A Paradigm Under Pressure
HIV-AIDS model owes popularity to wide-spread censorship
by Gordon Stewart, MD
AIDS entered the medical domain quietly in 1981
with a report in Los Angeles of five cases of severe pneumonia caused
by a parasite, Pneumocystis carinii, common in animals but uncommon
in humans. All five were young homosexual men who engaged in anal
intercourse very frequently, with multiple changes of partners;
had histories of previous attacks of gonorrhea and other sexually-transmissible
diseases (STDs); and used mind-altering drugs regularly. They became
fatally ill with uncontrollable diarrhea, weakness, and wasting.
Also in 1981, a series of cases of an unusual form of skin cancer,
Kaposi's sarcoma, was reported in New York City in young homosexual
men with similar histories, many of whom also had the same kind
of pneumonia together with opportunistic infections in the mouth,
gullet, intestine, and skin, with enlargement of lymph glands.
Within a few months, many similar cases attracted
attention in Los Angeles, San Francisco, and New York City because
they were all homosexual men in their twenties who used drugs freely,
either by inhaling volatile nitrites from 'popping' capsules or
by injecting or ingesting heroin, amphetamines, and other illicit
drugs. Although usually previously healthy except for attacks of
STDs, they succumbed rapidly to debilitating illness as described
above, with the same unusual pneumonia, yeasty white saliva, uncontrollable
diarrhea, and other infections to which they seemed to have no immunity.
They lacked energy, lost weight, and suffered pitifully before early
death. This condition was described in the official publication
of the US Centers for Disease Control at first as a gay-related
wasting syndrome and then, after further investigation of immune
status, as Gay-Related Immune Deficiency (GRID). A similar disease
was noted in non-homosexual drug addicts who shared needles for
heroin injection, and a similar loss of immunity -- already well
recognized in patients who were rejecting skin and other surgical
grafts -- was described in hemophiliac patients who began about
this time to receive transfusions of the corrective Factor VIII,
prepared from pooled donations of blood plasma. GRID was then renamed
the Acquired Immune Deficiency Syndrome (AIDS).
Thus defined, AIDS spread rapidly in the USA in
promiscuous homosexual men and drug addicts, and then in conurbations
in Europe and Australia. There were no reports in females, older
persons, or children until similar cases were detected in much smaller
numbers in women or girls who used drugs or were partners of bisexual
males. In late 1983, Science magazine published a report
from the Pasteur Institute in Paris claiming discovery of a new
retrovirus in a culture from an enlarged lymph gland in an otherwise
asymptomatic homosexual man. Workers at the US National Cancer Institute
in Washington then claimed that the new retrovirus in this culture
was one which they had already isolated from many homosexual men
with AIDS in the USA. The virus presumed to be present in these
cultures was pronounced in 1984 by the US Secretary of Health to
be the sole cause of AIDS and after some argument about priorities
and patents,. named the Human Immune Deficiency Virus (HIV).
In this way, AIDS entered the public domain in headlines
as a plague already causing thousands of cases in North America
as the start of a lethal, global pandemic. This pronouncement --
without confirmation by isolation of the original retrovirus --
was accepted instantly by responsible medical scientists and hence
by health authorities worldwide because antibodies, allegedly specific
for indirect detection of HIV, were found in the blood of patients
with AIDS. Wider testing supported the belief that HIV had spread
beyond the risk groups defined above to the general population by
heterosexual transmission. This became a dogma accepted without
further question by an international consensus. Up to this point,
the origins and causation of AIDS had been investigated openly and
without prejudice. However, with the "discovery" of HIV
as the putative, universally infectious retrovirus and the conversion
of this hypothesis into a dogma by the consensus, all dissent began
to be suppressed by anonymous censorship, which became absolute,
amazingly pervasive, and apparently immune from disclosure of conflicts
of interests.
While all this was happening, I was acting as a
consultant to the World Health Organization (WHO) on social and
behavioral aspects of communicable diseases. Although I accepted
HIV as a possible participant in the complex pathogenesis of AIDS,
I was impressed by the overriding fact that, in all countries with
reliable registration procedures, full-blown AIDS was confined to
the original risk groups of homosexual men and drug users, and to
those -- like female partners of bisexual men and their infants
-- who were passively exposed to the same risks. This trend was
so invariable by 1987 that predictions based on appropriate mathematical
formulae were accurate in numbers and distribution, year by year.
There was no evidence whatsoever in 1987 that AIDS was being transmitted
heterosexually in general populations except in headline propaganda
about the scare of AIDS internationally. But I found then that,
although the data and opinions that I offered to the WHO received
attention internally, they were barred from publication. Meanwhile,
medical literature exploded, with worldwide coverage in all media,
to accommodate the consensus view that AIDS was becoming a global
pandemic. Alarming figures accepted at face value by WHO from some
third world countries were used to support this assertion.
In 1987, Professor Peter Duesberg, a pioneer in
retrovirology at the University of California in Berkeley, suggested
instead that HIV was a latent virus incapable of causing AIDS which
was due, in his view, either to suppression of immunity by toxic
drugs or to a recrudescence of other diseases. A fuller statement
of his view, published by the prestigious US National Academy of
Sciences in 1989, caused a furor. Duesberg's arguments were not
debated. He was almost universally demonized but not silenced. Indeed,
his dilemma became the focus of all doubts about AIDS, from whatever
source. This did not help his courageous effort to promote rational
debate because, by attracting irresponsible support, it enabled
the consensus to discredit responsible doubts.
In 1989 also, the Royal Society organized a learned
symposium on epidemiology. With few caveats, this endorsed earlier
predictions of tens of thousands of cases in the UK by 1992. When
I suggested that this was exactly what was not happening, the editor
of the Society's Transactions generously invited me
to submit my data and analysis of the problem. A four-year correspondence
ensued, of questions by numerous peer-reviewers and answers by myself,
which ended in 1994 when my paper was finally rejected. Among the
two-inch file of correspondence amassed in that time were such comments
as "Why should I read a paper by someone who believes the earth
is flat?", and "the alternative proposed by the author
provides no coherent criticism of the accepted position, for reasons
that were well articulated in the national press following the notorious
Duesberg Channel 4 program." The first comment says more, I
think, about the reviewer, than about my paper, while the latter
defies belief. That peer reviewers selected for their specialist
knowledge should take a cue from the popular press is somewhat unusual,
to say the least.
Meanwhile, the passage of time showed that my predictions
made in 1989 were accurate to within 10 percent of actual registrations
of AIDS, whereas those published in the symposium, official projections,
and other expert quarters were exaggerated, often by orders of magnitude.
It seemed that I was right for the wrong reasons whereas they were
wrong for the right reasons -- a not impossible contingency, which
should have provoked debate.
Instead, since 1990, Nature , Science
, the New England Journal of Medicine , the British
Medical Journal and other mainstream, peer-reviewed journals
have preferred to reject papers by others besides my colleagues
and me containing verifiable data that throw doubt on the claim
that AIDS is capable of causing epidemics in general populations
of developed countries by heterosexual transmission of HIV, and
also falsify the hypothesis that HIV is the sole cause of AIDS.
The Lancet has published some short letters but has
consistently refused to publish fuller reasons for dissent. This
is interesting in a journal which, since 1945, has regularly accepted
papers from me on other subjects, and often invited me to draft
editorials and assist with reviews. Twice I have been invited by
the Royal Statistical Society to present my views and then turned
down peremptorily. On many occasions, I have been asked by the BBC
and other networks to talk about AIDS only to find, at the last
minute, that my appearance was canceled. This happened also when
a program with several distinguished experts participating made
by Meditel Productions for Channel 4 was unaccountably stopped.
Secretive censorship like this is familiar to everyone
who has dared to question orthodox views on AIDS. The result is
that essential questions are never debated openly except in a few
lesser journals, or in well-informed non-medical magazines like
Reappraising AIDS and Continuum . The
barrier to discussion at a UN Global AIDS Conference was breached
for the first time by the (Swiss) International Forum for Access
to Science in Geneva in 1998 in a marginalized session. Otherwise,
the censorship maintained by the international consensus of experts
in the main research councils, learned societies, official committees,
and WHO is unyielding; so also are the main channels in radio, television,
and the press. This censorship is not unique, but in my 57 years
as a professional, I have never encountered anything like it nor
did I ever think that I would in the world of medical science where,
as in all other science, difference of opinion is the sine qua non
of all advance.
There are many reasons for the censorship I have
encountered. Different reasons for different people -- scientists
profess scientific explanations for rejecting articles, editors
profess editorial reasons, such as, "it's no longer news."
In all, however, colleagues and I attempting to publish have met
an unholy alliance intent on rejecting any papers that offer serious
criticisms of the orthodoxy. There are, naturally, vested interests
involved; many bodies and individuals receive high rewards for their
work within orthodox AIDS science. Underlying much of this, the
pharmaceutical companies have their own obvious agenda.
The mainstream journals and media to which I refer
pride themselves on their independence and support for open debat,
but whenever they are presented with reasonable doubts about AIDS,
they close ranks like regimented clams.
Gordon Stewart serves as emeritus professor of public health
at the University of Glasgow, a consultant in epidemiology and preventive
medicine, and as an RA Director.