VIRUSMYTH HOMEPAGE


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 £ 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 £ 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." *


VIRUSMYTH HOMEPAGE