By John Strausbaugh

New York Press 18-24 April 2001

South African President Thabo Mbeki’s AIDS Advisory Panel issued its first report two weeks ago–to thundering silence from world media. But given that the world thought the very impaneling of the group was an act of madness on Mbeki’s part, this reaction is hardly a surprise.

"They’re not even paying any attention to it," snaps Dr. David Rasnick, the American chemist who was a chief organizer of the panel. "Where’s the coverage? I predicted this. The first defense is silence. But it’s pretty hard to keep silent forever when a head of state’s involved."

The international panel convened twice last year, in Pretoria last May and again in Johannesburg in July. Between sessions there was supposed to be a period of Internet discussion. What made the group so highly controversial–and widely denounced as folly–was that the selection of panel members gave equal weight to traditional AIDS scientists (like the CDC’s Dr. Helene Gayle, HIV pioneer Luc Montagnier and South Africa’s Dr. Malegapuru Makgoba) and so-called AIDS "dissidents" like Rasnick, who’s an expert in enzyme inhibitors and has been questioning mainstream AIDS theories for two decades, and UC Berkeley retrovirologist Peter Duesberg, who’s long argued that HIV does not cause AIDS. People like Rasnick and Duesberg have been anathematized as dangerous lunatics, homophobes and even, when the rhetoric really heats up, genocidal maniacs. That Mbeki was giving them for the first time ever an official government platform to air their arguments against standard HIV/AIDS theory elicited shrieks of dismay around the world. (Cf. two previous New York Press articles: my "The AIDS Heretics," from 3/8/00; and Celia Farber’s "AIDS & South Africa," from 5/24/00.)

It also ensured a panel that got along about as well as a passel of stray cats tossed in a burlap sack. "It’s one of the cleanest, crispest differences of opinion that you could possibly imagine," Rasnick told me over the phone last week. "Those who say AIDS is contagious, sexually transmitted, caused by HIV and the drugs are saving people, and us, who say AIDS is not contagious, not sexually transmitted, not caused by HIV and the drugs are killing people. You can’t get a clearer difference."

The result is a most schizophrenic report. You should read it for yourself, since you may not see much about it in the media: It’s clear that while there was much expressing of opinion, there wasn’t a lot of what you’d call "dialoguing" between the opposing camps, and often a lot of talking at cross purposes. Mainstream HIV/AIDS scientists were dragged into the meetings with the greatest reluctance, and basically boycotted the Internet discussions. All recommendations are given twice: first, "recommendations from panelists who do not subscribe to the causal linkage between HIV and AIDS," which are then diametrically opposed by "recommendations from panelists who subscribe to HIV as the cause of AIDS."

Given that this second group completely dominates AIDS research and treatment around the world, and the first group is considered a lunatic fringe, there’s not much hope this report will be taken very seriously–anywhere but in Mbeki’s government, which is taking it very seriously indeed.

Meanwhile, if nothing else it represents for the lay reader an excellent primer on the HIV/not-HIV debate. For example, the report lays out three viewpoints on HIV as the cause of AIDS: "that HIV is both ‘necessary’ and ‘sufficient’ to cause AIDS" (the most widely accepted theory); "that HIV is sufficient but not necessary to cause AIDS"; and "that HIV is neither necessary nor sufficient to cause AIDS." It goes on:

"There were two opposing views on the debate around risk factors that are critical for the transmission and spread of AIDS. One school of thought argued that poor economic status was a sufficient risk factor in the acquisition of AIDS. Another argued that low socio-economic status and poverty contributed to circumstances that would increase the risk of acquiring AIDS, but that these factors are not in themselves sufficient in the acquisition and spread of AIDS...

"The implications of the HIV-is-both-necessary-and-sufficient theory of AIDS causation are that everyone is at equal risk of HIV infection and AIDS. Everyone exposed to an equal dose of HIV should have an equal chance of chronic infection. Everyone infected with HIV should progress to AIDS at the same rate. The only way to stop the progress of AIDS would be to stop HIV (Weiss 1993; Ho 1996).

"Though Prof. Montagnier is convinced that HIV plays a central role in the cause of AIDS, he found it difficult to explain, on the basis of the HIV-only-theory, why the AIDS epidemic was restricted to male homosexuals and intravenous drug users in the USA and Europe but has a heterosexual profile in countries of the South. Dr. Sonnabend was another proponent of the HIV-causes-AIDS hypothesis who believed that issues of poverty and malnutrition were more important in the development of AIDS than the mainstream scientific establishment was currently acknowledging."

A Dr. Giraldo, a "dissident," offered a pretty radical list of what he considers "risk factors that cause AIDS," from malnutrition to environmental pollutants to "exposure to lasers, electromagnetic fields, infrared light radio frequencies and free radicals." (One pictures the mainstream panelists throwing up their hands.)

Rasnick makes some of the most radical statements in the report. He denies that there is anything like an "AIDS epidemic" in sub-Saharan Africa, despite all the data the other side throws at him. The report itself cites WHO figures stating that of 5.6 million new HIV cases reported worldwide in 1999, 3.8 million were in sub-Saharan Africa. That year, the WHO claims, an estimated 2.2 million sub-Saharan Africans died of AIDS, representing 85 percent of all AIDS deaths worldwide. In South Africa, surveys conducted in antenatal clinics showed an explosion of HIV infections, from 0.73 percent of those tested in 1990 to 22.4 percent in 1999.

Rasnick rejects all such figures. "They don’t have any information, no documentation, at all, whatever, of an AIDS epidemic in South Africa," he tells me. "All they have are some prenatal clinic HIV tests. That’s it." And since he doesn’t believe HIV causes AIDS, he considers those figures worthless. "They don’t have one AIDS case documented," he insists.

The report offers a good thumbnail description of current HIV testing methods:

"The ELISA, Western Blot and PCR Viral Load are the most frequently used tests to confirm HIV infections. The ELISA and Western Blot tests detect HIV antibodies in the serum of patients, whereas the PCR Viral Load test is a genetic test that detects small HIV nucleic acid fragments in whole blood. The veracity and reliability of these tests are key to the validity, reliability, quality and accuracy of epidemiological data used by any country. The ELISA test is mainly used to screen for HIV infection in blood donors and for general surveillance, whereas the Western Blot and PCR are generally used as confirmatory tests and in the context of research. All these tests, individually or in combination, are considered by the proponents of the HIV/AIDS theory as important indicators of infection by HIV."

This is followed by one of the most striking passages in the document:

"Dr. Rasnick, supported by Prof. Mhlongo, recommended that the South African government should consider terminating HIV testing by blood banks and for general surveillance since the results of all the tests are unreliable and non-specific and hence give wrong information. He argued further that AIDS would disappear instantaneously if all HIV testing were outlawed [emphasis added]. The basic question was whether hundreds of people in South Africa are dying of AIDS or of TB, malaria, Pneumocystis carinii pneumonia and parasitic infections. The absence of data indicating the rate of deaths due to AIDS should receive urgent attention."

I ask Rasnick if he really believes AIDS would "disappear instantaneously if all HIV testing were outlawed."

"That’s right," he replies. "And why isn’t that in The New York Times, to show what a fool, what an idiot I am?"

So Rasnick’s contending that there’s no such thing as AIDS in South Africa, and that if people stopped calling it that tomorrow, it would be immediately obvious that what patients are actually presenting are various other diseases all being clustered under the AIDS rubric?

"In other words, all those things would still be there, they just would no longer be called AIDS," he says, and the government could get down to combating the real problems of TB, hepatitis, parasitic infections and so on.

Rasnick, et al., call for an instant halt to all HIV testing in South Africa.

"Absolutely," he says to me. "Those damn tests should be outlawed. They’re lethal. First of all, it’s a death sentence in South Africa. People commit suicide, they’ve been stoned to death, they’ve had their houses burned down, they’ve been murdered. Just for having antibodies to HIV. They have been ostracized. And in certain rural communities, ostracism is equivalent to death. So you’re scared to death, first of all. And then you start taking the anti-HIV drugs, which cause AIDS, and if you take them long enough they will kill you."

This is another major contention of the dissidents: that AZT and the other antiretroviral drugs that have been prescribed to HIV-positive people since the mid-1990s are not only not curing them, but potentially lethal, and are in fact are causing the conditions we know as AIDS. Therefore they recommend: "Anti-retroviral drugs and any other immune suppressive drugs should under no circumstances be used to treat AIDS patients or any other patients that are immune-compromised." (One might have thought the media would have picked up on that little item as well.)

The dissident panelists proposed 10 experiments they believe will prove or disprove the HIV-causes-AIDS hypothesis once and for all. They range from simple-sounding epidemiological surveys to more complex-sounding laboratory experiments. Rasnick proposed a six-month test on chimpanzees to see whether it’s HIV or AZT that’s killing human patients:

"We already know that chimps don’t get AIDS from HIV, because 150 of them have been HIV-positive for 20 years, and they’re dying of old age," he explains to me. "None of them got AIDS yet." He proposes putting some of them on the anti-AIDS drugs. "As soon as we give them those damn drugs, it breaks my heart, but they’re gonna start getting sick and they’re gonna die." What’s the point? "Nobody pays any attention that we’re killing tens of thousands of people with these drugs. Maybe if you focus on these poor animals, sometimes people have more sympathy for animals than they will for humans."

The South African government has agreed to fund all 10 tests, and will make no major changes to its AIDs policies until the tests are completed. Although this part may look like a victory for the status quo on the surface, Rasnick points out there’s a deeper significance: it means that the government will continue not to distribute AZT and the other anti-AIDS drugs, which Mbeki has been refusing to give out despite worldwide cries of outrage.

How long will the 10 tests take? Some will take weeks or a few months, Rasnick says, others longer. "It also depends on whether or not there’s cooperation. There has been considerable stonewalling. That’s why this damn thing has taken so long." The CDC in the U.S., and the equivalent agency in South Africa, has had "absolutely no interest" in cooperating, Rasnick claims. At any rate, he says the longest tests should take no more than a year.

To the world, this means that AIDS will rage unchecked in South Africa for another year. A panelist named Dr. Bertozzi, who "shared his experiences on his work on the epidemiology of the disease in Africa," put it this way: "His experience had convinced him that sub-Saharan Africa is ‘on fire’ due to this epidemic. The nature of the problem was so urgent that emphasis had to be placed on what could be done now to halt the spread of this epidemic. To Dr. Bertozzi South Africa was like ‘a building that is burning and our first focus needs to be on getting people out of the building and putting out the fire. We will have time over the decades to come to debate the mechanisms of how the fire was started…’"

Won’t Rasnick and his dissidents be internationally denounced for dithering while South Africa burns?

"Well, South Africa’s burning anyway," he replies with an audible shrug. "It’s from poverty, malnutrition, poor sanitation, all that. If you give them the drugs, it’ll just expedite their demise, and make them miserable before they die...

"Thabo Mbeki is weaning the people of South Africa away from AIDS," he goes on. "He is never going to allow the anti-HIV drugs into that country. It’s possible that Africa, and [specifically] South Africa, could end this whole insanity. They could be the solution."