[DEBATE] : journal Nature takes on the denialists -- and Thabo and Manto
MFleshman at aol.com
MFleshman at aol.com
Fri Apr 7 11:31:56 BST 2006
from the indispensable HealthGap e-group. Nature takes on the denialists,
with Thabo and Manto front and center.
Nature Medicine 12, 369 (2006)
'There are non-HIV causes for every AIDS disease; HIV has never been
properly isolated; AIDS can be treated effectively without anti-HIV
drugs.' Such views, typical of AIDS denialists and taken from one of
their websites, may have exited the scientific press by the mid-1990s,
but they persist to the detriment of millions of HIV-infected people.
These ideas have clearly had a big impact, particularly in South Africa,
home to the largest number of HIV-positive people in the world. AIDS
denialists there continue to spread conspiracy theories and
misinformation to a susceptible public wary of antiretroviral drugs.
Even more dangerously, government support of such views-tacit and, in
some cases, open-hinders the task of getting drugs to the people who
Activists, voters and politicians must continue to exert pressure to
counter this onerous trend. Scientists also have a role to play in
explaining the science behind AIDS and showing that antiretroviral drugs
can effectively treat the disease. One group of scientists has done just
that, launching a website (http://www.aidstruth.org
<http://www.aidstruth.org/> ) in response to a recent article in
Harper's Magazine that gives credence to denialist viewpoints.
People with ill-conceived ideas calling themselves mavericks (or in this
case, 'rethinkers') will always be among us. Still, it's difficult to
gauge what motivates AIDS denialists to champion their views in the face
of overwhelming evidence to the contrary. The denialists almost
universally invoke distrust of what they call "pharma-corporate vested
interests" and they exploit fears arising from controversies over drug
pricing or safety. Some even claim that antiretroviral drugs actually
cause the symptoms of AIDS.
Despite their deep distrust of science, people who promote these views
seek scientific credibility, repeating the tired theories of a tiny
minority of scientists who say they are unconvinced that HIV causes
AIDS. To support their ideas, some AIDS denialists have also
misappropriated a scientific review in Nature Medicine which opens with
this reasonable statement, "Despite considerable advances in HIV science
in the past 20 years, the reason why HIV-1 infection is pathogenic is
still debated" (Nat. Med. 9, 853-860; 2003
<http://dx.doi.org/10.1038/nm0703-853> ). For the record, we think that
the scientific evidence that HIV causes AIDS is conclusive and that
antiretroviral drugs save lives.
Unfortunately that knowledge-informed by years of research-has failed to
reach many in the African-American community, a group with
disproportionately high rates of HIV infection. According to a 2005
survey by the RAND Corporation and Oregon State University, 53% of
African-Americans say that a cure for AIDS is being withheld from the
poor, and 44% believe that the people who take HIV drugs are being used
as government guinea pigs. Men who agree with such myths report that
they are less likely to use condoms regularly.
In South Africa, extreme ideas on antiretroviral treatment have made it
to the top. President Thabo Mbeki is well known for recruiting
'dissident' scientists as HIV advisors and for his vocal distrust of
antiretroviral therapy. In 1999, he urged government ministers to
examine whether AZT is toxic and dangerous to health by "accessing the
huge volume of information on this matter over the internet."
Fortunately, Mbeki's overt early embrace of AIDS denialism has been
quelled in public, partly through persuasion by scientists. Six years
ago, 5,000 scientists signed the 'Durban Declaration,' published in
Nature, affirming the link between HIV and AIDS.
But the health minister of South Africa, Manto Tshabalala-Msimang,
carries on. She publicly praises nostrums such as garlic and beetroot,
while emphasizing the side effects of HIV drugs. She has failed to
energize the rollout of antiretroviral drugs and has fostered an
environment where hucksters thrive (Nat. Med. 11, 581; 2005 and Nat.
Med. 12, 6; 2006).
Chief among these is the German salesman Matthias Rath. He blankets
communities heavily affected by AIDS with pamphlets proclaiming that his
vitamin treatment reverses the course of AIDS and that antiretroviral
drugs exacerbate the disease. Msimang has not publicly refuted Rath's
views-instead, Rath's employees were reportedly invited to address
health officials last September. The famed activist group Treatment
Action Campaign (TAC) and the South African Medical Association have
together filed a lawsuit against Rath and the South African government.
These groups aim to stop Rath from running human trials with his pills,
which he has detailed on his website. TAC has already won a case against
Rath, ruling that he cannot defame them as a front for the
Rath's vitamins are just one of many unproven AIDS treatments gaining
hold in South Africa. The country, one of the wealthiest in Africa,
could serve as a model for how to combat HIV. But as of December, only
about 112,000 people were receiving treatment through state
facilities-far behind the government's own targets. An estimated 500,000
of the 5.3 million HIV-infected people in the country need treatment.
Efforts by scientists to counteract AIDS misinformation take time away
from the very real scientific, political and economic challenges of the
epidemic. But these efforts are necessary.
In South Africa, overworked doctors and nurses must often coax HIV
patients into taking their drugs. They gently explain to them that
antiretroviral therapy itself is not poisonous, that in fact the drugs
will save their lives. For providers and patients in South Africa and
elsewhere, AIDS denialism is not a product of academic argument or an
oddity on the internet. For them, it's reality.
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