AIDS;
WHY WE WON'T BE SILENCED
By Neville Hodgkinson
The Sunday Times (London) 12 Dec. 1993
The Sunday
Times has been subjected to a wave of extraordinary attacks in
recent weeks over its attempts to widen discussion of one of the
most crucial medical and scientific issues of our time: the cause
of AIDS.
A growing body
of evidence suggests that when the medical and scientific communities
rallied in 1984 behind a call to arms against the Human Immunodeficiency
Virus (HIV) as the purported cause of a terrible new syndrome afflicting
homosexuals and drug-users, they may have picked the wrong target.
This sensational
possibility, now being contemplated by numerous doctors, scientists
and others intimately concerned with the fight against the disease,
deserves the widest possible examination and debate. Yet it has
been largely ignored by the British media and suppressed almost
entirely in the United States.
Not content
with failing to report crucial developments in the science surrounding
HIV and AIDS, several broadsheet newspapers, normally supporters
of balance and objectivity, have uncritically reflected views hostile
towards this newspaper expressed by scientists who have built careers
and reputations, and fortunes in some instances, from the HIV theory.
The science
establishment considers itself on high moral ground, defending a
theory that has enormous public health implications against the
"irresponsible" questioning of a handful of journalists.
Their concern is human and understandable, even if we might expect
our leading scientists to retain more concern for the truth while
pursuing public health objectives.
But neither
the quality press nor mainstream science would be so sure of themselves
if one magazine had been doing its job properly. That magazine is
Nature, the British weekly science journal of prestige.
Nature is the
bible of the church of science, and its editor, John Maddox, is
the high priest. He has persistently refused to publish letters
and articles from doctors and scientists who question the HIV theory
of AIDS, and its corollary that heterosexuals around the world are
at risk from a new infectious agent. To him, the theory is fact.
To challenge
that view, he argues, is to encourage teenagers not to bother with
condoms. It is also to promote homophobia "made the more vivid
by the smug wish-fulfilment that no harm will come to heterosexuals
from AIDS because they do only what they have always done, and also
behave 'naturally"'.
That was what
he wrote in an attack on this newspaper in July last year, after
we had punctured an AIDS panic over an HIV-positive haemophiliac
in Birmingham who was claimed to have infected four women with the
virus. The health authority said there were no special risk factors
in the case; we reported that, on the contrary, the man had engaged
in anal intercourse with at least three of the women.
Last week,
in a denunciation of The Sunday Times's recent coverage of AIDS,
Maddox called on the faithful within his church to bring us back
into line. In a two-page editorial he accused us of selective reporting,
of neglecting the opinions of public health officials while reporting
the views of two French health workers in Uganda (it was Tanzania,
actually, and we took the trouble to go there as well as to several
other African countries), and of unbalanced editorial practice in
declining to publish at least one critical letter from a researcher
in the field (we have published dozens of letters, a majority of
them critical).
Despite distortions
and inaccuracies, the editorial deserves a wider audience than Nature's,
both in the interests of open debate and because of the insight
it gives into the mind of the journal's editor. So we reprint it
in full below, with Maddox's permission though he requested Pounds
200 for the privilege.
Each week,
he says, brief reports on our articles will be published in Nature
"to let readers judge whether the newspaper's line on HIV and
AIDS shows signs of being modified". As well as putting the
newspaper under this pressure to recant, such a service will be
useful "if only to save readers the trouble of buying it".
If we persist
in our heresy, we will be further punished. Apart from subjecting
us to "reason and ridicule", readers can besiege us with
suitable letters of protest. If we do not publish them, Nature will
consider doing so. Maddox falls short of calling for copies of offending
articles to be burned, a course of action he once discussed in relation
to a book by Rupert Sheldrake, the Cambridge biologist.
He also grudgingly
acknowledges that censorship is abhorrent, though "the public
interest requires that The Sunday Times should not follow its perverse
line on the causation of AIDS". In previous attempts at ridiculing
our articles on the AIDS controversy, Maddox has run articles describing
our efforts variously as "tabloid", "perverse",
and "fickle".
His latest
attack reveals a more sinister intent, in which the magazine has
become so tied to one particular hypothesis on the cause of AIDS
as to make it feel anybody who questions that theory must not only
be in error, but must be silenced. Such intolerance and arrogance
do not befit the editor of a scientific journal.
IF it were
not for Maddox's inability to represent the views of those who disagree
with him either fairly or accurately on which more later his pledge
to publish summaries of our reports for the benefit of Nature readers
could be welcomed. It would allow some of his readers to become
exposed for the first time to facts and arguments which Nature should
long ago have reported and debated in detail.
We will check
forthcoming editions of Nature to see how the journal conveys the
following:
During the
1980s,The Sunday Times faithfully reported the official view that
a deadly new sexually-transmitted "time bomb" virus was
sweeping the world, putting millions into the pipeline of death.
Gradually, however, it became clear that in Europe and the United
States no such spread was occurring.
Anonymous screening
surveys across Britain have produced an official estimate that there
are 23,000 HIV-positive people nationwide. This is about a half
to a third of estimates made six years ago. In the United States,
there are an estimated lm HIV-positive people. The figure has not
changed for eight years. A new or mutant virus does not remain static
in this way.
An 11-member
panel of the US National Research Council has concluded in a 300-page
study that many geographical areas and population groups are virtually
untouched by AIDS and probably never will be. Instead the syndrome
has remained largely confined to the "socially disadvantaged"
such as homosexuals, drug-users, the poor and under-educated. A
syndrome that discriminates in that way is unlikely to be caused
by a new virus. Its prime determinants are much more likely to be
social or behavioural.
HIV is said
to be responsible for the progressive loss of immune system cells,
which protect the body against infections. But in every AIDS patient
studied so far, there is never more than an average of one in 1,000
cells infected by HIV, far fewer than needed to cause illness. (An
attack of flu, for example, hits about one in three lung cells.)
There are suggestions
that HIV may trigger the immune cells to self-destruct, without
infecting them. But that is speculation, made implausible, some
say, by the fact that many healthy people millions, if one is to
accept long-standing World Health Organisation (WHO) estimates of
HIV-positivity in Africa have co-existed harmlessly with HIV for
many years.
Even Luc Montagnier,
who discovered HIV, has argued that microbes called mycoplasma,
which he now knows to have been present in his original "AIDS
virus" culture, are the chief cause of the death of the immune
cells in AIDS patients, though he still hopes to preserve a central
role for HIV.
Maddox himself
now admits that the failure to discover beyond doubt the causation
of AIDS "has been a profound disappointment to the research
community", and that "the mechanism of the pathogenesis
(how it causes illness) of the disease has not yet been uncovered".
He concedes
that 10 years after the virus's discovery "the evidence that
it causes AIDS is still epidemiological". In other words, it
all comes down to the claim, put to me by Professor Sir Richard
Doll, the distinguished British epidemiologist, when I first began
to question the HIV consensus, that wherever you find HIV, you get
AIDS; and wherever you see AIDS, HIV is also present.
But it is now
clear that neither of those statements is true, and that the links,
such as they are, may be to some extent an artefact of the way cases
of HIV or AIDS are handled and defined.
Dr Kary Mullis,
winner of this year's Nobel prize for chemistry, who thinks AIDS
arose in promiscuous homosexuals through "an enormous level
of exposure" to many human viruses and bacteria, pointed out
in our pages two weeks ago that when someone falls sick with various
diseases and HIV is present or thought to be present, it is called
AIDS; while if someone is sick and HIV is not present, it is called
something else.
"The HIV
theory, the way it is being applied, is unfalsifiable and therefore
useless as a medical hypothesis," he told us. We look forward
to seeing Nature open its pages to the views of this distinguished
scientist, who received the prize for a genetic test now used worldwide
by AIDS researchers.
For several
years after HIV was announced to be the cause of AIDS by Dr Robert
Gallo on April 23, 1984, the day Gallo lodged the first patent application
for an HIV test the link with AIDS was assumed to be 100%, even
though some 50,000 of America's 250,000-plus AIDS cases have been
presumed HIV-positive but never actually tested.
However, in
July last year, American public health experts admitted for the
first time that they had seen several cases of what looked like
classic AIDS in which all attempts to isolate HIV had failed. Their
announcement, at an AIDS congress in Amsterdam, caused great confusion.
They couldn't be AIDS cases, they said, because there was no HIV.
So what were they? A new name has been invented to accommodate these
cases, of which 5,000 have now been reported in the medical literature:
"idiopathic CD-4 lymphocytopenia". All that means is "AIDS
of unknown origin".
Nature should
also be discussing the remarkable story of the HIV-positive haemophiliacs
whose immune systems, after declining for many years in ways that
were attributed to HIV, have recovered fully after they were switched
to a new form of treatment for their blood-clotting disorder. There
now seems no reason why they should not live a normal lifespan,
regardless of their HIV status.
The new treatment
is 1,000 times "cleaner" than the old preparation: it
contains only the protein they need to correct their disorder, and
not the many other unwanted blood proteins contained in their previous,
so-called "intermediate purity", treatment.
In any normal,
sane, scientific environment, this would be regarded as dramatic
proof that HIV was probably not the cause of their previous decline
towards "AIDS", and that the real cause was the repeated
assaults on their immune system from having other people's blood
proteins injected into them.
Perhaps even
more dramatic was our story describing the findings of an authoritative,
10,000-word review article published in BioTechnology, a sister
journal to Nature, which concluded that the HIV test has never been
properly validated and ought to be reappraised.
In particular,
the authors of that article presented evidence indicating that a
high proportion of the millions of Africans who are said to be HIV-positive
may not be infected with HIV, but show up as false positives because
of the inadequacies of the test.
We look forward
to seeing debate and discussion about this paper, which threatens
to undermine the entire HIV "industry", in Nature.
CONTRARY to
Maddox's assertion, we have never argued that any of these findings
rule out a role for HIV in AIDS. We simply think it is disgraceful
that instead of examining their significance, he attacks and censors
those who draw attention to them. It is also untrue that we are
encouraging teenagers not to bother with condoms. Our first article
setting out the "AIDS dissidents" case included the comment
that condoms "are common sense".
Maddox further
misleads his readers by writing that we now insist we do not accept
the whole of Professor Peter Duesberg's view on AIDS, which is that
the real cause is excessive drug use, both medical and recreational.
We have never accepted it, and have made that plain from the day
we became the first national newspaper to set out his case. Nor
have we rejected it, unlike Maddox, who has never even allowed Duesberg
to set out his case in Nature, despite publishing numerous attacks
against it, and who is now even denying Duesberg the right of reply
to these attacks.
There are worrying
indications that the misrepresentation and distortion of our position
is not just accidental, but systematic in Nature's coverage of AIDS.
When Maddox
criticised our reporting on the Birmingham haemophiliac last year,
he published a letter of reply from Dr Per-Erik Asard, emphasising
the hazards of anal sex. But the last paragraph of the letter was
not published. It read: "In conclusion, I think that the information
The Sunday Times gave to the public in the Birmingham affair was
of utmost importance."
Professor Gordon
Stewart, a public health expert of great distinction who has for
several years made accurate predictions of the spread of AIDS on
the basis of a hypothesis that lifestyle factors such as anal intercourse
and drug abuse are primary causes, has also been treated with questionable
objectivity by the journal.
In rejecting
a manuscript setting out his case, the magazine wrote: "Given
the provocative nature of that hypothesis, we feel that its exposure
to a wide general readership such as ours could only be justified
in the wake of definitive supporting evidence."
It is an editor's
prerogative to reach a judgment like that. But Michael Fumento,
the American author, has presented clear evidence of bias and censorship
by Nature in a new edition of his book, The Myth of Heterosexual
AIDS.
When the first
edition came out, Nature commissioned a review from the homosexual
AIDS activist, Duncan Campbell. Among other things, Campbell stated:
"Only a writer whose prejudices deny humanity could write in
such bad taste as this: 'Although AIDS is no joke, there is good
news and bad news about the length of HIV infectiousness ... the
"good news" (is) that the great majority and perhaps almost
all, of HIV-infected persons will develop debilitating symptoms
or die'."
In fact, what
the book said after "infectiousness" was: "The 'good
news' here is actually terrible news for anyone infected. Originally,
it was thought that only a small percentage of those infected with
the virus would go on to develop the disease. While this was reassuring
to infected persons, it made the long-term outlook for the spread
of the disease look bad because it meant that large numbers of healthy
persons would be spreading the virus to others indefinitely. But
a consensus of opinion has now formed that the great majority, and
perhaps almost all, of HIV-infected persons will develop debilitating
symptoms or die."
In a paperback
edition, just published, Fumento writes angrily about the way Campbell
concertinaed this passage, giving a false impression of Fumento's
position. "There is no nice term for what Campbell did in his
review," he says. "Further, when I offered a reply, Nature
refused to run it. The acting book review editor, Maxine Clarke,
wrote back: 'My own view is that Mr Campbell is surely at least
as qualified as you to comment on the AIDS epidemic'."
The consensus
Fumento referred to is now challenged by evidence of prolonged good
health in haemophiliacs, in homosexual men who have cleaned up their
lives and avoided the anti-viral drug treatment, AZT, and in HIV-positive
Africans who recover from their illnesses when they receive nutritional
support and appropriate medical treatment.
But the point
of the story is what it tells us about Nature and its attitude to
the AIDS controversy.
IF science
does one day prove that HIV causes AIDS, The Sunday Times will of
course report the fact. So far it has not. As Mullis told us: "If
there is evidence out there that HIV causes AIDS, there should be
some scientific documents which either singly or collectively demonstrate
that fact, at least with a high probability. There is no such document."
Yet on the
basis of an unproven hypothesis, Nature has led a propaganda war
which may have unnecessarily stigmatised millions of HIV-positive
people by implanting the idea that they are harbouring a new and
deadly virus which threatens everyone.
Despite being
supported by billions of dollars of research funds, the hypothesis
has got nowhere in 10 years. It is in those circumstances that Maddox
seeks to silence The Sunday Times.
Perhaps the
time has come for doctors and scientists everywhere who have a concern
for truth to make their views known on Maddox's editorial. We suggest
they write to the magazine, with copies of their letters to ourselves,
and we will see how many are published.
Alternatively,
they may wish to write directly to us. Because much money and power
rest on the HIV theory (sales of AZT alone run at Pounds 230m a
year), their own careers may be jeopardised by speaking out against
it, so we will preserve their confidentiality if requested to do
so. But the search for truth wherever it lies must continue. *
JUDGE AND JURY IN THE WORLD OF SCIENCE THEORY
By
Greg Hadfield
John Maddox,
editor of Nature, has no doubt. It is unquestionably, he insists,
the leading science journal in the world and one that can make or
break careers. And Maddox is Nature.
Unlike the
handful of other elite journals of its kind, it has no editorial
board and asks independent experts to review, in advance of publication,
only about a third of the 200 papers it receives each week. For
all but seven of the past 27 years he relinquished the editorship
during 1973-80 Maddox, 68, a former science correspondent of The
Guardian, has put his autocratic imprint on Nature. He is a combative
controversialist with an iconoclastic bent and an eye for publicity.
"Once
you get tied up with an editorial board, your decisions are slow
and you are required to behave rather properly. We prefer a rather
brash position which gives a lot of freedom journalistically,"
Maddox says.
In the past
decade, the weekly journal's circulation has more than doubled to
60,000, attracting voluminous and lucrative advertising. Its track
record is impressive. "Since the turn of the century we have
published most of the major scientific discoveries. Most recently
the Crick and Watson paper on (the structure of) DNA."
To have a research
paper published in Nature can bestow enormous authority and credibility.
Last year it was cited 218,000 times as a crucial source in research
papers around the world.
So influential
is Nature that it has prompted some scientists to question if it
is right for so much power to reside in one publication or one individual.
Few criticise it openly, fearful perhaps of accusations of bitterness
about papers being rejected or worried that criticism might influence
decisions about whether to publish in future.
Some suggest
that what Nature publishes depends too much on the whim of its editor.
"The problem with Nature is that it is capricious in what it
will accept. It will make a decision based on the editorial staff's
impression of the importance of a piece of work," said one
scientist who insisted editors of such journals should not impose
their own value judgments on pure research.
"Nature
can make careers. It is rare that we break them," answers Maddox.
The case of Jacques Benveniste, a respected French biologist, is
instructive. In 1988, Nature published the controversial findings
of an experiment that appeared to provide a scientific basis for
homoeopathy. At the same time and after a review of the results
by independent experts who could not find fault with the data Maddox
wrote an editorial rubbishing the research.
Shortly afterwards
he spent a week in Benveniste's laboratory with two other biological
"ghostbusters", including James Randi, a magician and
seasoned debunker. Within a fortnight they produced an even more
critical report that branded Benveniste's findings a delusion.
Maddox's behaviour
and suspicions that it was an unscientific publicity stunt only
added to the controversy. Why did Nature publish research if it
did not believe it to be competent and why, having decided upon
publication, did it add such an uncompromising "health warning"?
The answers
lie in Maddox's support for the tenets of orthodox science and his
relationship with the science establishment. He sees Nature as a
watchdog of sound scientific practice "a part of what we do
is look after the manners of the scientific community". Benveniste
is not the only scientist Nature has fingered, he says. Others see
it as symptomatic of an unwillingness to give a platform to heterodox
propositions and theories.
Maddox concedes
that Nature would not now publish research such as that by Crick
and Watson, the DNA pioneers: "The refereeing process would
have given that paper a hard time because it was so speculative."
Benveniste
was a different matter, Maddox says: "A speculative suggestion
that rings an intellectual bell is one thing, but the claim by Benveniste
was an assault on reason."
Last week Nature
published the final chapter in the Benveniste controversy, with
research from University College London that contradicted his findings.
John Foreman,
reader in immunopharmacology and the leader of the UCL team, criticised
Nature's initial response as inappropriate. He said that disbelief
was never a good enough reason to rubbish scientific research: "That
really is not how science proceeds." *
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