The May 23 issue of the New York Review of Books has a long article
by Richard Horton (editor of Lancet) titled "Truth and Heresy
About AIDS." It is a review of Duesberg's Inventing the AIDS Virus,
and also of two collections of essays edited by Duesberg that were published
at about the same time. Horton's review essay is very long, and will not
be available on-line as far as I know, so I will post a summary with quotations.
Direct quotations are indented. My commentary is included in brackets throughout,
and at the end.
I hope this summary is widely read. I do not think the NYR will
object to the direct quotations, especially since I urge all readers to
purchase this issue and read the article in its entirety. I think the NYR
has covered itself with glory by devoting so much space to such a substantial
article, even though I am severely critical of some parts. I have to use
quotations because it is so important not to give the ever-present HIV-obscurantists
a chance to complain that anything has been misreported.
The review essay is in 5 parts.
After characterizing Duesberg as "a brilliant virologist, and the
former recipient of an award for outstanding investigative research from
the NIH," Horton summarizes the Duesberg position:
"If AIDS was caused by an infectious agent, Duesberg claims, one
would expect it would have five specific characteristics: (1) it would
spread randomly between the sexes: (2) the disease would rapidly appear
-- at least within months: (3) it would be possible to identify "active
and abundant [HIV] microbes in all cases", (4) cells would die or
be impaired, beyond the ability of the body to replace them; and (5) we
would see the development of a consistent pattern of symptoms in those
infected. None of these expectations has been met. In the US and Europe,
men are affected far more commonly than women; the onset of clinical disease
takes a median of ten years; the virus is difficult to isolate in patients
with AIDS. Nor are the direct effects of the virus on one group of target
cells, called CD4 lymphocytes, believed to be responsible for the observed
immunodeficiency. And the symptoms vary strikingly, for example, between
Africa and America, although they have a supposedly common infectious origin."
Arguments such as these have persuaded respected scientists to express
their skepticism that HIV is the cause of AIDS. Kary Mullis, who won the
Nobel Prize for chemistry in 1993, writes in his foreword to Inventing
the AIDS Virus, "I like and respect Peter Duesberg. I don't think
he knows necessarily what causes AIDS; we have disagreements about that.
But we're both certain about what doesn't cause AIDS. We have not been
able to discover any good reasons why most of the people on earth believe
that AIDS is a disease caused by a virus called HIV. There is simply no
scientific evidence demonstrating that this is true."
Horton goes on to describe Duesberg's "drug-AIDS hypothesis,"
and then concludes:
" Here Duesberg's arguments take him into dangerous territory.
For if HIV is not the cause of AIDS, then every public health injunction
about the need for safer sex becomes meaningless; every call to offer clean
needles to injecting drug users may be unnecessary -- or worse. Duesberg
notes that "the clean needle program of the AIDS-establishment would
appear to encourage rather than discourage intravenous drug use."
And he writes, most remarkable of all, that "screening of blood for
antibodies to HIV is superfluous, if not harmful, in view of the anxiety
that a positive test generates." In his opinion "AZT is AIDS
by prescription"; this drug should "be banned immediately."
[It may be "dangerous" for Duesberg to oppose AZT, but it
is far more dangerous for the AIDS establishment to prescribe it, especially
for infants, in view of the acknowledged toxicity and inadequate evidence
of clinical benefit. Avoiding known venereal diseases is sufficient reason
to refrain from unsafe sex practices, regardless of what one thinks about
Horton concludes Part One with the obvious question:
"How could so many scientists have got it all so badly wrong?"
[Indeed, that is a very excellent question. But in the next section
seems to answer it by saying in effect that -- "Of course, they couldn't
have got it wrong. To forestall that unacceptable possibility, their most
dubious evidence must be accepted as absolute, unchallengeable fact."]
Horton observes that the Duesberg dissent emphasizes that even a perfect
correlation cannot prove causation without "functional evidence"
-- i.e., evidence of how the virus supposedly does its damage. He goes
on to comment that That "functional evidence" is now accumulating
rapidly. However, researchers readily admit that there are huge gaps in
our understanding. In the recent authoritative account, The Molecular Biology
of HIV/AIDS, edited by A.M.L. Lever, scientists write:
"Despite knowing so much about the molecular biology of HIV we
still have little understanding of how HIV causes AIDS and why progression
to disease can take a long and variable time.
It remains to be established precisely how viral replication and viral
gene expression are regulated and how they influence progression to clinically
The cell type which is first infected following HIV transmission has
still not been defined."
"These uncertainties do not mean that HIV is not the cause of AIDS.
Here is an important distinction that Duesberg ignores. Though we may not
understand exactly how HIV causes AIDS, we have a large, most scientists
would say overwhelming, mass of evidence linking HIV to this form of acquired
immunodeficiency. HIV has been shown to be a necessary factor for the occurrence
of AIDS. Whether it is sufficient remains open."
[Throughout the article, Horton uncritically repeats as fact the claim
that AIDS never exists except in the presence of HIV, ignoring that this
is true only because the syndrome is defined that way, and never mentioning
that exactly the same symptoms or (29) indicator diseases are diagnosed
as AIDS only when HIV (usually, antibody) is either shown or presumed to
be present. Tuberculosis (for example) accompanied by a positive antibody
test is AIDS; if the test is negative, it is just tuberculosis. Horton
does not even refer to the dozens of cases admitted by the AIDS establishment
to exist and reclassified as "ICL" solely because no trace of
HIV cannot be found even after prolonged efforts. The reason that so many
scientists could be so wrong is that they have not bothered to observe
elementary principles of logic in evaluating claims of correlation. Horton
must know about the circular definition because the Duesberg books and
articles make the point repeatedly. Hence his failure to note the point
and respond to it appears to be a deliberate omission.]
Horton's position, then, is that HIV is necessary but not necessarily
sufficient for AIDS. So he goes into the question of possible co-factors:
"Could drugs be an additional cofactor? Duesberg writes that there
are high rates of drug use among AIDS patients, and he has correlated drug
use "epidemiologically and chronologically" with the AIDS epidemic
in both the US and Europe. He cites studies showing that 96 percent of
representative groups of male homosexuals had used nitrite inhalants, up
to 70 percent had used amphetamines, and up to 60 percent cocaine or LSD.
His uncompromising rejection of the causal power of epidemiological evidence
is temporarily set aside when he dogmatically affirms that distinct AIDS
diseases occur in distinct risk group[s] -- because they use distinct drugs
(e.g., users of nitrites get Kaposi sarcoma, users of intravenous drugs
get tuberculosis, and users of AZT get leukopenia and anemia). . . . The
duration and toxicity of drug consumption and individual thresholds for
disease determine when AIDS occurs, irrespective of when and whether HIV
"Here Duesberg has abandoned the skepticism about epidemiology
that he deployed so tenaciously in his criticisms of HIV causality. In
fact, the issues he raises have been tackled by researchers. Well-designed
studies cited in A.M.L. Lever's book show that the annual probability of
developing AIDS does not differ significantly between hemophiliacs infected
via factor VIII [i.e., a clotting protein, whose absence leads to bleeding],
homosexuals infected sexually and those who acquired HIV as a consequence
of intravenous drug use. These findings provide presumptive evidence against
a role for bacterial infections or for drug and alcohol use, all of which
are more common in intravenous drug users, in disease progression."
[Duesberg is guilty of no inconsistency. Correlations point to suspects,
but more is needed to prove causation. That is why Duesberg makes well-designed
research proposals to (for example) study the effects of poppers in mice.
After HIV was identified as a suspect in AIDS, biomedical researchers expected
to see it infecting and destroying cells directly. Once they learned that
HIV does not even infect most of the cells it is supposed to be destroying,
and that, as Horton admits, there is no direct cell-killing mechanism,
the HIV theory should have been reconsidered. Duesberg predicts that unbiased
epidemiological studies, in which the HIV-positive subjects are (for the
first time) compared with a carefully matched group of HIV negatives who
are otherwise identical in health risks, will discredit the alleged correlation
between HIV and immune deficiency, Kaposi's sarcoma, or other AIDS-defining
Correlation is not proof, but evidence well short of proof may be a
sufficient basis for urging people to give up some recreational substance
like cigarettes or amyl nitrites. A much greater degree of proof should
be required before prescribing some highly toxic drug like AZT, that is
likely to make them very sick.]
Horton concludes his Part Two with an unwitting demonstration of the
misuse of correlation evidence to protect the HIV theory:
"In Musuka district, in southwest Uganda, if you are an HIV-positive
adult you are twenty times more likely to die than if you are HIV-negative.
To claim that HIV is not causally associated with immunodeficiency-related
diseases is to ignore the evidence of thousands of deaths."
"Another crucial, and decisive, line of evidence refuting Duesberg
comes from the hemophiliac population. The British researcher Sarah C.
Darby reported last year on deaths among the UK population of hemophiliacs
between 1977 and 1991. Between 1977 and 1984, the annual death rate among
patients with severe hemophilia was 8 per 1000. Between 1985 and 1992,
this rate remained identical among HIV-negative hemophiliacs, but increased
to 81 per 1000 in 1991-92 in those with HIV infection. Moreover, interruption
of the spread of HIV clearly prevents the occurrence of AIDS. Contrary
to Duesberg's hypothesis, preventing HIV transmission prevents AIDS."
[Such raw correlations between HIV (actually, proteins which are linked
to antibodies to HIV), and such a very general condition as "death,"
can be very misleading when employed as proof of causation. The reasoning
rests on a non-sequitur: More people with positive antibody tests die of
something-or-other; therefore HIV causes immunodefiency." Most of
those Ugandans did not die from "AIDS" --even though that syndrome
is diagnosed in Africa by the very broad "Bangui" definition.
Hemophiliacs have a multitude of health risks -- including, now, AZT. If
epidemiologists accept as "decisive proof of causation" mere
correlations between some factor and death from whatever cause, then it
is no wonder that they can come to disastrously wrong conclusions. But
I am sure Horton understands these elementary points -- so why does he
Horton said in PART ONE that "functional evidence of how HIV causes
AIDS is now accumulating rapidly." In this brief section, he explains
what he means by that statement:
"It was formerly thought that the virus, once integrated in a host
cell, existed in a latent phase. Duesberg makes much of this belief. In
l995 he wrote that HIV is latent, and neither chemically nor clinically
detectable in 'HIV antibody-positives' [i.e., people with HIV] with and
"This is not so. Soon after it is assembled, HIV undergoes tremendous
replicative activity and a high level of virus can be found in the blood.
Although the virus is then cleared from the blood, replication continues
apace throughout the body's lymphoid tissue, which is the main repository
of our immune system. This continued and damaging activity over the long
term is believed to lead to immunodeficiency, leaving the infected individual
susceptible to infections, such as Pneumocystics, and cancers, such as
[This is mainly handwaving, since even "tremendous replicative
activity" does not show immune cell destruction. (HIV is grown for
these experiments in "immortal" T-cell lines, which somehow avoid
destruction.) Moreover, the conclusion -- "is believed to lead to
immunodeficiency" -- is phrased in language which betrays its speculative
nature. Anyway, Duesberg and his supporters argue that claims of massive
replication of HIV (following the clearing of the primary infection) in
the lymph nodes or elsewhere are an artifact of the quantitative PCR method
which is employed to detect traces of viral particles. (Kary Mullis, the
inventor of the PCR technique, is a famous Duesberg supporter.)
If live and active virus were really present in such quantity, it could
be found without employing the PCR. Just as HIV-partisans have accepted
obviously dubious epidemiological correlations as "proof," they
have viewed claims of biochemical support for their theory with a notable
lack of skepticism.]
This section deals with the failure of AZT and other so-called "antivirals"
to meet expectations. Horton reports:
"Trials of drugs to combat HIV infection have passed through three
phases. The first period began and ended in 1987 with the publication of
a single clinical trial that showed that AZT helped patients with HIV infection
who had symptoms of disease to survive longer. AZT was licensed for use
shortly afterward and optimism ran high. From 1987 to 1994, a deepening
mood of pessimism bordering on cynicism set in. Several early studies were
based on the notion that early treatment-- when the patient was infected
but free of symptoms -- was the sensible and biologically plausible course.
They seemed to indicate that intervention n symptom-free or early symptomatic
stages of HIV infection might be beneficial. However, in 1992 J.D. Hamilton
and his colleagues showed that AZT produced no survival benefit in patients
with early symptoms. This result was followed by the devastating findings
of the Anglo-French Concorde study group. In this, the largest and longest
trial of AZT in HIV-positive men and women, early use of the drug conferred
no advantages. Worse still, further studies have shown significantly more
deaths in the group treated early. The Concorde study also showed that
commonly used "soft" measures of a drug's efficacy, such as the
lower or higher number of CD4 cells in the blood, were no substitute for
"harder" clinical measures, such as survival."
[But AZT is still widely used for asymptomatics, and is being forced
upon mothers and their infants despite the lack of evidence of any health
benefits. "Dangerous"? You bet! Horton attributes the failure
to develop a vaccine or cure to the fact that "HIV does not play by
the old rules." Another possibility is that HIV researchers do not
play by the elementary rules of logic and empirical testing.]
Horton concludes his section on failed therapies with this observation:
"The obstacles to developing new treatments and ascertaining the
precise mechanisms by which HIV damages the immune system have had profound
effects on AIDS research in the U.S. For instance, the fifteen-member National
Task Force on AIDS Drug Development, launched with government fanfare in
1993 by Donna Shalala, the Secretary of Health and Human Services, was
recently disbanded owing to lack of progress. The $1.4 billion US AIDS
budget is undergoing careful review: it is projected to increase by only
1.6 percent in 1997, according to the President's latest research and development
budget. And the organization of AIDS research has recently been subjected
to critical scrutiny by a congressionally mandated review panel chaired
by Arnold Levine from Princeton. A consistent message running through his
report is that HIV research, especially vaccine development, needs to be
freed from the "impediment" of the NIH establishment. What is
needed, according to the panel, is a climate in which more innovative and
imaginative lines of investigation can be pursued."
A plausible example of what the committee had in mind might be an inquiry
into the interaction between viral particles and potential cofactors, such
[In brief: orthodoxy is getting nowhere, and we had better be prepared
to consider some new ideas, much as we may hate the thought. I judge this
to be the true overall message Horton is trying to convey.]
[Horton gives a moving description of the brutal censorship that has
characterized HIV-science since 1984. He quotes scientific politicians
like John Maddox and June Osborn, who would not recognize the truth if
it hit them straight between the eyes. As Horton himself said at the end
of PART ONE, "How could so many scientists have got it all so badly
wrong?" Horton's answer is all too painfully obvious]:
"I remember clearly the press conference called by the Wellcome
Institute in London at the time of the Concorde study's publication. The
gathering was not intended, as one might imagine, to explain to medical
journalists the intricacies of the research and how it might be interpreted."
"The room was, instead, packed with financial journalists who were
there to hear of the resolve of the company officials to destroy the credibility
of a new study that they had helped to design and analyze, but which had
gone against their project."
"Apparently under pressure from the company, two coauthors of the
study withdrew their support from the clear implication of the trial that
AZT was ineffective in otherwise healthy HIV-positive individuals. At the
same time, in the final trial report published in The Lancet, it was noted
that "representatives of the Wellcome Foundation, who were also members
of the Co-ordinating Committee, . . . declined to endorse this report."
if the latest crop of new drugs -- the protease inhibitors -- proves successful,
both Merck and Abbott would each earn from their products several hundred
million dollars in the US alone. An open debate with Duesberg could have
grave commercial consequences."
[Oh yes it could, and that helps to explain why the drug companies and
their scientific retainers have been so determined to prevent that debate
from occurring, or from reaching the attention of the public. So now at
last we get to the bottom line]:
"Yet another part of the current medical landscape that the Duesberg
affair illuminates is political and ideological. What does the orthodox
scientific establishment do to a scientist whose work and views are out
of step with majority opinion? Apparently, in some cases, cut off his funding."
"One of the most disturbing aspects of the dispute between Duesberg
and the AIDS establishment is the way in which Duesberg has been denied
the opportunity to test his hypothesis. In a discipline governed by empirical
claims to truth, experimental evidence would seem the obvious way to confirm
or refute Duesberg's claims. But Duesberg has found the doors of the scientific
establishment closed to his frequent calls for tests. To begin with, the
grant he was awarded in 1985 to support his work on cancer was not renewed
despite an appeal supported by the administration of the University of
California at Berkeley. The experimental virology study section of NIH
wrote that Duesberg was an "applicant whose productivity has recently
diminished both in quantity and most disturbingly in quality." Between
May 1993 and December 1994, six further grants to Duesberg to fund cancer
research were rejected. In AIDS research, between February 1993 and August
1994, Duesberg tried to secure funding to investigate his hypothesis (which
has with time hardened into more of a belief) that nitrite inhalants are
a cause of AIDS. These applications were made to the university-wide AIDS
Research Program at the University of California and twice to the National
Institute of Drug Abuse. His two grant applications to NIDA -- both entitled
"Animal tests of the AIDS risks of nitrite inhalants" -- were
supported by letters from Daniel E. Koshland, then editor of Science. All
three applications were rejected, and the validity of his hypothesis still
"Although an overwhelming body of evidence exists to confirm the
causal association between HIV and AIDS, the principle that original experimental
investigation should be given primary importance in science, recently emphasized
by the Levine committee, supports the argument that proposals made by serious
scientists with proven records of high-quality research deserve careful
consideration. This is especially the case in view of the current widely
acknowledged uncertainty about the origins and mechanisms of HIV disease.
It is not only Duesberg who points to this uncertainty. Michael Ascher
and his colleagues at Berkeley wrote in 1995 that those who would see AIDS
as a more-or-less conventional viral infection have consistently refused
to recognize the paradoxes that are clearly evident in the experimental
data -- the problem continues."
"And Jon Cohen commented in Science that no treatment, to date,
has had much success. And unless that bleak reality changes, alternative
thinkers will likely keep needling their establishment colleagues and urging
them to rethink their basic understanding of the disease."
"But how far will this rethinking be allowed to proceed? Duesberg,
for his part, not only fails to understand the strengths and weaknesses
of the epidemiological method; he also, as has been seen, recklessly deploys
ill-thought-out epidemiological arguments to support his own drug-AIDS
point of view. Nevertheless, as a retrovirologist, Duesberg deserves to
be heard, and the ideological assassination that he has undergone will
remain an embarrassing testament to the reactionary tendencies of modern
science. Irrespective of one's views about the validity of some of Duesberg's
arguments, one is forced to ask: At a time when fresh ideas and new paths
of investigation are so desperately being sought, how can the AIDS community
afford not to fund Duesberg's research?"
[Horton ends on so positive a note that I feel almost ungenerous in
stating the obvious: Duesberg understands perfectly well the "strengths
and weaknesses of the epidemiological method," and he "uses epidemiological
arguments to support his own drug-AIDS point of view" only to establish
that the drug-AIDS hypothesis is worthy of testing on a level playing field.
Animal testing of the long-term effects of amyl nitrites is an example
of the kind of research that the HIV establishment refuses to fund. This
could be because the reviewing authorities think that the nitrite hypothesis
has no merit, or it could be because they are afraid that it will be confirmed.]
Why did Richard Horton choose to write, and the New York Review of Books
make available, so many pages to a dissenting position that the HIV establishment,
and the editors of Science and Nature, have always insisted
to be unworthy of serious consideration?
Why does Horton take a schizophrenic position, so intelligently describing
what is wrong with HIV-science at one point and so uncritically endorsing
the conclusions of that same HIV-science at other points -- on the basis
of correlations he must know to be faulty? Why does he end with that powerful
concluding sentence, that might have been written by Duesberg himself?
Draw your own conclusions, but here are mine:
The most perceptive thinkers in the biomedical establishment can see
that HIV-science is headed towards a crackup. They have long known how
flimsy a basis there was for Gallo's announced "discovery" of
the cause of AIDS at that decisive 1984 press conference, when the theory
was set in concrete. For a long time they gave the benefit of the doubt
to the Gallo's and Fauci's, but now they begin to see the handwriting on
the wall. Even the hitherto acquiescent press has begun to revolt, with
publicity in the Wall Street Journal and other newspapers about how the
U.S. Government's CDC has deliberately furthered the false impression that
HIV-AIDS is rapidly infecting the general population outside the original
The HIV/AIDS establishment has been hoping desperately for a research
breakthrough that would rescue the situation, perhaps in the form of discovery
of a mechanism by which HIV could cause damage to the cells of the immune
system. I surmise that the well-connected Horton knows that those hopes
are fading. That is why "fresh ideas and new paths of investigation
are so desperately being sought." Yes, the man said "desperately."
Eventually, the press and the public will catch on to the fact that
this very expensive research establishment is spinning its wheels. In that
case, how is the research community to extricate itself from a blind alley?
Admitting a fundamental error is out of the question, with the financial
and reputational interests that are at stake. Think of the blizzard of
lawsuits and recriminations that would follow! The only way out is to move
gradually to a new theory or perhaps a redefinition of the syndrome. That
will be a very delicate operation; Horton is sending a signal that it is
necessary to begin. *