HIV/AIDS denialism
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HIV/AIDS denialism is the belief, despite conclusive evidence to the contrary, that the
The
Despite its lack of scientific acceptance, HIV/AIDS denialism has had a significant political impact, especially in South Africa under the presidency of Thabo Mbeki. Scientists and physicians have raised alarm at the human cost of HIV/AIDS denialism, which discourages HIV-positive people from using proven treatments.[2][8][10][11][12][13] Public health researchers have attributed 330,000 to 340,000 AIDS-related deaths, along with 171,000 other HIV infections and 35,000 infant HIV infections, to the South African government's former embrace of HIV/AIDS denialism.[14][15] The interrupted use of antiretroviral treatments is also a major global concern as it potentially increases the likelihood of the emergence of antiretroviral-resistant strains of the virus.[16]
History
A constellation of symptoms named "
At a 23 April 1984 press conference in Washington, D.C.,
In 1986, the viruses discovered by Montagnier and Gallo, found to be genetically indistinguishable, were renamed HIV.[22]
In 1987, molecular biologist Peter Duesberg questioned the link between HIV and AIDS in the journal Cancer Research.[23] Duesberg's publication coincided with the start of major public health campaigns and the development of zidovudine (AZT) as a treatment for HIV/AIDS.
In 1988, a panel of the
In 1989, Duesberg exercised his right as a member of the National Academy of Sciences to bypass the peer review process and published his arguments in Proceedings of the National Academy of Sciences of the United States of America (PNAS) unreviewed. The editor of PNAS initially resisted, but ultimately allowed Duesberg to publish, saying, "If you wish to make these unsupported, vague, and prejudicial statements in print, so be it. But I cannot see how this would be convincing to any scientifically trained reader."[27]
In 1990, the physiologist Robert Root-Bernstein published his first peer-reviewed article detailing his objections to the mainstream view of AIDS and HIV.[28] In it, he questioned both the mainstream view and the "dissident" view as potentially inaccurate.
In 1991, The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis, comprising twelve scientists, doctors, and activists, submitted a short letter to various journals, but the letter was rejected.[29]
In 1993, Nature published an editorial arguing that Duesberg had forfeited his right of reply by engaging in disingenuous rhetorical techniques and ignoring any evidence that conflicted with his claims.[30] That same year, Papadopulos-Eleopulos and coauthors from the Perth Group alleged in the journal Nature Biotechnology (then edited by fellow denialist Harvey Bialy) that the western blot test for HIV was not standardized, non-reproducible, and of unknown specificity due to a claimed lack of a "gold standard".[31][32]
On 28 October 1994, Robert Willner, a physician whose medical license had been revoked for, among other things, treating an AIDS patient with ozone therapy, publicly jabbed his finger with blood he said was from an HIV-infected patient.[10] Willner died in 1995 of a heart attack.[33]
In 1995, The Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis published a letter in Science similar to the one they had attempted to publish in 1991.[34] That same year, Continuum, a denialist group, placed an advertisement in the British gay and lesbian magazine The Pink Paper offering a £1,000 reward to "the first person finding one scientific paper establishing actual isolation of HIV", according to a set of seven steps they claimed to have been drawn up by the Pasteur Institute in 1973.[35] The challenge was later dismissed by various scientists, including Duesberg, asserting that HIV undoubtedly exists.[35] Stefan Lanka argued in the same year that HIV does not exist.[36] Also that year, the National Institute of Allergy and Infectious Diseases released a report concluding that "abundant epidemiologic, virologic and immunologic data support the conclusion that infection with the human immunodeficiency virus (HIV) is the underlying cause of AIDS."[37][38]
In 1996, the
In 1998, Joan Shenton published the book Positively False – Exposing the Myths Around HIV and AIDS, which promotes AIDS denialism. In the book, Shenton claims that AIDS is a conspiracy created by pharmaceutical companies to make money from selling antiretroviral drugs.[43]
In 2006,
In 2007, members of the Perth Group testified at an appeals hearing for Andre Chad Parenzee, asserting that HIV could not be transmitted by heterosexual sex. The judge concluded, "I reject the evidence of Ms Papadopulos-Eleopulos and Dr Turner. I conclude… that they are not qualified to give expert opinions."[47]
In 2009, a paper was published in the then non-peer-reviewed journal Medical Hypotheses by Duesberg and four other researchers which criticized a 2008 study by Chigwedere et al.,[14] which found that HIV/AIDS denialism in South Africa resulted in hundreds of thousands of preventable deaths from HIV/AIDS, because the government delayed the provision of antiretroviral drugs. The paper concluded that "the claims that HIV has caused huge losses of African lives are unconfirmed and that HIV is not sufficient or even necessary to cause the previously known diseases, now called AIDS in the presence of antibody against HIV."[48] Later that year, the paper was withdrawn from the journal on the grounds of it having methodological flaws, and that it contained assertions "that could potentially be damaging to global public health". A revised version was later published in Italian Journal of Anatomy and Embryology.[49]
US courts
In 1998, HIV/AIDS denialism and parental rights clashed with the medical establishment in court when Maine resident Valerie Emerson fought for the right to refuse to give AZT to her four-year-old son, Nikolas Emerson, after she witnessed the death of her daughter Tia, who died at the age of three in 1996. Her right to stop treatment was upheld by the court in light of "her unique experience".[50] Nikolas Emerson died eight years later. The family refused to reveal whether the death was AIDS related.[51]
South Africa
In 2000, South Africa's President Thabo Mbeki invited several HIV/AIDS denialists to join his Presidential AIDS Advisory Panel.[52] A response named the Durban Declaration was issued affirming the scientific consensus that HIV causes AIDS:
The declaration has been signed by over 5,000 people, including Nobel Prize winners, directors of leading research institutions, scientific academies and medical societies, notably the US National Academy of Sciences, the US Institute of Medicine, Max Planck institutes, the European Molecular Biology Organization, the Pasteur Institute in Paris, the Royal Society of London, the AIDS Society of India and the National Institute of Virology in South Africa. In addition, thousands of individual scientists and doctors have signed, including many from the countries bearing the greatest burden of the epidemic. Signatories are of MD, PhD level or equivalent, although scientists working for commercial companies were asked not to sign.[13]
In 2008, University of Cape Town researcher Nicoli Nattrass, and later that year a group of Harvard scientists led by Zimbabwean physician Pride Chigwedere, each independently estimated that Thabo Mbeki's denialist policies led to the early deaths of more than 330,000 South Africans.[14][15] Barbara Hogan, the health minister appointed by Mbeki's successor, voiced shame over the studies' findings and stated: "The era of denialism is over completely in South Africa."[53]
In 2009, Fraser McNeill wrote an article arguing that South Africa's reluctance to openly address HIV/AIDS resulted from social conventions that prevent people from talking about causes of death in certain situations, rather than from Mbeki's denialist views.[54] Similarly, political scientist Anthony Butler has argued that "South African HIV/AIDS policy can be explained without appeals to leadership irrationality or wider cultural denialism."[55]
In July 2016 Aaron Motsoaledi, the Health Minister of South Africa, wrote an article for the Centre for Health Journalism in which he criticised past South African leaders for their denialism, describing it as an "unlucky moment" in a country which has since become a leader in treatment and prevention.[56]
Denialists' claims and scientific evidence
The term "HIV/AIDS denialism" denotes the rejection of the mainstream scientific view that AIDS is a medical condition that is brought about by HIV infection. The use of the term encompasses the denial of the existence of the virus (HIV denialism), the denial of the causation of AIDS by HIV (that is, the proposed link between the virus and the syndrome), and the denial of the effects on the human body that are ascribed to HIV (that is, the description and characterization of the virus). In a framework incorporating the second denial and/or the third, criticism of the current scientific view has variously been rested on the claim that HIV has not been adequately isolated,
Such claims have been examined extensively in the
Early denialist arguments held that the HIV/AIDS paradigm was flawed because it had not led to effective treatments. However, the introduction of
In a 2010 article on conspiracy theories in science, Ted Goertzel lists HIV/AIDS denialism as an example where scientific findings are being disputed on irrational grounds. He describes proponents as relying on rhetoric, appeal to fairness, and the right to a dissenting opinion rather than on evidence. They frequently invoke the meme of a "courageous independent scientist resisting orthodoxy", invoking the name of persecuted physicist and astronomer Galileo Galilei.[69] Regarding this comparison, Goertzel states:
...being a dissenter from orthodoxy is not difficult; the hard part is actually having a better theory. Publishing dissenting theories is important when they are backed by plausible evidence, but this does not mean giving critics 'equal time' to dissent from every finding by a mainstream scientist.
— Goertzel, 2010[69]
Denialist community
Denialists often use their critique of the link between HIV and AIDS to promote
AIDS denialists [prefer] to characterize themselves as brave "dissidents" attempting to engage a hostile medical/industrial establishment in genuine scientific "debate". They complain that their attempts to raise questions and pose alternative hypotheses have been unjustly rejected or ignored at the cost of scientific progress itself...Given their resistance to all evidence to the contrary, today's AIDS dissidents are more aptly referred to as AIDS denialists.[70]
Several scientists have been associated with HIV/AIDS denialism, although they have not themselves studied AIDS or HIV.[9] One of the most famous and influential is Duesberg, professor of molecular and cell biology at the University of California, Berkeley, who since 1987 has disputed that the scientific evidence shows that HIV causes AIDS.[23] Other scientists associated with HIV/AIDS denialism include biochemists David Rasnick and Harvey Bialy. Biologist Lynn Margulis argued that "there's no evidence that HIV is an infectious virus" and that AIDS symptoms "overlap...completely" with those of syphilis.[71] Pathologist Étienne de Harven also expressed sympathy for HIV/AIDS denial.[72][73] AIDS researcher Seth Kalichman lists biochemist Kary Mullis "among the who's who of AIDS pseudoscientists" despite Mullis winning the 1993 Nobel Prize in Chemistry for his role in the development of the polymerase chain reaction.[74] Mullis, who did not do any HIV research, expressed skepticism about the relationship between HIV and AIDS in his 1998 autobiography.[72]: 124
Additional notable HIV/AIDS denialists include Australian academic ethicist
HIV/AIDS denialism has received some support from
In a follow-up article in Skeptical Inquirer,[87] Nattrass overviewed the prominent members of the HIV/AIDS denialist community and discussed the reasons of the intractable staying power of HIV/AIDS denialism in spite of scientific and medical consensus supported by over two decades of evidence. She observed that despite being a disparate group of people with very different background and professions, the HIV/AIDS denialists self-organize to fill four important roles:[87]
- "Hero scientists" to provide scientific legitimacy: Most notably Duesberg who plays the central role of HIV/AIDS denialism from the beginning. Others include David Rasnick, Étienne de Harven, and Kary Mullis whose Nobel Prize makes him symbolically important.
- "Cultropreneurs" to offer fake cures in place of antiretroviral therapy: Matthias Rath, Gary Null, Michael Ellner, and Roberto Giraldo all promote alternative medicine and remedies with a dose of conspiracy theories in the form of books, healing products, radio shows and counseling services.
- HIV-positive "living icons" to provide proof of concept by appearing to live healthily without antiretroviral therapy: Christine Maggiore was and still is the most important icon in the HIV/AIDS denialist movement despite the fact that she died of AIDS related complications in 2008.
- "Praise singers": sympathetic journalists and filmmakers who publicize the movement with uncritical and favorable opinion. They include journalists Brent Leung and Robert Leppo.
Some of them had overlapping roles as board members of Rethinking AIDS and
Former denialists
Several of the few prominent scientists who once voiced doubts about HIV/AIDS have since changed their views and accepted the fact that HIV plays a role in causing AIDS, in response to an accumulation of newer studies and data.[88] Root-Bernstein, author of Rethinking AIDS: The Tragic Cost of Premature Consensus and formerly a critic of the causative role of HIV in AIDS, has since distanced himself from the HIV/AIDS denialist movement, saying, "Both the camp that says HIV is a pussycat and the people who claim AIDS is all HIV are wrong... The denialists make claims that are clearly inconsistent with existing studies."[89]
Joseph Sonnabend, who until the late 1990s regarded the issue of AIDS causation as unresolved, has reconsidered in light of the success of newer antiretroviral drugs, stating, "The evidence now strongly supports a role for HIV… Drugs that can save your life can also under different circumstances kill you. This is a distinction that denialists do not seem to understand."[89] Sonnabend has also criticized HIV/AIDS denialists for falsely implying that he supports their position, saying:
Some individuals who believe that HIV plays no role at all in AIDS have implied that I support their misguided views on AIDS causation by including inappropriate references to me in their literature and on their web sites. Before HIV was discovered and its association with AIDS established, I held the entirely appropriate view that the cause of AIDS was then unknown. I have successfully treated hundreds of AIDS patients with antiretroviral medications, and have no doubt that HIV plays a necessary role in this disease.[90]
A former denialist wrote in the Journal of Medical Ethics in 2004:
The group [of denialists] regularly points to a substantial number of scientists supportive of its agenda to re-evaluate the HIV/AIDS hypothesis. Some of those members still listed are people who have been dead for a number of years. While it is correct that these people supported the objective of a scientific re-evaluation of the HIV/AIDS link when they were alive, it is clearly difficult to ascertain what these people would have made of the scientific developments and the accumulation of evidence for HIV as the crucial causative agent in AIDS, which has occurred in the years after their deaths.[68]
Death of HIV-positive denialists
In 2007, aidstruth.org, a website run by HIV researchers to counter denialist claims,
In 2008, activist
Local community group denialism
Australia: In 2009 representing the then
Canada: The Alberta Reappraising AIDS Society created the petition in March 2000 and has reportedly since attracted "2,951 doubters" representing groups and individuals. Signatories reportedly deny "that Aids is heterosexually transmitted".[97]
Impact beyond the scientific community
AIDS-denialist claims have failed to attract support in the scientific community, where the evidence for the causative role of HIV in AIDS is considered conclusive. However, the movement has had a significant impact in the political sphere, culminating with former South African President Thabo Mbeki's embrace of AIDS-denialist claims.[98] The resulting governmental refusal to provide effective anti-HIV treatment in South Africa has been blamed for hundreds of thousands of premature AIDS-related deaths in South Africa.[53]
North America and Europe
Skepticism about HIV being the cause of AIDS began almost immediately after the discovery of HIV was announced. One of the earliest prominent skeptics was the journalist John Lauritsen, who argued in his writings for the New York Native that amyl nitrite poppers played a role in AIDS, and that the Centers for Disease Control and Prevention had used statistical methods that concealed this.[99] Lauritsen's The AIDS War was published in 1993.[100]
Scientific literature
The publication of Duesberg's first AIDS paper in 1987 provided visibility for denialist claims. Shortly afterwards, the journal
In the following few years, others became skeptical of the HIV theory as researchers initially failed to produce an effective treatment or vaccine for AIDS.[103] Journalists such as Neville Hodgkinson and Celia Farber regularly promoted denialist ideas in the American and British media; several television documentaries were also produced to increase awareness of the alternative viewpoint.[104] In 1992–1993, The Sunday Times, where Hodgkinson served as scientific editor, ran a series of articles arguing that the AIDS epidemic in Africa was a myth. These articles stressed Duesberg's claims and argued that antiviral therapy was ineffective, HIV testing unreliable, and that AIDS was not a threat to heterosexuals. The Sunday Times coverage was heavily criticized as slanted, misleading, and potentially dangerous; the scientific journal Nature took the unusual step of printing a 1993 editorial calling the paper's coverage of HIV/AIDS "seriously mistaken, and probably disastrous."[105]
Finding difficulty in publishing his arguments in the scientific literature, Duesberg exercised his right as a member of the
HIV/AIDS denialists often resort to special pleading to support their assertion, arguing for different causes of AIDS in different locations and subpopulations. In North America, AIDS is blamed on the health effects of unprotected anal sex and poppers on homosexual men, an argument which does not account for AIDS in drug-free heterosexual women who deny participating in anal sex. In this case, HIV/AIDS denialists claim the women are having anal sex but refuse to disclose it. In haemophiliac North American children who contracted HIV from blood transfusions, the haemophilia itself or its treatment is claimed to cause AIDS. In Africa, AIDS is blamed on poor nutrition and sanitation due to poverty. For wealthy populations in South Africa with adequate nutrition and sanitation, it is claimed that the antiretroviral drugs used to treat AIDS cause the condition. In each case, the most parsimonious explanation and uniting factor – HIV positive status – is ignored, as are the thousands of studies that converge on the common conclusion that AIDS is caused by HIV infection.[5]
Haemophilia is considered the best test of the HIV-AIDS hypothesis by both denialists and AIDS researchers. While Duesberg claims AIDS in haemophiliacs is caused by contaminated clotting factors and HIV is a harmless passenger virus, this result is contradicted by large studies on haemophiliac patients who received contaminated blood. A comparison of groups receiving high, medium and low levels of contaminated clotting factors found the death rates differed significantly depending on HIV status. Of 396 HIV positive haemophiliacs followed between 1985 and 1993, 153 died. The comparative figure for the HIV negative group was one out of 66, despite comparable doses of contaminated clotting factors. A comparison of individuals receiving blood donations also supports the results; in 1994 there were 6888 individuals with AIDS who had their HIV infection traced to blood transfusions. Since the introduction of HIV testing, the number of individuals whose AIDS status can be traced to blood transfusions was only 29 (as of 1994).[4]
Lay press and on the Internet
With the introduction of
Scientists among the HIV dissidents used their academic credentials and academic affiliations to generate interest, sympathy, and allegiances in lay audiences. They were not professionally troubled about recruiting lay people—who were clearly unable to evaluate the scientific validity or otherwise of their views—to their cause.[68]
In addition to elements of the popular and alternative press, AIDS denialist ideas are propagated largely via the Internet.[108]
A 2007 article in
Because these denialist assertions are made in books and on the Internet rather than in the scientific literature, many scientists are either unaware of the existence of organized denial groups, or believe they can safely ignore them as the discredited fringe. And indeed, most of the HIV deniers' arguments were answered long ago by scientists. However, many members of the general public do not have the scientific background to critique the assertions put forth by these groups, and not only accept them but continue to propagate them.[8]
AIDS activists have expressed concern that denialist arguments about HIV's harmlessness may be responsible for an upsurge in HIV infections. Denialist claims continue to exert a significant influence in some communities; a survey conducted at minority gay pride events in four American cities in 2005 found that 33% of attendees doubted that HIV caused AIDS.
South Africa
HIV/AIDS denialist claims have had a major political, social, and public health impact in South Africa. The government of then President
Independent studies have arrived at almost identical estimates of the human costs of HIV/AIDS denialism in South Africa. According to a paper written by researchers from the
Durban Declaration
In 2000, when the
In his address to the International AIDS Conference, Mbeki reiterated his view that HIV was not wholly responsible for AIDS, leading hundreds of delegates to walk out on his speech.[115] Mbeki also sent a letter to a number of world leaders likening the mainstream AIDS research community to supporters of the apartheid regime.[114] The tone and content of Mbeki's letter led diplomats in the U.S. to initially question whether it was a hoax.[116][117]
AIDS scientists and activists were dismayed at the president's behavior and responded with the Durban Declaration, a document affirming that HIV causes AIDS, signed by over 5,000 scientists and physicians.[13][115]
Criticism of governmental response
The former South African health minister Manto Tshabalala-Msimang also attracted heavy criticism, as she often promoted nutritional remedies such as garlic, lemons, beetroot and olive oil, to people suffering from AIDS,[118][119][120] while emphasizing possible toxicities of antiretroviral drugs, which she has referred to as "poison".[121] The South African Medical Association has accused Tshabalala-Msimang of "confusing a vulnerable public".[122] In September 2006, a group of over 80 scientists and academics called for "the immediate removal of Dr. Tshabalala-Msimang as minister of health and for an end to the disastrous, pseudoscientific policies that have characterized the South African government's response to HIV/AIDS."[123] In December 2006, deputy health minister Nozizwe Madlala-Routledge described "denial at the very highest levels" over AIDS.[124]
Former South African president Thabo Mbeki's government was widely criticized for delaying the rollout of programs to provide antiretroviral drugs to people with advanced HIV disease and to HIV-positive pregnant women. The national treatment program began only after the Treatment Action Campaign (TAC) brought a legal case against Government ministers, claiming they were responsible for the deaths of 600 HIV-positive people a day who could not access medication.[114][125] South Africa was one of the last countries in the region to begin such a treatment program, and roll-out has been much slower than planned.[121]
At the
It [South Africa] is the only country in Africa … whose government is still obtuse, dilatory and negligent about rolling out treatment… It is the only country in Africa whose government continues to promote theories more worthy of a lunatic fringe than of a concerned and compassionate state.[123]
In 2002, Mbeki requested that HIV/AIDS denialists no longer use his name in their literature and stop signing documents with "Member of President Mbeki's AIDS Advisory Panel".[114] This coincided with the South African government's statement accompanying its 2002 AIDS campaign, that "...in conducting this campaign, government's starting point is based on the premise that HIV causes AIDS".[126] Nonetheless, Mbeki himself continued to promote and defend AIDS-denialist claims. His loyalists attacked former President Nelson Mandela in 2002 when Mandela questioned the government's AIDS policy, and Mbeki attacked Malegapuru William Makgoba, one of South Africa's leading scientists, as a racist defender of "Western science" for opposing HIV/AIDS denialism.[53]
In early 2005, former South African President Nelson Mandela announced that his son had died of complications of AIDS. Mandela's public announcement was seen as both an effort to combat the stigma associated with AIDS, and as a "political statement designed to… force the President [Mbeki] out of his denial."[127][128]
Post-Mbeki government in South Africa
In 2008, Mbeki was ousted from power and replaced as President of South Africa by Kgalema Motlanthe. On Motlanthe's first day in office, he removed Manto Tshabalala-Msimang, the controversial health minister who had promoted AIDS-denialist claims and recommended garlic, beetroot, and lemon juice as treatments for AIDS. Barbara Hogan, newly appointed as health minister, voiced shame at the Mbeki government's embrace of HIV/AIDS denialism and vowed a new course, stating: "The era of denialism is over completely in South Africa."[53] Since then, thanks to the introduction of fixed-dose combination and an increase in the eligibility antiretroviral therapy for South Africans, the number of South African people with HIV undergoing ART has increased to 91.5%[129] and viral suppression in South Africans on ART has increased to 72% for women and 45.8% for men.[129]
See also
- Anti-intellectualism
- Discredited HIV/AIDS origins theories
- Germ theory denialism
- List of global issues
- Misconceptions about HIV and AIDS
- Traditionalism
- Vaccine hesitancy
Footnotes
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References
- ISBN 978-0-387-79475-4.
Further reading
- Fourie, P (2006). The Political Management of HIV and AIDS in South Africa: One Burden Too Many?. ISBN 978-0-230-00667-6.
- Steinberg, J (23 June 2009). "Five myths about HIV and AIDS". New Scientist. Archived from the original on 2 January 2010.
- Nattrass, N (2012). The AIDS Conspiracy: Science Fights Back. New York: Columbia University Press. ISBN 978-0-231-14912-9.
External links
National Institute of Allergy and Infectious Diseases pages:
- "The HIV-AIDS connection". Archived from the original on 9 September 2016
- "The evidence that HIV causes AIDS". Archived from the original on 9 September 2016.
- "Series of articles in Science magazine examining denialist claims". Archived from the original on 28 December 2015.
- "HIV Causes AIDS". Avert. 23 June 2015. Archived from the original on 17 October 2015.
- AidsTruth.org, an organization that advocates against AIDS denialism