By David Brown

The Washington Post 2 July 2000

More than 5,000 prominent scientists and physicians from around the world yesterday released a document asserting that the AIDS virus causes AIDS.

By stating the obvious with overwhelming force, the group hopes to snuff out a resurgent movement of doubters who believe AIDS is caused by drug use, malnutrition or microbes other than human immunodeficiency virus (HIV).

The statement was unveiled a week before the 13th International AIDS Conference convenes in Durban, South Africa, a nation that has more people infected with HIV than any other. In recent months, South Africa's president, Thabo Mbeki, has publicly doubted the certainty that HIV causes AIDS.

The evidence for the link between the virus and the disease, however, "is clear-cut, exhaustive and unambiguous, meeting the highest standard of science," the authors of the statement wrote. "The data fulfill exactly the same criteria as for other viral diseases, such as polio, measles and smallpox. . . . HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives."

The document, called "The Durban Declaration," summarizes in 18 paragraphs and 13 footnotes the proof that HIV, a member of the retrovirus family of microbes, causes AIDS, a disease of the immune system that is currently incurable and ends in death in nearly all cases. The statement also notes that "prevention of HIV infection must be our greatest worldwide public-health priority" and mentions ways that can be accomplished.

"This is the scientific community saying enough is enough," said Michael S. Saag, an AIDS researcher at the University of Alabama at Birmingham and one of the early organizers of the effort. "We have so much to do and so little time that we have no time left for these discussions."

The best-known proponent of the idea that AIDS is not caused by HIV is Peter H. Duesberg, a cell biologist at the University of California at Berkeley. For more than a decade, he has propounded theories that AIDS is caused primarily by chronic use of illicit drugs or by antiviral drugs such as AZT, laying them out in a 722-page book, "Inventing the AIDS Virus," published in 1996.

More recently, a new school of dissidents has formed that believes AIDS is caused by human herpes virus-6 (HHV-6), often with, but sometimes without, the simultaneous presence of HIV. This view is presented in the book "The Virus Within," by journalist Nicholas Regush. Several splinter chapters of the AIDS activist organization ACT-UP also disbelieve that HIV causes AIDS. Last month, they bought a full-page ad in the Capitol Hill newspaper Roll Call and urged legislators to cut AIDS funding and put the money toward food, housing and drug treatment programs instead.

Undoubtedly, however, the biggest boost to AIDS doubters came from Mbeki, the successor to Nelson Mandela.

According to various reports, Mbeki last year asked his health advisers why South Africa had a galloping AIDS epidemic while some other African countries, such as Senegal, had mild epidemics or, like Uganda, had had severe epidemics much earlier.

South Africa is not alone in having a late, intense epidemic. The same is happening in Zimbabwe and Botswana. However, epidemiologists do not have a clear idea why HIV has been comparatively slow to get to southern Africa. In searching for an answer, Mbeki consulted AIDS-related sites on the World Wide Web.

"His general question was entirely fair, and one to which there are not good answers," said Stefano Bertozzi, a prominent AIDS researcher in Cuernavaca, Mexico. "Unfortunately, in trying to answer that question, he ran across the teaching of some people who do not believe that HIV causes AIDS."

Mbeki personally contacted Duesberg, whose claim of isolation and persecution by the AIDS "establishment" struck a responsive chord in the president, who was once exiled for his fight against white minority rule. Mbeki then convened a panel of 33 scientists from around the world and asked it to review the evidence for HIV's causative relationship to AIDS. About half the panel members were AIDS doubters, with Duesberg the most prominent.

The panel met on May 6 and 7 but could find no consensus, according to Bertozzi, who is a member. It will meet again tomorrow and Tuesday. What form its report to Mbeki, due after that, might take is uncertain.

The Durban Declaration, which will be published Thursday in the journal Nature, was conceived in April by Peter Hale, an editor with the AIDS Research Alliance in Los Angeles, and a handful of American and European AIDS researchers. The group ultimately enlisted an "organizing committee" of 265 scientists and physicians, including three Nobel laureates. Among the many African members is M.W. Makgoba, the head of the Medical Research Council of South Africa, the equivalent of the National Institutes of Health.

When an early draft of the declaration circulated in the weeks before Mbeki's state visit to the United States late last month, AIDS researchers and officials employed by the federal government were told not to sign it, according to several sources. Since the visit, however, several have. One is Helene D. Gayle, the head of the AIDS office at the Centers for Disease Control and Prevention, who is also on the Mbeki-appointed panel.

"I didn't think it was anything inconsistent with the scientific evidence or our overall policy on these issues. I think it is an important declaration at an important time," she said yesterday before leaving for South Africa.

Some prominent AIDS researchers, however, declined to sign. One was Anthony Fauci, the director of the NIH's National Institute for Allergy and Infectious Diseases.

"I think in a backhanded way it gives them [AIDS doubters] greater credibility," he said. "It's sort of like a bunch of people saying the Earth is flat, and then you have to get everyone in the aerospace world to say that the Earth is round. That's crazy."