AIDS; WORDS FROM THE FRONT
By Anthony Liversidge
Spin Aug. 1991
After seven years of debate over who really discovered HIV, accusations
mount against Dr. Robert Gallo. Did Gallo lie about discovering the virus
he's built his career on? Anthony Liversidge reports.
It is hard for a reporter not to like Robert C. Gallo, the chief of
the Laboratory of Tumor Cell Biology at the National Cancer Institute and
longtime ruler of AIDS research in America. Gallo, despite his renowned
arrogance, has a vitality and personal warmth rare among scientists, and
he flatters, cajoles, and evades pointed questions with a teasing charm.
He has long played on the weakness of the press in dealing with the top
AIDS scientist. Establishment reporters need to keep on the right side
of big shots whose quotes give their stories credibility.
Now, however, the game may be up for Bob Gallo, whose own credibility
is in serious doubt, and this time by his own admission. In late May Gallo
finally admitted, point-blank, in a letter to the top scientific journal
Nature that he had not - as he has insisted for seven years - independently
discovered HIV, the AIDS virus. In effect, he acknowledged that he discovered
HIV in the mail. The specimen he found in his NCI laboratory in 1984 was
the same HIV forwarded twice to him by Luc Montagnier of the Pasteur Institute
in Paris. Gallo apologized for throwing more heat than light on the question
in the past.
The turnabout came at the end of a series of revelations. First, in
February of this year, Gallo claimed that his virus was not - as had long
been established - the same as the French virus. He had analyzed leftover
samples from his lab refrigerator and found they had a different molecular
sequence from Montagnier's. He had suggested that perhaps Montagnier had
discovered Gallo's virus, rather than vice versa.
Montagnier, stung by this effrontery, went back to his own fridge and
discovered that the HIV samples both sides had patented were indeed contaminated.
But the contamination had first taken place in the Pasteur laboratory.
Conclusion: Gallo's virus was without doubt the one first found in Montagnier's
lab. The Pasteur Institute had sent a mislabeled sample to Gallo, which
later had been "discovered" by Gallo. Gallo had to concede.
The stunning admission has many ramifications. One of them is that the
validity of the U.S. patent for a blood test for HIV antibodies is now
in doubt. The lucrative patent has earned Gallo and a colleague half a
million dollars each in royalties so far. Beyond that, it renews questions
of how good a scientist Gallo actually is, questions raised at length by
Pulitzer Prize - winning reporter John Crewdson in the Chicago Tribune
since November 1989.
At best, the mix-up was due to unwitting contamination, which is now
Gallo's excuse. Contamination is a risk in every virus laboratory. In fact,
Gallo made a fool of himself this way in 1975 when a new "human"
virus he published had to be retracted - it was a contamination, a mix of
gibbon and baboon viruses.
At worst this incident was conscious fraud, stealing credit for finding
the alleged key to AIDS. What outside observers must now wonder is how
much truth there is in the rest of Crewdson's accusations. Crewdson has
portrayed a Gallo who stole credit from underlings on several occasions,
and then tried to destroy their careers. Gallo rewrote the record of scientific
meetings to make it look like he had presented papers that he had not.
He even refused to lend the Centers for Disease Control samples of "his"
HIV unless they promised in writing not to compare it with other viruses - prima
facie evidence that he feared they would find it the same as the French
one.
Montagnier himself has now publicly accused Gallo of lying. The accusations
are being investigated by a National Institutes of Health review panel,
which is due to report shortly. If the report concludes that Gallo deliberately
stole the virus, he faces the loss of his job and possible criminal prosecution.
These are not the only flies of scandal swarming around Gallo's head. In
the past two years two of his chief researchers have been accused of stealing
federal funds, and one was convicted last year. Meanwhile, NIH has banned
Gallo's collaboration with a French scientist on AIDS vaccine research.
Gallo's vaccine is said to have been tested on children in Zaire without
NIH authorization.
The credibility of Gallo and his science is critical to AIDS research.
The entire multibillion-dollar effort to combat AIDS worldwide rests on
the theory that HIV causes the dread syndrome, a theory that ultimately
rests squarely on Gallo's shoulders. For unlike Montagnier, Gallo rushed
to label HIV the AIDS culprit in April 1984, joining Margaret Heckler,
the U.S. Secretary of Health and Human Services. In a press conference
which made the theory official U.S. - and thus world - policy.
Even at the time, the evidence fell short of solid proof; among other
problems, HIV itself had been found in only half the AIDS patients tested.
And Berkeley's Peter Duesberg, Gallo's fellow retrovirologist and a leader
in the field, has never tired of pointing out that the evidence that has
accumulated since more often undermines the theory than serves to shore
it up. As Mathilde Krim, head of AmFar once said, as a scientific question
the issue remains open: "We can't prove HIV causes AIDS and Duesberg
can't prove it doesn't!"
In fact, the sideshow of Gallo dodging brickbats of scandal has distracted
attention from the most important issue in AIDS. Is Gallo leading the world
down the garden path with HIV? The fierce quarrel over whether Gallo stole
credit for HIV has falsely suggested that no one can question the value
of the prize.
In the seven years since Gallo triumphantly announced his theory, he
has been notably unenthusiastic about reviewing it, though HIV science
has failed to yield a vaccine, a cure, or even a safe medication for AIDS.
Gallo's most blatant failure to answer the scientific doubts about HIV
followed the publication of Duesberg's most thorough critique, a 10,000-word
paper in the Proceedings of the National Academy of Sciences, over two
years ago. Gallo received an early copy of the paper and promised the editor
that he would reply. The journal published a notice to that effect, but
Gallo never did so.
All this is why the biggest news of the past two months is not the unfolding
scandals surrounding Gallo, but this: The prominent researcher has finally
replied to Duesberg - sort of. He hasn't replied in a scientific journal,
where he would have had, like his critics, to provide proper scientific
references for every claim, and have his facts reviewed by other scientists
before publication.
But Gallo has now published an outspoken autobiography, in which he
devotes generous space to the arguments of his most active scientific critics,
Duesberg and Robert Root-Bernstein of Michigan. Until the NIH verdict is
public, Virus Hunting - AIDS, Cancer, and the Human Retrovirus: A Story
of Scientific Discovery (Basic Books, New York), is the best answer
to the double barreled question at the core of AIDS: How good a scientist
is Gallo, and why is he so sure that HIV is the cause of AIDS?
Probably only those with a detailed knowledge of the arguments, counterarguments,
and counter-counterarguments for and against HIV can judge for themselves
how good a case for HIV Gallo makes.
But there are indications of weakness in the very style. Gallo's review
of HIV theory is not the judicious, evenhanded overview of an elder statesman
of science. It is, disappointingly, heavily partisan. This is advocacy
science. Name-calling is barely restrained.
In Gallo's view all his critics are unqualified, and anyone who does
not "accept the scientific results we have achieved with HIV"
is like a member of the "Flat Earth Society, which has evolved a complex
rationale to explain away all the evidence that the earth is round."
Most scientists "get some fun out" of Duesberg, Gallo says,
or see him as a "useful gadfly" who nevertheless is "very
wrong." Duesberg, he tells readers, is a Ph.D. with a background in
chemistry, who made "significant contributions to our understanding
of animal (especially chicken) retroviruses many years ago and is a member
of the National Academy of Sciences." But "he is not an epidemiologist,
a physician, or a public health official. He has never worked on...
any disease of humans, including AIDS. Nor has he ever worked with HIV."
All very true. But then, is Gallo, M.D., any more qualified than Duesberg
to explain why HIV is the cause of AIDS? Like Duesberg, he is not an epidemiologist
(an expert on how disease occurs among populations). On the evidence to
date, Gallo's lab work in virology has raised far more questions than Duesberg's,
which a letter last year in Nature claimed was good enough to deserve
the Nobel Prize. Meanwhile, Duesberg's expertise in AIDS epidemiology is
now great enough that he recently published another paper in the Proceedings
showing that the evidence of epidemiology - now virtually the only basis
for saying HIV causes AIDS - actually argues that HIV does not cause AIDS.
Gallo makes a fair (though not always accurate) statement of Duesberg's
case against HIV in his book, before trying to demolish it. But even outsiders
will wonder how good Gallo's thinking is when they see obvious flaws. Gallo
is so busy contradicting everything in sight that he quite often contradicts
himself. The only major point Gallo concedes is that the correlation of
HIV with AIDS doesn't prove the virus is the cause, though he calls it "one
hell of a good beginning."
Gallo agrees that HIV does not meet the requirements of Koch's postulates,
the rules framed by the German bacteriologist Robert Koch a century ago
to pin down the cause of a disease. Gallo reasons they must be out of date.
It is hard to see why, since they are rules of logic, hardly more than
common sense. Koch only suggested that if possible, a suspected cause has
to be found in every case of the disease, and then, when taken out and
injected into a healthy animal, produce the disease again.
Koch's ghost haunts Gallo, who actually invents a whole new Koch postulate
in order to prove Koch wrong - that "in every case where we find the
germ, we find the disease." None of the standard reference works list
this rule, and it seems unlikely that Koch, who discovered the tuberculosis
bacillus, didn't appreciate that it inhabits many more people than come
down with the disease (in fact, probably most of us carry it).
In fact, a few pages on, seemingly forgetting what he said earlier,
Gallo writes that "the asymptomatic carrier and subclinical infections
[are] known for almost every microbe. We learned this in the century since
Koch, and actually Koch knew it himself. Think of how many people get exposed
to and infected from Koch's TB bacterium and never get sick!"
What emerges is that Gallo is defeated by the same inconsistencies in
HIV-think that bother his critics. He really can't answer the awkward question
of why AIDS is still overwhelmingly concentrated (91 percent) in men in
the U.S., whereas in Haiti and Africa it has always been equally distributed
between the sexes. Speculating wildly, Gallo conjures up, among other things,
"ritualistic voodoo practices."
Nor can he explain the absence of detectable virus in the blood cells
of so many AIDS patients, even dying ones. Gallo claims that a virus increases
outside blood cells as disease progresses, quoting two papers to that effect
which have appeared in the past two years. The papers have never been confirmed.
Meanwhile, Gallo doesn't admit that the amount remains negligible by any
standards.
Such concern with how much virus there is is "pure sophism,"
according to Gallo. But one of the studies recorded the awkward fact that
1S percent of the AIDS patients involved had no detectable evidence of
the virus at all in their blood plasma, the supposed new reservoir of HIV,
the supposed cause of their illness.
Nor can Gallo explain how, since HIV gets into only one in several hundred
of the T-cells that disappear in AIDS, the virus is apparently able to
kill billions of T-cells it does not ever inhabit. Gallo can still only
say that there must be as yet unidentified "less direct mechanisms."
In the end, Gallo abandons his long insistence that HIV by itself "kills
like a truck" to agree that cofactors may be involved in AIDS - though
the only ones he favors are the herpes virus HHV-6, and HTLV-1, both his
own discoveries. Here again he contradicts himself. A hundred pages earlier
he writes as an argument against the theory of cofactors: "Multifactorial
is multi-ignorance. Most of the factors go away when we learn the real
cause of a disease." *