GlaxoWellcome’s medical director Dr Peter Moore said on Carte Blanche
in November last year that AZT was not registered and
not recommended for HIV prophylaxis after rape.” Confused pause. “He wasn’t
reported properly,” she replied, “and you have to take it with 3TC. You never
take AZT on its own.” (Guess which pharmaceutical corporation also makes 3TC?)
I pointed out, “According to GlaxoWellcome’s current PRODUCT INFORMATION
releases for AZT, 3TC and both drugs in combination (Combivir), none had ‘been
shown to reduce the risk of transmission of HIV to others through sexual
contact…’.” In fact, in the case of AZT and 3TC taken in combination, under the
heading Description of Clinical Studies,
GlaxoWellcome admit, “There have been no clinical trials conducted with
COMBIVIR.” None at all. Let alone to test efficacy for rape victims. “No,” she
explained, “what that means is that if you are HIV-positive, taking AZT will
not prevent you from infecting other people.” Which is not what GlaxoWellcome
told our Minister of Health when she asked about this. Inquisitive about the
extent of GlaxoWellcome’s control over the information fed by these
clearing-houses to the worried public, I opened with, “Is there a single
central HIV/AIDS Helpline or are there different offices around the country?”
“There are a number of Helplines,” she answered, and volunteered,
“For this one we have an arrangement with
GlaxoWellcome.” As Smith’s description “the GlaxoWellcome HIV/AIDS Helpline”
might suggest. “What sort of arrangement?” I asked. “That’s private. I can tell
you about the services we provide, but the financial side is private. Why are
you asking all these questions?”
[85] On 19 June 2000, Dr
Andrew Robinson of GlaxoWellcome in South Africa confirmed to me that “the jury
was still out”, and that data were being collected to determine whether AZT
administered to rape victims had any effect upon HIV-seroconversion. At this
stage, he told me, GlaxoWellcome, had not shifted from the position publicly
stated by Dr Peter Moore, namely that AZT is “not registered” and “not
recommended” for anti-HIV prophylaxis following rape.
[86] The Sunday Times published part of an
exchange of correspondence on the subject of AZT for rape victims between D P
leader Tony Leon and Mbeki on 9 July 2000. Mbeki’s grip on the subject is
astonishing. His ‘experts’ having let him down, one sees the trouble he has
gone to in acquainting himself personally with the nuts and bolts of the controversy.
His nose for the racism imbuing the ‘African AIDS’ construct is evident too,
and he pulls the covers off GlaxoWellcome’s rank commercial opportunism in the
hysterical climate fanned by Smith. John Kearney, managing director in South
Africa, has changed GlaxoWellcome’s tune, we see. He’s all for AZT for rape
victims now, and appropriately employs the party of big white money to
spearhead his company’s drive into this new market. This is Mbeki’s letter
dated 1 July 2000:
“Dear Tony
Thank you for your letters of June 19 and 27, 2000 relating to the AIDS issue.
Thank you also for the copy of the letter of the South African CEO of
GlaxoWellcome, Mr J P Kearney. As you are aware, during the last few months, I
have tried to familiarize myself with all elements relating to the HIV-AIDS
matter. Necessarily, this has also meant studying as much literature as
possible on the question of anti-HIV retroviral drugs. What I said in
parliament was based on the information I had managed to garner on the issue
you raised. As you correctly indicate, this related to the efficacy of AZT in
stopping HIV infection in cases of rape. Your statement, that 80% of women
raped by HIV-positive men would not become HIV-positive if they are given AZT,
has no scientific basis whatsoever. In this regard, I suggest that, among
others, you obtain a copy of the
publication of the US CDC, MMWR September 25, 1998/47 (RR17). Among other
things, the CDC says: “no data exist regarding the efficacy of (antiretroviral
drugs) for persons with nonoccupational HIV exposure...” (As you must be aware,
‘nonoccupational exposure’ includes rape.) “Some physicians believe that
antiretroviral agents are indicated for persons with possible sexual,
injecting-drug-use, or other nonoccupational HIV exposure. However PHS (the US
Public Health Service) cannot definitely recommend for or against
antiretroviral agents in these situations because of the lack of efficacy data
on the use of antiretroviral agents in preventing HIV transmission after possible
nonoccupational exposure. Efficacy and effectiveness data and additional
epidemiologic information is needed...” and, “Research is needed to establish
if and under what circumstances antiretroviral therapy following
nonoccupational HIV exposure is effective.” The CDC makes this equally
important statement: “Postexposure antiretroviral therapy should never be
administered routinely or solely at the request of a patient. It is a
complicated medical therapy, not a form of primary HIV prevention. It is not a
‘morning-after pill’.” In the same report, the CDC says that: “The risk for HIV
transmission…per episode of receptive vaginal exposure is estimated at 0.1% -
0.2%.”
In this regard, you might care to consider what it is that distinguishes Africa
from the United States, as a consequence of which millions in sub-Saharan
Africa allegedly become HIV-positive as a result of heterosexual sexual
intercourse, while, to all intents and purposes, there is a zero possibility of
this happening in the US. In your letter to me of June 19, you make the
extraordinary statement that AZT boosts the immune system. Not even the
manufacturer of this drug makes this profoundly unscientific claim. The reality
is the precise opposite of what you say, this being that AZT is immuno-suppressive.
Contrary to the claims you make in promotion of AZT, all responsible medical
authorities repeatedly issue serious warnings about the toxicity of
antiretroviral drugs, which include AZT. For example, in its Report, MMWR May
15, 1998/Vo. 47/No. RR-7. the CDC says: “The selection of a drug regimen for
HIV PEP (post-exposure prophylaxis) must strive to balance the risk for
infection against the potential toxicity of the agent(s) used. Because PEP is
potentially toxic, its use is not justified for exposures that pose a
negligible risk of transmission.” In this context, please bear in mind the 0.1%
- 0.2% risk of transmission indicated by the CDC with regard to receptive
vaginal exposure. The matter is not in dispute between us that AZT is not licensed
by the South African MCC for use in rape cases. Further to this, GlaxoWellcome
has not applied to the MCC for such a licence. Indeed, the approved package
insert for AZT makes no claim about the efficacy of AZT with regard to rape
cases. I would presume that the reason that GlaxoWellcome has not applied for a
licence is precisely because it knows that there is no scientific evidence it
could produce to justify this application. It is very strange that you have
proven scientific information which GlaxoWellcome, the CDC, the MCC and every
responsible medical authority does not have, that 80% of rape victims in our
country would not have become HIV-positive if they had been given AZT. It may
be that I underestimate the scientific expertise of which your party disposes.
Accordingly, I am ready to change my views on this matter, to pay due tribute
to such expertise, if it is demonstrated that you do, indeed, have such
expertise. If it is necessary, I can present the argument about the obvious
logical absurdity of the claim that viral infection can be stopped by the use
of drugs, provided that the virus was communicated in circumstances of forced
heterosexual sexual intercourse. It is in this context, apart from extant
scientific information, that the issue I raised in the National Assembly about
AZT not being a vaccine assumes its relevance. The PEP argument about AZT (and
other antiretrovirals) cannot be sustained unless vaccine-like efficacy is
attributed to these antiretroviral drugs. Accordingly, the statement you make
in your 19 June letter that I am “correct to indicate that AZT is not a
vaccine, which I (you) did not suggest it was”, is inconsistent with your
argument that AZT should be used as though it were a vaccine. I am very
disturbed at Mr Kearney's statement that your incorrect statements about AZT
and rape are “essentially accurate on the scientific aspects of using AZT as
post-exposure prophylaxis in individuals who have been raped.” I imagine that
all manufacturers of antiretroviral drugs pay great attention to the very false
figures about the incidence of rape in our country, that are regularly peddled
by those who seem so determined to project a negative image of our country.
What makes this matter especially problematic is that there is a considerable
number of people in our country who believe and are convinced that most black
(African) men carry the HI virus. In addition to this, reflecting a view among
these about rape in our country, Charlene Smith was sufficiently brave, or
blinded by racist rage, publicly to make the deeply offensive statement that
rape is an endemic feature of African society. This is what she wrote recently
in the US Washington Post: “Here, (in South Africa), HIV is spread primarily by
heterosexual sex - spurred by men’s attitude towards women. We won’t end this
epidemic until we understand the role of tradition and religion - and of a
culture in which rape is endemic and has become a prime means of transmitting
the disease, to young women as well as children.” The hysterical estimates of
the incidence of HIV in our country and sub-Saharan Africa made by some
international organisations, coupled with the earlier wild and insulting claims
about the African and Haitian origins of HIV, powerfully reinforce these
dangerous and firmly-entrenched prejudices. None of this bodes well for a
rational discussion of HIV-AIDS and an effective response to this matter,
including the use of antiretroviral drugs. Whatever his obligations as the
Chief Executive of the company that manufactures AZT, I think it is grossly
unethical that Mr Kearney should seek to increase the sales of AZT, and
therefore GlaxoWellcome’s profits, by exploiting the justified health concerns
of our people. I consider it deeply offensive and contemptuous of our people,
our country and its laws that, as you and Charlene Smith say, GlaxoWellcome
should promote the sales of AZT by selling ‘cut-price’ AZT in our country for
use by rape victims, knowing very well that this is in violation of the law and
that no scientific evidence exists proving the efficacy of this drug in cases
of rape. I have noted the fact that Mr Kearney seeks to achieve his commercial
purposes “together with you and your Party.” It is amazing and completely
unacceptable that you, the Leader of the Official Opposition, should consider
all of this, including blatant disrespect for the rule of law, as “irrelevant”,
the word you use in your letter to me. You will remember that during the debate
around the legislation we introduced enabling the parallel import of drugs and
medicines, to make these affordable for our population that is deeply mired in
poverty, your party was correctly and needlessly very vocal about the necessity
to ensure that all pharmaceutical products available to our people should be subject
to approval by the MCC. Why is a double standard now being applied with regard
to AZT, making the need for the certification of drugs by the MCC “irrelevant”?
Only recently, your party has been very strident in demanding respect for the
rule of law in Zimbabwe. Why is a double standard now being applied with regard
to AZT, making the requirement for observance of the rule of law “irrelevant”?
In his letter to you, Mr Kearney says his company is committed “to improve
access to drugs for HIV-positive individuals.” In more direct and plain
language, this means that, consistent with its normal and understandable
commercial objectives, GlaxoWellcome is committed to increase the sales of AZT
in our country, in competition with antiretroviral drugs manufactured by other
companies. If Mr Kearney did not pursue this objective as vigorously as
possible, his company would be entitled to terminate his contract. You and I,
as public representatives of our people, pursue, or should pursue, a different
objective. With regard to the matter under discussion, our objective must
surely be to improve the health of all our people. I think that it is dangerous
that any of our public representatives and political parties should allow
themselves to be used as marketing agents of particular products and companies,
including drugs, medicines and pharmaceutical companies. I accept that it is
perfectly within their right for private individuals, such as Charlene Smith,
to play this role, as it would be for you, in your private capacity. In the
controversy that has attended the questions our government has raised about
various matters relating to HIV-AIDS, much has been said about us, in a
sustained effort to force us uncritically to accept a so-called orthodox view.
We have resisted this pressure and will continue to do so, because of the
decisive importance of an accurate understanding of AIDS and its specifics in
our own country. I trust that our discussion about AZT and rape will convince
you that despite the fervent reiteration of various assertions, supported by
many scientists, medical people and NGO’s, about the existence of some
unchangeable and immutable truths about HIV-AIDS, as public representatives we
have no right to be proponents and blind defenders of dogma. Whatever the
intensity of the campaign to oblige us to think and act differently on the
HIVAIDS issue, the instinctive human desire in the face of such a barrage, to
obtain social approval by succumbing to massive and orchestrated pressure, will
not lead us to become proponents and blind defenders of dogma. The cost of AIDS
in human lives is too high to allow that we become blind defenders of the
faith. Unless you have evidence to demonstrate that what I have said about AZT
and rape is wrong, I would expect that you make a public statement distancing
yourself from the false claims so regularly propagated in this country,
concerning the efficacy of AZT as post-exposure prophylaxis in cases of rape,
propaganda in which you joined. Not only is this the only honourable thing to
do, but, as a high-level public representative, I believe you have an
obligation to correct the misleading impression on the matter we are discussing
that you and your party have conveyed on more that one occasion, in parliament
and elsewhere. Needless to say, to uphold the rule of law and to fulfil the
government’s obligations with regard to the health of our people, we will
follow up on the matters you have brought to our attention, concerning the
disturbing behaviour of GlaxoWellcome. Given that the matters about which you
have written to me were discussed openly in the National Assembly, during which
debate I suggested that you convey my views to GlaxoWellcome, I believe that it
would be correct that we make the correspondence between us available both to
the National Assembly and the general public. Once again, I would like to
suggest that you inform yourself as extensively as possible about the AIDS
epidemic. Again, for this purpose, I would like to recommend that you access
the Internet. On the various websites, you will find an enormous volume of
literature, including CDC, WHO and UNAIDS documents, editions of various highly
respected science journals as well as “dissident” articles. As you know, many
frightening statements are made with great regularity about the incidence of
HIV-AIDS in our country and continent and the threat this poses to our very
survival as a country, a continent and as Africans. I believe that it is
imperative that all our public representatives should base whatever they say
and do on the HIV-AIDS matter, on the truth and not necessarily on the comfort
of fitting themselves into the framework of whatever might be considered to be
‘established majority scientific opinion’.”
[87] A week later, Tony Leon
- smarmy, smart-aleck attorney to the end, even when boxed down flat on his
back - responded with a triple-cocktail of unpleasant politician-speak,
country-club superiority, and breathtaking naivete. The fallacies he advances
leap off the page.
“Dear President Mbeki
Thank you for your letter of the 1st of July. I appreciate the great time and
effort that you have obviously put into your response, although I find much of
the tone and content unhelpful in promoting rational debate on this important
matter. If I understand your letter correctly, you argue against the provision
of AZT to rape victims on two grounds: Firstly, you argue that there is “no
scientific evidence” to support the argument that the provision of AZT could
prevent the transmission of HIV to rape victims. Secondly, you claim that the
risks of potential transmission are so low that they do not warrant the use of
AZT, which as you correctly point out can have severe side effects. You base
your argument on numerous quotes from the publication of the Centers for Disease
Control in America, Morbidity and Mortality Weekly Report, September 25, 1998/
Vol 47/ No. RR-17. I do not believe that, when read as a whole, the document
supports your arguments. I will deal with each argument in turn. The evidence
from the CDC report which you provide to support your first argument is a quote
from the CDC which says “no data exist regarding the efficacy of
(antiretroviral drugs) for persons with nonoccupational HIV exposure . . .”;
the fact that the US Public Health Service “cannot definitely recommend for or
against antiretroviral agents in these situations because of the lack of
efficacy data”; and that further research is needed “to establish if and under
what circumstances” such therapy would be effective. The CDC report is extremely
even-handed. It scrupulously weighs up the evidence both for and against the
provision of antiretroviral drugs following non-occupational HIV exposure. You
have unfortunately only quoted the arguments against. A point that must be made
at the beginning is that the CDC does allow the provision of antiretroviral
drugs by physicians to rape victims. The document is an attempt to highlight
the “potential benefits and risks” and so provide a guide to physicians on
whether or not to pursue such a course of treatment. The CDC has published
formal guidelines for physicians should they choose to use AZT. The reason for
the lack of “efficacy data” is that there have been no prospective trials
conducted to measure the effectiveness of AZT for non-occupational exposure. It
is simply impossible to conduct such trials because one would need to establish
beyond doubt the HIV status of both the rape suspect and the rape survivor
before and after the rape. While this in itself is almost impossible, the fact
that it is illegal to test for HIV against a person’s will makes such research
harder still. The best that can be done is to conduct a retrospective case
control study. One is currently being conducted by the CDC. It is for this
reason that the CDC is unable to recommend either for or against antiretroviral
drugs for rape victims. This does not mean that there is “no scientific basis
whatsoever” for my statement that the provision of AZT would reduce HIV
transmission to rape survivors. In fact, the CDC report evaluates data from
various trials, which could have a bearing on the potential efficacy of
antiretroviral PEPs. It makes reference to various trials conducted on animals,
but I will deal only with its references to studies on humans. Two are of
significance: Firstly, the CDC quotes the study (which I referred to in my
letter) from a 1995 survey where investigators used “case control surveillance
data from health care Workers” in Europe and America to document that AZT use
“was associated with an 81% decrease in the risk for HIV infection after
percutaneous exposure to HIV-infected blood.” According to the CDC this study
“demonstrated antiretroviral effectiveness” following needle stick injuries.
The CDC also refers to the study where there was a 67% reduction in transmission
of HIV from mother to child when AZT was administered during pregnancy, labour,
and for six weeks after birth. The CDC states that there was evidence that a
“prophylactic effect” on the foetus before, during or after birth “could
account for some reduction in perinatal transmission”. Although the CDC report
acknowledges that these studies “might not be directly relevant to
non-occupational exposure” they do “suggest that antiretroviral agents are
potentially valuable for treating HIV exposures in these settings”. These
trials are obviously not conclusive for they have to be extrapolated to
nonoccupational settings. However, they do suggest that antiretroviral agents
can act as a post-exposure prophylaxis and reduce a person’s risk of acquiring
HIV infection after exposure. The CDC report states “it can take several days
for infection to become established in the lymphoid and other tissues. During
this time, interventions to interrupt viral replication could represent an
opportunity to prevent an exposure from becoming an established infection.”
Thus, if providing AZT to rape victims can prevent an exposure to HIV from
becoming an established infection (and there is substantial evidence to suggest
it can) the benefit is massive, if not priceless. The victim is literally saved
from a death sentence. Which brings me to your second argument, which is that
the chances of HIV transmission from rape are so small, and the side effects of
AZT are so large, that providing such treatment to rape victims is not really
worth the candle. You quote the CDC as saying that in selecting a drug regimen
for post-exposure prophylaxis the physician should “balance the risk for
infection against the potential toxicity of the agent(s) used. Because PEP is
potentially toxic, its use is not justified for exposures that pose a
negligible risk of transmission.” You then state, “in this context, please bear
in mind the 0.1% - 0.2% risk of transmission indicated by the CDC with regard
to receptive vaginal exposure.” You seem to be implying that “receptive vaginal
exposure” constitutes a “negligible risk of transmission” and that consequently
it is not worth providing rape survivors with AZT with potentially toxic side
effects. This is disingenuous for two reasons: Firstly, the risk of HIV
transmission following rape (particularly in South Africa) is not “negligible”
at all. Rape does not constitute “receptive” sex and as such is likely to lead
to trauma and consequently a far greater risk of HIV transmission. The risk is
compounded in South Africa by the high levels of HIV in the population as well
as the prevalence of Sexually Transmitted Diseases, which greatly increase the
possibility of HIV transmission. Secondly, the CDC is not referring to rape or
consensual sex when it states that PEPs are not “justified for exposures that
pose a negligible risk of transmission”. Rather, it is referring to contact
between infected body fluid and intact skin. This would be clear had you quoted
the whole sentence from the CDC report, which reads, “Because PEP is
potentially toxic, its use is not justified for exposures that pose a
negligible risk of transmission (e.g. potentially infected body fluid on intact
skin)”. This is just one example of
where you have pruned quotes to make them fit your argument. Elsewhere you
quote the CDC report as saying “Postexposure antiretroviral therapy should
never by administered routinely or solely at the request of a patient. It is a
complicated medical therapy, not a form of primary HIV prevention. It is not a
‘morning-after pill...’.” Yet you omit to mention that the report continues
(from precisely the point where you left off) “but, if proven effective, can
constitute a last effort to prevent HIV infection in patients for whom primary
prevention has failed to protect them from possible exposure”. Reading through
your letter I had the strong feeling that you have reached your conclusions
already. You then selectively choose quotes to support your argument, and
ignore others that don’t. If the quotes do not quite fit your purposes, you lop
off the awkward parts. What is most disturbing about your letter is the way you
impute sinister motivations on the bona fide actions of others. You seem to
believe that the request by my party, Charlene Smith and others for the government
to provide AZT to rape victims, and the offer by GlaxoWellcome to provide it at
greatly reduced prices, is all part of a giant conspiracy. You imply that this
conspiracy is the result of some unholy alliance between a civil society
motivated by racism and an international pharmaceutical industry driven by
greed. It seems that underlying your letter is a belief that civil society is
once again being driven by an overriding desire to reaffirm “its belief that
its racist stereotype of Africans [is] correct” (ANC statement to HRC on racism
in media). Out of a “determination” to project a “negative image” of South
Africa, unnamed forces peddle what you describe as “very false figures” on the
incidence of rape in this country. You claim that the AIDS debate in South
Africa is being driven (and distorted) by people “who are convinced that most
black (African) men carry the HIV virus”. Among their number you name Charlene
Smith who you claim was “blinded by racist rage” when she wrote that rape was
endemic in South African society. You proceed to complain that by publishing
“hysterical estimates” and by making “wild and insulting claims” about the
African origins of HIV, the international community is (whether out of accident
or design) acting to “reinforce these dangerous and firmly-entrenched
prejudices”. You then claim that the international pharmaceutical companies are
driven by even more sinister motivations. You suggest that the sole and
overriding desire of the pharmaceutical companies is to maximise their profits
by exploiting every available opportunity to flog their drugs to South Africa,
regardless of their efficacy or toxicity. You claim that having had their
interest pricked by the high incidence of rape in this country, GlaxoWellcome
set out to cynically exploit the “justified health concerns of our people” in
order to (once again) “increase the sales of AZT”. To top off this
giant-racial-capitalist-conspiracy, you accuse Charlene Smith and I of being
“marketing agents” of the pharmaceutical companies. (For the record: Neither I
nor the Democratic Party have received any financial assistance of any nature
from GlaxoWellcome.) What concerns me about your letter is the tendency to turn
questions of fact into questions of motive. This method of propaganda may be
useful means of silencing (or isolating) your critics without responding to
their arguments, but is not particularly conducive to rational debate. It is
somewhat hypocritical to accuse overseas opinion of intolerance and then to try
to shut down dissent domestically by labeling people “racists” or “pawns of the
pharmaceutical industry”. Your statement that the government will take steps
against the “disturbing behaviour of GlaxoWellcome” is frankly sinister. Your
determination to resist the imposition of what you call the “dogma” of
scientific opinion seems to be matched only by a desire to impose your own. Yet
what is most worrying for South Africa is that it seems your party has actually
started to believe its own propaganda. Instead of identifying, confronting, and
then dealing with the immense problems facing our country, the ANC is
perpetually chasing shadows. You seem more concerned with the possibility that
high rape and AIDS figures might confirm the prejudices of some, than with the
massive human tragedy in our country which those figures are merely an
indication of. In consequence, your obsession with the motives of others has
begun to harm the interests of the very people you claim to represent. As the
earlier part of my letter has indicated, there are strong scientific grounds
for providing post-exposure prophylaxis to victims of rape. I cannot see how
the offer by GlaxoWellcome to provide AZT to rape survivors at reduced prices
can be described as “grossly unethical”. Similarly, I cannot see how you can
equate the provision of AZT to rape survivors with the state-sponsored campaign
of terror and intimidation in Zimbabwe. It is a nonsensical comparison. I, like
you, am a layman on these matters. You are entitled to your personal opinion on
whether AZT is effective in reducing HIV transmission, and indeed, whether HIV
even causes AIDS. However, it is wrong for you to use your current position
(which was gained on the basis of political rather than medical talent) to
block the provision by your government of such treatment. It is perfectly
consistent with the CDC report (which you quote!) for our government to make
available AZT for prescription to rape victims. Obviously, our doctors must
weigh up the risks and benefits of prescribing such treatment. They must act
both with the informed consent of the patient, and according to proper
guidelines such as the CDC provides. The point is that the physician and the
patient must be left to make that decision. By denying rape victims AZT you are
denying them the choice. With all due respect, you lack both the moral right
and the medical expertise to make such a life and death decision. I agree that
this correspondence should be made available to the National Assembly and the
general public.”
[88] The kind of thinking
about AIDS that Mbeki was deploring in his letter to Leon is captured in cameo
by Donald McNeil’s characteristically alarmist and racist article in the New York
Times on 2 July 2000 entitled Writing the Bill for Global AIDS: “The
question is: How much would it cost to contain the global AIDS epidemic?”
McNeil echoes the full-page ad I saw in the Natal
Witness a couple of years ago with a pretty young African girl
recommending, “Just say no to sex for a brighter future”, and answers with a rhetorical
question: “How much would it cost to banish ignorance, to deaden lust, to shame
rape, to stop war, to enrich the poor, to empower women, to defend children, to
make decent medical care as globally ubiquitous as Coca-Cola - in short, to get
rid of all the underlying causes of the epidemic in the third world?” McNeil
flies into Africa and contemptibly makes the poor to blame for their broken
health by typifying them as beasts. With an offer of American pills to save
them from themselves.
[89] Responding to Leon’s
insults and barbs delivered during their joust over AZT, Mbeki laid bare Leon’s
inarticulate racism in a beautiful address delivered at the Oliver Tambo
Memorial Lecture in Johannesburg on 11 August 2000. Quoting from Shakespeare’s
The Tempest, he opened by recalling
Miranda’s response to her father Prospero’s explanation of “how he, the Duke of
Milan, lost his dukedom as a result of the machinations of a perfidious
brother, and she, her identity”: “Your tale, sir, would cure deafness.” He responded
to Leon’s criticism of the uppity nigger’s rejection of AZT and the American
notion that the poor health of the impoverished is the result of hi-octane
sex-lives rather than as a consequence of not enough good food, uncontaminated
water and decent shelter: “I believe that what I will try to talk about during
this Second Oliver Tambo Lecture, dedicated to the memory of a noble African,
should, because of its drama and pathos, evoke among all people of conscience,
a Miranda-response, sufficient to cure deafness itself. Recently, a leading
white South African politician spoke his mind either honestly or,
alternatively, seemingly without inhibition. As with Prospero’s brother,
circumstance had created the apparent necessity that he needs must be absolute
Milan (sic). Just over a fortnight
ago, one of our newspapers reported that this white politician had said that
the President of our Republic had damaged the reputation of the government.
According to the newspaper, the white politician accused the President of
suffering from a ‘near obsession’ with finding African solutions to every
problem, even if, for instance, this meant flouting scientific facts about
AIDS, in favour of ‘snake-oil cures and quackery.’ (Business Day: July 26,
2000.) Our own absolute Milan, the white politician, makes bold to speak openly
of his disdain and contempt for African solutions to the challenges that face
the peoples of our Continent. According to him - who is a politician who
practices his craft on the African Continent - these solutions, because they
are African, could not but consist of the pagan, savage, superstitious and
unscientific responses typical of the African people, described by the white
politician as resort to ‘snake-oil cures and quackery’. By his statements, our
own absolute Milan, the white politician, demonstrates that he is willing to
enunciate an entrenched white racism that is a millennium old. This racism has
defined us who are African and black as primitive, pagan, slaves to the most
irrational superstitions and inherently prone to brute violence. It has left us
with the legacy that compels us to fight, in a continuing and difficult
struggle, for the transformation of ours into a non-racial society. Such crimes
against humanity as slavery, colonialism and apartheid would never have
occurred unless those who perpetrated them, knew it as a matter of fact that
their victims were not as human as they. Our white politician would not have
made the statements he reportedly made, unless he knew it as a matter of fact
that African solutions amounted to no more than snake-oil cures and quackery.
The Martinique revolutionary, Frantz Fanon, has written: ‘Colonialism, which
has not bothered to put too fine a point on its efforts, has never ceased to
maintain that the Negro is a savage; and for the colonist, the Negro was
neither an Angolan nor a Nigerian, for he simply spoke of ‘the Negro’. For
colonialism, this vast continent was the haunt of savages, a country riddled
with superstitions and fanaticism, destined for contempt, weighted down by the
curse of God, a country of cannibals--in short, the Negro’s country.’ (African
Intellectual Heritage: Molefi Kete Asante & Abu S. Abarry, eds: Temple
University Press, Philadelphia, 1996. p. 238.) It is not the arrogance of the racism
of those who have convinced themselves that they are superior, the
colonialists, that we seek to talk about today. What we wish to address is the
response of the victims of that arrogance, to the arrogance of those who
believe themselves to be superior - the arrogant certainty of those who would
be our absolute Milan.” Mbeki went on to elaborate relentlessly, richly citing
du Bois, Malcolm X, Biko, Tambo and others to drive home his case. (The speech
is posted in full at http://www.gov.za/president/index.html)
Did any of it reach Leon? Did he squirm like a grub impaled on a thorn? Not a
chance. The Sunday Times in London
reported on 14 August 2000: “ Mr Leon, whose party is predominantly white, responded
by accusing Mr Mbeki of an ‘obsession’ with finding African solutions to every
problem, even if he ignored scientific facts about Aids in favour of ‘snake-oil
cures and quackery’. Mr Leon has been one of South Africa’s most vociferous
critics of Mr Mbeki’s questioning of the relationship between HIV and Aids; his
support for Virodene, the discredited anti-Aids ‘miracle drug’ whose main
ingredient is an industrial solvent, and his opposition to giving anti-Aids
therapies to pregnant women with HIV… Mr Leon accused Mr Mbeki of
‘squandering his prestige on what
might rightfully be called a form of quackery, and now takes issue with me
because I dare to mention this blindingly self-evident fact’. He added: ‘Since
everyone who disagrees with President Mbeki is a racist I presume that [his]
views on this matter are so discredited as not to require serious attention…’.”
The white press agreed. Dull to Mbeki’s plaint, journalists immediately panned
him for it.
[90] None of South Africa’s
AIDS journalists and public-spirited types who have been crowing in morally
indignant tones for the free provision of AZT to HIV-positive pregnant women
have taken the trouble to find out what has bothered Mbeki about the drug. As
Ofelia Olivero of the US National Cancer Institute mentioned to me in a private
note, nobody is really interested in “the bad news” about AZT. In the public
perception in South Africa it represents a miracle salvation from certain
death. Father Cosmas Desmond, a quiet hero of the struggle against apartheid,
condemned me in a newspaper article as “some crank” for instigating Mbeki’s
enquiry into the safety of AZT, and in the headline of his piece asserted that
to deny AZT to babies in utero was
tantamount to genocide. And he still thinks so, he told me, even after I sent
him a copy of this debate. He’s not alone. On 21 July 2000, Mail and Guardian
editor Philip van Niekerk shrieked in unison with a typically weak editorial headed
A failure to act now is genocide. This
is about right from a newspaper reduced since he took over from bold dissident
manifesto to banal, carping, middle-class tabloid: “Just say yes, Mr President
[that HIV causes AIDS]” – Mail and
Guardian front-page headline, 15 September 2000. (Just accept that you’re a
sinner and that the Lord died for you! Just accept Jesus into your life!) In
her article Women demand anti-Aids drugs
Sue Segar reported on 26 July 2000 that “A large group of key women’s and
HIV/Aids organisations have issued the government with a strong statement of
concern on women and HIV/Aids, demanding that the government provide
anti-retrovirals to pregnant HIV-positive mothers…. The organisations…include
the Aids Law Project, Black Sash, Commission for Gender Equality, KwaZulu-Natal
Coalition for Gay and Lesbian Equality, and the South African National NGO
Coalition (Sangoco).
[91] AIDS journalists in the local print media
(those on the Citizen and noseweek apart), sold on the fantastic
properties of AZT one and all, have responded to warnings about its toxicity
with smarting dismissals, loyally turning to and quoting GlaxoWellcome
representatives to slap down the government’s concerns. Without a trace of the
investigative journalist’s basic professional curiosity and scepticism of
corporate denials of claims made about allegedly unsound products, their
writing about AZT has been published under such headlines as Denigration of AZT
Outdated and Irresponsible (Adele Sulcas on the
Sunday Independent) Truth and Lies
about AZT (Aaron Nicodemus on the
Mail and Guardian) and Mbeki’s claims
on AZT are problematic (Michael Cherry for Business Day). Cherry moaned,
“President Thabo Mbeki’s recent
statement that government would not take the ‘irresponsible’ step of supplying
antiretroviral drug AZT to people who have HIV/AIDS until it could be
established that the drug imposed no health risk has caused immense public
confusion.” A hostile editorial in the Mail
and Guardian claimed, “More recently, Mbeki set alarm bells ringing by
resisting the use of the drug AZT - especially in the prevention of mother to
foetus transmission - …on the grounds of its supposed toxicity.” In other
words, it’s safe for babies. Laurice Taitz on the Sunday Times reported that
Martin had written to the President to
put his mind at rest, with the assurance that “there is a considerable body of
evidence” on AZT from which to conclude that it was safe. Taitz herself advised
readers not to worry, “…the truth is that the drug is [not] toxic…” In another
searching article in the same newspaper, General
Mbeki and his troops nowhere near the front line in the war against AIDS
she wrote, “In the US and UK, the standard of care in preventing HIV infections
to newborn babies is a long costly regimen of AZT… At the [Durban AIDS]
conference which…13000 delegates attended…In session after session, activists,
researchers, and international researchers repeated the same phrase, ‘We know
what works’. They were referring to among other things, the use of
antiretroviral drugs to prolong the lives of those infected with HIV and prevention-of-vertical
transmission programmes which have reduced the rate of transmission to under 2%
in developed countries.” In a front page headline story in the Mail and Guardian,
R1,99 TO SAVE A CHILD…but govt has ignored own Aids report, Belinda
Beresford complained, “The government has been sitting on a report it
commissioned that vigorously endorses the use of antiretroviral drugs in
stopping the transmission of HIV between mothers and children… [which could]
save about 14000 lives [and] save South Africa as much as R270m a year.” But
then look where she gets her thinking cap from. In the same issue in an article
about the death of the family char, her father David Beresford concluded from
the panopoly of ailments that had troubled her before she died, “We decided
that it must be AIDS.” (Of course, David, it’s what the natives get.) The Financial
Mail did itself proud with an
editorial by Peter Bruce hammering Mbeki on AZT entitled Confusing all the people
most of the time and articles such as Lies, damn lies and AZT, and AIDS -
AZT and Mbeki: Price, not efficacy,
is the issue. In the latter, a case study in advocacy journalism, Claire
Bisseker argued strenuously for AZT, starting with her headline The AZT scare
triggered by government is a
red herring - and a setback in the fight against Aids, say the experts. She
went on, “…the aspersions President Thabo Mbeki has cast on the safety of AZT
have opened Pandora’s Box… As a result of Mbeki’s comments, his instruction
that the Medicines Control Council (MCC) review AZT, and Duesberg’s resultant
appearance on prime-time television, HIV-positive patients have been thrown
into confusion… Medscheme’s Aids benefit management programme, Aid for Aids,
supports 3 000 HIV-positive members, of whom just over half are taking AZT. The
programme’s clinical co-ordinator, Dr Leon Regensberg, is being inundated with
calls from fearful patients who think new evidence must have emerged about the
drug’s toxicity…There are 12 antiretrovirals licensed in SA. All have side effects,
except for lamivudine [that’s not what GlaxoWellcome says], and some have as
many side effects as AZT, if not more. If AZT was not beneficial and well
tolerated, or was under genuine suspicion, doctors would switch to
alternatives, and their peers in the litigious US would be too scared to
prescribe it… The Southern African HIV Clinicians Society has come out in
support of the drug. ‘AZT is a valuable drug,’ says Martin. ‘We recognize that
there are serious toxicities involved with AZT and all other antiretroviral
drugs, as is the case with certain cancer drugs, and that patients on AZT
therefore need to be monitored carefully.’ …Now Mbeki is casting aspersions on
AZT. It’s like Virodene and Sarafina 2 again. This time fewer people will
confuse political manoeuvering with hard facts.”
[92]
Imagine the scorn they would have drawn had such journalists on sentinel
newspapers with socially conscientious traditions responded in like manner to early
alerts about the dangers of Thalidomide or DES, approaching their manufacturers
to set the story straight in order to allay public fears, consulting the
stuffed shirts at the top of Medicine’s notoriously pompous and complacent
bureaucracies for similar comforting advice, and quoting their statements as
the “truth” of the matter without more ado. But it’s no surprise that our
journalists have put up such a poor show on AZT. Time after time, with fawning
reverence they parrot every utterance of doctors and medical scientists making
a handsome living on the back of proclaimed new medical menaces. Which come and
go like the seasons, often linked to a Judeo-Christian aversion to unrestrained
sexuality; witness the enormous syphilis and herpes public health campaigns
before the AIDS era - fatuous official panic-mongering, nothing else. (In the
Middle Ages, doctors explained leprosy as the price of fornication.) For the
immense medical-industrial complex, most journalists exhibit not a wit of the
healthy suspicion they have for other financial, political, and ideological
aggregations. In matters medical and scientific, their deference invariably
demonstrates a tragi-comic blind spot. Blow me down if columnist Steven
Friedman didn’t openly admit as much. Having mocked the President for his
safety enquiry in a sarcastic article Mbeki
Medicine: Web therapy at its best in the
Sunday Independent supplement Reconstruct,
Friedman declined to revisit the issue or be drawn on expressing a view on AZT
in the light of this debate, a copy of which had since come his way, on the
basis that “I believe in sticking firmly to my sphere of competence.” He
admitted to me frankly that he had written without “the knowledge to form a
judgement” and that he had approached the subject having been raised “with a
deep reverence for the medical profession and for pharmaceuticals.” But unable
to help himself, Friedman was then off again holding the floor in the Mail and
Guardian with a cliché-bloated
article, Getting the AIDS politics wrong,
in which he criticised the government’s policy and initiatives on AIDS and
treatment issues: “Friction seems to center on the government’s refusal to
approve the use of AZT for AIDS treatment…[and] its previous support for the
development of virodene, which would have had higher toxicity levels than AZT…”
- from Mr Toxicology Expert, speaking from his “sphere of competence.” In her
adulatory hagiography in Business Day,
[Medical Research Council president Dr William] Makgoba is a statesman in the
world of science on AIDS issue,
consumer journalist Pat Sidley jeered at Mbeki’s AIDS Advisory Panel which had
met in Pretoria a few days earlier, calling it “Monty Pythonesque,” but
admitted to me that she did “not understand…anything about the science involved
in this debate.” High on the agenda of the meeting was the safety of AZT, the
issue which had sparked Mbeki’s wider uncertainties, but when I raised it with
her the best she could do was say, “…about what AZT does and doesn’t do to
people, pregnant and otherwise, I simply don’t have a clue” and made sternly
plain to me that she had no intention of looking into it: “I am not interested
in the aspects of it which would require greater scientific knowledge than I
have.” Which is not very much on her own version. Nonetheless, like the rest of
South Africa’s white liberal journalists who righteously assume the high ground
in our country’s political discourses, she cluelessly rose to defend
GlaxoWellcome and AZT in the April 2000 issue of the British Medical Journal
in an article in entitled Clouding the AIDS Issue, and criticised
Mbeki for his “fight against zidovudine” and Minister of Health Dr
Tshabalala-Msimang “who, in a television appearance, started a campaign against
GlaxoWellcome’s drug zidovudine...” Sidley told us happily, “A rejoinder was
published later in the week by GlaxoWellcome’s local chief executive officer,
whose company had borne the brunt of the attacks by Mbeki and
Tshabalala-Msimang, both of whom are adamant they will not buy zidovudine for pregnant
women.” Pulitzer worthy stuff this. All of it. Shakespeare’s King Henry VIII
could have had Mbeki in mind when he said, “You have many enemies that know not
why they are so, but like village curs, bark when their fellows do.” But for
its cost, AZT is a poison fit only for cleaning drains. The media-driven
consolidation of an almost universal popular consensus around the notion that
it delivers life is perhaps the most egregious current example of that
phenomenon Noam Chomsky describes in his classic critique Manufacturing
Consent. And it must be one of modern journalism’s
starkest failures.
[93]
True believer that he is, Martin sonorously praises “Highly Active
Antiretroviral Therapy” (HAART - cocktails of AZT and other metabolic poisons)
as “good news” and “highly effective”, and even reports mass Lazarus cures with
entire hospital wards closing down. Really? Not according to big-time AIDS
clinician Dr Michael Saag of the University
of Alabama, co-editor of the ‘cutting-edge’ text AIDS Therapy published in
January 1999. No dissident, he’s a paid
consultant for GlaxoWellcome and other pharmaceutical corporations. In an
interview in Esquire in April 1999,
he confessed that the HAART “‘dam’ is already leaking; there’s high danger of
it collapsing altogether. Failures are occurring right and left.” He stated
plainly that doctors “should expect failure with whatever [HAART cocktail they]
first use. We should plan on it. We should prepare for it. Clinicians should
expect failure.” And failure they get.
[94] Carr and
Cooper wrote in the Lancet in
December 1998, “As the evanescent blush of success with so-called highly active
antiretroviral therapy regimens begins to recede into the darkness…post-1996
AIDS conference hype [about] combination therapy including a protease
inhibitor…[has come] back to haunt us.”
[95] In April
1999 in the journal AIDS, Dr Steven
Deeks and his colleagues at San Francisco General Hospital and the University
of California, reported treatment failure for more than half their AIDS patients
given HAART ‘triple-therapy’. Similarly, Medical Professor Dr Julio Montaner,
head of AIDS Research at St Paul’s Hospital/University of British Columbia,
Vancouver, and co-director of the Canadian HIV Trials Network told us in the
May 1999 issue of the Journal of the
American Medical Association that “Given the complexities and the
increasingly recognized potential for long-term adverse effects of many of the
currently available treatments, it is hardly surprising that [for] an
alarmingly high proportion of patients…the failure [rate] has been in the order
of 30% to 50% of patients at 1 year…”
[96] Several
other research papers published about AZT-based HAART in May and June 1999 all
point a thumbs-down. In May, in the New
England Journal of Medicine, Zhang et
al at the Aaron Diamond AIDS Research Center in New York reported that
following combination antiretroviral therapy “replication-competent virus can
still be recovered from latently infected resting memory CD4 lymphocytes; this
finding raises serious doubts about whether antiviral treatment can eradicate
HIV-1… Six of the eight patients had no significant variations in proviral
sequences during treatment…[and] it may require many years of effective
antiretroviral treatment to eliminate HIV-1.” The researchers fret, “We are
unable…to explain why drug-sensitive HIV-1 is capable of replicating at low
levels during treatment with three or four drugs. But it is essential to the
therapeutic effort that the answer, be it pharmacokinetic or cellular in nature,
be obtained promptly.” Furtado and colleagues of the Northwestern University
School of Medicine in Chicago and Los Alamos National Laboratory in New Mexico,
reporting their research findings in the same issue, didn’t beat about the bush
so much: “HIV-1 infection cannot be eradicated with current treatments.” And
Harrigan et al at St. Paul’s Hospital
in Vancouver, British Columbia reported in AIDS
in May that in six patients with undetectable viral loads who gave up HAART
“because of lipodystrophy, narcotic overdose, insomnia, and/or high blood
pressure,” all experienced “HIV rebound…within 6 to 15 days…and approached or
exceeded pretherapy [plasma HIV RNA] levels…within 21 days of stopping
therapy.”
[97] Faced
with these dismal findings, US AIDS boss Anthony Fauci concedes with his
characteristic up-beat gloss on yet another broken therapeutic promise, “What
all these studies underscore is the pressing need to develop more effective,
less toxic medications that can be used over the long term to suppress HIV, as
well as novel strategies to then purge residual virus from the body and boost
the immune system.” In plain English, this translates into an urgent need to
find alternatives to AZT-cocktails because they are too poisonous and too
ineffective to justify continued use. More openly admitting the pointlessness
of these drugs at the Durban Aids Conference, he said on 17 July 2000, “It has
become clear that no matter what you do, you will never eradicate the virus
completely.”
[98] In Nature Medicine in May 1999, two other papers documented how
useless and harmful AZT-based ‘triple-therapy’ is. The first by Finzi et al at Johns
Hopkins University
Medical School told the “depressing news” that “resting T-cells” said to be
infected by HIV are impervious to HAART and appear to need a lifetime’s
uninterrupted treatment - a regimen which the researchers point out is not
feasible due to its toxicity. The second paper by Picker et al of the University
of Texas Southwestern Medical Center
suggested that patients on HAART need to take “vacations” from such medicine
periodically, in view of their finding that HAART itself causes a reduction in
their patients’ T-cell counts, and that patients suffer a significantly
weakened immune capacity after such treatment. And in the May issue of AIDS,
Ibanez et al at the Fundació
irsiCaixa, Retrovirology Laboratory,
Hospital Universitari Germans Trias i Pujol, in Barcelona, Spain reported their
findings that “48 weeks
of HAART does not significantly reduce the integrated HIV-1 proviral DNA load
in the latently infected CD4 T cell reservoir.” In July 1999, an article in the Lancet
mentioned a disappointing study
reported in Annals of Internal Medicine
by Lucas et al at Johns Hopkins
University School of Medicine. Of 273 patients given HAART over a two year
period, only “23% of the cohort had fewer than 500 copies/mL HIV1 RNA in all
three time intervals” during the trial.
[99] Commenting ruefully on
the Finzi and Zhang studies in the June 1999 issue of Nature Medicine, Saag
and his colleague Michael Kilby at the AIDS
Clinical Trials Unit, University of Alabama rubbed in the rude fact that HAART
doesn’t work: “As [Zhang et al have]
suggested, immediate attention should focus on the reasons why three- and
four-drug potent anti-retroviral therapy does not completely suppress virus
replication…even in the presence of undetectable HIV plasma RNA levels.”
[100] In the face of
mounting evidence of HAART’s unacceptable toxicity, the USA Panel of the
International AIDS Society, (Carpenter et
al) updated their antiretroviral therapy recommendations in the Journal of
the American Medical Association
in January 2000 with the concession: “Offsetting perceived benefits of early
treatment of established HIV infection is growing concern about the long-term
adverse effects of therapy. Apart from adherence problems, impact on quality of
life, drug-drug interactions, and viral resistance, the potential for metabolic
abnormalities raises important long-term concerns, including possible premature
cardiovascular disease.” The rest of their paper is rudderless, high-sheen
waffle reflecting the utterly befuddled state of the art. For example:
“Physicians and patients must weigh the risks and benefits of starting
antiretroviral therapy and make individualized informed decisions. When to
initiate therapy and what regimen to choose are crucial decisions; otherwise,
future options may be severely compromised. Ultimate long-term success may also
be a function of the aggregate effectiveness of sequential therapies.”
[101] The
question of “when to initiate therapy” is now all over the place. The ‘standard
of care’, on the advice of Aaron Diamond AIDS Research Centre head, Dr David
Ho, used to be “hit early, hit hard”. But a paper published in December 1999 in
AIDS by Egger et al reported their finding that whether HIV-positive heroin
addicts (87% not ill) were treated with HAART early or later did not “translate
into an increased risk of clinical disease progression.”
[102] Countering the
oft-heard excuse for the failure of HAART treatment, i.e. ‘the virus mutates
and becomes resistant’, Dr Martin Markowitz of the Aaron Diamond AIDS Research
Center answered with uncommon candour in an editorial in the Journal of the American
Medical Association
in January 2000, “Multiple investigators have reported ongoing viral
replication during therapy without demonstrable resistance.”
[103] You’d think that
people told by their doctors that they will die without the medicine prescribed
would take it religiously. But this is not what Descamps et al reported in the
same issue of JAMA: “Adherence as measured by pill counts revealed a
statistically significant difference in median adherence rates between cases
and controls for patients prescribed either zidovudine or indinavir during
maintenance therapy.” And it doesn’t do
to blame the patient for treatment failure for not taking the sour pills as
ordered. In his editorial, Markowitz observed, “Nonadherence is clearly a
critical factor but cannot be assumed to be the origin of treatment failure in
the presence of rebound with wild-type virus.” Richard Grimes, a professor of
management and policy at the University of Texas, Houston School of Public
Health, told the Durban AIDS Conference on 13 July 2000 that despite free
drugs, refills by phone and medication by mail, in three consecutive studies 73
to 95 percent of HIV-positive patients at two Houston clinics did not stick to
their medication schedules. “It's probably worse than this,” he said, since the
study only looked at prescription refills not whether the pills were actually
swallowed. A friend of his explained, “I had to have a period of not being sick
before I made myself sick taking those drugs.”
[104] Two papers presented
at the 7th Conference on Retroviruses and Opportunistic Infections, which
commenced at the end of January 2000 in San Francisco, provided more evidence
of lethal HAART toxicity.
[105] Witek et al reported their study of a cohort
of more than a thousand AIDS patients: “Among an urban population…mortality
continues to be significant even with early access to HIV care and HAART…
Patients who died in 1999 had: lower viral loads on presentation to care
(66,500 vs 189,500); longer time in care (45 vs 24 months); and higher final
CD4 counts (67 vs 26.5). Those who died in 1999 had taken more antiretroviral
regimens (3 vs 2), had better adherence, and appeared more likely to have ever
had a virologic response to HAART (59% vs 16%). 11 out of 40 patients died with
viral loads less than 5,000 copies, 7 of whom had viral loads less than 400
copies. The 3 most common causes of death for both years were wasting syndrome,
complications related to hepatitis C infection, and mycobacterial disease.” On
data like these, is it too much to expect of ‘AIDS experts’ that they might
begin questioning the worth of encouraging surrogate marker measures like low
‘viral load’ and high CD4 cell-counts when their patients are busy dying off?
And suspect the treatment as their patients waste away with liver damage and
mycobacteria feasting on their poisoned tissues?
[106] At the same conference, Chowdhry et al confirmed the Witek findings:
“…there is a recent trend to an increase in death rates in our large HIV clinic…
Deaths are occurring in persons with greater levels of immune capacity as
reflected in CD4 cell counts and also in persons under good virologic control.”
Strikingly, the researchers noted, “The proportion of deaths due to end-organ
failure rose from 20% in 1995 to >50% in 1999.” Since “end-organ failure”
has never before been classified an AIDS indicator disease, the authors’
suggestion that “end-organ failures are often terminal complications of AIDS”
misses the obvious culprit, the indiscriminate cellular toxicity of HAART.
[107] The “established
experts” preach that AZT-based HAART prevents new rounds of HIV infection by
stopping HIV DNA from producing HIV RNA and thence the proteins and particles
which these experts identify as HIV. Since these latest research findings
reveal that during HAART, the HIV viral burden - the amount of DNA provirus -
does not alter, the “established experts” are confronted with small choice in
rotten apples. Either HAART isn’t antiretroviral, or there is no relationship
between HIV DNA and HIV RNA (which runs counter to a fundamental notion in the
HIV theory of AIDS), or all that these cyto-toxic drugs do is hinder cells
making RNA of any kind, or perhaps they just interfere in the measurement of
whatever RNAs there are. Or all of the above. Take your lucky pick.
[108] In the Esquire article, Saag complained that
the death rate of his patients on combinations of AZT, its chemical cousins
like 3TC and ddI, and protease inhibitors is on the rise: “They aren’t dying of
a traditionally defined AIDS illness,” he says. “I don’t know what they’re
dying of, but they are dying. They’re just wasting and dying.” Could it be that
cell-poisons poison cells? But such myopia is par for AIDS doctors who learn
their trade by rote. And from drug advertisements. Of course the thought that
Saag is killing his patients with his sponsors’ drugs is probably too awful to
entertain. “It is sobering;” Saag continued, “while we are making good guesses,
they are just guesses. We don’t know what we are doing.” It’s hard to disagree.
How good the treatment guesses are was revealed during an interview by Ted
Koppel on Nightline on 19 May 1999.
Saag admitted that “unfortunately, right now, the roller coaster is headed back
downhill. And it’s not really clear how far down it’s going to go, but the
momentum right now is certainly in the wrong direction.”
[109] US AIDS
treatment specialist Dr Joseph Jemsek is more forthright. On 8 January 1999, he
was interviewed on the ABC television
news show 20/20:
Q: And…in
addition, the drugs themselves could kill her by damaging her heart, liver, her
pancreas?
JJ: The drugs
aren’t perfect. They cause side effects, which are cumulative and inexorable.
Now I’m starting to see people die again.
Q: So people
are actually dying of the side effects of these...
JJ: Yes, you’re...
Q: …anti-viral drugs?
JJ: Yes, you’re starting to see that.
[110] To stay
in business, even as their patients on ‘antiretroviral therapy’ die off, doctors
who traffic in this poison have invented a new speciality, “salvage therapy”,
and have started holding conferences at which they portentously celebrate their
incompetence. In April 2000, shortly after the Third International Workshop on
Salvage Therapy for HIV-1 Infection held in Chicago, Mellors and Montaner
mentioned the findings of Amanda Mocroft of Royal Free Centre for HIV Medicine,
London in the Lancet: “…rates of
treatment failure in the EuroSIDA cohort were 50%, 70%, and 80% after first,
second, and third courses, respectively.” The rest of their report makes an
equally disappointing read. It talks of
“increasing complexities associated with the use of antiretroviral
therapy” - code for complete confusion. It contains gems of unintended black
humour such as, “The authors of three separate observational studies reported
on the use of drug regimens involving up to nine drugs. Because of the absence
of controlled studies and the potential for serious drug toxicity such an
approach was not recommended, however. Neither was strategic treatment
interruption, because of safety concerns and the absence of data showing an
improved response when treatment is restarted. Of some concern was that, over
the past year, the development of several promising drugs has been put on hold
or stopped because of toxicity, unfavourable pharmacokinetics, and inadequate
potency; presentations from key regulatory agencies underscored the need for
innovative trial designs.” And unable to find sense or results in their poison
treatments, the authors and fellow quacks throw up their arms and confess
themselves to be at a complete loss: “Delegates agreed that the growing
challenge of salvage therapy can be met only through the integrated and timely
efforts of industry, government, and academia.”
[111] Current
HAART research reports are reminiscent of the pellagra plague in the US South
in the first four decades of the twentieth century, for which Fowler’s Solution
(arsenic) was the drug of choice. Heaps of impressive research articles were
published in the medical journals regarding treatments for the germs causing
this terrible disease, which affected millions and caused people to die in
droves. It turned out that the experts were all barking up the wrong tree.
Everyone knows now that pellagra is a disease of nutritional deficiency, and
has nothing to do with infection. Pity about the quarantined patients in all
the specially built pellagrin-hospitals who died of arsenic poisoning before
the experts eventually changed their minds. Too bad about the wretches thrown
off trains and ships, the babies wrenched from mothers’ arms and installed in
orphanages to prevent them getting infected too.
[112] On 27
July 2000 at a memorial for Stephen Gendin, who had predicted his own death on
AIDS drugs in his article in POZ the
year before, If the virus doesn’t get you
the drugs you take will, Larry Kramer spoke bitterly and desperately about
his community’s experience of the drugs, and about the state of AIDS medicine
generally: “What can we do to honor Stephen? ...He was a gentleman, a
soft-spoken, kind-hearted, very very sweet and very very smart young man...
This fine young man is dead now. In his death we see what awaits us. He went on
the very first drugs, and he took every drug and pill and treatment there was
for him to take. Look into your future boys and girls and have a little more
fear and trembling than you’ve been showing these past few years. Why, at
Durban even Dr. Fauci said that taking these drugs for the rest of our lives is
“not an option.” ...Stephen was a poster boy. You looked at that open and kind
and interested face and as it smiled at you, you felt good. He and Mark and
their friends were “the look” of that new organization coming into being called
ACT UP. Because of how they looked, and how they acted, and how they talked and
what they said and did, smart thoughts came out of their mouths and they spent
a lot of time doing deeds beside dancing. Other smart young people flocked to
ACT UP to be like them. This was the new activism. Do you remember it? It’s
almost as dead as Stephen. Well, like Stephen, it was wonderful while it lived.
Fighting the enemy with devoted comrades-in-arms makes you feel wonderful. And
clean. Is your life wonderful now? Do you feel clean? Have all these shitty
drugs we fought so hard to get made you feel wonderful and clean? ...People ask
me why I wear overalls all the time now. You want to know the real reason? I
don’t have a butt anymore. Pants fall off of me when I wear them. I have to
walk down the street with my hands in my pockets holding them up. Unless I have
my hands in my pockets hiking up my underpants. Or my Pampers. Stephen and
I had an inimitable conversation
not so long ago exchanging stories about shitting in your pants before you could
get to a john. Yeah, I feel dirty and shitty in lots of ways. No, I, and you, all of
us, never finished
the job. We started something and when a bunch of rebels left us [Treatment
Action Group] we let them get away with it, almost grateful that somebody else
was going to be doing the work now. Let them have their turn, even if they shut
out everybody who didn’t think the way they did. After all we’d been rebels
ourselves once, hadn’t we. But in their leaving, ACT UP pretty much fell apart.
The new rebels haven’t turned out much better. They can't finish the job
either. They’re on the same shitty drugs we are and feel just as shitty as we
do. ...Research, very little of it very original, is still in the hands of a
only few people. We know who they are. We kiss their asses and pal around with
them and go to conferences with them and pretend they’re our friends and we’re
their friends. Where has it got us? Here... Betrayal. We have been betrayed at
every turn. Getting inside the NIH got us dipshit. The drug companies? We gave
them our bodies, an army of bodies, to be their guinea pigs, so they could
develop decent treatments that could then be exported to the rest of a
desperately needy dying world. We got them fast track so they could make
billions instead of finishing their work, refining their product. They used our
bodies to create poisons that kill HIV and kill us too, and then they decamped
without improving their wares, and without any consideration for all the dying
people everywhere. This is immoral. Can’t you feel hate in your heart for every
greedy slimy bastard who works at a drug company? Isn’t this a good time to
scare the shit out of them because now they need us desperately? We’re a huge
market now, one they count on for huge profits. If we don’t buy their product,
if we bad mouth their product, if we tell the world Dupont’s Sustiva is one of
the most inhumane medicines ever launched into the bloodstream of man, maybe
they’ll become so afraid of us they’ll start behaving like scientists and not
like Nazi experimenters. Why, if we all stopped our drugs every other month
their profits would be halved. That would be a strategic drug interruption
indeed. Yes, we’re in a wonderful position of bargaining now, better than ever
before. They blame us, you know, for their crappy drugs. We're not compliant
enough. What kind of medicine requires 95% adherence? Stephen was 100%
compliant. Stephen is dead. There has to be a way to make all these bastards
work for our money, harder and faster. There are two types of doctors that we
go to: One is the self- proclaimed expert who is on the payroll of the drug
companies, who does studies for them, who talks for them, who goes on vacations
with them. They don’t talk to other doctors, or listen to us. Because of Managed
Care, if you’re not on a drug they don’t make any money. You can only make
money by being a bad doctor. The other type of doctor is the kind who doesn’t
see many HIV patients… Do you go to one of these doctors? Of course you do.
There aren’t any other kind. Like most of our best activists most doctors have
been co-opted by the drug companies. I guarantee that 95% of you go to a doctor
who pimps for a drug company. And the more hard-up doctors are becoming on
Managed Care, the more they sign up for a drug company assignment. What does it
take for us to learn once and for all that we mustn’t be co-opted, that we only
fool ourselves when we think having so many of our people on the inside will
save Stephen. You people on HAART, for whom HAART is working now and who get
angry when anyone says anything against HAART: you’re being selfish, thinking
only of yourself. You feel okay now. You’re not going to for long. Stephen was
one of the first to take every drug you now are taking. How long do you think
you have? Dr. Ho has disappeared into the miasma of never-never land and Dr.
Fauci says taking these drugs is “not an option.” How good and clean and
wonderful can you feel? ...I challenge each and every one of you to form a
group of your own and pick things you can accomplish to ruin a pharmaceutical’s
day. The drug companies are our main target. They are rich beyond belief. This
is the only country in the entire world where drug companies are free to charge
what they want. Scare the shit out of them. Scare their stockholders to death.
For every slimy pill of shit they pump out for us to pump in....Find the things
you can do exceptionally well and that will drive people crazy and do them.
Stop going to all those meetings with the FDA and the NIH and the CDC, and Abbott
and Glaxo and fucking Dupont. That is conspiring with your murderer. Form a
cell, like the Mafia, like the Irgun, the French Resistance, and keep them
small and secret and only tell the people in your cell what each of them needs
to know to do a specific job. Thus if one person or cell goes too far we are
able to deny knowing anything about it. There is only so much that can be said
about this publicly. I have given you a blueprint. A road map. Plan your own
route. I think you get the general idea. I hope this plan pleases Stephen and
that he will no longer think that I, and you, have walked away from him. He is
watching us, you know.”
[113] In June 1999, in a special supplement to the academic medical journal
Current Medical Research and Opinion,
Papadopulos-Eleopulos et al published
their monumental examination of the molecular pharmacology of the drug, A
Critical Analysis of AZT and its Use in
AIDS. It is archived on the internet by Librapharm at:
http://www.librapharm.co.uk/cmro/vol_15/supplement/main.htm
A literature review of some
30 000 words, it explodes all pretensions that AZT has ever had to having any
therapeutic value. In the light of all the principal medical literature on AZT,
both early and current, the authors demonstrate that there is “no…evidence” to
support early claims that AZT disrupts the “HIV replication cycle by a
selective inhibition of viral reverse transcriptase thereby preventing the
formation of new pro-viral DNA in permissive, uninfected cells”, that AZT is
not triphosphorylated to any significant extent in vivo when administered
to patients - a process all HIV experts
agree is essential to prevent the formation of pro-viral HIV DNA - and that AZT
is incapable of exerting an anti-HIV effect accordingly. On the other hand, the
paper mentions “a
number of bio-chemical mechanisms [elucidated in the scientific literature]
which predicate the likelihood of widespread, serious toxicity for the use of
this drug.” The authors wonder, “Based on all these data it is difficult if not
impossible to explain why AZT was introduced and still remains the most widely
recommended and used anti-HIV drug.” They conclude that the continued
administration of AZT “either alone or in combination…to HIV sero-positive or
AIDS patients warrants urgent revision.” This withering indictment of AZT ought
to sound its death knell in clinical practice. No doctor whose adult or infant
patient sickens or dies on AZT will be safe from damages actions founded on
medical negligence after this.
[114] Let’s illustrate the
triphosphorylation problem with an analogy. My brother Timothy Brink is a
practising Jew. He converted to marry his spectacular Jewish wife. To attend
the wedding in the synagogue, we gentile family and friends had to don
yarmulkes handed out at the door. Everyone knows that there’s no joining in the
celebration without a hat. Suppose my brother reported to a cousin overseas
that all 100 of his gentile buddies attended his wedding. That would imply that
the doorman had enough yarmulkes to go around. But suppose that it turned out
that the bloke had only two to give out. My brother’s story about his
well-attended wedding would be in trouble. GlaxoWellcome claims that AZT is
converted from its inert form as a pro-drug by the addition of three phosphor
molecules inside cells. Only after this has happened can the show begin. The
company recognises that AZT can’t enter cells already triphosphorylated, for
the reason that large molecules such as nucleotides - natural like thymidine,
or synthetic like AZT triphosphate - can’t get through cell walls. In a private
note, the originator of AZT explains, “The hydrophobic interior of cell
membranes is a barrier to the passage of most hydrophilic molecules.
Membranes are intrinsically impermeable to
large polar molecules such as nucleotides, amino acids, and glucose. Membrane
transport proteins are specifically required for movement of amino acids and
glucose into cells from outside the cells.
Such transport proteins appear to be generally lacking for transport of
nucleotides into cells. This was
clearly shown by Leibman and Heidelberger, J.
Biol. Chem., 216:823-830 (1955), The
metabolism of P32-labeled ribonucleotides in tissue slices and cell
suspensions. Since the publication
of that paper it has been generally accepted that nucleotides are not
transported into cells without prior dephosphorylation. There are other
references, but the one I’ve
cited is the key reference, historically.”
This is why the manufacturer sells AZT as a nucleoside -
unphosphorylated. In order to act as a chain terminator of HIV DNA, by slipping
into the DNA chain in place of natural thymidine, AZT must first be triphosphorylated
inside the cell. GlaxoWellcome claims it is. But when researchers look into the
extent to which AZT is converted into its active triphosphorylated form “by
intracellular enzymes” they find that this process hardly takes place at all.
Very little AZT is triphosphorylated. Very little gets a
three-phosphor-molecule hat. Way too little for it to exert its alleged
‘antiretroviral’ effect. Like just a couple of policemen of a force of
thousands issued with truncheons to contain an English soccer riot, and the
rest standing around uselessly. Not only uselessly, but getting in the way and
drawing big danger-allowances, so the town gets ruined. In a different way.
Because although AZT is hardly triphosphorylated at all, it is readily mono-
and biphosphorylated, and this process drains off available phosphor resources,
which means that cells don’t get the energy they need for dividing. So they
die. There’s another thing. Once AZT has been phosphorylated by the addition of
one or two phosphor molecules (and maybe three, but hardly at all) it becomes
too large to exit through the cellular membrane. It can’t get out. So it sits
inside the cell poisoning the atmosphere like a sour live-in mother-in-law who
causes a marriage to sicken and die.
[115] Asked to comment on
the Papadopulos-Eleopulos et al paper,
GlaxoWellcome in London blustered that there is “overwhelming data in vitro
and in vivo in favour of AZT as an effective antiviral and anti-HIV
drug” and cited a 1993 paper in Drugs
by Wilde and Langtry: Zidovudine: an
update of its pharmacological and pharmacogenetic efficacy, supported by an
impressive 450 references. In her reply in Continuum
in 1999, Papadopulos-Eleopulos pointed out that nowhere in this paper did the
authors get around to discussing the effect of AZT, if any, on HIV antigenaemia
(levels of p24, an alleged key HIV protein), viral burden (‘HIV DNA’) or viral
load (‘HIV RNA’), which are the “only parameters by which an anti-HIV effect
can be evaluated.” Perhaps because in their massive review of the research into
this, Papadopulos-Eleopulos et al
demonstrated that in point of fact, AZT does not modulate them. Which is the
long way of saying that AZT doesn’t work. She continued: although the authors
accept that “Zidovudine triphosphate is the active form” they proceed on the
wild claim, unsupported by any study, that AZT triphosphate “has been shown to
comprise up to 67% of total phosphorylated zidovudine in peripheral blood
mononuclear cells” and state that “Maintenance of optimal virustatic zidovudine
[triphosphate] concentration at greater than 1mol/L (a theoretical target based
on in vitro data) with oral
intermittent regimens is difficult because of the short term and dose-limiting
adverse effects of zidovudine.” Papadopulos-Eleopulos points out that according
to all “presently available data, even the peak levels of triphosphorylated AZT
are less than 1pmol [an infinitesimal fraction of that, so] it is impossible to
achieve virustatic levels and thus anti-HIV effects.” In a private note, her
co-author Turner sums up: “All the available data on AZT shows beyond
reasonable doubt that it cannot work and it does not work. Its conversion to
the active drug is minuscule and at least one order of magnitude below that
which ‘inhibits HIV’ in the test-tube. Its failure is confirmed in humans where
it has no significant effect on plasma ‘viral load’. So it’s all risk and no
benefit. The ratio is infinite.”
[116] Medical Research
Council president Dr William Makgoba was quoted above dismissing my critique
(“nonsensical”) by Dr Michael Cherry, lecturer in Zoology at Stellenbosch
University, and South African correspondent for Nature. In January 2000,
Cherry wrote a second piece for Business Day disparaging Mbeki for
ordering an enquiry into the safety of AZT, and again quoted Makgoba making his
dull boast about not having seen any of the papers cited in this review. It was
apparent to me when Cherry telephoned me before going to print with his article
in Nature knocking this review that
he hadn’t actually read it (even though he said that he had a copy) because
couldn’t answer any of the questions that I put to him about it. He just seemed
bemused by the fact that a mere lawyer had upset the AIDS establishment’s
apple-cart, and had won the ear and confidence of the President. On 6 February
2000 in an interview by senior editors of the Sunday Times, Mbeki
rightly reproached both Makgoba and Cherry for sounding off about the AZT
controversy without having taken the trouble to acquaint themselves with the
literature beforehand: “Take this very difficult issue that we raised about
HIV/AIDS. It really would be very good if people could read. A university
lecturer wrote an article for one of the daily papers and said that he and the
president of the Medical Research Council, Professor William Makgoba, have not
read any article in medical and scientific literature which speaks against the
use of a particular drug. The conclusion was: ‘Therefore we don’t know what the
President is talking about.’ I wrote to the lecturer and said: ‘You know, it’s
possible that you people haven’t read any such articles. Please find enclosed
an article published in 1999 in a very senior scientific journal, a very
lengthy article with millions of references, presenting whatever that
particular group of scientists [Papadopulos-Eleopulos et al] thought
about that matter.’ There you have university
people, professors and scientists who haven’t read. I was very surprised in
that particular incident when [Cherry] wrote back to me and said: ‘Mr
President, I will respond to you in a fortnight, I’m afraid I don’t know very
much about this subject. I’m going to consult a friend of mine.’ Well, why did
he write his article? What do you do if professors won’t read articles about
subjects they write about? What do you do?”
[117] Unashamed and
unrepentant, Makgoba hit back at Mbeki in an article in the Financial Mail
on 21 April 2000.
Lamenting the controversy in South Africa started by the President’s public
doubts about the safety of AZT, Makgoba suggested that the whole affair should
be entrusted to experts like him: “The
effect of the current political/scientific furore on HIV/Aids…[is that it
is]…sending mixed signals to those who have dedicated themselves to the
alleviation and eradication of this epidemic…[and]…undermining scientists and
the scientific method in a developing country…” Even if, as Mbeki pointed out,
Makgoba and his ilk can’t be bothered to read their journals and keep abreast
with the latest research on AZT before making public statements about it.
[118] Having received this
most damaging paper from Mbeki, and finding himself in over his head, Cherry
took it over to two other AZT fans, Professor Gary Maartens at Groote Schuur
Hospital in Cape Town and Dr Carolynn Williamson at the University of Cape
Town. A physician and virologist respectively, whose knowledge of molecular
pharmacology comprised a smattering of undergraduate training during their
basic medical degrees, they were equally perplexed by Papadopulos-Eleopulos’s
startling assertions that (a) AZT cannot conceivably exert any anti-HIV effect
having regard to how inefficiently it is triphosphorylated in vivo, and (b)
this has long been obvious from research reports,
notwithstanding its tremendous reputation as the original, premier ‘gold
standard’ of HIV treatment. So all three scooted over to see the big guy, Dr
Peter Folb, Professor of Pharmacology at the University of Cape Town and, until
recently, chairman of the Medicines Control Council for 18 years.
[119] Now one might imagine that such a senior expert
would be seized with the importance of the occasion, and that he would take
very seriously indeed the responsibility weighing upon him. The President was
seeking specialist advice. He had publicly claimed that AZT was unacceptably
dangerous and had been universally slated for it, locally and abroad. He now
sought comment on a very lengthy disquisition on the molecular pharmacology of
AZT published in a prestigious peer-reviewed academic medical journal that went
much further; it pointed out that a fundamental and essential claim about the
pharmacology of the drug was wrong: AZT is not “triphosphorylated
intracellularly” to any significant extent as its manufacturer asserts; it is
therefore unable to terminate viral DNA chain formation as alleged, and for
this reason cannot be an anti-HIV drug. And that according to all measures of
its efficacy, it plainly didn’t work, as one might have predicted from all
this. But no. Instead of reading the paper carefully, examining the literature
it reviewed, and providing a considered opinion, Folb’s response was to shoot
from the hip, to pontificate condescendingly - way out of his depth - and to
rubbish the Papadopulos-Eleopulos paper like this:
[120] “The article is a review article, and as such does
not present original research findings, but purports to synthesize the findings
of workers in the field. They do not present their own data, but selectively
review the literature, which is now vast - we found 6472 peer reviewed articles
available on AZT. They are thus not presenting their own work to substantiate
their arguments. There is of course nothing wrong in writing review articles,
but their conclusions should be placed in the correct context. In a nutshell,
the article makes two assertions: first, that AZT can inhibit HIV replication
by acting as a chain terminator only in the triphosphorylated form; and second,
the AZT is inadequately triphosphorylated in human cells and is therefore not
effective. In our opinion, the first assertion is well founded, but the second
is not. The authors appear to have ignored a large number of studies in the
scientific literature which provide evidence that AZT is adequately
triphosphorylated in human cells. This allows it to work well as a blocker of
HIV replication in vitro, and in vivo when tested on mammalian cells
in sensible concentrations. It’s routinely used in academic research
laboratories in experiments where inhibiting HIV replication is part of the
experimental protocol. The original research reports cited by Papadopulos-Eleopulos
et al do not, to our knowledge, come
to the conclusion which Papadopulos-Eleopulos et al do, viz. that AZT is
inadequately triphosphorylated in human
cells to be effective. These reports appear, however, mostly to date from the
period 1991 to 1994, when assays for determining phosphorylation were not
nearly as sophisticated as they are now. This, combined with the fact that
different assays were used by different workers in these experiments, may
explain why these results indicate varying and low degrees of
triphosphorylation. The article is not comprehensive and not up-to-date, as it
omits to refer to many important recent studies which are relevant to the field
under review. Both recent and more sophisticated studies showing higher degrees
of triphosphorylation, as well as other studies reporting on the efficacy of
drugs-based trials on mother-to-child transmission, appear to have been ignored
by the authors. The article also raises the issue of toxicity associated with
AZT. Like many medical interventions, AZT is widely acknowledged to have toxic
effects, which should be weighed up against its potential benefits. Our
understanding is that these have been carefully and critically assessed
specifically in the context of preventing mother-to-child transmission, by the
South Africa Medical Research Council’s recent report to the country’s Health
Minister.”
[121] In similar terms Folb wrote to me, “Of the two
major contentions of the above article …the one regarding the mode of action of
AZT is wrong according to what is now established by modern laboratory methods.
Papadopulos-Eleopulos et al draw
largely on research from 1991 to 1994, when assay techniques were different and
less sensitive than those that are used today, and their conclusions are likely
to have been different had they considered all the available and up to date
scientific evidence.”
[122] Had Folb not got lost and bored early in this long
and dry but seminal paper, he would have seen discussion of seven further consistent
papers published since 1994. And a quick search for the latest “available and
up to date” AZT research reports on this critical issue would have revealed a
further one by Font et al published
in December 1999 in the journal Antimicrobial
Agents and Chemotherapy. Using
the most “modern laboratory methods”, the researchers came to a Determination of
zidovudine triphosphate
intracellular concentrations in peripheral blood mononuclear cells from human
immunodeficiency virus-infected individuals by tandem mass spectrometry
which confirmed findings published in previous reports that AZT is
triphosphorylated in vivo too
inefficiently and at levels far too low for it to exert an anti-HIV effect.
[123]
Cherry submitted Folb’s take on the paper to Mbeki in the form of a submission,
without identifying the author of the views therein contained. However Folb
volunteered his role to me in drawing the submission, and its clumsy language
matches that employed in his correspondence between us. Although couched magisterially
in the superficially authoritative lingo and jargon of the trade, it is obvious
at a glance that the submission doesn’t even touch sides with the issues raised
in the Papadopulos-Eleopulos paper. So I was pleased when Folb invited
questions from me about it: “I am willing to consider precisely any points of
science regarding AZT ... but would need you to refer me to them quite
specifically.” I asked, “1. What are these ‘modern laboratory methods’, and new
more sensitive assay techniques to which you referred? 2. What did they
establish about the extent to which AZT is triphosphorylated in vivo? 3.
Who are the authors of the
recent papers to which you allude, which, you say, disprove the findings of
several investigations in the 90’s (reported in the papers cited by
Papadopulos-Eleopulos et al, and
confirmed a couple of months ago by Font et
al) that AZT is far too inefficiently triphosphorylated in vivo for it to exert the
antiretroviral effect claimed in GlaxoWellcome’s explanation of its basic pharmacology?
4. What ‘available and up to date scientific evidence’ do you contend
Papadopulos-Eleopulos et al omitted
from their 30 000 word review of the principal literature on AZT that would
have led more diligent or honest or competent scientists to “different...conclusions”
about the pharmacology of the drug? As you know, your views were presented to
President Mbeki via the Cherry submission, although this did not appear from it
because you were not a cosignatory. Obviously the correctness of your advice to
the President is a matter of considerable national importance…” Folb then hung
up, as it were, and has refused to respond, perhaps because my questions
exposed his false statements to Mbeki and his scandalous failure to apply his
mind properly. Interviewed by the Sunday
Times on 28 May 2000, Makgoba said, “…scientists get fired for bending the
truth.” Gee, if only they were. In my own line of work, were I to mislead a
judge in the course of legal argument on a point of law, by asserting vaguely -
without any foundation in the law reports - that there existed a line of
precedent case authorities that superceded and contradicted the dozen
consistently adverse cases cited by my opponent, I’d be struck off and out
sweeping streets for a living the following day.
[124] Fortunately Mbeki was
unimpressed by Folb’s careless bad advice, as were the authors of the paper he
sought to dismiss; “not exactly earth-shattering”, they smiled, but more than
that I’m not at liberty to reveal. The issues of AZT’s safety and efficacy
remain formally under investigation in South Africa, but the army has
jettisoned the drug already: On 21 April 2000, The New York Times quoted
a spokeswoman saying, “The courses have
been stopped and there will be no new prescriptions.” The government’s final
attitude is apparent from Presidential spokesman Parks Mankahlana’s statement
in the Mail and Guardian on 9 June
2000, “We need investment…in the event that we decide to administer AZT and
other retroviral drugs. That is, if we shall ever do so.” And journalists like
Robert Kirby who once bellowed forever for AZT now bleat for Nevirapine
instead, as he did in the Mail and
Guardian on 8 September 2000. Who cares about “Rash in 17% of patients (7%
discontinued due to rash, many patients require hospitalisation) Stevens
Johnson Syndrome reported; transaminase elevation; severe hepatitis; fever;
nausea; headache” under the ADVERSE EFFECTS column for Nevirapine in the table
on antiretroviral drugs in pregnancy, contained in the US Department of Health
and Human Services’ 2000 edition of A
Guide to the Clinical Care of Women with HIV. Just what a pregnant woman
and her baby really needs. Quite how anyone with any brains, like Kirby, could
believe the claims of ‘AIDS experts’ for Nevirapine (or AZT) to ‘prevent
perinatal transmission’ is a perfect riddle. As reckless as the ‘AIDS experts’
might be, they’re all agreed that you don’t give AZT to pregnant women before
fourteen weeks. So says the aforementioned Guide.
Which also stipulates that Nevirapine should be administered during labour and
then to the baby within 72 hours of birth. By all of which times if the mother
is infected so the baby will be, because physiologically speaking the oven and
the bun inside it are practically one. Aren’t they? Since the ‘AIDS experts’
teach that HIV is a retrovirus that integrates itself by reverse transcription
into human host DNA, and there is no AIDS drug yet made which claims to oust
it, one wonders with a lump in the throat for Kirby and his ‘AIDS experts’ how
on earth these drugs can conceivably ‘prevent perinatal transmission’? And that
cutting the baby out instead of allowing a normal birth can achieve this too?
(Maybe there’s just something about Western medicine that moves doctors to meet
the arrival of new life with knifes and poisons.) But since ‘AIDS experts’
employ HIV antibody and PCR tests to determine infection rates among babies, in
defiance of every documented reason not to, anything is possible with these
guys. As Eleni Papadopulos-Eleopulos aptly remarked to me at the second meeting
of Mbeki’s AIDS Advisory Panel in Johannesburg, “AIDS-science isn’t science.
It’s all just rubbish, rubbish.”
[125]
Folb’s refusal to account fits the pattern I’ve found. The most vocal advocates
of AZT seem to be the most retiring when invited to step away from their
sloganeering and get down to the nitty-gritty. As I did for Folb, I sent copies
of this debate to other AZT protagonists. Silence from Pietermaritzburg AIDS
expert Dr Neil McKerrow, paediatrician at Greys Hospital. I never received any
reply from Judge Edwin Cameron, at that stage on the Transvaal Provincial
Division bench. I quoted Dr William Makgoba’s brush-off above. Economics
Professor Nicoli Nattrass (my occasional childhood playmate) responded to my
first essay at the level, more or less, of ‘better dead than red’ and was again
selling AZT in the Mail and Guardian
on 21 July 2000 on the basis of another silly cost-benefit economic analysis.
Not a peep from the Green Party’s Judy Soal, the Inkatha Freedom Party’s Dr
Ruth Rabinowitz, or D P leader Tony Leon - provided a copy via Mike Ellis
MP. AIDS Treatment Campaign organiser Zackie Achmat
said he was too emotionally distressed to chat - perhaps when the “danger of
tremendous public confusion” about AZT had passed, he said. (That phrase
again!) Whenever I telephone, AIDS Law Project head Mark Heywood is “not
available.” Never is. And ChildrenFIRST
editor Cosmas Desmond said he was too busy to respond to the points I thought
important about the dangers of AZT for his little people. Probably because he
was occupied with fixing a bumper June/July 2000 special AIDS issue of his
magazine. (Nothing pulls donor funds like an AIDS gloss on the otherwise
uninteresting misery of the African poor.) It included a prescription written
by McKerrow for the poisoning of African children - his speciality.
[126] Disregarding a warning
by the late Casper Schmidt - “Never interfere with a sacrificial ritual” - I
had approached Cameron about the slow poison he was on with some apprehension.
(Schmidt, a South African gay psychiatrist practising in New York when he died
in 1994, wrote a brilliant psychosocial explanation of the appeal of the
HIV-AIDS paradigm for many gay men in The
Group-Fantasy Origins of AIDS.) I can imagine Professor Brandt’s
trepidation in going to Hitler to point out that the huge daily dose of
strychnine and belladonna that he was getting from his physician Dr Theo Morell
in the form of a quack gut tonic called Dr Koester’s Antigas Pills was
poisoning him, causing terrible stomach cramps, trembling and skin
discolouration. Hitler was deaf to this counsel, and worse. He instantly sacked
Brandt as his personal surgeon and from all other political offices too. That
wasn’t the end of it. On his personal orders he then had Brandt brought before
a summary court and sentenced to death on such trumped-up charges as ‘losing
faith in victory’. (The war ended before he could be dispatched, whereafter he
was tried for his real crimes.) Such is the power of belief in poisonous
medicines sometimes. In his address at the Durban AIDS Conference on 10 July
2000, Cameron exhibited a similar conviction about the virtues of his metabolic
poisons - AZT, 3TC and Nevirapine - saying he was still alive only because he
was “able to pay for life itself”, which reminded me of the perverse AIDS-drug
poster I picked up at the conference, “Think drugs, think life.”) He said that
to his “grief and consternation”, Mbeki had made no announcement about
providing pregnant women with AZT at the opening ceremony the night before (an
unbelievable mix of Moonie mass wedding, Nuremberg rally and Liberace concert).
He deplored the government’s decision not to provide AZT to HIV-positive
pregnant women dependent on public health care, and said that because of this,
about 5 000 babies were born HIV-positive every month. How the AIDS cult loves
its big fat round numbers! He added that as a Constitutional Court judge
responsible for maintaining human rights in the country, he felt compelled to
speak out about what was keeping him alive, while millions of South Africans
were dying. As if his pills would make the difference. As if the right not to
be exposed to transplacental cell-poisons and carcinogens in utero
should take second place to the great righteous ‘War on
AIDS’. Like the right to life going on the backburner for lost souls thinking
and speaking out of order during the inquisition. With sympathetic priests
smiling beneficently on the condemned, as their lives faded in agony, the evil
within them justly purged out in the process. When I met him at the Durban AIDS
Conference, Cameron confirmed that he’d received an early draft of this debate
and asked whether I’d received his reply. I hadn’t. He said he was sure he’d
written. I confess I find it impossible to credit that after digesting the
implications of the papers cited in this review, a judge of our highest court
should still be promoting AZT for administration to pregnant women.
[127]
On Tim Modise’s radio talk show on 18 July 2000, Cameron responded
incredulously when my brother Paul Brink read out Sigma’s skull and cross bones
label on AZT bottles, and suggested that it was a spoof cooked up by a
satirist. When journalist Anita Allen pointed out that AZT is not
triphosphorylated, so simply cannot work as claimed by its manufacturer, he
admitted that he didn’t know what she was talking about. This from
GlaxoWellcome’s hottest asset, an acting Constitutional Court Justice acting as
its PRO, adored and mobbed by the press like a pop singer. But if you buy the
line, there’s just no budging. It’s like Catholic wine and wafers: At the AIDS
Conference in Durban, Cameron claimed - to a jet-plane roar of approval,
“…the new combination drug treatments are
not a miracle. But in their physiological and social effects they come close to
being miraculous. But this near miracle has not touched the lives of most of
those who most desperately need it. For Africans and others in resource-poor
countries with AIDS and HIV, that near miracle is out of reach.” The rest of
his speech was a tub-thumping exposition of the modern AIDS theology of sex and
death. Unless you get the holy water. From GlaxoWellcome. The whole thing was
redolent of a homily by Pastor Ray McCauley. Only a lot more treacle. A
mystical fable of condemnation - implicitly for illicit sex - and medical
redemption. Via the ministrations of the guys in white coats and stethoscopes.
He went on mysteriously, “We know what prevention methods work, yet prevention
isn’t working. The epidemic is washing the African continent in blood.
Fearfulness is at its heart. I’m filled with rage that we don’t do more to
change it.” The Hebraic drama! The evangelical fervour! Today drinking poisons;
handling rattlesnakes tomorrow? In case you’ve forgotten, and you’ll be
forgiven if you have, this is a judge talking. One of those cool-headed,
well-balanced guys who make decisions about our lives and fortunes. On the day
before Cameron’s sermon, Dr Scott Gottlieb at Mount Sinai Hospital in the US
described his own experience of the miracle drugs after a needlestick injury in
an article in the New York Times
entitled The Limits of the AIDS Miracle:
“I was prescribed four days of ‘triple therapy’ with the latest protease
inhibitors and other antiviral medicines… But those four days left me with a
realistic view of what infected patients often face. Between nausea and aching
pains in my bones, I felt febrile and weak. I was unable to exercise. After one
day, I was no longer well enough to work, to go out with my friends or to eat a
full meal without vomiting. While it is true that over time some people are
able to tolerate the drugs better than others, for many patients these symptoms
never go away. Many doctors and the pharmaceutical industry have failed to
convey the human toll that ‘triple therapy’ takes…” Christine Maggiore, a
healthy drug-free HIV-positive mother and AIDS dissident activist from Los
Angeles, provided an evocative account by e-mail of the revival tent colour of
the proceedings where Cameron held court at an invited breakfast during the
conference: “Another type of circus atmosphere was found at a breakfast with
AIDS drug advocate Justice Edwin Cameron at the Durban Country Club. Since
Cameron characterizes those of us who raise questions about AIDS as “holocaust
deniers” and “white supremacists” [on the Tim Modise talk show in retort to
Professor Sam Mhlongo’s polite probe about the source of our fabulous AIDS
statistics], I still wonder if I was invited by mistake or with the mistaken
notion that I might be, as Dr. Mark Wainberg (the AIDS expert who thinks we
should be jailed) put it to my husband Robin, “converted to the right side.”
…Cameron’s breakfast introduced his new AIDS organization [AIDSETI, whose
handout preaches “buying drugs is buying life”] …Cameron’s fellow drug
activists claimed that “when people are given AZT they see the face of God!”
How right they are. On a calculus of AZT’s life-ending pharmacokinetics, on AZT
you’re undoubtedly on your way to the cemetery. For the big reunion.
[128] So what does one say
to people who swear by the poisons they drink? Like Hitler, Cameron, and his
friends who hold Jesus’ hand when high on AZT. Or the crazy auntie at the
Durban AIDS Conference who ranted about how AZT saved her life, and then
sneaked up when I wasn’t looking to honour me with a crown of curry and rice on
my head. One’s man’s meat…? Each to their own? Whatever rings your bell? Maybe
the shock of taking the poison stimulates an immune response, like other
invigorating drinks in the olden-days: Martindale’s classic reference The Extra
Pharmacoepia reminds us that
“Arsenic was formerly extensively used as a ‘tonic’.” Why it should have been
is baffling because it was also good for destroying “the nerves before filling
teeth” in dentistry, and was “widely employed as a constituent of weedkillers
and sheep-dips, and for the destruction of rats and mice.” Strychnine similarly
“long had a reputation as a ‘tonic’ because of its extremely bitter metallic
taste and its potent action on the central nervous system.” Take too much and
you end up with “sudden convulsions quickly involving all muscles. The body
becomes arched backwards in hyperextension with the arms and legs extended and
the feet turned inward. The jaw is rigidly clamped and contraction of the facial
muscles produces a characteristic grinning expression known as ‘risus
sardonicus’.” And then you stop
breathing. So like Cameron’s AZT, be sure to take just a little bit. Western
medicine has typically proceeded on the footing that if the compound is
‘active’, in other words makes you damned sick, it must be good for you. Like
that useless poison quinine. And if after your dose of calomel you went off
retching, sweating, shaking, and salivating with your tongue turned black, boy
it’s really working. If you need any more persuasion about this after
Martindale’s mention of a couple of once common medically prescribed ‘tonics’,
just look over the rest of his “authoritative reference work on drugs and
medicines in current use.” Try mercuric cyanide, a “disinfectant” - not quite
as good as mercurous chloride, doctors reported. Served dissolved as Harrison’s
Solution, it was terrific for “vaginal irrigation” they said. Imagine the
jollies doctors got dutifully squirting that stuff up. Even more exhilarating than
giving pregnant women AZT. It’s something like a once popular use for carbolic
acid that Martindale primly omits: a cure for hysteria when applied (by the
experts) to the clitoris.
[129] Perhaps
like some pool chlorine in the fish tank to sort out the algae, AZT - poisonous
to everything - wipes out whatever germ or fungal infestation is getting out of
hand. With plenty of collateral damage, but some of us are more stout than
others. Not many can manage a bottle a day, but some do for years. On the other
hand, I have friends who spurn my coffee. Too strong. We’re all different. We
shouldn’t forget the considerable power of belief either - the placebo effect.
While bleeding, purging with antimony, arsenic and mercury salts were all in
vogue, and for a mighty long time too, there was no shortage of passionate
expounders of their superlative merits. I mean the incontestable fact that
these treatments restored the balance of the four humours was plain for all to
see. What stupid “flat-earther” or “denialist” would dispute it. Even if the
patient incidentally died. But there is only one sure thing. AZT is not
antiretroviral. And sooner or later it will kill you. Cameron told listeners to
the talk show that his daily dose is small. This is why he doesn’t vomit uncontrollably
into a bucket every day, on his hands and knees like my dying colleague.
Cameron’s dose reminded me of a case I once handled for some bakery workers who
were stealing bread. As long as the number of lost loaves was kept low, the new
daily production batch masked the loss. But it couldn’t go on forever, because
eventually the pinch was felt. Then the game was up. Cells are killed by AZT,
because AZT was designed to kill cells. For the time being at least, the
differential between the judge’s cells killed and replaced is apparently
unnoticeable. But the clock will be ticking. Would somebody care to tell him?
I’ve already tried.
[130] For most reasonably
well-informed guys, the fact that AZT is terribly poisonous is not a matter of
any contention; the debate concerns whether it has therapeutic or prophylactic
value to outweigh this. Even Wouter Basson, apartheid’s own accused Nazi
doctor, knows about AZT’s toxicity because during his trial in the Pretoria
High Court on murder and other charges, a biochemist testified on 1 June 2000
that she had regularly reported to Basson about her “research on countering the
negative … toxic side effects of AZT” in the late 1980’s. Foolishly ignorant,
ALP director Mark Heywood maintains differently. In an interview on CNN
on 1 April 2000, he stated, “There
is no evidence that has been tabled showing that AZT is toxic to either mother
or child.” Or maybe he just sings the factory song meretriciously because, as
an attorney working for his AIDS Law Project told noseweek investigative
journalist Marten du Plessis, GlaxoWellcome
kindly foots the bill for their trips to conferences overseas. By the way, in
April 2000 Heywood and Achmat, who run the Treatment Action Campaign together,
succeeded in shaking Pfizer down for free supplies of its fungicide Fluconazole
- although at its shareholders’ expense of course. The donated medicine is only
for “AIDS sufferers” - both rich and poor. (To blazes with Cryptococcus
meningitis patients who don’t have an ‘I’m HIV-positive’ tee-shirt.) Now in the
criminal law, however lofty the motive, employing coercion to induce owners to
part with their goods without getting paid is known as extortion. But Heywood
wouldn’t know. The head of the AIDS Law Project sports an English degree. But hey,
in AIDS, anything goes. Take Project Inform in the US, a front operation for
the pharmaceutical industry, run by an energetic Eichmann clone, Martin
Delaney, a straight HIV-negative former advertising agency executive, who
ditched his old job for richer pickings in AIDS. His pal, Mark Harrington, with
equally underwhelming qualifying credentials, runs the Treatment Action Group,
an organization with a substantially similar agenda: get those drugs moving.
Both are openly in the pay of the pharmaceutical corporations. They need to be
for their big-ticket salaries. They are quite frank about this; it’s just their
rationalizations that get murky. Like L. Ron Hubbard, they’ve cottoned on to
how to make big loot from selling funky Zen koans like having sex and suckling
babies kills, but drinking poison imparts life - the difference being that
nobody ever died from squeezing Ron’s corny e-meter cans. The same can’t be
said of the ‘health advice’ purveyed by these two gents. The point of it all is
that in AIDS the yobbos with the loudest mouths make the splash. And get the
dough. Not serious scientists, the careful bookworms hung up on corny
old-fashioned ideas like ‘the scientific method’. Who spoil the party with
unwelcome questions about the biochemistry of the new treatments. Talking about
yobbos: in a media manipulating stunt just like one at the Geneva AIDS
Conference in 1998, the Durban Conference saw the pharmaceutical corporations
again using ‘AIDS treatment activists’ as rent-boys. On 13 July 2000, the Mail
and Guardian reported that
“Geoffrey Sturchio, executive director of public affairs for Merck Sharpe and
Dome (MSD) admitted funding the controversial Aids Coalition to Unleash Power
(Act-Up) to demonstrate at the stall of rival Boehringer Ingelheim. The
admission came after Act-Up staged a demonstration at Boehringer Ingelheim and
after a vocal altercation with conference organisers moved to the MSD stall.
Here [on videotape] Sturchio admitted the company funded Act-Up. In the last
few days, Act-Up has disrupted several meetings at the 13th
International Aids conference, demanding that the South African government
supply anti-retrovirals to pregnant women. This is not the first time that
collaboration between MSD and Act-Up has been uncovered. At the 12th
international Aids conference in Geneva, security personnel admitted to a
journalist that the two had collaborated to stage an aggressive publicity stunt
at the company’s booth.” I politely asked one of these pouting radical poseurs
a simple question at their own booth. It was an Achilles arrow, the answer to
which had to sound foolish, even to a believer as he mouthed it. I watched the
guy’s hard-drive processing as he fixed me with a suspicious stare, and then
realising I thought it was all bull, he replied, “I’m not prepared to talk to
you” and turned his back.
[131] On 16 July 2000
Heywood was quoted in the Washington Post
blathering away on his favourite hobby-horse, AIDS-drug access: “This
conference is unique for its focus on treatment and barriers to treatment for
people living with HIV in Africa and the rest of the developing world.” How
profound. As if we needed telling that in reality the Durban conference was
nothing more than a sickening mega-buck exercise in drug merchandising to the
‘developing world’. A friend of mine opened a “Confidential” envelope addressed
to Lawrence Altman on the New York Times,
the journalist who invented the expression “the virus that causes AIDS”, and
showed me the contents: a drug company press release about a new product, full
of the usual weary hype. To be published immediately as news. All the better to
achieve free advertising. Heywood continued, “There is this anger at the drug
companies, and there is this very real anger at Mbeki. We’ve always expected
the worst from the pharmaceuticals, and now we’re just getting our act together
in figuring out how to challenge their pricing policies, which put drugs out of
reach to so many poor people. But this is the first time that, internationally,
people have questioned the legitimacy of the new South African government.”
Fancy that. The English immigrant oppugns our new democracy because the
government doesn’t pander to his demand that its citizens be treated to a
repeat of the catastrophe that decimated homosexual men and haemophiliacs in
Europe and the US. (In England, deaths among HIV-positive haemophiliacs shot up
in 1987 and by 1995 had increased by tenfold - coincidentally with the
introduction of AZT and similar drugs as the standard of care. The figures can
be found in a letter by Darby et al
to Nature in 1995.) It looks like
Heywood ghostwrote the Mail and Guardian’s
ridiculous ‘genocide’ editorial on 21 July 2000 too. It snarled with his
fingerprint gausherie, “Mbeki and his government must get their act together in
combating HIV/AIDS - now - or get out of government.” Radio 702 talk show host
John Robbie displayed a similar sentiment on 5 September 2000. Annoyed because
Minister of Health Dr Manto Tshabalala-Msimang pulled him up for addressing her
repeatedly as ‘Manto’ (“I am not Manto to you. I am not your friend”) and would
not commit to an answer when pressed on whether she shared Mbeki’s doubts about
the HIV-AIDS model, (“You will not pressurise me to answer that”), he chased
her off his show with, “Go away. I cannot take that rubbish any longer. Can you
believe it ... I have never in my life heard such rubbish.”
[132] The risible thing
about the Oxbridge Fabian as he struts about like a bantam rooster at marches
and on television, playing populist crusader and firing off revolutionary
exhortations (“Why we must struggle to provide treatment for people with
HIV/AIDS” and “Our determination to fight”), is that Heywood serves the
valuable role of loyal opposition to the pharmaceutical conglomerates, just like
bantustan leaders during apartheid. In their common agenda to get ‘drugs into
bodies’, Heywood and the drug corporations run together as snug as dick and
mick. The extraordinary confluence doesn’t raise an eyebrow. Nobody pinches
their nose to keep out the reek.
[133] With comical
gullibility Heywood gulps down the propaganda of the AIDS industry and then
throws it up undigested in chunks. It’s that myth-making cycle which has seen
one fallacy stacked on the next, an Empire State Building with foundations of
hot air. On 10 July 2000, interviewed on an American radio programme Democracy
NOW, he told listeners that
“4.2 million people [in South Africa] live with HIV and AIDS [with] no access
to essential medicines…drugs that can prevent and treat HIV.” His voice aquiver
with indignation, Heywood decried Mbeki’s opening address at the Durban AIDS
Conference, whining: “I was scandalized by his speech [given on] the same day
as the Sunday Times [published an
article Young, gifted and DEAD by
Lauritz Taitz (but of course) showing]
the changing pattern of death… a huge rise in death among people 18-34… [Mbeki]
is continuing to put across ideas…flying in the face of reality. He is
scandalizing us … undermining us … the government is throwing into question
[the value of AIDS] drugs...” A good thing too! In an expose of Makgoba’s inept
effort to discredit Mbeki, noseweek
pointed out in its August 2000 issue that the trebled annual death rate in
South Africa from 1991 to 1999 claimed by Makgoba and trumpeted by Taitz as
proof of the deadly ‘AIDS epidemic’ was an abuse of statistics at its crassest.
The 1991 figure counted deaths in white South Africa only; the 1999 one
everybody, including people in the former ‘homelands’. The Department of Home
Affairs immediately issued an embarrassed disclaimer, and regretted the bid to
“create…panic through selective and sometimes incorrect use of statistics.”
Stats SA repudiated “the huge rise in death” allegation with the myth-cracking
statement that official statistics reflected no changing pattern, that the
mortality rate in South Africa over the past decade was “not a new profile.”
Want to know what is killing young people? Not loving each other, as Heywood
has it. Quoting Stats SA, noseweek reveals:
“…in the black community a significantly larger number of young people die of
unnatural causes such as violence and accidents…[and among males] a stunning
27%…” Which kind of leads one to ask just who is living in cloud cuckoo land,
Mbeki or Heywood?
[134] In his ChildrenFIRST article, McKerrow let us
know that he wasn’t going to be told what to do by some busybody lawyer, by
writing an insouciant advice on “the use of antiretroviral therapy (ARV) in the
management of the HIV-infected child” called Just what does the doctor order?
It reads like a dark tome on
witchery and its stern solutions in centuries past, full of hocus-pocus dressed
in certain authority. A charming marginal note conveys its gist: “If the child
is under 12 months old, the therapy is recommended regardless of clinical,
immune or virologic status.”
[135] On 25 March 2000, the Star in Johannesburg reported a
remarkable answer by Mbeki to a
written appeal for the provision of AZT to HIV-positive pregnant women by Justice
Cameron, head of the Anglican church Archbishop Ndungane, head of the Methodist
church Bishop Dandala, and chairman of the Durban AIDS Conference,
paediatrician Professor Coovadia. He also answered a letter from Cape Town
immunologist Dr Johnny Sachs, deploring “individuals in leadership positions”
doubting the integrity of the HIV/Aids causation model: “I am taken aback by
the determination of many people in our country to sacrifice all intellectual
integrity to act as salespersons of the product of one pharmaceutical
company [AZT manufacturer,
GlaxoWellcome.]… I am also amazed at how many people, who claim to be
scientists, are determined that scientific discourse and inquiry should cease,
because ‘most of the world’ is of one mind… The debate we need is not with me,
who is not a scientist, or my office, but [with] the scientists who present
‘scientific’ arguments contrary to the ‘scientific’ view expressed by ‘most of
the world’… By resort to the use of the modern magic wand at the disposal of modern
propaganda machines, an entire regiment of eminent ‘dissident’ scientists is
wiped out from the public view, leaving a solitary Peter Duesberg alone on the
battlefield, insanely tilting at the windmills.” Referring in his reply to the
Blanche and De Martino papers on AZT’s foetal toxicity, and
Papadopulos-Eleopulos’s refutation of GlaxoWellcome’s claims about its
molecular pharmacology, Mbeki said further, “It is clear from your letter that
you believe that we should ignore or merely note these findings because of the
current ‘consensus amongst responsible and authoritative scientific leaders’ as
well as ‘the available evidence’. Undoubtedly, such ‘consensus’ and ‘available
evidence’ also existed on the use
of Thalidomide… Faced with the findings indicated in this letter, I am afraid
that my own conscience would not allow that I respond only to the ‘consensus’
with which you are in agreement.” Mbeki concluded with a reference to his
decision to form an international expert panel “to discuss all HIV-Aids matters
that are in dispute”, and expressed the hope that “you will agree with me that
such a meeting should be inclusive of all scientific views and not only those
representative of the ‘consensus’ to which you refer. I fully recognise that I
have much to learn and must be ready to admit and correct whatever mistakes I
might make as a result of not heeding the advice that ‘a little learning is a
dangerous thing’.”
[136] The President’s office
reflected his sentiments pithily on 29 March 2000 (per Reuters): “President
Mbeki is going to intensify the fight to
[end] discrimination against and exploitation of people who live with HIV/AIDS,
both by insurance and medical schemes, and the pharmaceutical giants who are
the sole beneficiaries in the dogged defence of AZT by large sections of the
media.” Quite so.
[137] On 16 April 2000, on the television programme Carte Blanche, Mbeki was
interviewed by Joan Shenton. His answers
revealed more bull’s-eye perspicacity:
J S: “Last year you were
reported in Parliament as being concerned about giving AZT to pregnant mothers.
Why were you concerned?
MBEKI: Well, because lots of
questions had been raised about the toxicity of the drug, which is very
serious. We as the government have the responsibility to determine matters of
public health, and therefore we can take decisions that impact directly on
human beings, and it seemed to me that doubts had been raised about the
toxicity and the efficacy of AZT and other drugs, so it was necessary to go
into these matters. It wouldn’t sit easily on one’s conscience that you had
been warned and there could be danger, but nevertheless you went ahead and said
let’s dispense these drugs.
J S: Some AIDS doctors say
the evidence is overwhelming that AIDS exists and AZT is of benefit. What is
your comment on that?
MBEKI: I say that why don’t
we bring all points of view. Sit around a table and discuss this evidence, and
produce evidence as it may be, and let’s see what the outcome is, which is why
we are having this international panel which we are all talking about. They may
very well be correct, but I think if they are correct and they are convinced
they are correct, it would be a good thing to demonstrate to those who are
wrong, that they are wrong.
J S: People say you are not
keen on giving AZT to pregnant women because it is too expensive and in some
ways you are seen as penny-pinching. What do you reply to that?
MBEKI: That surely must be a
concern to anyone who decides this drug must be given to stop transmissions,
again from mother to child, which is extremely costly and must be taken into
account. But we also need in that context to answer the particular questions of
toxic effect of this drug. If you sit in a position where decisions that you
take would have a serious effect on people, you can’t ignore a lot of
experience around the world which says this drug has these negative effects.
J S: Why have you been so
outspoken recently about greed and the pharmaceutical companies?
MBEKI: I think a lot of the
discussion that needs to take place about the health and treatment of people
does seem to be driven by profit. We’ve had a long wrangle with the
pharmaceutical industry about parallel imports, and what we were saying is we
want to make medicines and drugs as affordable as a possible to what is largely
a poor population. We need to find these medicines that are properly
controlled, properly tested, the general product and no counterfeits.
J S: In the press you are
exhorted to confine yourself to the job to which you were elected, and leave
specific subjects to the taking of best available advice.
MBEKI: I don’t imagine Heads
of Government would ever be able to say I’m not an economist therefore I can’t
take decisions on matters of the economy; I’m not a soldier I can’t take
decisions on matters of defence; I’m not an educationist so I can’t take
decisions about education. I don’t particularly see why health should be
treated as a specialist thing and the President of a country can’t take Health
decision. I think it would be a dereliction of duty if we were to say as far as
health issues are concerned we will leave it to doctors and scientists, or as
far as education is concerned we will leave it to educationists and pedagogues.
I think the argument is absurd actually.
J S: How do
you feel about the reaction of your country’s leading virologists and
intellectuals to your position?
MBEKI: I
get a sense that we’ve all been educated into one school of thought. I’m not
surprised at all to find among the overwhelming majority of scientists, are
people who would hold one particular view because that’s all they’re exposed
to. This other point of view, which is quite frightening, this alternative view
in a sense has been blacked out. It must not be heard, it must not be seen,
that’s the demand now. Why is Thabo Mbeki talking to discredited scientists,
giving them legitimacy. It’s very worrying at this time in the world that any
point of view should be prohibited, that’s banned, there are heretics that
should be burned at the stake. And it’s all said in the name of science and
health. It can’t be right.
J S: Now it
has been said that the pharmaceutical industry is more powerful than
government. Are you going to take this debate to other world leaders like
President Clinton, Prime Minister Blair or the Prime Minister of India, who has
expressed support for an investigation into these issues, as you are?
MBEKI:
Certainly I want to raise the matter with politicians around the world, at
least get them to understand the truth about this issue, not what they might
see on television or read in newspapers. And we were very glad to see India get
themselves involved in this issue. The concern around probable questions, which
in a sense have been hidden, will grow around the world and the matter is
critical, the reason we are doing all this is so we can respond correctly to
what is reported to be a major catastrophe on the African continent. We have to
respond correctly and urgently. And you can’t respond correctly by closing your
eyes and ears to any scientific view that is produced. A matter that seems to
be very clear in terms of the alternative view, is what do you expect to happen
in Africa with regard to immune systems, where people are poor, subject to
repeat infections and all of that. Surely you would expect their immune systems
to collapse. I have no doubt that is happening. But then to attach such
important defence to a virus produces restrictions and what we are disappointed
about as an Africa government is that it seems incorrect to respond to this
AIDS challenge within a narrow band. If we only said safe sex, use a condom, we
won’t stop the spread of AIDS in this country.”
[138] Jon Jeter wrote in the Washington Post on 16 May 2000 that Mbeki
displayed “an impressive breadth of scientific knowledge, using terms more
common to the head of a university biology department than to a head of state.”
He quoted the President pointing out that AZT needs to be triphosphorylated in
order to be active against HIV: “When you are dealing with a virus and
you...put some drug into the human body, whatever antiviral agent comes into
this particular cell, it has to...produce phosphorous particles, which are the
things that have an impact on the virus,” he said. But “science isn’t even
agreed upon that question,” he continued. “Does such phosphor relation [sic]
take place?” Exactly. How many of
the ‘experts’ who have castigated Mbeki for wondering publicly whether AZT is
safe - indeed whether it even works - share his familiarity with this
fundamental problem regarding the molecular pharmacology of the drug. Certainly
not Makgoba, who fulminated in Science
on 28 April 2000, “This man will regret this in his later years. He displays
things he doesn’t understand.” Writing in the Mail and Guardian on 21 July
2000, David Plotz agreed, and insulted
him for the trouble he has taken to do the homework on AZT that his ‘experts’
haven’t: “Fiercely intellectual and curious, Mbeki encountered dissident Aids
research while surfing the web late one night [a popular myth]. He read the
scientific papers and now talks confidently about ‘toxicities’ and ‘the
phosphor relation’ [sic]. He portrays
himself as an educated sceptic about AIDS. But his late night web trolling,
credulity about what he reads online, and $10 scientific phrases smack less of
scepticism than obsession. Mbeki is acting like a nutter. It’s a shame that
Mbeki has been diverted by this bizarre Aids twaddle, because he is normally
rational… Mbeki’s Aids paroxysm, in short, is uncharacteristic of his lifetime
of reasonableness.” Poor Plotz: “phosphor relation”. Like Jeter, he can’t even
spell the word, let alone understand what it means.
[139]
Former President Nelson Mandela has voiced support on television for Mbeki’s
initiatives on AIDS causation and treatment issues. In an article on 8 June
2000, Mandela sings Mbeki's
praises, the internet Daily Mail & Guardian reported his appraisal of
his successor: “President Mbeki is a leader I support very fully. He has done very
well and I am very glad South Africa appointed him President. I do not think
there is anybody in the history of South Africa who has put South Africa on the
map as has President Mbeki.” And closing the Durban AIDS Conference he said of
him, “The President of this country is a man of great intellect who takes
scientific thinking very seriously and he leads a government that I know to be
committed to those principles of science and reason.”
[140]
It took four centuries before medicine finally recognised that calomel
(mercurous chloride) couldn’t cure, only kill, and dumped it from its
pharmacopoeia. Until then, notwithstanding its manifest poisonousness, doctors
had advocated it, some with poetic fervour, as a panacea for gout, headache,
menstrual pain, syphilis, and no end of other ailments. No modern doctor,
especially any who has seen that ghastly clip of Japanese families crippled by
mercury poisoning in Minamata Bay in the fifties, or our own recent victims -
former workers at the Thor mercury-waste ‘reprocessing’ plant in KwaZulu-Natal
- would dream of ladling mercury salts down their patients’ throats nowadays.
When is the penny going to drop with AZT?
[141] The repackaging of lethal cell-poisons like AZT as ‘antiretrovirals’ is a
vast and callous pharmaceutical fraud. But as a Greek Cynic noted appositely a
couple of millennia ago, the law has always been a web in which small flies get
caught; the great ones burst through.
[142] So much for Doc Martin’s Celestial Elixir.
CONTENTS
DEBATING AZT
VIRUSMYTH HOMEPAGE