VIRUSMYTH HOMEPAGE

ALL THE PRESIDENT'S SCIENTISTS
Diary of a Round-Earther

Anonymous

The Mail & Guardian (South Africa) 8 Sept. 2000

These are extracts from the detailed diary kept by a member of the Presidential AIDS Advisory panel:

MAY 2000

I was invited to participate on the Presidential AIDS Advisory Panel which would have high visibility given President Thabo Mbeki's famous letter to United States President Bill Clinton and his flirtation with denialists--a small group of "scientists" who do not believe HIV causes AIDS.

Among the first people I met were Malegapuru Makgoba, head of the Medical Research Council, and Slim Karim (Professor Salim Abdool-Karim), another South African scientist. Slim was fat and Makgoba was thin. Slim was energetic and political, a mobiliser. Makgoba was a friend of Mbeki's, a thoughtful scientist, and I noticed at the airport next to Mbeki's collection of speeches, a book which Makgopa had written. Over a buffet and pizza, we talked. Makgoba said he had spent time with his friend Mbeki, trying to talk him out of the idea of taking seriously those who think that HIV does not cause AIDS. He claimed Mbeki is in fact concerned about feeling certain that HIV causes AIDS, that his questioning is not just a political move.

FIRST DAY

The closed session began at 9 am, under the guidance of a facilitator, a lawyer named Professor Owen. The first go around the table was supposed to be an opportunity for each panel member to identify key issues around the "terms of reference" but in practice two other things were focused upon: each member spoke identifying themselves and their position in the context of the aetiology question. The day would prove to be a long one. One of the first people to speak in the first go round was Dr M Smith, a previous chair of the Federal Drug Administration anti-retroviral (ARV) committee. He lifted up the invitation with the terms of reference saying: Mbeki's first question is "what causes AIDS". Smith looked up, and in a monotone said "HIV", then remained silent. As we went around the room, it became clear where people stood:

Slim Karim: Strongly in favour of finding a way to get ARVs into Africa in a meaningful way.

Harvey Bialy: Writing a biography of Peter Duesberg.

Stefano Bertozzi: Cautious but firm: HIV causes AIDS. An expert in health care economics.

Etienne DeHarven: A person who was unbelievable in having no problem denying the existence of AIDS.

Helene Gayle: From the Centers for Disease Control (CDC).

Roberto Giraldo: Describes himself as Colombian although he seems to have lived for the past many years in New York.

Klaus Koehnlein: This interesting man does not believe AIDS exists at all, and that there isn't really any increase in deaths going on, just artifacts on how data is collected.

Cliff Lane: National Institute of Health.

Makgoba: A leader of the South African contingent, and a very knowledgeable person.

Sam Mhlongo: Very confusing person who seems to side with the dissidents.

Wilfred Nkomo: From Malawi, an epidemiologist with a sense of humor and no patience for denialists.

George Perez: Wants to focus on what can be done, not argue about HIV.

David Rasnick: Thinks the drugs kill people and does not think HIV causes AIDS.

Joe Sonnabend: An orthodox member of the committee who believes there are co-factors which explain the virulence and spread of the illness in Africa.

By my count, which could be off, there were 26 people with 10 flat-earthers more or less, and 16 definite round-earthers. Others would arrive on Sunday. The meeting reconvened, and continued in an endless round table conversation that basically got nowhere. Lunch and then more endless round table talk.

The good guys met in Slim's room that night and made plans.

SECOND DAY

Sunday's talks, as they were inevitably going to, broke down. The group resisted getting pushed into consensus because everyone, including the denialists, agreed it was misleading. Looking only at consensus would lead to, for example, a consensus that AIDS drugs have toxicities, but no consensus that they helped with the illness. This would mean they should not be used, from a policy point of view, a very misleading conclusion. There is also the problem that consensus can lead to agreement on precisely the most irrelevant aspects of a problem.

As the meeting degenerated into political manoeuvring to find ways to force a misleading consensus forward, resistance kept occurring to the pressure to get results. But aside from the entertainment value and perhaps some educational value, the meeting did not accomplish much.There had been an effort to divide the group into three groups to deal with aetiology, treatment and prevention. The three groups had a recorder and a mix of dissidents and us, and the results were chaotic and terribly misleading. We all decided to throw away the results of this effort.

It was decided that we would divide into two groups, the one writing a list of suggestions starting from the premise that HIV causes AIDS and the other with the opposite premise. This idea led to two sets of suggestions which were the reported back to the main group.

Andrew Herxheimer spoke for denialists and their report said: HIV does not cause AIDS; AIDS is not infectious; drugs are poisonous; treat the opportunistic infections (OIs).

Our side was represented by Slim and Bertozzi: Move to reduce the incidence of blood-borne infection; reduction of mother-to-child transmission; reduction of sexual transmission; treatment.

After the meeting on Sunday the health minister announced that there would be an Internet discussion for six weeks and a follow-up meeting.

As of now, the debate continues via the Internet although it is confusing as everyone has not gotten their passwords.

JULY

For several weeks people duelled on the Internet. Most round-earthers decided that to play with their new friends was a waste of time and made them feel intellectually compromised by even entertaining their half-baked ideas.

SUNDAY EVENING

The round-earthers met in special session. Jerry Coovadia, an important scientist in South Africa, was in the papers, identified as a troublemaker by the health minister. This is the same Coovadia who was chosen by Slim and others to do our presentation on aetiology, but the press office crossed his name off the list.

There is genuine concern about the report itself being tampered with before it gets to the president. I have discovered a room treat: green onions stuffed with anchovies.

MONDAY JULY 3

The programme for the day consisted of four sessions.

An aetiology of AIDS with Carolyn Williamson (because Coovadia was not allowed to speak). Then we had a presentation from Duesberg on etiology which was amazingly intellectually shallow. Session two was prevention of AIDS with Giraldo, a presentation bordering on incoherence. It was embarrassing. This was followed by Slim, whose presentation was so good the moderators did not feel we'd have to revisit this issue.

After lunch were Sonnabend and Rasnick on treatment. The latter was humorous as Rasnick sees no evidence that there is an epidemic and if there were, feels the damage is being done by medicines and that the best thing South Africa could do would be to stop testing and never treat.

It became clear the staff wants to make sure this is the last meeting and that closure is reached. Their vision of protecting the president requires that this be the last meeting and that something come out of it that the president can embrace without being embarrassed.

Note: As I am writing this this morning, the day after the second day of meetings, lawyer Owens is on his way to speak to Mbeki. He said he was going to advise Mbeki to push forward with the five-year plan, to say he had now heard all sides, that the government would be doing everything including the use of ARVs--and that he would advise Mbeki to look into parallel importation and compulsory licensing. This is what Minister of Health Manto Tshabalala-Msimang mentioned repeatedly. When Williamson opened the remarks on aetiology, the first thing she said was that "Coovadia was not allowed to give the presentation". You could hear everyone, including Rasnick, was genuinely surprised. Earlier, Rasnick and Bialy were laughing over the perception that our group kept changing who would present because we were afraid of battling with the great Duesberg. Williamson introduced a more disturbing reality, that politics had entered into this chamber to the point of dictating who would speak. It appeared that the politics was of a more personal nature and connected to many events outside of the opinions of Coovadia on AIDS.

Then Duesberg got up to speak. He is a handsome man with white hair, a tan, and a slight German accent. He is dramatic and moves around a lot while speaking. He starts by making reference to Albert Camus's definition of plague--his intention is to question whether the thing called AIDS fits the definition of an epidemic. "Real" pathogens, he argues, do not discriminate in such a way that doctors are immune but other groups like gays are preferentially hit (these are patently ridiculous assertions). He said the retrovirus had as an organism the lowest IQ you can get in biology--"any lower and you get chemistry", he said.

He asserts that HIV parallels the drug epidemic (for some reason he feels there is a drug epidemic but he offers no proof or data). Then in a play on words which may shed some light on his thinking, he clarifies "an antiviral drug epidemic". In other words, all people with AIDS use drugs which causes the AIDS that we see. Again the lack of depth is frightening, such as the presence of AIDS long before the drugs existed.

He claims that only 75 000 people had AIDS in Africa out of the many millions of people who live here.

Duesberg essentially argues that AIDS is not a problem in Africa (which makes you wonder why the president has assembled an international expert panel to focus upon it). He referred to using ARVs as "AIDS by prescription".

After these two presentations, there is opportunity for the panel members to comment.

Makgoba shows a group of children who are HIV infected. He notes that the mortality of this group is huge--one-third dead in one year if you are positive. Gayle says transmission to health-care worker is a well documented phenomenon. (This is in reply to the sweeping generalisation of Duesberg's that no health-care worker has ever been infected, that this is a disease of toxicity and is not infectious.)

Whiteside: In Malawi, "they were shocked in the most recent census to find that there were two-million people 'missing'" (Malawi had only 10-million to begin with). From watching the reactions of the various dissidents, their body language and shaking of heads makes it clear this did not affect them. They are into denial of the epidemic.

SECOND SESSION

Giraldo puts forth a borerline incomprehensible and basically embarrassing amalgam of paranoid observations and pseudoscientific jargon. He essentially constructs a conspiracy hypothesis, on a worldwide basis. He is not clear in identifying the cause of the conspiracy, just hinting at the bad guys being the drug cartels. He assumes that promotion of condoms was part of the conspiracy on the part of those who make condoms. He made a list of the bad ideas or erroneous ideas being pushed by this conspiracy, including on his list: HIV is infectious; it is transmissible; HIV leads to AIDS which, untreated, leads to death.

These people (he says) are also pushing clean needles. "These people are promoting the diseases they say they are trying to prevent. UNAIDS and other institutions are trying to stop breastfeeding. Companies that commercialise [formula] are happy with that idea." Giraldo is an embarrassment to education.

He claims tropical diseases cause all of the immunological changes associated with AIDS. "Immunological stressors" is the catchphrase he puts up as the cause of AIDS. He claims immunological stressors hurt the immune system in a way which leads to a positive test for HIV.

He then makes a list of the "principles for prevention": avoid poisons (immune stressors); disintoxicate; vitamins (stimulate the immune system); treat OIs.

He stresses the use of antioxidants, and vitamins A and B.

He went on to say the World Bank wants you to get loans to buy AZT and condoms. This will ensure poverty in Africa and increase the wealth of the West.

After Giraldo's speech, Slim makes a presentation on prevention. Although in theory there are not two sides here, in practice even the facilitators acknowledge the reality of two sides. Each side has been conferred with separately and has been given 30 minutes apiece to do a presentation on each of the four topics.

Slim starts by noting that AIDS in South Africa has only been found associated with HIV-1, Clade B in the first epidemic confined pretty much to homosexuals. Clade C starting later in the 1980s and was confined to heterosexuals. There is an explosive nature to Clade C--the prevalence rates were 1991: 4,2%; 1993: 7,9%; 1995: 14%; 1997: 27%; 1998" 29%. Rasnick: "We only talk about HIV. Where is the data on AIDS?"

At this point the meeting got a bit raucous. I could hear people yelling things like: "I've yet to see a crack addict in Soweto"; "Hey, I've been using antibiotics [on my patients] for years and it does not cause AIDS"; "Kids with HIV are 17 times more likely to die than HIV-negative babies. Why?"

Kothari: "In India HIV is not a problem."

Coovadia: "HIV is not unique in causing different symptoms. Measles leads to weight loss, dementia and so on. We are not in the hands of pharmaceutical companies. We are doing more studies on how to preserve breastfeeding than anywhere in the world."

SESSION THREE

Joe Sonnabend (for the round-earthers): The OIs associated with AIDS are not new diseases. What is new is that the kind of people getting them never used to.

Rasnick ( for the dissidents): Spoke about the Fourth of July, freedom and tied it together with Mbeki's decision to allow dissidents to speak, congratulating Mbeki on his support for freedom. We are shifting the blame from ourselves to an "innocent virus".

AIDS peaked in 1992 and then fell ever since until the CDC changed the definition of AIDS and then it continued to fall after that. One big way to bring down the amount of AIDS in the US is to change the definition of AIDS.

Bialy and Duesberg started to act out a little, hand gestures, gesturing to friends, acting a lot like little kids at school.

Rasnick: "I think AIDS would disappear in South Africa if we outlawed tests for HIV".

FINAL SESSION

Duesberg: Trashed personal or anecdotal statements. He alluded to promiscuity as a problem for Africans.

Indian doctor: "Back home we had a film director of importance jump to his death because he found out he was [HIV-] positive." Let's treat OIs and leave HIV alone. Science is creating stigmas that lead to death (applause from dissidents).

Mhlongo: HIV testing should be abandoned today. If there are lots of blacks with AIDS in South Africa then there are lots of blacks that are promiscuous.

Rasnick: "I have no beliefs about AIDS, I have only data. Since I came here in May ... I have seen no evidence there exists an AIDS catastrophe, epidemic in South Africa. "If I had the power to outlaw HIV tests I would across the board. I know HIV does not cause AIDS. The tests are lethal. It destroys your life ... Get rid of PCR, viral load, Western blot, Elisa [all HIV tests] and you will get rid of 99% of the AIDS crisis."

Makgoba: Young people now in South Africa are dying as fast as people in their 70s.

The representative from the secretariat (Khotso Mokhele) talked a bit: essentially said that the Internet debate should have taken care of the debate that was happening today, and that the moderators were forced out of practicality to have two sides because the group could not work together. He said they would work to create a series of questions which would make the basis of the next day's talk, and that the answers to these would provide the material for the report to the president.

TUESDAY JULY 4

The day began by having Makgoba represent in detail his data on the situation in South Africa. It was devastating. Mhlongo insisted that the only thing happening is that medical care is now available so that we are now seeing the death rates and sicknesses that were always there.

Duesberg: Despite Makgoba's presentation there is no explanation for fear, doom and gloom when you have a 2,8% death rate of AIDS only.

Makgoba: "This data is an underestimation of the real picture. A population of young people is dying. What happened? New toxins? Mortality rates that increased from 18 per thousand to more than 300 per thousand require an explanation."

At this point, the team of Bialy, Gayle and Makgoba were asked to summarise their work.

In the original formulation, they were supposed to undertake an experiment to determine to everyone's satisfaction whether HIV causes AIDS. They got as far as laying out the parameters for experiments that would do this. There was a mandate at this point to break into three groups: aetiology and getting data; treatment; co-factors.

The groups met for 90 minutes apiece and prepared reports. Then there were presentations. Gayle and Bialy did the first group, Slim did prevention, Slim did the therapy session.

The recommendations were: create an ongoing process for treatment guidelines relying on South African doctors; use compulsory licensing and parallel importing to get prices down; treat OIs and STDs and TB; create a permanent body to provide advice to the president; use anti-retrovirals on people who are sick; debt relief agreements ought be tied to public health actions.

Giraldo: Stop drug abuse.

Slim on prevention: Life skills for youth; nevirapine for pregnant mothers and improve intervention therapy: prophylaxis. Focus on vaccine development, lower migration rate, money for gender equality. Rasnick: Do not give healthy people drugs. Treat sick people according to their symptoms. Since HIV has no symptoms do not give anti-retrovirals to people. Owen closed the lengthy session with a thank you and a promise that facilitators would develop an accurate report to the president.

VIRUSMYTH HOMEPAGE