Is Peter Duesberg Finally Paying His Dues?

Exclusive:
AIDS Scientist 
Investigated for 
Misconduct
After Complaint

by Greg Miller on April 16, 2010, Science Insider 
UPDATE: Huffington Post / Daily Californian pick up the story:UC Berkeley Professor Under Investigation For Controversial AIDS Article; 
Statement by Nathan Geffen on Complaint Against Peter Duesberg 

University of California, Berkeley, professor of molecular and cell biology Peter Duesberg tells ScienceInsider that he is the subject of a misconduct investigation launched by the university. Duesberg has been a controversial figure for decades because of his vocal skepticism that HIV is the cause of AIDS. But he says this is the first time he has ever been investigated for misconduct, and ScienceInsider has learned that an AIDS activist may have helped initiate the investigation.



The charges apparently stem from a paper Duesberg and four colleagues published last summer in Medical Hypotheses that challenged the assertion that HIV has caused massive loss of life due to AIDS, and more specifically, disputed a 2008 study arguing that hundreds of thousands of lives have been lost in South Africa because of delays in distributing antiretroviral drugs (ARVs). Under pressure from AIDS researchers, Elsevier, the journal's publisher, withdrew the paper and told its editor to either implement a peer-review process or hand in his resignation. 

The university would neither confirm nor deny that Duesberg is under investigation, but he forwarded a letter to ScienceInsider, signed by university Vice Provost Sheldon Zedeck and dated 18 November 2009, that says the university has appointed a faculty member to investigate allegations it received. According to this letter:

The specific allegations are that an article you submitted to Medical Hypotheses was investigated and then withdrawn by the publisher based on issues of credibility and false claims. The allegations also state that you failed to declare a relevant conflict of interest with regard to the commercial interests of your co-authors.

Duesberg says he heard nothing more until last week, when he received an e-mail from the university's investigator, epidemiologist Art Reingold, requesting a meeting to discuss the allegations. Duesberg says he declined to meet until he receives more information about the charges against him. According to the university's faculty code of conduct, disciplinary actions can range from a written reprimand to salary reduction to dismissal.

In response to Duesberg's request, Reingold sent him two letters of complaint the university received in August 2009. The authors' names are redacted, but ScienceInsider confirmed one of them is Nathan Geffen of Treatment Action Campaign, an advocacy group in South Africa.

Geffen says his chief concern is an undeclared conflict of interest. "In particular, there is no mention in theMedical Hypotheses article that [co-author] David Rasnick worked with Matthias Rath, a vitamin salesman, and that the basis of their business model was to claim that vitamins, not ARVs, treat AIDS," Geffen says. (Rath was not an author on the Medical Hypotheses paper.) This information about Rasnick was not disclosed in the paper, but it should have been, Geffen says. And as first author, Duesberg should have taken responsibility, he says.

Rasnick says he worked as a salaried senior scientist with Rath's nonprofit foundation in South Africa from March 2005 to July 2006. But he says he currently has "no financial interest whatever" in the Dr. Rath Health Foundation.

Given that Rasnick stopped working with Rath almost 3 years before the Medical Hypotheses paper was published, Duesberg says, "I don't see that there was a conflict of interest." Duesberg is convinced that the allegations stem from a desire to censor his unpopular views. "There is clearly some movement to get rid of any dissent against the HIV-AIDS hypothesis," he says.

Peter Duesberg and the AIDS Genocide in South Africa

  















Research now confirms that the AIDS denialist policies of former South African President Thabo Mbeki contributed to the senseless death of hundreds of thousands of people. It is also well known that Mbeki's AIDS denialist policies were underwritten by University of California biologist Peter Duesberg and his companion David Rasnick. As part of their ongoing propagation of AIDS denialism, Duesberg and Rasnick are trying to publish a paper that refutes the impact of Mbeki's refusal to expand HIV testing, prevention and treatment in South Africa. Their paper titled "HIV-AIDS Hypothesis Out of Touch with South African AIDS – A New perspective" was originally rejected from a legitimate scientific journal and then published in a non-peer reviewed outlet (Medical Hypotheses), only to be retracted. [see posts on August 8, September 9, and September 11].

Nevertheless, Duesberg's article lives on in cyberspace and Duesberg continues to seek its publication. It is important to show yet again that Peter Duesberg is wrong on HIV/AIDS. Below is an excerpt from a new article by Pride Chigwedere and Max Essex published in the journal AIDS and Behavior. 


DISCLOSURE ALERT: I am the Editor of AIDS and Behavior and this paper was peer-reviewed. The full article is available FREE  online. 

AIDS Denialism and Public Health Practice
By Pride Chigwedere and Max Essex
Published in AIDS and Behavior

We recently published a paper estimating the human cost of not using antiretroviral drugs in South Africa Questioning whether HIV causes AIDS and the safety of using antiretroviral drugs (ARVs), the South African government led by former president Thabo Mbeki withdrew government support from Gauteng clinics that had begun using zidovudine (ZDV or AZT) for preventing mother-to-child transmission of HIV (PMTCT) in 1999, restricted the use of nevirapine donated free of charge by Boehringer Ingelheim in 2000, obstructed the acquisition of grants for AIDS treatment from the Global Fund in 2002, and generally delayed implementing a national ARV treatment program until 2004.







By considering the decreasing costs of ARVs, the increasing availability of international resources to fight AIDS, and comparing South Africa to neighboring Botswana and Namibia, we conservatively estimated the number of AIDS patients that could have received ARVs for treatment or PMTCT. Factoring in the efficacy of ARVs, we concluded that from 2000 to 2005 at least 330,000 South Africans died prematurely and 35,000 babies were infected with HIV as a result of Mbeki’s policies. Independently and using a different model, Nattrass arrived at similar estimates.

Duesberg and colleagues published a critique of the study in the Journal Medical Hypotheses which was subsequently retracted by the publisher pending an investigation of the quality and global health implications of the paper. Peter Duesberg is the most well known AIDS denialist who was part of President Mbeki’s commission tasked to determine whether HIV causes AIDS in 2000, and he has recently received attention from a mainstream magazine and a whistleblower award for his AIDS denialist
67 writings.1 Consistent with earlier writings, Duesberg and colleagues:

1) Deny that HIV causes AIDS; that instead, it is a harmless passenger virus;

2) Deny that ARV drugs are useful, and therefore Mbeki’s decisions could not have harmed anyone;

3) Deny that hundreds of thousands of South Africans have died from AIDS, and thus it does not make sense to attribute 330,000 deaths to Mbeki.

We choose to respond to the issues raised above for two reasons: first, some readers may be hoodwinked by Duesberg’s dishonest arguments and think that there is a genuine debate in light of the surge in denialist coverage, and second, to emphasize the grave implications of AIDS denialism for public health practice.

Does HIV Cause AIDS?

Duesberg has been denying that HIV causes AIDS for more than 20 years. President Mbeki joined the debate in 85 1999 initially by questioning whether AZT was safe for use by pregnant women, and then joined the denialists by questioning whether HIV was the ‘‘real’’ cause of AIDS as a way of broadening the debate from the usefulness of AZT to the usefulness of all antiretroviral drugs in fighting the AIDS epidemic, since they all target HIV. He then appointed Duesberg and others to a commission to examine whether HIV causes AIDS. Whether HIV causes AIDS is therefore at the very center of the policies implemented by Mbeki.

The evidence that HIV causes AIDS has been available for over 20 years. Careful epidemiological studies showing that individuals with a new, severe immunosuppressive disease clustered among homosexual men, intravenous drug users, female sexual contacts of drug users, hemophiliacs, other recipients of blood transfusion products, and newborn babies suggested that the cause was an infectious agent transmitted by body fluids. Early suggestions that illicit drugs or immune reactions to sperm were the cause could not explain all the patient groups affected by the immunosuppression.

Serological studies then suggested that the causative agent was likely to be a retrovirus, and this was confirmed by isolation and culture of the retrovirus from infected patients. Diagnostic assays were developed and much larger studies were then possible to identify HIV-infected persons using the presence of HIV antibodies, antigens, viral nucleic acids and virus, and to compare them to uninfected persons in longitudinal studies to learn the virology, immunology, pathology, and clinical and population features of the disease. HIV meets several standards of epidemiologic causality. 


HIV has satisfied Koch’s postulates, the traditional standard of infectious disease causation. To satisfy Koch’s postulates, one has to isolate the infectious agent from diseased animals, culture it in the lab, inoculate the agent into healthy animals which then develop disease, and reisolate the same infectious agent.

The difficulty in fulfilling the postulates was because HIV does not cause disease in animals other than humans and it is unethical to infect healthy persons with HIV just to satisfy Koch’s guidelines. However, the postulates were satisfied when the HIV virus was isolated from AIDS patients, cultured in vitro, and upon accidental inoculation into previously uninfected lab workers who subsequently developed AIDS, the exact laboratory HIV clone was reisolated from the patients. Using a causal model developed for chronic disease, HIV satisfies all of Sir Bradford Hill’s guidelines for assessing causality: numerous studies comparing infected and non-infected persons have shown that AIDS develops only in those infected with HIV (very strong association, consistency and specificity); follow-up cohorts have shown that the time relationship is that HIV infection always precedes AIDS (temporality); higher level of virus as measured by viral load correlates with and predicts severity of disease (biological gradient) ;treatment that suppresses virus leads to clinical improvement (experiment); there is an almost unique pathophysiological mechanism of how HIV leads to AIDS through the loss of CD4 lymphocytes (specificity and plausibility; and numerous studies on HIV-1,HIV-2, SIV, SHIV and other viruses satisfy the coherence and analogy guidelines.

The above data have been presented and debated over the last 25 years. Duesberg’s response has been to ignore or deny the data that does not support his position, and to cherry-pick statements from studies and present them out of context to suggest that the evidence for HIV causation is unconvincing. His early argument was that HIV had not satisfied Koch’s postulates for infectious disease causation, and he also indicated several aspects of the pathogenesis that were not understood then.

However, when lab workers accidentally inoculated themselves with the virus and satisfied the postulates, Duesberg refused to accept the data and now conveniently does not discuss the postulates. Similarly, early on, Duesberg agreed that hemophiliacs were the best group to test whether HIV causes AIDS because most of them did not have the drug use exposures that Duesberg considered causes, and both HIV-positive and HIV-negative hemophiliacs had received transfusions, hence ‘‘foreign-protein contaminants.’’

When Darby and colleagues published mortality data in the complete UK population of 6,278 hemophiliacs showing that those with HIV had 10 times the mortality of those without with 85% of the deaths attributable to HIV, journal editors who had hoped this was an honest debate asked whether Duesberg was going to concede defeat. He did not. He just moved the goal posts and suggested that AZT was the cause of AIDS; the approach that he had agreed to of using ‘‘hemophilia as the best test’’ was no longer relevant.

While the other points raised by Duesberg pertain to pathogenesis and not causation, most of the mechanisms are understood today. Thus, molecular techniques were developed and it became possible to isolate and quantify free virus in plasma; the dynamics between virus and CD4 cells and how this relates to disease progression were unraveled; highly effective medications that work by suppressing virus were developed and are now in widespread use; and opportunistic infections similar to those in the US were reported from Africa and Asia. Duesberg has moved on from those arguments.

One of his remaining arguments is that if there is no AIDS vaccine, which some predicted we would have soon after the discovery of HIV in 1984, then HIV does not cause AIDS. The same reasoning could of course be used to argue that Plasmodium falciparum does not cause malaria, as there is no malaria vaccine.

What therefore causes AIDS, in Duesberg’s opinion? His answers are inconsistent and contradictory. On the one hand, he seems to argue that AIDS (the syndrome) does not exist at all, labeling it ‘‘a fabricated epidemic,’’ since all opportunistic infections that define it already existed before AIDS. On the other hand, he also concedes that AIDS exists and offers causes, and seems unbothered by posing mutually exclusive arguments at the same time.

In his earlier writings, he accepted that there is statistical association between HIV and AIDS (although he argued this was insufficient for causation) and even considered the HIV-antibody test as useful surrogate to identify patients at risk of AIDS; today, he denies that and argues that HIV is a passenger virus with no relationship whatsoever to AIDS. In the same contradictory way, Duesberg has argued that HIV is not the cause of AIDS because ‘‘in most individuals suffering from AIDS, no virus particles can be found anywhere in the body’’; yet at about the same time that he published this, he was involved in a disagreement with other AIDS denialists who had challenged the very existence of HIV where he defended that ‘‘HIV has been isolated by the most rigorous method science has to offer.’’ Duesberg clings to the early argument that AIDS is caused by use of recreational drugs, but as explained above, this hypothesis was discarded when AIDS was seen in patients that had never used drugs including hemophiliacs, transfusion recipients, babies, and some African populations.

For hemophiliacs, he suggests that ‘‘foreign-protein contamination’’ through blood products is the cause, yet does not explain how AIDS from transfusion has virtually been eliminated just by incorporating the HIV test into blood screening. The strangest cause he proposes is that AIDS is caused by AZT and other antiretroviral drugs, even though AZT was only used after 1987 and used primarily on persons already with AIDS rather than healthy persons. To this, Duesberg replies that there was no AIDS in persons other than illicit drug users before 1987.In babies, he moves from arguing that there is no AIDS in babies and HIV cannot cause AIDS in babies (as it would otherwise kill itself together with its host), arguing that there is immunosuppression in babies but it is different and characterized by B cell deficiency, then that babies with AIDS are born to drug-addicted mothers.

Nevertheless, there are data showing that pediatric AIDS is real and has killed over 250,000 children per year since 1998, that it has the same immunological profile of CD4 deficiency as in adults, and that HIV-negative babies born to drug addicts do not get AIDS. What of Africa, the worst affected continent, which has comparatively much less recreational drug use and until this decade did not have ARVs in large supply? Duesberg suggests that the cause is ‘‘protein malnutrition, poor sanitation and subsequent parasitic infections.’’

However, AIDS has affected the well-off and over-nourished Africans, not just the undernourished, and this raises the question why the same explanation does not apply to other less-developed countries outside Africa that do not have as much AIDS, or earlier time periods when poverty and the attendant sanitation and nutritional problems were not any less in Africa (and other places). Moreover, AIDS is a particular type of immunosuppression with selective depletion of CD4 lymphocytes, and neither homosexuality, illicit drugs, ARVs, blood transfusions, malnutrition, nor living in Africa cause this.

In short, any explanation other than that HIV causes AIDS seems better to Duesberg—he therefore moves from the claim that AIDS does not exist to a multiplicity of causes even if it means creating a different cause for different geographies, different time periods, and different demographic groups, and without producing a shred of evidence. This is what is called denialism— ‘‘the rejection of objective reality to sustain a flawed,
hurtful, and ultimately dangerous belief system’’.

Are ARVs Effective in PMTCT and AIDS Treatment?

Estimating the human cost of not using ARVs in South Africa rests on the efficacy of ARVs when used for PMTCT and AIDS treatment. Mbeki entered the AIDS debate by questioning whether AZT was safe and useful for pregnant women, and Duesberg argues this position for all ARVs.

There are two observations to make from the way Duesberg argues the case. First, he discusses how and when AZT was first discovered and its mechanism of action inhibiting DNA synthesis, then cites some anecdotal cases, and concludes that all ARV drugs are toxic and not useful. Mechanisms of action are interesting to scientists but this is the wrong evidence to evaluate for efficacy. If one were to ask how best to treat hypertension, for example, the answer does not come from the interesting neurobiology of the hypothalamic blood pressure control centers, the crystal structure of angiotensin, or how Captopril was initially discovered.

The relevant standard of proof, the gold standard, is the clinical trial where the drug in question is compared to placebo (or alternative treatments) in a randomized controlled manner and a priori chosen outcomes analyzed]. This is why the US Food and Drug Administration requires clinical trial data before licensing any new drug. By choosing mechanisms of action, Duesberg is using inappropriate evidence, but purposefully so as to obfuscate the argument.

After deciding on the standard of proof—which is the clinical trial—the second step is to agree on how to assess the results from many such trials done in different countries and populations. Duesberg’s method is narration, where he ignores the data he dislikes, cherry-picks the statements he likes from different publications, and selectively interprets them to support his position, disregarding even the main conclusions of the studies.

Narrative reviews, while very common and perhaps relatively less demanding to perform, have the drawback that it may be unclear whether all the relevant evidence has been used or the reviewer selected studies that support a desired conclusion, and whether the apportionment of weight to studies was based on objective criteria such as sample size. The relevant standard here is a meta-analysis, that is, a systematic review with statistical synthesis of all relevant available data. When a meta-analysis is performed well, there is an a priori protocol specifying the question asked, the databases to be searched for publications, justifiable inclusion and exclusion criteria, the data to be extracted from studies, the quality assessment score to be used for each study, and models for statistical analysis.

For Duesberg to convince impartial readers that ARVs are useless or toxic when used for PMTCT and AIDS treatment, he has to produce a properly conducted meta-analysis (the objective standard for summarizing evidence) of clinical trials (the highest grade of evidence for assessing efficacy) where the drugs were used. Obviously, he cannot produce this because numerous clinical trials and meta-analyses have already been conducted and the evidence, as shown below, is unanimous in that the benefits of ARVs outweigh the side effects.

To quote an example from our work, we recently published ‘‘Efficacy of Antiretroviral Drugs in Reducing Mother-to-Child Transmission of HIV in Africa: A Meta-Analysis of Published Clinical Trials.’’ The question asked was how efficacious have ARVs been in PMTCT in Africa, first to generate an efficacy estimate directly relevant for policies on the continent that is worst affected by HIV/AIDS, and second, to pre-empt the debate on what is feasible in Africa (due to drug compliance, C-section rates, breastfeeding, late antenatal presentation, etc.) by considering only studies performed in Africa. The key result of this meta-analysis is that ARVs reduce mother-to-child transmission of HIV from 21% (combined placebo estimate) to 10.6% (combined ARVs estimate) at 4–6 weeks after birth. From all the studies that reported toxicity, ARV regimens for PMTCT are well tolerated by both the mothers and babies.

The quantity of this evidence is 10 clinical trials with a combined sample size of over 7,000 HIV-infected pregnant women, and over 800 transmission endpoints. The type of evidence is high grade, that is, randomized clinical trials rather than observational, cross-sectional, or case reports. The Jadad quality of the individual clinical trials is high.

The efficacy of using ARVs versus placebo is 50%. Using the US Institute of Medicine categories of certainty in assessing evidence, the evidence establishes that ARVs are efficacious in reducing MTCT in Africa, and the evidence favors rejection of the hypothesis that ARVs, in the doses used, are toxic to the mothers or babies. Example diagrams are shown in the published paper [click here]

Contrary to what Duesberg suggests, there are unanimous data (all trials conducted in Africa published by December 2006) to demonstrate the usefulness of ARVs in PMTCT in Africa, and other groups have arrived at the same conclusions for ARV use in PMTCT generally.

Likewise, extensive clinical trials data demonstrate the efficacy of ARV drug combinations in treating AIDS. The results from use of drugs in combination were so dramatic that the term ‘‘HAART,’’ for Highly Active Anti-Retroviral Therapy, was coined. Many systematic reviews have been conducted and updated by the Cochrane Collaboration and other groups, and the data are unanimous regarding efficacy. In addition, data are now available from the use of ARVs at the program level in African countries and these support the efficacy observed in clinical trials. Several studies have systematically reviewed the data just for developing countries and Africa, and others compared low and high-income countries.

In short, if Duesberg wishes to demonstrate that certain ARVs are no better or worse than placebo or other treatments, he has to conduct a meta-analysis that considers all available evidence, rather than his approach of discussing the molecular biology of DNA chain termination and somehow inferring that ARVs are not beneficial.

Moreover, for Duesberg to totally discredit the paper on the human cost of not using ARVs, he has to argue that all ARVs are totally ineffective when used for AIDS treatment and PMTCT because if some ARVs are even marginally effective, then it means that some South Africans could have benefited, however, small the benefit, had Mbeki not obstructed drug use.

Population Growth and AIDS Deaths

The third of Duesberg and colleagues’ arguments is that there is no evidence of large-scale deaths in South Africa, and therefore whatever policies Mbeki implemented, they did not lead to deaths. To support this, they present two arguments: one, that the population of South Africa increased over the last 30 years, and two, the statistics of reported AIDS deaths in South Africa. Regarding the first argument, it is true that the population of South Africa increased over the last 30 years. The population in a country is determined by the balance between the number of live births, the total number of deaths, and net migration. Without doing an analysis of the above determinants, it not possible to use such aggregate population trend data to infer that the number of AIDS deaths was small. If this reasoning is sound, then it should be applicable to other countries and diseases as well. Is it logical to infer that AIDS deaths are few in any country that has increased its population over the last three decades?


Similarly, is it logical to infer that there has been no increase in the number of persons dying of cardiovascular diseases and cancer or that the absolute numbers of death from these diseases are small in the US, whose population has increased over the last half century?

This argument does not support Duesberg’s assertions at all. The second part of the argument quotes Statistics South Africa, which recorded an average of 12,000 deaths per year in South Africa between 1997 and 2006. The shortfall is that these data are ‘‘Findings from Death Notification.’’ First, as explained by surveillance experts, ‘‘In resource-poor countries with underdeveloped health infrastructures, reports of AIDS or HIV cases are usually not complete enough to be considered reliable measures of the scope of the epidemic’’. This simply means that the death notification system in South Africa had/has much underreporting. Indeed, the ‘‘former so called independent homelands of Transkei, Boputhatswana, Venda and Ciskei (TBVC) were not included in the reporting system until 1994’’ when the reporting system began centralization, and a new death certificate was introduced in 1998 to improve reporting. 


The second shortfall is that of misclassification of deaths. AIDS patients die of the resulting opportunistic infections and cancers, and these immediate causes of death are often recorded without noting the underlying acquired immunodeficiency. According to the Medical Research Council (SA), up to 61% of HIV deaths are misclassified and the majority of them are recorded as tuberculosis and lower respiratory tract infections, which become the leading causes of death. It is apparent that Duesberg selected highly deficient statistics. [This section continues. Click here to download the entire article]

Implications
There are several implications to draw from this work. First is the translation of denialism into public health practice. One of Duesberg’s first papers questioning whether HIV causes AIDS was published in the prestigious journal Science in 1988. Some researchers initially took this as a genuine scientific debate but as Koch’s postulates were fulfilled, randomized controlled trials demonstrated the high efficacy of ARV, there was much success in PMTCT, and studies elucidated the dynamics between virus and CD4 cells, Duesberg maintained his arguments and it became clearer that he was not just a dissident scientist but a denialist. When Mbeki took up the denialists’ position in 2000, there was international outcry.

Not only was he lending his ear to discredited scientists, but AIDS denialism was crossing into national health policy through a head of government. Participants at the 2000 International AIDS Conference in Durban (SA), news outlets, scientific journals, and the public were outraged and some went as far as saying that South Africa was tripping into anarchy, descending into an abyss. South Africa did descend into that abyss. Mbeki withdrew support from clinics that had started using ARVs, restricted use of donated ARVs, obstructed Global Fund grants, and generally delayed implementing a national ARV program. Two independent studies have estimated that Mbeki’s policies led to at least 330,000 premature deaths. When AIDS denialism infiltrates public health practice, the consequences are tragic.

The second implication follows directly from the first and concerns accountability. Mbeki implemented negligent policies that led to the premature death of hundreds of thousands. His reasons, as stated by himself and health minister Tshabalala-Msimang, were that he questioned whether HIV causes AIDS and whether ARVs are safe, and neither ever publicly backed down from this thinking. The science behind Mbeki was Duesberg and other denialists.

Duesberg is still arguing for AIDS denialism and defending Mbeki and the policies that led to more than 330,000 deaths. By any reasonable standard, this requires some form of accountability.

Seth Kalichman has likened the AIDS denialists to the Holocaust deniers and Edwin Cameron likened letting AIDS patients die without medications to those who silently enabled the evils of Nazi Germany and apartheid South Africa to go unchecked.

John Moore and Nathan Geffen have called for AIDS denialists to be put on trial and Mark Wainberg has argued that denialists should be charged with public endangerment and ‘‘people like Peter Duesberg belong in jail.’’

Zachie Achmat has called for a commission of enquiry such as the Truth and Reconciliation Commission that was tasked with handling the apartheid era crimes. For how are South Africans ever going to trust their health system again?

How can a modern government be penetrated by denialists to the extent of implementing policies that kill hundreds of thousands?

William Makgoba suggested that impeding AIDS treatment was collaborating in committing genocide, and

Wycliffe Muga has asked whether Mbeki’s killing of 330,000 by obstructing life-saving medications is much different from Sudan’s President al Bashir’s killing a similar number in Darfur through obstructing humanitarian aid and militias. Is this not a crime against humanity?

Does the International Criminal Court not have a role, for it was established to handle those cases where national courts may be unable or unwilling to prosecute? 


Whatever the most appropriate avenue is, what seems apparent is the need for accountability.

The third implication somewhat generalizes the argument. AIDS denialists are dangerous to the general population; many have been persuaded into risky behaviors, ineffective alternative remedies, and other harmful actions, although there is no easy way of evaluating how many. Similarly, denialists can impact public or national health policy and South Africa is one extremely tragic case.

However, denialists seem ineffective against physicians as a group. The reason is that if an AIDS patient goes to a physician, and the physician decides not to treat, the physician is held for malpractice. The medical profession is practiced only by those who have earned defined credentials. The standards of practice are generally known and deviant practitioners are disciplined by the medical societies and deregistered by states.

Moreover, the law of torts offers patients a private right of redress against negligent doctors. The above seem absent in public and global health. The practitioners are ill defined and there are no laws restricting practice to persons with specified credentials. The concept of standards of practice is not well developed, and there are no bodies tasked with self-regulation and discipline.

The concept of public health malpractice has not yet been developed. Thus, at a general level, AIDS denialism in South Africa has also exposed the deficiencies of public health practice—it is open to unqualified practitioners, negligent policies go unchecked, and the consequences are tragic. How to rectify this is beyond the scope of this paper; here it suffices to point out the deficiencies of public health in terms of standards, practitioners, and accountability, as exposed by the South Africa example.

Last, Duesberg was able to publish his paper (which was later withdrawn) only because it was not reviewed by peers knowledgeable on the subject. Denialist writings require close scrutiny and peer review before being published in scientific journals, especially when they have the potential to impact public health practice.

When AIDS denialism enters public health practice, the consequences are tragic. The implications start in honest science but extend to the need for accountability and, perhaps, public health reform.


You can download the entire pdf of this article FREE at AIDS and Behavior's website.

Peer Reviewing Peter Duesberg – REJECTED—RETRACTED—REJECTED Again

This summer’s saga of Peter Duesberg’s Medical Hypotheses retracted article should probably be put to rest. The sad story of this broken scientist has been told many times. Here though Duesberg reaches an all time low as he teams up with pseudoscientist Henry Bauer to yet again claim that HIV is harmless.

Duesberg and his long time accomplice David Rasnick along with Loch Ness Monster Scholar Henry Bauer published the article “HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective” in the non-peer reviewed journal Medical Hypotheses. The article focused on the South African AIDS epidemic and research reported by Harvard scientist Dr. Pride Chigwedere in the respected Journal of AIDS. Duesberg disputes the death of over 300,000 South Africans and 30,000 babies unnecessary infected with HIV. Duesberg and Rasnick have a stake in denying AIDS in South Africa because they advised former President Thabo Mbeki to deny AIDS and delay HIV treatments. Duesberg’s ideas were so flawed that the publisher, Elsevier Science, took the unusual step of retracting the article.



The authors first tried to publish the article in the Journal of AIDS as a commentary on the Harvard study. But Duesberg was rejected after peer review. Of course Duesberg accuses the review process of corruption and unfairness. The authors said the following, “A precursor of this paper was rejected by the Journal of AIDS, which published the Chigwedere et al. article, with political and ad hominem arguments but without offering even one reference for an incorrect number or statement of our paper (available on request).”

Not surprisingly, requests for the reviewer comments are not honored; leaving us to imagine what the peer reviewers said about Duesberg's article. I decided to undertake a simulated peer review of the Duesberg article.
As the Editor in Chief of a peer reviewed journal, I figured, why not?

I took several steps to perform as close to a true peer review as possible. I stripped the text of all identifying information – the authors' names were removed from the paper. The text, tables and figures were cut and pasted to create a double spaced manuscript document suitable for blind review. I asked three leading researchers with expertise in South African AIDS to review the paper. None of the reviewers had any interest in AIDS denialism and none was aware of the Duesberg article. Here are my instructions:

"The attached manuscript is not under consideration at the journal which I edit, AIDS and Behavior. The paper is a critique of a modeling study of AIDS in Africa. This critique is a real manuscript and I am seeking peer reviews. Once you complete the task, I will inform you of what this is all about. I am asking that you, (1) Review the paper as if it were submitted to a journal of the caliber of Journal of AIDS or an equal level public health journal. (2) Provide written comments for the authors (no more than 1 single spaced page). (3) Recommend a decision to reject outright, reject with the option to resubmit, or accept the paper.”

All three reviewers recommended rejection. The simulated reviews offer a glimpse of what may have been raised by the Journal of AIDS. The consistency of our three independent reviews is remarkable.

Medical Hypotheses would probably have rejected the paper if only they sent it out for peer review.

Why Peter Duesberg continues to humiliate himself by ignoring science and affiliating with pseudoscientists remains a mystery.

The unedited blind reviews follow.

Review #1

This paper is an attempt to rebut a recently-published estimation of the lost benefits of antiretroviral therapy (ART) use in South Africa. The original paper essentially argued that by failing to implement an ART program that was “reasonably feasible” at the time, the South African government failed to prevent 330,000 deaths and 2.2 million person-years. The authors of the current article believe that the estimate is overblown and unrealistic; furthermore they argue that HIV does not cause AIDS. For the latter argument, apart from a very few scientists who believe HIV does not cause AIDS, there is broad scientific agreement and decades of scientific evidence that contradicts this claim of the authors. I cannot see why JAIDS would want to (re) engage in this obviously dead-end debate.

In addition, the paper has a number of methodological flaws, as noted below. I would therefore recommend rejection.

Major comments:
You fault Chigwedere and colleagues for overestimating the number of deaths averted, but the data that you use to revise (downward) his estimate is obviously wrong. Who but an AIDS denialist would believe that a) the South African mortality registration system would yield an accurate count of deaths due to HIV/AIDS and b) that 1 death per 1000 HIV-positive people per year were anything close to an accurate measure of the rate at which people with HIV/AIDS die. Even a back of the envelope calculation is enough to show that this estimate is off by several orders of magnitude: If the average person, untreated, with HIV/AIDS in South Africa lives 10 years as has been roughly shown in several other African natural history studies, then on average (assuming constant rates of infection) about 10% will die per year. This number is clearly much closer to the truth and 1 death per 1000 HIV-positive person per year is obviously wildly off target. In short, mortality registration is a very poor and inaccurate measure of HIV/AIDS deaths and cannot and should not be trusted to estimate how many people with HIV are likely to die per year.

You make much of the fact that the population in South Africa actually increased during the time period under consideration, but fail to realize that population can increase even in the face of large number of HIV/AIDS deaths; these two things are not mutually exclusive as you imply. The question is not whether the population increased – you can still have an increasing number of deaths accompanied by and increased size of the total population if there are more births or more immigration. Rather, the question is whether deaths from HIV/AIDS increased and how many could have been averted if treatment had started earlier than it did. Further, you state that “since the African HIV-epidemics coincided with steady and massive growths if the affected populations, we conclude that HIV-epidemics are not likely causes of AIDS epidemics.” In light of the above, this makes no sense at all. The assertion that because there has been population growth HIV epidemics do not likely cause AIDS epidemics is illogical and unscientific.

You seem to miss the point about vertical transmission, either unwittingly or purposely. When it comes to estimating the rates of vertical transmission, you fail to acknowledge that several randomized clinical trials (RCTs) have shown definitively the positive impact of ART in reducing the probability of vertical transmission. In other words, it is well established that antiretroviral drugs can help prevent a significant amount of vertical transmission, a fact you prefer to ignore.

You mix up population prevalence and antenatal prevalence, which, importantly, measure 2 different things. These things cannot be used interchangeably. Your table 1, 2nd column is “HIV in the South African population” yet the data you display there are the national antenatal statistics, very different indeed from the population prevalence that is implied. The same is true of your 2nd paragraph on page 6.

You further mix up prevalence and incidence, again, basic epidemiological concepts. Page 20, graph b is NOT HIV incidence as labeled at the bottom of that page, but rather annual antenatal prevalence.

You imply that toxicity (in the context of vertical transmission) is universal to all who use ARVs. You fail to mention or quantify the frequency of these events; nor do you meaningfully weigh the pros and cons of receiving ART and avoiding an HIV infection compared to the likelihood of a severe and debilitating side effect. Every drug has side effects and can therefore be toxic. The question is whether the benefits outweigh the risks, something that you ignore by repeatedly raising the “toxicity” alarm without quantifying its frequency or severity. Asprin has side effects and taken at extreme doses can cause toxicity. But that does not mean you shouldn’t use asprin when you have a headache.

Reviewer #2

I think we are long past the issue of whether HIV causes AIDS. I think it is very important to be open to other ideas including controversial ones. But even this primary issue is not taken on in a very convincing manner.

The basic argument is that if HIV is really responsible for so many deaths, why aren't they reflected in the death rates. I'm not a demographer, but the demographic projections I have seen for almost all of the hyperendemic countries still allow for substantial population growth even with AIDS.

South Africa is a country where there is a lot of denial and silence about when and whether someone dies of AIDS, so it would not be surprising to see a lot of underreporting in official cause of death. So the 1 per 1000 reported HIV-death rate (or even 2.5%) is not at all credible.

The rates of HIV prevalence are grossly overstated (given as 25-30%). Actually the overall rate for the population over 2 in South Africa in 2008 in the HSRC survey was only 10.9%. So the author's HIV-attributable mortality is widely off the mark.

As I look at the numbers, it is not unreasonable that a country such as South Africa could be growing at about 600,000 per year while at the same time experiencing 66,000 excess deaths per year from HIV/AIDS.

The authors do make a valid point that we may be underestimating the long-term toxicity of ARVs.

But I do not see value over all in this paper and would not recommend if for publication (i.e. reject outright.)

Reviewer #3

This manuscript responds to a recent study that found that in South Africa, at least 3.8 million person-years were lost due to delays in implementing ARV/prevention of mother to child transmission (PMTCT) programs because of beliefs that HIV was not the cause of AIDS and that ARV were not useful to patients (Chigwedere). The manuscript raises two issues: (1) What evidence exists for the huge loss of lives? And (2) What is the evidence that anyone would have benefited from the ARVs? The manuscript also raises the question as to whether HIV is a passenger virus.

Overall, the manuscript does not provide a convincing or logical argument to counter the assumptions made by the Chigwedere study. For instance, while the manuscript provides some evidence for their hypotheses, the authors do not address some of the claims of the Chigwedere article. For instance, the burden is on the authors to counter Chigwedere’s statement that “HIV satisfies all of Koch’s postulates…and all of…Hill’s epidemiological guidelines for assessing causality.” I would recommend rejecting the manuscript for publication based on its lack of logic in its arguments against the Chigwedere study, but also in the presentation of the authors’ own hypothesis.

In the first section of the manuscript, the authors state that there is no evidence of huge losses of life. The data are presented along with the assumption that population growth could not have occurred concurrently with an HIV epidemic. This assumption does not demonstrate knowledge of basic population dynamics or demography (e.g. a population can grow as long as birth rates are higher than death rates). The authors seem to conclude that HIV-related death and population growth are mutually exclusive, which is not true.

The authors point to data that only 2.5% of total registered mortality were due to HIV-deaths.

The authors do not address (1) issues of quality of these data, and more importantly (2) the attributable fraction of mortality resulting from HIV-related deaths. The counter-factual of how many deaths from TB, for instance, would have been avoided if HIV had been reduced is not considered.

Page 9 – the authors assume that all pathogenic viruses “act” the same in a given population. What is the basis of this assumption? Are there exceptions to this (e.g. other viral STIs?)

In the second section of the manuscript, the authors state that there are unresolved problems with the belief that AZT/Nevirapine inhibit HIV. The authors do not address the evidence (notably those cited by Chigwedere) that indicate (using “gold-standard” epidemiological studies) that AZT/ZDV are effective.

On pages 10-11, the authors point out some of the negative outcomes resulting from ART and PMTCT. However, the authors do not indicate how common these outcomes are and whether the burden of these outcomes are greater than the burden associated with HIV infection. The authors then make a conclusion that the negative impacts of treatment means that they do not have any benefit, which is not a logical conclusion.

Goodbye Duesberg's and Ruggiero's Articles! Did You Ever Exist?

Over the past couple of months two AIDS Denialism articles were published in a journal called Medical Hypotheses. These papers surprised many of us because Medical Hypotheses was once a peer-reviewed medical journal that is printed by the world’s largest science publisher Elsevier. But it did not take much to notice that these papers were not peer reviewed.

The article “Aids denialism at the ministry of health” by Marco Ruggiero (seen here at the gates of UC Berkeley) was received by Medical Hypotheses on June 3, 2009 and was accepted on June 3, 2009. Hmmm, now that was fast. And the article “HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective” by Peter H. Duesberg, Joshua M. Nicholson, David Rasnick, Christian Fiala, and Henry H. Bauer was received on June 9, 2009 and accepted on June 11, 2009. Obviously the Editor at least contemplated Duesberg’s article before accepting it. Just as obvious, neither paper underwent peer review.



Duesberg’s paper had actually been submitted to a legitimate journal called the Journal of AIDS and rejected after peer review. The filters of peer review work most of the time. But of course, being Denialists Duesberg and friends made the following claim in their Medical Hypotheses article…

“A precursor of this paper was rejected by the Journal of AIDS, which published the Chigwedere et al. article, with political and ad hominem arguments but without offering even one reference for an incorrect number or statement of our paper (available on request).”

The AIDS Deniers were joyful because they once again circumvented peer review and managed to seep into a what could appear to be a scientific outlet. For instance author Henry Bauer took time away from searching for Monsters in the bog to write at his blog…

“A remarkable coup has just transpired in publishing serious questions about HIV/AIDS in a mainstream journal. A press release describes the article concerned, which is currently in press at Medical Hypotheses (though already available on-line to subscribers).”

And cheerleader David Crowe was sure to post at his website “July 8, 2009–AIDS Denialism at the Italian Ministry of Health? Six doctors from the University of Firenze (Florence) compile evidence that the Italian Ministry of Health doesn't really believe in the infectious AIDS theory in an article in ‘Medical Hypotheses’.”

As an author who publishes in Elsevier journals, I found it hard to believe that the company would so easily and repeatedly publish pseudoscience. As a tax payer, I was outraged that the State of Connecticut was purchasing a pseudoscience outlet for our state libraries. Librarians started receiving letters that included the following statement…

“Medical Hypotheses has become a tool for the legitimization of pseudoscientific movement with aims antithetical to the goal of public health goal. One such movement, AIDS denialism, questions the existence of the Human Immunodeficiency Virus (HIV) and/or its role in causing AIDS. The public health consequences of this movement have been dire, particularly in South Africa, where several hundred thousand people are estimated to have died because availability of treatments was delayed due to the influence of AIDS denialists. Medical Hypotheses, with its lack of peer review and careful editorial oversight, has published numerous articles advancing AIDS denialism, allowing individual denialists, none of whom has ever published original research on HIV, to claim legitimacy as HIV researchers because their work has, after all, appeared in a “scientific” journal. In the most recent of these articles, two prominent denialists, David Rasnick and Peter Duesberg, along with several co-authors, claim ludicrously that HIV and AIDS have had no significant effect on public health in Africa and that antiviral medication has had no effect on AIDS mortality in North America and Europe. The authors make these claims by selectively quoting and misquoting the legitimate scientific literature in a manner that even the most cursory editorial oversight could not allow. It appears that the false claims in this paper were not vetted by the editor of Medical Hypotheses and that the journal, by publishing this and similar papers, has contributed significantly to the spread of medical misinformation and loss of life and wellbeing.”

But in the words of Henry Bauer, “a remarkable coup has just transpired”. The papers are gone. They have vanished. They are no more.

Ruggiero’s and Duesberg’s articles no longer exist at the Medical Hypotheses website. The articles that once were are no more. Oh sure, there are plenty of copies floating around. I know I have mine. And the abstract summaries have not yet been removed from the major indexing services, although that should hopefully happen soon.

This is yet another case where AIDS Denialists can fool some of the people some of the time, even journal editors. But once exposed for who and what they are, the damage caused by Denialists can stop and even be undone.

UPDATE: Examining Elsevier’s policies on removing articles from electronic data bases, which is the case for Duesberg and Ruggiero’s paper, it is apparent that the publisher found the articles to pose a threat to public health. A just finding...

Articles are removed when…

“the identification of false or inaccurate data that, if acted upon,
would pose a serious health risk (See Article removal or replacement).”

“In an extremely limited number of cases, it may unfortunately be necessary
to remove an article from the online database. This will only occur where
the article is clearly defamatory, or infringes others' legal rights, or
where the article is, or we have good reason to expect it will be, the
subject of a court order, or where the article, if acted upon, might pose
a serious health risk.

In these circumstances, while the metadata (title and authors) will be
retained, the text will be replaced with a screen indicating that the
article has been removed for legal reasons.”

On the Brink of Denialism: Why Peter Duesberg is Wrong and David Crowe is a Liar

Here is a real gem.

Onnie Mary Phuthe, an HIV+ woman from Botswana, wrote to South African AIDS Denialist Anthony Brink to ask about the organization Rethinking AIDS. The exchange is posted at AIDS Myth Exposed.

Brink’s response reminds me of a conversation I had with him while he was in Berlin attending an AIDS Dissident's Conference. I asked Brink about Peter Duesberg and he replied that Duesberg was washed up – old hat. The new ideas in AIDS dissidence were coming from contemporary scientists like Etienne de Harven. That seemed remarkable seeing as Peter Duesberg is 73 years old and de Harven is even older at age 81! Ah, the new ideas of AIDS Denialism.

Yet, I often wondered what Anthony Brink felt deep down about Rethinking AIDS and the people I had come to know as North America’s leading AIDS Deniers. Brink after all is responsible for feeding AIDS Denialism to the suspicious intellectual and former South African President Thabo Mbeki – ultimately bringing 300,000 of his fellow countrymen and 30,000 babies to their unnecessary deaths. Now Anthony Brink gives us some insight through his reply to Onnie. It
humoursly shows the infighting among AIDS Deniers, especially the Perth People and Duesbergians. This is worth a read. But be ready, Anthony Brink is not thrifty with words.



UPDATE: AIDS Myth Exposed has a thread to Defend David Crowe from Anthony The Brink of Disaster. Too funny. "If nothing else, it just makes it plain that Brink, and now Knoll are pushing to create a situation no matter what anyone thinks.I will say this though, I have corresponded with Dr. Bauer and he mentioned that Brink has no support from the Board to become RA President. I assume that goes no matter what happens to David. Brink will not ever be President of RA. Why on earth would he go out of his way to harm a terrific and effective dissident? Why would he brush aside the reasoned and caring pleas of a friend like Michael Geiger?

UPDATE: Is David Crowe a liar? Is he a fraud? Anthony Brink is not alone in making these claims against our favorite wannabe scientist AIDS Denialist. As posted at AIDS Myth Exposed...

"I am curious. Is this the same David Crowe who has been a long time executive in the Green Party of Alberta? If you go to the Facebook Group called Greens in Alberta you will find a great deal of information in some of the discussion groups that show how Crowe has operated in the past, and that Crowe and his friends fled the Green Party AGM and tried to hold a secret meeting in the parking lot (unbeknownst to hundreds inside the hall),. Now it is my understanding that he may be under investigation for extortion, fraud, forgery and submitting false documents."

UPDATE: David Crowe will not take Brink's abuse. What kind of denialist would not deny what an AIDS denier alleges! Not David Crowe. Read how David Crowe claims that it is Anthony Brink that is lying. The Snakes are getting rather vicious.

UPDATE: Anthony Brink (Junior Member at AIDS Myth Exposed) shares a string of emails that offer a glimpse into the snake pit. Thank Snout for this one.

From: Onnie Mary Phuthe
Sent: 22 July 2009 10:13 PM
To: arbrink@iafrica.com
Subject: Rethinking Aids

I came across the Rethinking Aids web.

I contacted Mr. David Crowe [David.Crowe@aras.ab.ca] since I wanted to attend he conference for 2009 Nov 4 but have no money.

I have huge interest in HIV and Aids; I have lived with HIV since 1994. I have seen for myself many things that truly support rethinking aids.

I really wish to be in contact with people who think in line with the rethink aids group since I am already living rethink aids. I really feel deceived by all the info being pushed by big pharma and crooked scientists, most of all I really feel pity for all the people who have believed what they heard with no question.

I am the kind of person who does not believe anything until I can also prove it myself. I don’t have a college education only form 4 but learn more at ke fodile, wena? (still under construction). The end of it will make me more enemies than friends about myself. Nevertheless, one thing I have personally witnessed is that most of the lies have come with 99% of the drug pushing diagnoses that are made on humans. It seems very important to treat people at the expense of their lives, health, and financial stability, and worst of all, a devastated mental state in the name of profit.

I truly thought I was in denial or crazy since I questioned everything and I did not believe all I heard. One thing I believe is that food, herbs, water, sunlight, unrefined sea salt, and others are the missing link between the human being of today and the past generations.

All disease that are identified come with a huge profit margin, and second they also comes with a huge cost for the humans involved. The question is animals are in the wild but manage well without vets. Whereas humans because they know and can buy are never fully treated, but rather are always lead to believe what is not true about their bodies.

Disappointing enough, but how can we trust scientists and their discoveries? I know what genuine research looks like.

It looks like this: all the board members, scientists, founders, directors and all others of Rethinking AIDS > Home ( DNN 4.3.5 ) and all their associates. I wish to learn with more clarity the puzzle that I am also putting together; I am missing some pieces here.

I really need to talk to other people who might think similar thoughts. When I talk to others in my country, I already see a threat of people fearing to tell the truth in favour of the funding they get from the spear-headers of the lies of the century.

I have made an ad at the link below. I do not want funding from the same people who got us in the mess, except those who want to deal with me will pay for themselves for the herbs I personally use. I get them fresh and prepare them raw. I am afraid to verbalize all that I know, because maybe I will be caught, I don’t know, but the thing is, does anyone else know what the truth is? If they know, why are we still being told the same lie over and over again, that is why I am afraid. There is something in it for those who choose to conceal the facts.

The challenge is that when it’s been almost thirty years of lies then it’s a challenge to make a statement to a brainwashed society (the world), plus the businesses would collapse if people knew and accepted the truth as it is.

Onnie Mary Phuthe
Botswana

Anthony Brink's reply

From: Anthony Brink [mailto:arbrink@iafrica.com]
Sent: 23 July 2009 03:33 PM
To: (Onnie)
Subject: RE: Rethinking Aids
Importance: High

Dear Onnie

Thanks for your email.

Very nice hearing from you.

We see things in much the same way.

As a fellow African, a pale African in my case, you need to know a few things about 'Rethinking AIDS', and you might want to share this information with your friends and family in Botswana so that they are not also misled about what this organization is.

'Rethinking AIDS' is basically a support group for Professor Peter Duesberg at the University of California, Berkeley, California in America, to promote and defend his scientific views on AIDS.

To see this you only have to go to 'About RA': About RA

Apart from reading about him there, and even finding a link to his website, you'll also read there an account of how and why 'The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis' was originally formed and its past activities.

Nowhere in the 'About RA' page is there any mention of the generally recognized scientific leaders of the AIDS dissident movement: the Australian physicist Eleni Papadopulos-Eleopulos and her colleagues (the Perth Group), who even before the publication of Duesberg's critique of the HIV theory of AIDS in 1987, on the basis that 'retroviruses' are always harmless, were already onto the real, more basic reason why the theory is wrong: 'HIV' has never been proven to exist.

You ask in your email, 'how can we trust scientists and their discoveries? I know what genuine research looks like.'

What you need to do is satisfy yourself about this by reading into the matter yourself.

You mustn't take things on authority. Like one of the Rethinking AIDS board members, a very senior member of the board, who says more or less: 'Duesberg's clever and experienced so I just go with what he says.'

It may interest you to know that to the best of my knowledge nobody who has read Duesberg's and the Perth Group's respective papers, and particularly their debate on whether 'HIV' exists, has come away with the conclusion that Duesberg is right that 'HIV' has been proved to exist, and that the Perth Group is wrong to claim that in truth and in fact 'HIV' has never been proved to exist.

Everyone who has studied the scientific disagreement between them has concluded that Duesberg is wrong.

This includes former South African Presidents Mbeki and Motlanthe (the latter currently Deputy President under President Zuma).

All of us feel rather embarrassed about this.

But it's awkward to say something like: 'My father, you need to take a bath, you really do. Everyone around you is noticing and saying so.'

It's so much easier just to pinch our noses and say nothing.

By the early years of our new century, 'The Group for the Scientific Reappraisal of the HIV/AIDS Hypothesis' had disintegrated.

It was dead.

In 2006 a Canadian businessman called David Crowe decided to form a new organization under his control.

He collected around him a handful of AIDS dissidents that he knew wouldn't give him any problems, and he formed a 'board of directors', most of whom are either active Duesberg partisans or 'sleepers' in the sense that they don't actively conduct themselves as directors should and do not express any disagreement with Mr Crowe (when one tries, we'll read below, Mr Crowe fixes him.)

This makes it easy for Mr Crowe to run things pretty much on his own along American lines.

It's a bit like the Treatment Action Campaign here in South Africa, which although it has many formal office bearers, is completely dominated and controlled by Zackie Achmat. Everyone knows this.

Now Mr Crowe needs to keep things running on American lines, because as usual that's where the money is.

Isn't it always so, Onnie? Don't we feel it over here in Africa all the time?!

Rethinking AIDS is funded by the same rich person who funds Duesberg, and do you know this same person even sits on the board of Rethinking AIDS, meaning he has the clout to govern its scientific policy? Can you believe such a thing, Onnie?

When one of the Rethinking AIDS board members tries breaking ranks and privately challenges Mr Crowe recently in a small closed internet forum about the things he says and does, whether in his opinion they're right or wrong, true or false, do you know that Mr Crowe sends him a demand by email that he should shut his mouth and in future submit any communications to that forum for him for prior censorship, just to make sure that the disobedient board member doesn't challenge Mr Crowe ever again? Can you believe your ears, Onnie?!

All of this makes it possible for Mr Crowe to run his show the way he wants it unaccountably to the international AIDS dissident community, and to pretend to the outside world that the little organization he formed in 2006 speaks for us all.

Obviously Mr Crowe made his move to form Rethinking AIDS in 2006 behind the scenes without telling the rest of us.

He did not contact every dissident on the list of those who'd signed their support for our basic cause that the HIV-AIDS hypothesis should be re-examined (see About RA page) and announce, 'I reckon it's a good idea to form a new AIDS dissident organization, what do you think? Please nominate yourself if you like and/or some other dissidents for election to a provisional representative body to discuss purpose and direction, scientific policy and operating strategy.'

That's not the way Mr Crowe works!

Behind the scenes is the way he works!

He wanted to make sure that Rethinking AIDS doesn't do any rethinking about anything important, anything really important such as whether 'HIV', which is at the core of the 'HIV-AIDS' construct, even exists.

No, we can't have that, Onnie!

We must stay off that matter!

This is why Mr Crowe made a point of snubbing the Perth Group and rejecting their request for representation on the board when they got to hear what he was up to behind the scenes.

Appropriating the name of the Group's former bulletin, Mr Crowe called his new organization Rethinking AIDS.

From this name and to read 'About RA' on his website, you get the impression that Rethinking AIDS is much the same scientific initiative as the Group.

People who don't know the real history will be deceived by this, but that's the whole idea!

In fact Rethinking AIDS is in no sense a representative organization, and it doesn't speak for the vast majority of AIDS dissidents who reject Duesberg's claim it promotes that 'HIV' has been shown to exist as childish scientific nonsense.

These structural, organizational and legitimacy issues aside, the main problem with Mr Crowe's Rethinking AIDS organization is that it promotes the lie that 'HIV' exists, just as the drug-pushing AIDS doctors, activists, journalists and academics say, only Rethinking AIDS says it's harmless.

This is like telling a child terrified by a noise outside his or her bedroom at night:

'Don't worry, my child, it's only a tokoloshe, it's definitely a tokoloshe. Never mind what everyone believes and tells you, the tokoloshe lurking outside your window won't come in and harm you. Just go back to sleep.'

You say this to the child knowing it's a lie, but you tell the lie to the child anyway because you think it's best to tell lies, maybe because telling lies comes naturally to you in your daily life and in your business dealings and you have a habit of telling lies and responding to what people say with emotive and disingenuous half-truths, and so you're comfortable with lies and half-truths, and/or because you think the child can't cope with the simple truth that tokoloshes exist only in the human imagination.

So it's better to tell the child a lie. The lie that tokoloshes really do exist. Even though it's quite easy to show they haven’t ever been proven to exist by the generally accepted procedure for proving things like this. And if anyone else comes into the room who has heard the child's cries, and says, 'There's no need to worry, my child, there's no tokoloshe outside, there are no tokoloshes', you say: 'Get out! Be quiet! You mustn't say this. It's too complicated for children to be told things like this. It will only confuse them.'

That's the approach to the problem of 'HIV-AIDS' taken by Mr Crowe's Rethinking AIDS organization.

This is how Mr Crowe thinks the myth of HIV-AIDS will be resolved.

He thinks the myth of HIV-AIDS will be resolved with lies.

But when you raise this matter with him, he says, 'But I have been questioning the existence of tokoloshes for many years.'

He doesn't say, 'I agree there are no tokoloshes in the real world.'

He says, 'I have been questioning the existence of tokoloshes for many years.'

Of course this is the kind of thing successful scheming politicians say, because it's evasive, self-serving, convenient and basically dishonest.

I mean successful in getting to be where they want to be for themselves.

I don't mean successful in serving the constituency they claim to represent.

Mr Crowe never says anything as directly truthful as 'There are no tokoloshes in the real world', because that would make it difficult for him as the self-appointed king of the tiny little country he's formed that's cut off from the rest of the world, which no one in the rest of the world recognizes, like Transkei and Bophuthatswana in apartheid South Africa, advised by a witchdoctor who says tokoloshes are very, very real, but are harmless.

What he worries about most is being king of his little country.

Like Ian Smith and his Rhodesian Front, claiming in 1965 to be the Prime Minister of all of Zimbabwe (then named Rhodesia after the businessman who stole the country). When actually he was representing only the tiniest minority of very foolish people.

We know all about people like this over here in Africa, don't we Onnie?

But Mr Crowe likes the feeling of being the king; it's almost as nice as the feeling one gets from being the president of a Rotary Club in a little town in the middle of nowhere that no one wants to go to.

Sorry, I should have said President, President with a capital P, because Mr Crowe always announces himself with a capital P.

He realizes that to deal with the underlying problems caused by his witchdoctor whose views about tokoloshes he promotes, even though deep inside he knows that they're lies, and the problems he causes us by the way he runs things in doing everything possible to prevent a proper ventilation of these lies, would mean the end of his reign as king with the crown he put on his own head, or asked a couple of his friends to put on his head. And he'd have to give up being the king, the king he likes being so much, either by abdicating in disgrace or being kicked out in disgrace with a hard boot up his arse for the tremendous harm he's caused our AIDS dissident movement, and remembered forever for the tremendous harm he's caused our AIDS dissident movement.

Particularly in the big case held by the elders in the shade of the big tree in the centre of the village concerning whether a certain man was causing the tokoloshe to come riding in on a hyena in the middle of the night when everyone was asleep to visit his neighbour and cause his cow to die and his mother to hurt her leg in a fall and his cousin to fail his exams.

In that case, the man accused had expert witnesses to explain to the court that he couldn't have done what he was being accused of having done because tokoloshes have never been proved to exist. And right in the middle of the case when it was going very well for the accused man and his expert witnesses, and everyone was noticing and commenting on how impressed the court was by the scientific evidence and arguments being presented, the President comes along, and behind the scenes he furtively tells the lawyer 'You're going to lose the case doing it this way, it's much better to tell the court that tokoloshes do exist, only they're harmless.' And not being a very bright lawyer, who also hasn't really had enough time to appreciate what's wrong with this kind of defence, and why the first and second defences are not complementary or alternative but must necessarily be mutually destructive, the lawyer thinks the President is right, why, he's the President of all the AIDS dissidents in the world, and he changes the defence strategy right in the middle of the case, when it was going very well as I said, and with that the case is on its way to hell, so that the unfortunate accused man ends up severely punished for calling out tokoloshes to visit and cause his neighbour's cow to die and his mother to hurt her leg in a fall and his cousin to fail his exams, and the historical opportunity is lost, the historical opportunity to show in court that despite what nearly everyone thinks and all the witchdoctors claim, actually tokoloshes have never been shown to exist.

And when it's all over the President doesn't even say I'm very sorry about the calamity I caused, I'm terribly sorry, I was only trying to help. I realize now that it's been pointed out to me that I made the most horrendous mistake. I feel sick to my stomach over what I have done.

No, he says, What are you complaining about? I did exactly the right thing going behind your backs and telling the lawyer to change his fundamental defence strategy right in the middle of the case and introduce a new defence that contradicts the original one.

He says, Go and jump in the lake, you and your complaints against me and what I did. You were going to lose the case anyway. I'd do it again!

So you see, Onnie, it would be better to avoid Rethinking AIDS for information about so-called HIV-AIDS.

It's always best to avoid taking advice from people who tell lies and behave in the way I've told you about.

You can get honest, reliable information about the basic trouble with the HIV theory of AIDS from the The Perth Group HIV-AIDS Debate Website.

My TIG Position Statement on 'HIV' will put you fully in the picture.

All the best

Anthony
Cape Town