THE AZT DEBATE Peter Duesberg interview

By Carte Blanche

7 Nov. 1999

Last Thursday President Mbeki sparked off a furious debate with an address to the National Council of Provinces. He referred to the scourge that is HIV/Aids and stated that "there is a large body of scientific literature alleging that this drug is in fact a danger to health." He gave the minister of Health, Dr Shabalala-Msimang a directive to further investigate these claims in order that South Africa's medical institutions can act with complete knowledge.

AIDS/HIV are such frightening diseases that anything connected to a possible remedy is sure to elicit highly emotive reactions. Here are some local views.

David Patient, one of the worlds longest surviving AIDS sufferers, "I was on the original trial of AZT in 1986 - I was on the drug for three months at Duke University then I transferred down to Miami where I did a further two months."

Charlene Smith, a rape survivor, has had first hand experience with AZT. "I was desperate, I had been raped. I didn't know if the person has HIV or AIDS. I was desperate to get the drugs."

"Not one of the people from that trial are still alive - I'm the only survivor," says David.

"All I wanted to do after being attacked with a knife and raped was to live. I felt that the antiretrovirals, AZT, 3TC and Quiksovan helped save my life," says Charlene.

"Today you take four pills per day. I was given twelve a day on those trials. I had physical manifestations in my body. I had fatigue in my legs, I had something called Mastitis. I lost an incredible amount of weight, I had thrush, shingles - there were a whole lot of manifestations," says David.

"I read through all the side effects, it's a long list and I was concerned that I'd be very ill - but surprisingly the after effects and side effects have been minimal," says Charlene.

Dr David Johnson of the Chris Hani/Baragwanath perinatal HIV unit; "When used for mother to child transmission AZT is an absolute lifesaver. It has the potential to save millions of babies. Do we know the long-term effects of the drugs? No, and it is a concern."

"Glaxo Wellcome is absolutely serious about the safety of its drugs - it is absolutely paramount to the company," says Dr Peter Moore, medical director of Glaxo Wellcome S.A.

"I believe, from my own experience, that stopping AZT saved my life," says David Patient.

"I would like full antiretrovirals [such as AZT] to be made available to us. I'd like to know where President Mbeki got the information in his speech," says Charlene Smith. "Last year government spent R54 million treating prisoners who had AIDS related illnesses in private hospitals. And yet they are denying women and children who are often gang raped - a brutal violation to any woman. And these women are denied the opportunity to save their lives with this drug. How dare Mbeki?"

"I have to state emphatically that AZT is not registered and we do not recommend it for use after rape," says Dr Peter Moore.

"I support President Mbeki's call to do further research. I think we misconstrued what he said - he didn't say 'halt it'. He said let's study it more and understand where we're coming from. I fully support his position," says David.

One of the major voices claiming that AZT is harmful is Professor Duesberg, professor of Biology at the University of California at Berkley. "I see AZT for what it is from a molecular biologists viewpoint. AZT was designed over thirty years ago - not as an anti- AIDS drug or an anti-HIV drug. It was designed as chemotherapy to treat cancer. It was designed to kill human cells. I have studied viruses and chemicals and their effects on animal and human cells and I have found that AZT is killing cells exactly as it was designed to do. And retroviruses like HIV have never in recorded history (the last 100 years of it) caused a fatality in animals outside the laboratory. AZT cannot help you for two reasons. HIV infects only one out a thousand cells. But AZT cannot distinguish - it will keep on killing your cells and we have no evidence to this day that HIV is causing AIDS. We do however have plenty of evidence from the AIDS establishments that HIV is not making it's own DNA once you are antibody positive."

AZT was the first drug to be approved in the fight against AIDS in 1987. Amidst great public demand the drug was fast tracked through the US Food and Drug Administration (FDA). This fast tracking concerned many scientists who felt that the toxic effects of this drug had not been properly tested. The manufacturers disagree, "I strongly feel that AZT had an extremely good safety profile and is one of the reasons it is registered in more than 100 countries around the world. It's supported by the Center for Disease Control (CDC) and is approved by the FDA," says Dr Peter Moore.

AZT was originally intended for cancer therapy - it's a powerful non-specific drug - a form of chemotherapy, which destroys healthy and infected cells alike. South African AIDS pioneer Dr Rubin Sher recalls the early days of AIDS, AZT and grappling with side effects. "There is no drug in the world that doesn't have side effects - with AZT it's mostly bone marrow depression. In the early days we used much larger doses but, because of the complications people were having they were reduced."

In 1994 the Concorde trial - the most comprehensive AZT trial yet undertaken - damned the drug. It concluded that the drug was too toxic for most people did not prolong life nor did it stave off AIDS in HIV positive people. Nevertheless AZT continued to flourish worldwide albeit in a more user-friendly packaging. "The Concorde study is a classic study but we must realize that they used AZT as a monotherapy, meaning it was used on it's own. The days of using AZT as a monotherapy are gone," says Dr Moore.

Today AZT also known as Retrovir, is often prescribed as part of a cocktail, the doses are smaller and not taken for long. It's claimed to be highly effective in preventing HIV transmission during pregnancy and needlestick injuries - The controversy continues.

Dr Duesberg, you indicated that there were no studies showing that AZT had any effect. But the Center for Disease Control have found that there is a 60% drop in mortality when people who were HIV positive do use the cocktail - how do you respond? "I would like to say that there have been plenty of studies showing effects. But not once has AZT cured anyone in ten years. No one has ever been cured by the AIDS establishments and it's not likely anyone will while on these treatments. In reality the Concorde study showed that the mortality of people treated with AZT is 25% higher. It has shown that AZT kills people and it's the largest controlled study of its kind."

Earlier this year Carte-Blanche ran a story on the tireless efforts of the perinatal/HIV clinic at the Chris Hani/Baragwanath Hospital. Under the leadership of Dr Glenda Grey, they claim to have drastically lowered the rate of HIV transmission from mother to baby. Dr David Johnston claims AZT to be one of his primary allies in the fight against AIDS. The group conducted their own trials, tracking the children's progress over a few years. They say they have encountered very little side effects and maintained health in all the children. Their results differed greatly from the Concorde trial. "The Concorde study addressed the question - 'does AZT prolong life?' And it found that it didn't. But you need to understand that the field of HIV has evolved very rapidly in the last ten years. What we thought was good therapy at the time of the Concorde study we don't anymore. You speak to HIV positive people who have been given that chance of going on the drug - they consider it a lifesaver," says Dr Johnson. He continues to petition vigorously for more affordable AIDS drugs.

Dr Duesberg, do you think it can cut transmission from mothers to babies? "The evidence is that it reduced from 25% to 17% which is a hypothetical gain because we don't know what HIV does. We have 25 to 30 million Africans with HIV. Almost all of them are healthy. You need to ask the experts why this is? And most of them don't even know they are HIV positive."

"The short or long term effects of the drug are; nausea, dizziness, weight loss, fatigue, a lack of strength, liver dysfunction, kidney collapse," remembers David Patient.

"Nausea, dizziness, some palpitations - but nothing you are not able to manage," says Charlene Smith.

"What I can tell you about AZT is that the symptoms it is supposed to prevent are actually created," says David. "It basically annihilates everything in sight so when we start taking AZT initially it will start to destroy the virus but in the process it will destroy the immune system. Your CD4 count may be going up but you're also a prime candidate for a heart attack or a stroke. I personally don't believe AZT is effective at all."

Professor, our hospitals are filled with people that are dying and who are not taking AZT - what is your solution if you don't prescribe AZT?

"I'd certainly not give them a drug that was designed to kill human cells before I knew what was going on. I would first try to find out what the people were dying from. According to the American CDC - thirty diseases, most of them have nothing to do with each other, are all called AIDS. In America dementia, TB, diahorrea, pneumonia, weight loss, yeast infection - are all called AIDS. All of this is supposedly transmitted from partner to partner?"

But chemotherapy, which also kills cells and has side effects, is used and recommended. Why is it that nobody is saying chemotherapy doesn't work or that nobody should have it? "There is a tremendous difference - in chemotherapy you have a legitimate target. You have a tumour that you want to prevent from killing you. This is why you restrict the therapy to a few weeks or months in the hope that the cancer dies before the patient dies. But with HIV we have no known target, HIV does not make any DNA - it is not replicating at the time and we are prescribing AZT for the rest of our lives. And they have all died from taking it - nobody has ever been cured," says Dr Duesberg.