By Gordon Stewart

The Sunday Times (London) 7 June 1992

Much humbug is being spoken and written about HIV and AIDS. Critics of recent articles in The Sunday Times questioning whether the human immunodeficiency virus (HIV) is the true cause of the disease seem to assume they alone hold the moral high ground. They say the public welfare is so intimately involved that nobody should question their utterances, except perhaps within the confines of specialist journals.

But what if the orthodox view is manifestly and tragically wrong? And what if those journals refuse to publish even verifiable data that puts the conventional view into question?

While arguments continue about the role of HIV, the public has been led to believe AIDS is bound to spread to the general population by natural heterosexual intercourse, so that everyone who is sexually active is at risk. This is true, says the World Health Organisation in its Global AIDS News, "not only in developing countries ... but in the industrialised world as well". A grim prospect for human health and survival.

Yet an analysis of official registrations of AIDS cases both in northern industrialised Europe and the United States shows that this is exactly what is not true.

AIDS is almost exclusively confined to certain groups that engage in some very specific behaviours that put them continuously at risk of various infections. Those infections are then manifested in potent form as the diseases we call AIDS. Outside those groups, there are some tragic accidents such as AIDS in recipients of contaminated transfusions, and in infants born to mothers who have developed AIDS because of being on drugs or otherwise at risk.

But there are no signs to date that the disease is going to spread to the general population in Britain. This is true also of America, where AIDS struck several years earlier and is eight times more common than here.

I have tried repeatedly to draw attention to the discrepancy between these facts and the official view of what is happening with a series of articles submitted to the leading medical and scientific journals. So far, every one has been rejected and my experience is not unique.

It is a scandal that the major medical journals have maintained a conspiracy of silence over any dissent from the orthodox views and official handouts.

A fresh example of the misleading propaganda and half-truths being fed to both the public and the medical profession appears in this week's British Medical Journal.

A lead letter draws attention to the high (although declining) rate of HIV infection among drug users in Edinburgh, a state of affairs that has been known about for many years. But what is not stated is the fact that the latest official statistics, for April, show there were no new cases of AIDS in women in Edinburgh during that month, or indeed anywhere in Scotland. There were only four cases in men: two homosexual, one on drugs, the other with a partner abroad.

This, in miniature, is the pattern of AIDS for most of the United Kingdom, where there were only 112 new cases in April, an incidence of one in 500,000. That is about one case per 300 GPs except perhaps in London, which accounts for 70% of AIDS in the UK, mainly in three or four well-defined districts.

From 1982, when AIDS first appeared in the UK, the cumulative total of cases to the end of April this year is 5,894, of whom 5,523 (94%) are men. Of the 371 (6%) women registered as AIDS cases, only 24 (one woman in 750,000) are in non-risk groups. Hardly an epidemic. In fact, a somewhat rare disease, though sad enough in human and financial (Pounds 100,000 per case) cost to our country.

Critics will argue that these tiny figures are nevertheless the seeds of an epidemic that spells danger for the future. But it is at some unspecified time in the future the supposed incubation time between infection and disease keeps being extended, and now stands at 10-15 years, with some saying it could be up to 30 years, because so many HIV-positive subjects remain in good health. The situation is rapidly becoming ridiculous.

Most significantly, the critics are overlooking the view of the future provided by what is happening in New York city, where last October there were 35,392 cases in adults registered by comprehensive city-wide surveillance since 1982. Of those, 29,992 (85%) were men. Of the 5,400 cases in women, 4,774 (89%) were in high-risk groups and only 27 (0.5% of cases, 1 in 100,000 women) in the low-risk general population. And New York city is an epicentre of AIDS, with 20% of all cases in America.

Information about what is happening in New York is accessible in greater detail than in London. It shows that 94% of cases are in risk groups; and of those, 13% are men with Kaposi's sarcoma, a condition that even the AIDS orthodoxy now accepts can occur in young homosexual men without HIV, and 57% are diagnosed with pneumonia due to the same parasite, Pneumocystis carinii, that distinguished the first AIDS cases.

The epidemic is undoubtedly a product of various forms of risk behaviour. In its beginnings in New York and California, AIDS was identified because of its unique occurrence in certain communities of homosexual and bisexual men, and of drug addicts.

The men in these homosexual communities, who were not representative of all homosexual men, engaged in anal intercourse and various traumatic para-sexual activities with each other and multiple partners, mainly in bath-houses where by definition any infections present were shared.

Drugs also played a part, including immuno-suppressive drugs such as nitrites (poppers: freely on sale in London) and antibiotics for self-treatment of the sexually transmissible infections that were rampant.

The bisexual members of these communities transferred infection to their women partners who were, apart from drug-users and victims of transfusions, the only part of the female population to get AIDS.

The other main risk group are drug-users of both sexes who acquire unmanageable infections because they use contaminated drugs, share needles, and often live in very unhygienic conditions. These are the two main groups in whom AIDS started and is continuing.

In 1983, when I retired, the World Health Organisation asked me to look at behavioural and social aspects of communicable diseases and their impact on family planning and other programmes. This led me straight into AIDS.

Information from the grass roots was emphatically that AIDS was spreading alarmingly in the risk groups, and only rarely outside them. Predictions calculated on this basis gave results very close to what subsequently happened. As shown in the table, they are much more accurate than predictions about the likely course of the epidemic made by the government's advisers on AIDS, by the Health Education Authority, and by many other experts and authorities.

They show, for example, that on the basis of data available in 1989, it was possible to predict there would be 1,326 new cases in the UK in 1991 as opposed to 3,690 cases (reduced from an earlier estimate) predicted by members of the Cox Committee, who were official advisers to the government. The actual total of new cases registered by the diligent surveillance unit of the public health service was 1,370.

The simple model upon which my predictions are based works also for New York, where it correctly predicts a cumulative incidence of a little over 40,000 cases to date.

One reason for the errors in the official picture has been the assumption that HIV was a new virus that would inevitably spread disease in the general population.

There is indeed strong correlation between the presence of HIV in a population and AIDS. But there is more to AIDS than just HIV. Professor Peter Duesberg and, more recently, Professor Luc Montagnier, leader of the team that first isolated HIV, have shown that this retrovirus does not have the power to kill cells of the body's immune defence system by itself.

The hypothesis that HIV is the sole cause of AIDS simply does not fit the clinical and epidemiological facts.

None of this is meant to justify any complacency. Like other sexually transmissible infections, HIV is a marker of behaviour which, in itself, carries high risks of disease. The virus also has the power to cause disease in lymph glands, and it may contribute to a state of autoimmunity whereby normal defences against infection become disordered. But the infections that lead to severe disease and death in AIDS can occur independently of HIV.

AIDS in Britain and similar countries is a predictable disease, largely man-made because of the sudden, unprecedented extension during the 1970s of sexual and drug-taking behaviour that courted risks of all kinds of infections in the mouth, gullet, lung, lower bowel, rectum, genital organs and bloodstream. Addictive drugs are by themselves highly damaging to the body's defences and vitality. So, also, are genetic and other defects of immunity in many members of the risk groups.

By regarding AIDS as a new viral infection to which everyone was susceptible, and by exempting the behaviour leading to it from the social sanctions, contact-tracing and plain language applicable to other dangerous infectious diseases, health authorities gave a green light to the continuation of risk behaviour.

At the same time, through their panic statements about everyone being at risk, they spread undue alarm and anxiety among millions, including those who were HIV-positive.

This article will probably incur a further bout of furious criticism from members of the orthodoxy. My final word is for them. I would ask them, first, to recognise the extreme danger to public health produced by the package of risk behaviours outlined above.

And second, to ponder the further danger of ignoring, belittling and suppressing verifiable information that rightfully belongs to the public, whose understanding and co-operation are essential for the control of this man-made menace to the health of the younger half of the world's population. *