Science = Death?: The AIDS Debate
Everyone knows who's buried in Grant's tomb, and the color of Washington's white horse has long been agreed upon. But tautology collectors beware: Not all redundancies are made equal.Take, for instance, the deceptively simple statement "The AIDS virus causes AIDS."On April 24, 1984, The New York Times introduced the term "the AIDS virus" in reference to the LAV/HTLV-III retrovirus (later renamed HIV), which only the day before had been announced in a press conference as the probable cause of the Acquired Immunodeficiency Syndrome or AIDS. AIDS had been commanding increasing attention in the American and European media since 1981, when the U.S. Centers for Disease Control and Prevention began reporting instances of gay men in Los Angeles and New York City dying from a rare pneumonia or an uncommon tumor called Kaposi's sarcoma.Though there was much speculation about why these two previously known diseases were on the increase, no one hazarded a definitive answer to the problem until the now-infamous gathering where Robert Gallo, a research scientist at the National Institutes of Health, told the fourth estate he had found the elusive cause.Gallo's paper was not published or reviewed by his colleagues until weeks after the press conference. Nevertheless, his claim still hit the newsstands the following day. Robert Gallo had proven HIV causes AIDS because Robert Gallo said so, apparently. Had the Times waited for Gallo's data to follow the normal scientific process of peer review and publication, it would have seen that his studies could not, in fact, support his unequivocal conclusions. (Only a fraction of his AIDS patients showed any evidence of having HIV.) Additionally, in 1989 The Chicago Tribune discovered that Gallo had stolen the very virus he claimed as his own from a French study of a similar virus isolated from one patient -- a culture that was later found to be contaminated.Of course, 12 years, 100,000 scientific papers and $35 billion later, we can now look back on Gallo's initial follies with the knowledge that, as nearly any AIDS textbook will tell you, there is overwhelming evidence establishing HIV as the cause of AIDS. So overwhelming that the few remaining scientists bold enough to question the causal connection between HIV and AIDS inspire some of the most excoriating criticism in mainstream science today.Perhaps no one has been more vilified than Professor Peter Duesberg of the University of California, Berkeley -- the most outspoken opponent of the HIV/AIDS hypothesis. The scientific journal Nature, for instance, dirtied its hands in an editorial in May 1993 stating it would continue to publish attacks on Duesberg, but Nature said it considered itself under no obligation to print his responses. As Nature's editor later wrote: "The sad truth about debates on controversial issues in science is that there may come a point at which dissenters forfeit the right to make claims on other people's time and trouble by the poverty of their arguments and the exasperation they have caused."Universal consensus being one of the greatest enemies to scientific progress, what is so dangerous about Duesberg's ideas that they must be prevented from appearing in the very forums where they belong? As the founder of retrovirology (a study of a category of viruses to which HIV belongs), a member of the National Academy of Sciences and a seven-time winner of the National Institutes of Health Outstanding Researcher Award, Duesberg's scientific credentials are superlative. Indeed, even Gallo has noted that Duesberg "knows more about retroviruses than any man alive."And it is the very nature of retroviruses that ultimately led Duesberg to his heretical conclusion that HIV does not cause AIDS. "This virus is killing T-cells [one of the central components of the immune system]," Duesberg noted in a recent phone interview. "At the same time, all they ever found in patients was antibodies against the virus. And I said those two things don't make any sense at all. A retrovirus isn't killing cells. That's the one thing we always knew and agreed on about retroviruses -- that they do not kill cells. The second thing is viruses only cause disease when they are bonded, not when they are neutralized by antibodies. That's what you call a vaccine, when a virus is neutralized by an antibody." Duesberg's entire argument, detailed in his book Inventing the AIDS Virus (Regenery Publishing), has inspired such a polarized response since its release in late March that one might suspect his publisher of printing two different versions, Inventing the AIDS Virus: The Groundless, Irresponsible and Grossly Misinformed Edition and Inventing the AIDS Virus: The Courageous, Brilliant and Impeccably Argued Edition.His most vehement detractors have published their objections in many of the most prominent scientific journals, newspapers and book review periodicals in the world. However, his fellow skeptics (many of whom are in the organization the Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis) number more than 200 Ph.D.s and M.D.s, including three Nobel Prize winners.Yet the best Duesberg can get out of the scientific establishment he attacks -- a scientific establishment that has yet to save one life from the "death sentence" of AIDS, even after the most intensive medical research campaign in history -- is the continued insistence that he and his fellow heretics apologize and fall back in line with the majority of the scientific community. As Nature wrote last year, "Those who have made the running in the long controversy over HIV in AIDS, Dr. Peter Duesberg of Berkeley, California in particular, have a heavy responsibility that can only be discharged by a public acknowledgment of error, honest or otherwise. And the sooner the better."Nature can claim precedent here. The journal even has the template: "I, Galileo, being in my seventieth year, being a prisoner and on my knees and before your Eminences, having before my eyes the Holy Gospel, which I touch with my hands, abjure, curse and detest the error and heresy of the movement of the earth [around the sun]." Like other heretics in the history of science -- a field that makes some of its greatest progress through heresies and revolutions -- Duesberg has been all but drawn and quartered by his colleagues. If he is wrong, and the HIV virus does indeed decimate the human immune system as generally believed, then he will be, as one detractor put it, "A case of skepticism gone too far." However, if Peter Duesberg and his fellow doubters are right, then, in the words of his publisher, "he documents one of the great science scandals of the century."According to the U.S. Centers for Disease Control and Prevention, a person is said to have AIDS if he or she suffers from one or more of 31 different diseases -- all of which existed long before the AIDS epidemic -- and if he or she shows some evidence of being infected by HIV.So technically, it's a trivial statement that current AIDS mortality statistics correlate with positive HIV-antibody tests by nearly 100 percent. (It's not exactly 100 percent due to the sometimes contradictory results of different or subsequent antibody tests, plus the fact that somewhere between 40,000 and 60,000 AIDS cases in America have never been tested for HIV.) No matter what your symptoms, your illness isn't defined as AIDS unless you have HIV. Defenders of the establishment respond that the circular CDC definition of the disease was instituted for clinical convenience and that the HIV antibody test has proven such a useful diagnostic tool in finding and treating the people who will eventually come down with AIDS. However, the heretics counter that the standard treatment for an HIV- positive patient -- involving known immuno- supressive drugs like AZT and ddI -- will by itself lead to deterioration of the immune system that Duesberg has in his more heated moments called "AIDS by prescription."Furthermore, the overlap between HIV antibody-positives and AIDS is imperfect at best. That is, the population of HIV antibody- positive Americans has been estimated at around a million ever since Gallo's ominous entry into the public arena, while only a fraction of that population has shown signs of immune system weakness or the 31 diseases that define the syndrome. Additionally, after surveying recent literature on the subject, Duesberg has found more than 4,000 cases of people who meet all the characteristics of AIDS but test negative for HIV antibodies. The CDC has responded to this development, but only by changing its bookkeeping: It now has a separate label for HIV-negative AIDS, namely Idiopathic CD4 Lymphocytopenia or ICL.In the third world, the prevailing hypothesis holds that AIDS is caused by a virus called HIV-2, with a substantially different genetic makeup from the retrovirus first "discovered" by Gallo. However, the infection rates of HIV-2 in, say, sub-Saharan Africa involve a lot of guesswork, since African AIDS is frequently diagnosed without antibody tests at all but instead with a clinical definition involving cough, fever, persistent diarrhea and substantial weight loss. (In another age, wouldn't most or all of these symptoms be called "malnutrition"?) And when African AIDS patients are tested, as Duesberg points out, a large percentage -- sometimes half or more -- are HIV-negative. (51 percent in the Ivory Coast, Zambia and Zaire (4,383 tested) or 59 percent in Ghana (227 tested ).)Then there's the antibody test itself. Nearly every study quoting the presence of HIV in a population gets its data from the HIV antibody test -- the first of which, incidentally, was patented by Robert Gallo on April 23, 1984. The antibody test is based on the fact that since the retrovirus is so hard to find in the patient, the antibodies rallied by the immune system must be measured instead to detect the presence of HIV indirectly.However, as Kary Mullis -- winner of the 1993 Nobel Prize in Chemistry and an outspoken critic of the HIV/AIDS hypothesis -- cautions, "It turns out that all kinds of things like tuberculosis and a bunch of parasitic diseases will cross-react to the antibodies that they claim are actually to HIV. But those tests are based on a lot of assumptions that are not very easy to prove, because they've never isolated the organism completely by itself. There's not a tube of HIV in the country that's pure. There are cultures that have by mass something like one out of 100,000 is HIV. That's all. That's the best we've got." In addition, in a 1993 issue of the journal Bio/Technology, an Australian research team discovered that no one has yet been able to verify independently any HIV antibody test with what is called a "gold standard." (Obtaining the "gold standard" involves proving that a positive test consistently leads to finding the virus in the patient and a negative test consistently leads to finding no virus.) As they conclude, without this "quintessential element for the authentication of any diagnostic test," one has no way of knowing with certainty what a positive antibody test indicates. It may mean the virus is there; it may not.To all this confusion, Duesberg adds perhaps his most controversial hypothesis: He suspects lifestyle, environmental and drug-use factors as the real cause behind the epidemic."Most simply stated," he said, "AIDS is not an infectious disease, as most people think it is. Instead it is a disease caused by long- term recreational drug use and by some of the very drugs that were developed as anti- HIV drugs like AZT and ddI and all these chemicals that are given as AIDS prophylaxis. So, as such, AIDS is an entirely preventable disease, which should be an extremely good message for HIV-positive people. And we could do a hell of a lot of good on the basis of this hypothesis -- something that I would never dare to say for cancer, for dementia, for Alzheimer's, for aging, for osteoperosis. I think the prospects for doing good along these lines are very, very difficult. But on this one, it's very, very promising, just as it is for smoking and cancer. All it would take is a minute fraction of the money currently spent on HIV to test and confirm it and a tiny bit of an open mind to consider alternatives when everything else is so unsuccessful."With statements like the above -- statements that the orthodoxy charges are only "pandering to wish-fulfillment" -- one can see why Duesberg's name alone is enough to raise the hackles on the neck of many a conventional AIDS researcher.And whatever one thinks about Duesberg and company, his ideas and the ideas and writings of his fellow HIV/AIDS skeptics are voices too rarely heard in the most publicized epidemic in history. Since Duesberg first published on the subject in 1987, the AIDS heresy has to date been relegated to a few pockets in the media -- London's Sunday Times, some of the gay press like Provincetown Positive and New York Native and several radio and television shows like PBS's Tony Brown's Journal.But surprisingly, probably the most comprehensive coverage of the AIDS heresy has been found in the pages of the popular music magazine SPIN, which since 1987 has consistently turned a sympathetic ear to alternative points of view about AIDS. Their coverage has been called a "public health menace" by one pro-HIV AIDS organization and Celia Farber, SPIN's corespondent, was termed a "public health threat" by another.Heretics like Farber persevere, the textbook AIDS and HIV In Perspective (Cambridge University Press, 1994) asserts, because they are sadly misled. "Yet, despite the overwhelming evidence establishing HIV as the cause of AIDS, a very small number of maverick scientists have persisted to this day in sowing unnecessary confusion in the minds of the uninformed by disputing the role of HIV in AIDS ... While it is true that the ideology of science is founded on the principle of unfettered probing and exploring, these groundless diversions and deviations really serve little purpose other than to cause confusion and to squander valuable scientific energies which could be used for more worthwhile and productive research objectives and goals."When not speaking like Oz after Dorothy spotted the curtain, many of the scientists engaging the barbarians in substantial arguments have cited studies that they claim refute the heresy once and for all. For instance, Steven B. Harris M.D. wrote a lengthy response to Duesberg et al. in a 1995 issue of the periodical Skeptic. "Are we making any progress with AIDS or just wasting billions each year chasing fantasies?" he asks. "This essay will argue that we are not wasting all that money, and that when it comes to critics of the HIV/AIDS hypothesis, we have a practical case in which skepticism has been taken too far. Science, we are happy to report, still works, and it is making progress with AIDS."Among the epidemiological statistics he cites to buttress his argument are studies of populations of high-risk HIV-negatives who were followed and rarely if ever came down with AIDS, as might be expected if HIV antibodies do not correlate with AIDS. (Only one of 2,713 persistently HIV-negative homosexual men and four of 1,246 HIV- negative IV drug users showed any signs of immune system suppression.)More important, the prevailing paradigm has held sway since Gallo's press conference, so that by itself is a statement of its inertia. If Duesberg and his colleagues are even partly right, how could most of the industrialized world be (pace Patsy Cline) so wrong for so long?Duesberg, in part, sees it as a battle of egos, expertise and that eternal corruptive influence -- money."Look at all my peers in AIDS research," he said. "They're all virologists or retrovirologists like [me]. They're either on the boards of biotechnology firms developing vaccines, developing anti-viral drugs, developing AIDS-test kits, selling them, marketing them, owning the companies. They're millionaires. Gallo alone, even at the NIH, gets a supplement to his salary of over $100,000 a year. And that's a small token compared to what people get at private universities. [David] Baltimore sold a company on AIDS a couple of years ago for $30 million. [Harold] Varmus had to sell millions of investments before he could become director of the NIH. It is very difficult if you have 20 or 30 people working for you with a company that makes a couple of millions on the side to tell them, 'Hey guys, we're working on the wrong track. Let's give up that stuff.' So this explains why we have so little freedom to move here." Mullis sees matters in more fundamental terms. "The whole thing is really not a medical problem," he said. "It's a problem with the medical establishment and the scientific establishment, which is unfortunately run by idiots like me who make money out of it."According to his profile on the Internet (at www.gene.com), Kary B. Mullis is "a scientist and a surfer from La Jolla, California ... considered an 'intellectual maverick' by many, [winner of] a Nobel Prize in Chemistry in 1993 for developing PCR." His Polymerase Chain Reaction, in fact, has been used by HIV/AIDS researchers to find evidence of the HIV virus, even when it is present in minuscule amounts. (He was also frequently referred to as one of the genetic experts in the O.J. Simpson trial, which upstanding Americans will recall, spent weeks covering genetic evidence and counter-evidence.)As Duesberg notes, PCR is typically used by the orthodoxy to "amplify a needle into a haystack, so they can look at a haystack and say, 'Look what we got here.' But they don't tell you where that came from, that there was nothing there to begin with, that they amplified something from nowhere." Since Mullis first discovered that the HIV/AIDS hypothesis relied on a vast leap of faith that he felt was not merited, he has grown increasingly frustrated with a sloppy or even reckless scientific bureaucracy and a credulous press corps. "I'm disgusted with them for having done this. I think it's a disgrace to Western science and everything else," he said. "They have no balls, they've got no heart and they've got no reason."While Mullis agrees entirely with Duesberg's essential point that AIDS is not caused by an infectious disease, he does not concur that a single cause lies behind the syndrome of immunodeficiency in the risk groups of gay men, IV drug users, transfusion recipients and hemophiliacs."It's a hard thing to say, but it's a result of some elements -- and we don't know which, we can't sort them out because it's too complicated to try to figure out what causes all 29 diseases that are called AIDS because they aren't all caused by the same thing," Mullis said. "Semantically, they've made it impossible to make any progress." He does see larger cultural forces at work, though. Like Duesberg, he finds the initial AIDS cases among the bathhouse subculture of gay men -- for whom the tremendously dangerous and immunosuppressive nitrite inhalants ("poppers") remain a popular recreational drug to this day -- as a telling lead."The '60s had to be answered by the '90s." he said. "There was not any way we could avoid that unless we had Hari Seldon [from Isaac Asimov's Foundation trilogy] ... I feel like there was no way of avoiding something like AIDS. It's a human thing. It hasn't got anything much to do with the organism. If you look at it, and once you realize, 'My God, there wasn't an organism, was there?' It wasn't an organism, so what was it? These people who had these diseases for a long time, and everybody knew that if you're undernourished and you don't get any sleep and fill your body up with all kinds of weird combinations of drugs, not just once but all the time for 10 years, I don't think anybody would have predicted that you would have looked real healthy." "It was a terrible time for those people." he continued. "And then someone comes along and says, 'We've got this miracle cure [AZT]. It's going to make you feel a lot worse. And it isn't going to save you. But maybe you'll live a couple of days longer. You'll vomit all the time, and you'll hate yourself worse than you did before. But you might live a couple of days longer.' But it didn't look like after all the studies were in that anybody lived any longer. It looked like people were dying sooner."Mullis, Duesberg and the AIDS heretics may be wrong, and they may even be acting recklessly -- as their detractors so adamantly insist. But if Mullis and Duesberg are even partly correct, then the orthodoxy could be indicted on its own counts of wrongdoing and recklessness endangerment.If medical researchers can only cite epidemiological data to substantiate their claim that HIV is the cause of AIDS, more proof is clearly needed. (That is, if $35 billion has not produced an answer to the question, "How does the HIV retrovirus cripple the human immune system?" then the Group for the Scientific Reappraisal for the HIV/AIDS Hypothesis has a prominent role to play in the coming years.) However, only time and further research will tell whether, as Duesberg suggests, lifestyle, environmental and drug-related factors are the sole cause of AIDS.One thing is certain. The response to the heresy to date can be labeled many things, but one of those labels is not "science." If Duesberg, Mullis, anti-HIV activist groups like Los Angeles' Health Education AIDS Liaison and the Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis are all working from such weak foundations, then it will be readily apparent in a true scientific debate -- not the sandbox antics that now passes for reasoned discourse.In 1959, philosopher Karl Popper spelled out what a society should expect from its scientific theories -- or as he called them, 'anticipations': "Once put forward, none of our 'anticipations' are dogmatically upheld. Our method of research is not to defend them, in order to prove how right we were. On the contrary, we try to overthrow them. Using all the weapons of our logical, mathematical and technical armory we try to prove that our anticipations were false ... Bold ideas, unjustified anticipations and speculative thought are our only means for interpreting nature: our only organon, our only instrument for grasping her. And we must hazard them to win our prize. Those among us who are unwilling to expose their ideas to the hazard of refutation do not take part in the scientific game."Or as Mullis more directly puts it, "This debate is in part about two questions: What do you call a scientist? And how do you distinguish the scientist from a theologian?"For more information, contact the Los Angeles- based HIV-skeptic activist group Health Education AIDS Liaison at (213)896-8260.