ALL THE PRESIDENT'S SCIENTISTS
Diary of a Round-Earther
The Mail & Guardian (South Africa) 8 Sept. 2000
These are extracts from the detailed diary kept by a member of the
Presidential AIDS Advisory panel:
I was invited to participate on the Presidential AIDS Advisory Panel which
would have high visibility given President Thabo Mbeki's famous letter to
United States President Bill Clinton and his flirtation with denialists--a
small group of "scientists" who do not believe HIV causes AIDS.
Among the first people I met were Malegapuru Makgoba, head of the Medical
Research Council, and Slim Karim (Professor Salim Abdool-Karim), another
South African scientist. Slim was fat and Makgoba was thin. Slim was
energetic and political, a mobiliser. Makgoba was a friend of Mbeki's, a
thoughtful scientist, and I noticed at the airport next to Mbeki's
collection of speeches, a book which Makgopa had written. Over a buffet
and pizza, we talked. Makgoba said he had spent time with his friend
Mbeki, trying to talk him out of the idea of taking seriously those who
think that HIV does not cause AIDS. He claimed Mbeki is in fact concerned
about feeling certain that HIV causes AIDS, that his questioning is not
just a political move.
The closed session began at 9 am, under the guidance of a facilitator, a
lawyer named Professor Owen. The first go around the table was supposed to
be an opportunity for each panel member to identify key issues around the
"terms of reference" but in practice two other things were focused upon:
each member spoke identifying themselves and their position in the context
of the aetiology question. The day would prove to be a long one. One of
the first people to speak in the first go round was Dr M Smith, a previous
chair of the Federal Drug Administration anti-retroviral (ARV) committee.
He lifted up the invitation with the terms of reference saying: Mbeki's
first question is "what causes AIDS". Smith looked up, and in a monotone
said "HIV", then remained silent. As we went around the room, it became
clear where people stood:
Slim Karim: Strongly in favour of finding a way to get ARVs into Africa in
a meaningful way.
Harvey Bialy: Writing a biography of Peter Duesberg.
Stefano Bertozzi: Cautious but firm: HIV causes AIDS. An expert in health
Etienne DeHarven: A person who was unbelievable in having no problem
denying the existence of AIDS.
Helene Gayle: From the Centers for Disease Control (CDC).
Roberto Giraldo: Describes himself as Colombian although he seems to have
lived for the past many years in New York.
Klaus Koehnlein: This interesting man does not believe AIDS exists at all,
and that there isn't really any increase in deaths going on, just
artifacts on how data is collected.
Cliff Lane: National Institute of Health.
Makgoba: A leader of the South African contingent, and a very
Sam Mhlongo: Very confusing person who seems to side with the dissidents.
Wilfred Nkomo: From Malawi, an epidemiologist with a sense of humor and no
patience for denialists.
George Perez: Wants to focus on what can be done, not argue about HIV.
David Rasnick: Thinks the drugs kill people and does not think HIV causes
Joe Sonnabend: An orthodox member of the committee who believes there are
co-factors which explain the virulence and spread of the illness in
By my count, which could be off, there were 26 people with 10
flat-earthers more or less, and 16 definite round-earthers. Others would
arrive on Sunday. The meeting reconvened, and continued in an endless
round table conversation that basically got nowhere. Lunch and then more
endless round table talk.
The good guys met in Slim's room that night and made plans.
Sunday's talks, as they were inevitably going to, broke down. The group
resisted getting pushed into consensus because everyone, including the
denialists, agreed it was misleading. Looking only at consensus would lead
to, for example, a consensus that AIDS drugs have toxicities, but no
consensus that they helped with the illness. This would mean they should
not be used, from a policy point of view, a very misleading conclusion.
There is also the problem that consensus can lead to agreement on
precisely the most irrelevant aspects of a problem.
As the meeting degenerated into political manoeuvring to find ways to
force a misleading consensus forward, resistance kept occurring to the
pressure to get results. But aside from the entertainment value and
perhaps some educational value, the meeting did not accomplish much.There
had been an effort to divide the group into three groups to deal with
aetiology, treatment and prevention. The three groups had a recorder and a
mix of dissidents and us, and the results were chaotic and terribly
misleading. We all decided to throw away the results of this effort.
It was decided that we would divide into two groups, the one writing a
list of suggestions starting from the premise that HIV causes AIDS and the
other with the opposite premise. This idea led to two sets of suggestions
which were the reported back to the main group.
Andrew Herxheimer spoke for denialists and their report said: HIV does not
cause AIDS; AIDS is not infectious; drugs are poisonous; treat the
opportunistic infections (OIs).
Our side was represented by Slim and Bertozzi: Move to reduce the
incidence of blood-borne infection; reduction of mother-to-child
transmission; reduction of sexual transmission; treatment.
After the meeting on Sunday the health minister announced that there would
be an Internet discussion for six weeks and a follow-up meeting.
As of now, the debate continues via the Internet although it is confusing
as everyone has not gotten their passwords.
For several weeks people duelled on the Internet. Most round-earthers
decided that to play with their new friends was a waste of time and made
them feel intellectually compromised by even entertaining their half-baked
The round-earthers met in special session. Jerry Coovadia, an important
scientist in South Africa, was in the papers, identified as a troublemaker
by the health minister. This is the same Coovadia who was chosen by Slim
and others to do our presentation on aetiology, but the press office
crossed his name off the list.
There is genuine concern about the report itself being tampered with
before it gets to the president. I have discovered a room treat: green
onions stuffed with anchovies.
MONDAY JULY 3
The programme for the day consisted of four sessions.
An aetiology of AIDS with Carolyn Williamson (because Coovadia was not
allowed to speak). Then we had a presentation from Duesberg on etiology
which was amazingly intellectually shallow. Session two was prevention of
AIDS with Giraldo, a presentation bordering on incoherence. It was
embarrassing. This was followed by Slim, whose presentation was so good
the moderators did not feel we'd have to revisit this issue.
After lunch were Sonnabend and Rasnick on treatment. The latter was
humorous as Rasnick sees no evidence that there is an epidemic and if
there were, feels the damage is being done by medicines and that the best
thing South Africa could do would be to stop testing and never treat.
It became clear the staff wants to make sure this is the last meeting and
that closure is reached. Their vision of protecting the president requires
that this be the last meeting and that something come out of it that the
president can embrace without being embarrassed.
Note: As I am writing this this morning, the day after the second day of
meetings, lawyer Owens is on his way to speak to Mbeki. He said he was
going to advise Mbeki to push forward with the five-year plan, to say he
had now heard all sides, that the government would be doing everything
including the use of ARVs--and that he would advise Mbeki to look into
parallel importation and compulsory licensing. This is what Minister of
Health Manto Tshabalala-Msimang mentioned repeatedly. When Williamson
opened the remarks on aetiology, the first thing she said was that
"Coovadia was not allowed to give the presentation". You could hear
everyone, including Rasnick, was genuinely surprised. Earlier, Rasnick and
Bialy were laughing over the perception that our group kept changing who
would present because we were afraid of battling with the great Duesberg.
Williamson introduced a more disturbing reality, that politics had entered
into this chamber to the point of dictating who would speak. It appeared
that the politics was of a more personal nature and connected to many
events outside of the opinions of Coovadia on AIDS.
Then Duesberg got up to speak. He is a handsome man with white hair, a
tan, and a slight German accent. He is dramatic and moves around a lot
while speaking. He starts by making reference to Albert Camus's definition
of plague--his intention is to question whether the thing called AIDS fits
the definition of an epidemic. "Real" pathogens, he argues, do not
discriminate in such a way that doctors are immune but other groups like
gays are preferentially hit (these are patently ridiculous assertions). He
said the retrovirus had as an organism the lowest IQ you can get in
biology--"any lower and you get chemistry", he said.
He asserts that HIV parallels the drug epidemic (for some reason he feels
there is a drug epidemic but he offers no proof or data). Then in a play
on words which may shed some light on his thinking, he clarifies "an
antiviral drug epidemic". In other words, all people with AIDS use drugs
which causes the AIDS that we see. Again the lack of depth is frightening,
such as the presence of AIDS long before the drugs existed.
He claims that only 75 000 people had AIDS in Africa out of the many
millions of people who live here.
Duesberg essentially argues that AIDS is not a problem in Africa (which
makes you wonder why the president has assembled an international expert
panel to focus upon it). He referred to using ARVs as "AIDS by
After these two presentations, there is opportunity for the panel members
Makgoba shows a group of children who are HIV infected. He notes that the
mortality of this group is huge--one-third dead in one year if you are
positive. Gayle says transmission to health-care worker is a well
documented phenomenon. (This is in reply to the sweeping generalisation of
Duesberg's that no health-care worker has ever been infected, that this is
a disease of toxicity and is not infectious.)
Whiteside: In Malawi, "they were shocked in the most recent census to find
that there were two-million people 'missing'" (Malawi had only 10-million
to begin with). From watching the reactions of the various dissidents,
their body language and shaking of heads makes it clear this did not
affect them. They are into denial of the epidemic.
Giraldo puts forth a borerline incomprehensible and basically embarrassing
amalgam of paranoid observations and pseudoscientific jargon. He
essentially constructs a conspiracy hypothesis, on a worldwide basis. He
is not clear in identifying the cause of the conspiracy, just hinting at
the bad guys being the drug cartels. He assumes that promotion of condoms
was part of the conspiracy on the part of those who make condoms. He made
a list of the bad ideas or erroneous ideas being pushed by this
conspiracy, including on his list: HIV is infectious; it is transmissible;
HIV leads to AIDS which, untreated, leads to death.
These people (he says) are also pushing clean needles. "These people are
promoting the diseases they say they are trying to prevent. UNAIDS and
other institutions are trying to stop breastfeeding. Companies that
commercialise [formula] are happy with that idea." Giraldo is an
embarrassment to education.
He claims tropical diseases cause all of the immunological changes
associated with AIDS. "Immunological stressors" is the catchphrase he puts
up as the cause of AIDS. He claims immunological stressors hurt the immune
system in a way which leads to a positive test for HIV.
He then makes a list of the "principles for prevention": avoid poisons
(immune stressors); disintoxicate; vitamins (stimulate the immune system);
He stresses the use of antioxidants, and vitamins A and B.
He went on to say the World Bank wants you to get loans to buy AZT and
condoms. This will ensure poverty in Africa and increase the wealth of the
After Giraldo's speech, Slim makes a presentation on prevention. Although
in theory there are not two sides here, in practice even the facilitators
acknowledge the reality of two sides. Each side has been conferred with
separately and has been given 30 minutes apiece to do a presentation on
each of the four topics.
Slim starts by noting that AIDS in South Africa has only been found
associated with HIV-1, Clade B in the first epidemic confined pretty much
to homosexuals. Clade C starting later in the 1980s and was confined to
heterosexuals. There is an explosive nature to Clade C--the prevalence
rates were 1991: 4,2%; 1993: 7,9%; 1995: 14%; 1997: 27%; 1998" 29%.
Rasnick: "We only talk about HIV. Where is the data on AIDS?"
At this point the meeting got a bit raucous. I could hear people yelling
things like: "I've yet to see a crack addict in Soweto"; "Hey, I've been
using antibiotics [on my patients] for years and it does not cause AIDS";
"Kids with HIV are 17 times more likely to die than HIV-negative babies.
Kothari: "In India HIV is not a problem."
Coovadia: "HIV is not unique in causing different symptoms. Measles leads
to weight loss, dementia and so on. We are not in the hands of
pharmaceutical companies. We are doing more studies on how to preserve
breastfeeding than anywhere in the world."
Joe Sonnabend (for the round-earthers): The OIs associated with AIDS are
not new diseases. What is new is that the kind of people getting them
never used to.
Rasnick ( for the dissidents): Spoke about the Fourth of July, freedom and
tied it together with Mbeki's decision to allow dissidents to speak,
congratulating Mbeki on his support for freedom. We are shifting the blame
from ourselves to an "innocent virus".
AIDS peaked in 1992 and then fell ever since until the CDC changed the
definition of AIDS and then it continued to fall after that. One big way
to bring down the amount of AIDS in the US is to change the definition of
Bialy and Duesberg started to act out a little, hand gestures, gesturing
to friends, acting a lot like little kids at school.
Rasnick: "I think AIDS would disappear in South Africa if we outlawed
tests for HIV".
Duesberg: Trashed personal or anecdotal statements. He alluded to
promiscuity as a problem for Africans.
Indian doctor: "Back home we had a film director of importance jump to his
death because he found out he was [HIV-] positive." Let's treat OIs and
leave HIV alone. Science is creating stigmas that lead to death (applause
Mhlongo: HIV testing should be abandoned today. If there are lots of
blacks with AIDS in South Africa then there are lots of blacks that are
Rasnick: "I have no beliefs about AIDS, I have only data. Since I came
here in May ... I have seen no evidence there exists an AIDS catastrophe,
epidemic in South Africa. "If I had the power to outlaw HIV tests I would
across the board. I know HIV does not cause AIDS. The tests are lethal. It
destroys your life ... Get rid of PCR, viral load, Western blot, Elisa
[all HIV tests] and you will get rid of 99% of the AIDS crisis."
Makgoba: Young people now in South Africa are dying as fast as people in
The representative from the secretariat (Khotso Mokhele) talked a bit:
essentially said that the Internet debate should have taken care of the
debate that was happening today, and that the moderators were forced out
of practicality to have two sides because the group could not work
together. He said they would work to create a series of questions which
would make the basis of the next day's talk, and that the answers to these
would provide the material for the report to the president.
TUESDAY JULY 4
The day began by having Makgoba represent in detail his data on the
situation in South Africa. It was devastating. Mhlongo insisted that the
only thing happening is that medical care is now available so that we are
now seeing the death rates and sicknesses that were always there.
Duesberg: Despite Makgoba's presentation there is no explanation for fear,
doom and gloom when you have a 2,8% death rate of AIDS only.
Makgoba: "This data is an underestimation of the real picture. A
population of young people is dying. What happened? New toxins? Mortality
rates that increased from 18 per thousand to more than 300 per thousand
require an explanation."
At this point, the team of Bialy, Gayle and Makgoba were asked to
summarise their work.
In the original formulation, they were supposed to undertake an experiment
to determine to everyone's satisfaction whether HIV causes AIDS. They got
as far as laying out the parameters for experiments that would do this.
There was a mandate at this point to break into three groups: aetiology
and getting data; treatment; co-factors.
The groups met for 90 minutes apiece and prepared reports. Then there were
presentations. Gayle and Bialy did the first group, Slim did prevention,
Slim did the therapy session.
The recommendations were: create an ongoing process for treatment
guidelines relying on South African doctors; use compulsory licensing and
parallel importing to get prices down; treat OIs and STDs and TB; create a
permanent body to provide advice to the president; use anti-retrovirals on
people who are sick; debt relief agreements ought be tied to public health
Giraldo: Stop drug abuse.
Slim on prevention: Life skills for youth; nevirapine for pregnant mothers
and improve intervention therapy: prophylaxis. Focus on vaccine
development, lower migration rate, money for gender equality. Rasnick: Do
not give healthy people drugs. Treat sick people according to their
symptoms. Since HIV has no symptoms do not give anti-retrovirals to
people. Owen closed the lengthy session with a thank you and a promise
that facilitators would develop an accurate report to the president.