Times Higher Education - Unconventional thinkers or recklessly dangerous minds? - 0 views
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The origin of Aids denialism lies with one man. Peter Duesberg has spent the whole of his academic career at the University of California, Berkeley. In the 1970s he performed groundbreaking work that helped show how mutated genes cause cancer, an insight that earned him a well-deserved international reputation.
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in the early 1980s, something changed. Duesberg attempted to refute his own theories, claiming that it was not mutated genes but rather environmental toxins that are cancer's true cause. He dismissed the studies of other researchers who had furthered his original work. Then, in 1987, he published a paper that extended his new train of thought to Aids.
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Initially many scientists were open to Duesberg's ideas. But as evidence linking HIV to Aids mounted - crucially the observation that ARVs brought Aids sufferers who were on the brink of death back to life - the vast majority concluded that the debate was over. Nonetheless, Duesberg persisted with his arguments, and in doing so attracted a cabal of supporters
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In 1999, denialism secured its highest-profile advocate: Thabo Mbeki, who was then president of South Africa. Having studied denialist literature, Mbeki decided that the consensus on Aids sounded too much like a "biblical absolute truth" that couldn't be questioned. The following year he set up a panel of advisers, nearly half of whom were Aids denialists, including Duesberg. The resultant health policies cut funding for clinics distributing ARVs, withheld donor medication and blocked international aid grants. Meanwhile, Mbeki's health minister, Manto Tshabalala-Msimang, promoted the use of alternative Aids remedies, such as beetroot and garlic.
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In 2007, Nicoli Nattrass, an economist and director of the Aids and Society Research Unit at the University of Cape Town, estimated that, between 1999 and 2007, Mbeki's Aids denialist policies led to more than 340,000 premature deaths. Later, scientists Max Essex, Pride Chigwedere and other colleagues at the Harvard School of Public Health arrived at a similar figure.
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"I don't think it's hyperbole to say the (Mbeki regime's) Aids policies do not fall short of a crime against humanity," says Kalichman. "The science behind these medications was irrefutable, and yet they chose to buy into pseudoscience and withhold life-prolonging, if not life-saving, medications from the population. I just don't think there's any question that it should be looked into and investigated."
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In fairness, there was a reason to have faint doubts about HIV treatment in the early days of Mbeki's rule.
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some individual cases had raised questions about their reliability on mass rollout. In 2002, for example, Sarah Hlalele, a South African HIV patient and activist from a settlement background, died from "lactic acidosis", a side-effect of her drugs combination. Today doctors know enough about mixing ARVs not to make the same mistake, but at the time her death terrified the medical community.
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any trial would be futile because of the uncertainties over ARVs that existed during Mbeki's tenure and the fact that others in Mbeki's government went along with his views (although they have since renounced them). "Mbeki was wrong, but propositions we had established then weren't as incontestably established as they are now ... So I think these calls (for genocide charges or criminal trials) are misguided, and I think they're a sideshow, and I don't support them."
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Regardless of the culpability of politicians, the question remains whether scientists themselves should be allowed to promote views that go wildly against the mainstream consensus. The history of science is littered with offbeat ideas that were ridiculed by the scientific communities of the time. Most of these ideas missed the textbooks and went straight into the waste-paper basket, but a few - continental drift, the germ basis of disease or the Earth's orbit around the Sun, for instance - ultimately proved to be worth more than the paper they were written on. In science, many would argue, freedom of expression is too important to throw away.
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Such an issue is engulfing the Elsevier journal Medical Hypotheses. Last year the journal, which is not peer reviewed, published a paper by Duesberg and others claiming that the South African Aids death-toll estimates were inflated, while reiterating the argument that there is "no proof that HIV causes Aids". That prompted several Aids scientists to complain to Elsevier, which responded by retracting the paper and asking the journal's editor, Bruce Charlton, to implement a system of peer review. Having refused to change the editorial policy, Charlton faces the sack
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There are people who would like the journal to keep its current format and continue accepting controversial papers, but for Aids scientists, Duesberg's paper was a step too far. Although it was deleted from both the journal's website and the Medline database, its existence elsewhere on the internet drove Chigwedere and Essex to publish a peer-reviewed rebuttal earlier this year in AIDS and Behavior, lest any readers be "hoodwinked" into thinking there was genuine debate about the causes of Aids.
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Duesberg believes he is being "censored", although he has found other outlets. In 1991, he helped form "The Group for the Scientific Reappraisal of the HIV/Aids Hypothesis" - now called Rethinking Aids, or simply The Group - to publicise denialist information. Backed by his Berkeley credentials, he regularly promotes his views in media articles and films. Meanwhile, his closest collaborator, David Rasnick, tells "anyone who asks" that "HIV drugs do more harm than good".
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"Is academic freedom such a precious concept that scientists can hide behind it while betraying the public so blatantly?" asked John Moore, an Aids scientist at Cornell University, on a South African health news website last year. Moore suggested that universities could put in place a "post-tenure review" system to ensure that their researchers act within accepted bounds of scientific practice. "When the facts are so solidly against views that kill people, there must be a price to pay," he added.
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Now it seems Duesberg may have to pay that price since it emerged last month that his withdrawn paper has led to an investigation at Berkeley for misconduct. Yet for many in the field, chasing fellow scientists comes second to dealing with the Aids pandemic.
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6 May 2010 Aids denialism is estimated to have killed many thousands. Jon Cartwright asks if scientists should be held accountable, while overleaf Bruce Charlton defends his decision to publish the work of an Aids sceptic, which sparked a row that has led to his being sacked and his journal abandoning its raison d'etre: presenting controversial ideas for scientific debate