Wake up call and need for paradigm shift 3 April 2003
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Felix ID Konotey-Ahulu,
Kwegyir Aggrey Distinguished Professor of Human Genetics, University of Cape Coast, Ghana
Consultant Physician, Department of Tropical Medicine, Cromwell Hospital, London SW5 0TU

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Re: Wake up call and need for paradigm shift

Education and debate

One African’s Response

AIDS in South Africa

Wake up call and need for paradigm shift

I present my point-by-point response to Didier Fassin and Helen Schneider1, the value of whose article cannot be overestimated. They have gone farther than anybody in their diagnosis of what is happening with AIDS in South Africa in particular, and Sub-Saharan Africa in general.

President Thabo Mbeki’s Stance on HIV/AIDS in South Africa

“President Mbeki’s stance on the epidemic”1 was influenced by Professor Peter Duesberg who is credited for having initially mapped the genetic structure of retroviruses. Thabo Mbeki has been roundly condemned for putting Peter Duesberg, the apostle of ‘AIDS Dissidents’, on his panel of experts convened to advise him about “AIDS in Africa: the way forward”2.

Twelve years ago, The Heritage Foundation, invited 11 people around the world to examine the thesis of Peter Duesberg and Bryan Ellison and present their critique for publication. The thrust of Duesberg’s thesis was that HIV was not the main cause of AIDS. I was one of the eleven, approached on the basis of first-hand experiences of what was happening in Africa.3-14 I was sent Duesberg and Ellison’s paper which said “retroviruses are poor candidates to blame serious diseases on,”15 and that poverty, drugs, immunosuppressive behaviour, and certain “risk factors”, singly or in combination, could produce AIDS. The condition, they said, was not infectious and that it failed ‘Koch’s postulates’ test. I was charged with examining this thesis in the light of what was happening in Africa in general, and in my Krobo tribe in particular.

I knew a town where generations had been eating green monkey meat (with their retroviruses) for centuries. The only few AIDS patients in the town were females who had just been sent home to die, from Abidjan where they had gone for the sex trade.3 10 11 Duesberg could be right after all; eating green monkeys did not make HIV jump the species barrier, and if it did it was innocuous.

Searching Parameters for examining Peter Duesberg’s Thesis

I chose 13 socio-clinical parameters and examined each one in the light of Duesberg against what was happening in Africa.3 10-12 Of the 13, Duesberg and Ellison were wrong in 6, and could be vindicated in seven.16 “In summary”, I concluded, “there are ‘pluses’ and ‘minuses’ in the Duesberg and Ellison hypothesis…”16 One of the 6 parameters I failed Duesberg on16 was when he said HIV was not infectious.15 If such a world authority maintained that a retrovirus was not infectious and I said it was,16 then were we talking about the same thing?

Another Explanation?

Duesberg might be talking about naturally occurring retroviruses, while the ‘HIV’ I knew was wreaking havoc out there might not be natural at all – it could be artificial, as the astute English physician, Dr John Seale, pointed out in the world’s leading scientific journal Nature that first published the DNA structure. Seale’s short, but brilliant, communication was called “Artificial HIV?”17 Another English physician, Dr Victor Daniels stated: “The origins of the immunodeficiency virus are not totally clear. It has been suggested, but not confirmed that the virus has been man-made in the Soviet Union or United States as a weapon of biological warfare.”18 Writing under the title “The Biological Bomb” The Lancet gave this definition: “Biological warfare is the intentional use of living organisms or their toxic products to cause death, disability, or disease in man, animals, or plants or to poison food-supplies (‘public health in reverse’)”19 and that there was a “biological bomb lying at the heart of the cellular nucleus, ticking us to destruction.”19 At the same Lancet symposium, Lord Ritchie-Calder said: “While one group of scientists is devoting its energies to prevent diseases, another is devising man-made epidemics.”19 In their instructive article, Fassin and Schneider revealed: “As has recently been shown, in the last years of apartheid government laboratories were developing chemical and biological weapons (including anthrax, intended to eliminate black leaders), ..”1 Just the type of biological bomb Lancet wrote about 35 years ago19?

HIV versus ‘HIDDNA’

To understand the difference between the natural “retrovirus-HIV” Duesberg and some ‘AIDS Dissidents’ called “Science Fiction”15, and the real cause of Lancet’s “man-made epidemics”19 I now suggest the perception of ‘HIV’ as some hidden agent (hidd’n agent), ‘HIDDNA’ which term I have coined to stand for “Human Immune Deficiency DNA”, specially fashioned in an apartheid laboratory (“intentional use of living organisms”19) to attack the immune system for biological warfare since we are now told that some such research was going on in South Africa.1 Has South Africa been hit by a biological bomb?

Paradigm Shift in thought and approach is required to tackle the AIDS problem

The answer to whether a possible biological bomb involvement in South Africa explains what is happening needs a paradigm shift in one’s thinking – prepare to think the unthinkable, and believe the unbelievable. Look at the bare facts: On my African tour researching AIDS 3-14 20-22, I did not include South Africa because there were no cases among the black population, but I did communicate with Professor J Metz of the South African Institute of Medical Research in Pretoria who sent me some information on VIGS (AIDS in Afrikaans) confirming that AIDS began in the white population. Within 15 years the situation in the black community has become quite unbelievable. “With an estimated five million people infected” write Fassin and Schneider, “South Africa has the highest number of people with HIV in the world.”1 Experts maintain this is all from sex. Is it not cruel to suggest that black majority rule has suddenly produced a sexual revolution? When Gisselquist and colleagues point out that some HIV Positive children in sub-Saharan Africa have “HIV Negative mothers”23 and that “more research is warranted to clarify risks for HIV transmission”23 they were promptly slapped down by those who subscribed to the view of the African’s alleged sexual prowess. “Don’t emphasize the dirty needle contribution to AIDS”, they say, “it will only make them continue their promiscuity”. But North Africans are no less promiscuous than sub-Saharan Africans, yet they only have a fraction of the continent’s AIDS problem12 14.

BBC’s Disturbing Revelations

“Science In Action BBC World Service Sunday 18 October 1987 GMT 09.15 to 09.45”24 Stephen Hedges, regarding a hospital ward where 30% of the patients were HIV-Positive: “THE RAVAGES OF AIDS IN AFRICA. Film-maker Scot Finch reveals the frightening results of a fact-finding mission he undertook with a team of doctors and scientists to assess the spread of AIDS in Central Africa: ’We were in one hospital where the doctor has to use five needles for twenty patients; three syringes, and use the same syringes, the same needles on the AIDS and non-AIDS patients alike. Now this is absolutely horrifying’ (Scott Finch was talking to Stephen Hedges in Science In Action, coming to you from London in the World Service of the BBC)”. In the same report Scott Finch said: “One very eminent doctor said, ‘if we in the Congo don’t change our sexual habits, the Congo could be wiped off the map.’”24 It was like demonstrating the connection in the UK between infected blood and AIDS in haemophiliacs, only to prompt a campaign: “If you don’t change your sexual habits, and wear condoms, you haemophiliacs will all be wiped out”.

The Times recently ran the headline “Botched vaccinations blamed for AIDS in Africa”25 to highlight the report of Dr Gisselquist and colleagues23. An important aspect of Fassin and Schneider’s article1 is that when the multifactorial causes of the AIDS epidemic are ignored, suspicions are immediately raised in the African mind.

Suspicion? African Paranoia? Or both?

When South Africans become alarmed about the fact that “some white leaders…even publicly rejoiced over the possible elimination of black people by disease, as one member of parliament did in 1992”1 their suspicions of racist plots are always dismissed as “Conspiracy Theories”. We Africans should not be preoccupied with conspiracy theories, but when the President of the USA apologizes for Conspiracy Facts26, then it was time we began to look at all the channels of infection, for example “attempting to spread HIV through a network of infected prostitutes”1. On May 16, 1997 President Clinton apologized to the eight remaining survivors of the Tuskegee Syphilis Experiment: “The United States government did something that was wrong, deeply, profoundly, morally wrong. It was outrage to our commitment to integrity and equality for all our citizens. It was clearly racist.”26 In 1932, a group of scientists secretly selected 400 black people from Tuskegee, Alabama, who were never told they had syphilis. They were watched and monitored for 40 years. Even when Penicillin became available they were denied treatment. The experiment was stopped only when the American public was alerted to it, and became outraged, but by then many of the people had died from “syphilis-related heart conditions.”27

Should South Africans who are deeply suspicious about the phenomenal increase of HIV/AIDS among the blacks, and who kept asking: “What on earth is happening?” be branded paranoid? The Financial Times28 had a photograph of “Children from Zevenfontein, where 85 percent of the community are HIV- Positive.”28 Although it is impossible for sex alone to do this, we hear reputable broadcasters continue to say: “Rape incidence in South Africa is the highest in the world! Even babies less than one year old are raped regularly because the HIV-Positive African thinks having sex with a virgin gets rid of the infection. The younger the person raped, the better!” How many rapes per night and day would turn the Zevenfontein community to be 85% HIV-Positive? Or produce “the extremely rapid growth in HIV seroprevalence, for example from 0.7% in pregnant women in 1990 to 24.5% in 2000, reaching 36.2% in KwaZulu Natal”1? When Fassin and Schneider report that “in the year 2000 AIDS accounted for 25% of all deaths, and mortality was 3.5% times higher than in 1985 among 25-29 year old women and two times higher among 30-39 year men”1, is that not ‘a cry for help’ and a ‘wake up call’?

The British Medical Journal cover photograph and anti-retroviral drugs

The BMJ’s stunning cover photograph29 showed scores of youth wearing “H.I.V. POSITIVE” T-shirts, who appeared to be rejoicing, as if wearing ‘Badges of Honour’ but really were captioned: “South Africans protest for anti-retroviral drugs”29. The assumption is that all these youth, and the pregnant women, became sero-positive through sex, but from what we have seen above23 24, is it right to make that assumption? And now that HIV vaccines are being heralded as the only answer to Africa’s AIDS problem, should we not listen to what one Ghanaian physician said? Commenting on the “let’s wait for a vaccine” prescription for AIDS he said: “Look here, for a vaccine to be worth its name, it must produce antibodies. Would you surrender your seronegative status for a seropositive one?”30 If a pregnant South African lady was persuaded to be vaccinated, and she changed from being HIV-Negative to HIV-Positive, would she not also join this crowd demanding that President Thabo Mbeki sign a cheque for anti- retroviral drugs even though the government blocked their use, “citing the drugs’ side effects”1?

Widespread grumbling and non-compliance with the “wear condoms” message

Everywhere in sub-Saharan Africa this intense suspicion has turned to “African Paranoia”13:

Nairobi’s Kikuyu Province: ”We prefer the Missionary nurses to vaccinate our children. We do not trust the other vaccines.”

Maeduiguri University, Nigeria: “We fear the donated sanitary towels may contain HIV because they produce intense itching in our private parts”.

Lagos: “Vitamins are not vitamins anymore. They are full of contraceptives”.

Abuja: “They planted in our leading International Hotel, a very beautiful prostitute from Mali to infect us”.

Kampala: “The professor successfully treating HIV/AIDS with herbal immune boosters has been struck off the medical register. One attempt has been made on his life.”31

A Ghanaian city: “The haematology kit we got from abroad was dangerous. HIV- Positive blood showed ‘Negative’, and HIV-Negative became ‘Positive’ when we checked with our tested controls.”

Doctor in Tema, Ghana: “I am seeing more and more young adults with azospermia. Imported food with spermicides? Is that what the Genetically Modified food is meant to do? No wonder the Zambians turned down the GM food offer.”

Ghanaian Midwife, Accra: “The way Vitamin A is being pushed everywhere, radio, TV, newspapers, makes us very suspicious. Surely we have palm oil with plenty of Vitamin A? Why don’t we push that instead?”

Volta Region, Ghana: “The condoms have lubricant with HIV, and holes specially made to transmit the virus, but block sperm. Preventing pregnancy, and causing AIDS as well?”

Government doctor in East African country: “Instructions came that we should no longer test blood for HIV before surgery, because blood transfusion is not a significant cause of AIDS transmission in sub-Saharan Africa32”.

Mother of children in International School in sub-Saharan Africa: “The children brought a letter announcing vaccination against meningitis. It said children from other countries should go to their respective embassies for their jabs. Isn’t our vaccine good enough for the others?”

Businessman with children in International School: “My son born abroad received a letter telling him he needed to go to the embassy for any vaccinations he required in future, while my other son will be vaccinated at school. Why?”

Kumasi, Ghana: “The herbalist, Nana Drobo, who treated many people including French men with AIDS, was assassinated on his farm33. Anybody using African traditional herbs for AIDS treatment is threatened, as happened in Kenya.”

Douala, Cameroon: “The British-trained professor who has found a revolutionary way of treating AIDS, and is sending people back to their jobs, has been rubbished internationally”.

Abuja, Nigeria: “The Specialist treating HIV/AIDS his own way has been threatened with closure, even when he has successfully treated 30 Air Force personnel”.

Nairobi: “Why should they come to a church and get our children out of Sunday School to be vaccinated? Would they do that in England?”

Influential government official in West Africa: “What scares me is that I do not know how to tell the good white man from the bad one. I sent one packing last month only to find later that he was the good one.”

Accra: PhD Lecturer: “The ‘You are all at risk’ message with a finger pointing directly at one from the poster on the Brewery Road, near the Daily Graphic, always irritates me. How is a happily married man also at risk of HIV/AIDS? Unless, of course, they are spreading the thing quietly through needles as well.”

Kampala: “Police were sent to beat us up when we refused our children vaccination. My first child has not yet recovered from last year’s immunization. One friend of mine’s child turned HIV-Positive after vaccination.”

Lagos: [Secretary to the Cabinet, Chief Samuel Olu Falae]: “Don’t these scientists know that AIDS has less to do with green monkeys than blue movies?”22

Accra: [Scripture Union Chief Executive, Mr Jude Hama]: “NGO’s come offering us money to distribute condoms to students. Our converts are taught not to have sex outside marriage. Do these NGO’s want the children to have a taste for sex in their teens? Sadly, our own Medical Officers do not support us in this.”

And so on, and so forth. Even WHO and UN pronouncements are received coolly. The statement last year by a UN Senior Official that Heads of State should be “kicked out”34 if they did not toe the official line for AIDS control brought the paranoid retort: “They have been in charge of the AIDS Programme for the past 16 years, and all we see is calamity after calamity, while they blame it all on sex. Now we hear: ‘Obey our AIDS population control plan, and you stay in power. Disobey, and you go’. Soon they are going to ask us to submit to HIV vaccination that will turn us all HIV-Positive. The Head of State that does not enforce this, will be ‘kicked out?’”34

These interpretations of official intentions proliferate. Even the women in the sex trade whom I interviewed around the continent were full of such conspiracy theories. They are convinced someone wants to “wipe out Africa”, even while they continue with their “quantitative and qualitative abnormal sex”6 7 12 to produce a “preponderance of females with AIDS.”35

Everywhere I visited, I found suspicion, fear, and paranoia that seemed to undermine genuine immunization programmes.

The Population Dimension

Paranoid Africans think the white man’s plan for them is “Selective Population Control.” The Times’ leading article the same day Fassin and Schneider’s paper was published says: “The world’s population in 2050 is now expected by the UN Population Division to be 8.9 billion. That is 400 million fewer than expected as recently as 2000 and a billion below the figure predicted a decade back.” It goes on “By 2050, the death toll from AIDS is expected to have climbed to 278 million, and 178 million fewer babies will have been born because the impact of the epidemic on women of child-bearing age.” The Times proceeds (chillingly) “Despite high fertility rates, Southern Africa’s population will actually shrink.”36

Is any of this partly (or wholly) due to what The Lancet called Biological warfare’s “public health in reverse”19? Is an iatrogenic population depletion going on faster around the Tropic of Capricorn than anywhere else in the world?

Denial of reality & Denial of the unacceptable versus Denial of wrong doing

‘AIDS Dissidents’ have a broad spectrum ranging from those who deny that HIV exists at all, across to those who admit that something peculiar was happening, but that it should not be called HIV-AIDS but was a manifestation of old diseases, and on to those labelled ‘Dissidents’ simply because they queried the “official line” regarding anti-retroviral management. There are also some who, because they have tested ‘Positive’ in one laboratory (say in Africa) but ‘Negative’ several times in Europe, insist the whole thing is a hoax to lure them to take immune deprecating drugs that lead to AIDS and death. Joan Shenton37 lists scores of diseases that will test ‘HIV-Positive’ with some test kits.

Yet some others deny ‘HIV’ is infectious because they had refused to wear condoms when the wife was HIV-Positive, and they had remained HIV- Negative for ten years or more – the so-called ‘Discordant Couples’. They ask: “If the thing is infectious, why am I not infected, and why are there thousands of British HIV-Negative widows of haemophiliacs who had died from AIDS?” Then, as Fassin and Schneider state, there are yet others who deny HIV/AIDS – “even a state leader”1 – because they find it difficult “to comprehend the magnitude of the epidemic” and its consequences “such as the loss of 20 years of life expectancy within 2 decades.”1 In my opinion, such denial was very dangerous because while promiscuity continued to be blamed, transmission by needles could go on undetected.

There is also the denial of wrong doing. “How could anybody do a thing like that – deliberately (or accidentally) infect Africans with HIV? The thing is unthinkable”, they conclude, but because of apartheid hindsight, “what could be seen elsewhere as unfounded suspicion was in South Africa plain reality, historically attested.”1 When that meticulous epidemiological researcher-detective, Ed Hooper, described the role of accidental contamination of polio vaccine with HIV in the AIDS epidemic38 there were frenetic denials of wrong doing. Meanwhile, African Ministers of Health who kept denying that there was an AIDS epidemic, would never be concerned about ever asking the question: “Has the accidental contamination that Hooper revealed, stopped happening?”

Misinformation and Disinformation

‘Misinformation’ with ‘Disinformation’ about the AIDS epidemic on the African continent was rife9, and that was what made me decide to search out exactly what was happening in the sub-Saharan region. ‘Disinformation is deliberate misinformation’ 9 13. To say that eating green monkeys produced AIDS was misinformation, but for a professor of Immunology to publish that Africans could have developed HIV/AIDS through injecting monkey blood for sexual arousal39 was disinformation. To broadcast that Central Africans and some homosexuals with AIDS had inherited something found in their blood called group specific component Gc1f which predisposed them to AIDS40 was misinformation rather than disinformation because after it was pointed out to the authors that their facts were wrong 5 13 they apologized unreservedly and said there had been a laboratory fault 41.

For accredited authorities of ‘AIDS and the Third World’ to publish two maps showing Ghana striped with AIDS while neighbouring Ivory Coast (which had international prostitution legalized as an industry) was recorded as being entirely free of the disease42 was disinformation. A virtual ban on talk about the sex trade as a chief cause of spread of AIDS was officially maintained to avoid “sex discrimination”, which raised the kind of suspicions circulating in South Africa where it was feared attempts were made “to spread HIV through a network of infected prostitutes”1.

Sometimes the misinformation/disinformation debased the African, as when it was announced that some American scientists had discovered monkey retrovirus antibodies in the blood of Senegalese prostitutes. When the findings were challenged the authors admitted that they had made a mistake, and that there was contamination in their laboratory of human blood and monkey blood43. To redeem the reputation of their great university, a senior professor wrote an editorial about the episode which she called: “A case of mistaken non-identity”44. What surprises us Africans is that after the original misinformation had made world news, and the scientists later confessed error, not one newspaper or radio/TV channel went back to correct the facts. The general public therefore continued to believe that the African did, in fact, inject monkey blood into his thighs for sexual arousal, that Africans did share some genes with AIDS afflicted homosexuals, and that Africans harboured in their blood antibodies of monkey retroviruses. There seemed to be not a single international journalist worth his salt who would stand up for the African. Could all this be a manifestation of “racism”? And, in any case, why should people be mixing monkey blood with human blood in the same laboratory as the two professors did in Boston43?

Racism and Retroracism

Fassin and Schneider observed that racism had led to “suspicion in South Africa of science and orthodoxy – a suspicion that is widespread and not confined to the president and his advisers.”1 Certain scientists, in my opinion, genuinely believe that ‘blacks’ are inferior to ‘whites’. With little knowledge of the black person’s previous history and real potential, these prejudiced ‘whites’ have stretched Darwinian Evolutionism to absurd limits. The full title of Charles Darwin’s treatise45 is:

“THE ORIGIN OF SPECIES BY MEANS OF NATURAL SELECTION OR THE PRESERVATION OF FAVOURED RACES IN THE STRUGGLE FOR LIFE”

As I once I stated46: “The term ‘race’ is a misnomer. There is but one human race, with different peoples. James Bowman and Robert Murray47 should be applauded for the title of their excellent book, Genetic Variation and Disorders in Peoples of African Origin. Others would have used ‘the African Race’ in the title.”46 Sequencing the human genome confirmed recently the fact of just one human race. Darwin’s ‘favoured races’ would want to survive at the expense of the ‘unfavoured races’.

Looking at some unflattering pictures of half naked Africans in glossy magazine advertisements, for example, Chief Obijol and his “series of clicking sounds”48, racists would like to think that the African was inferior and slow to evolve. They would be terribly mistaken because the African, in his present sorry plight, is not a case of delayed evolution; he is a classic example of accelerated degeneration. There were Black Pharaohs in ancient Egypt, and before Europe was Europe, and while the Caesars were teaching the British Isles to read and write, the Ethiopian Chancellor of the Exchequer of Queen Candace, was reading The Prophet Isaiah fluently49.

There are South African whites who have vowed never to be ruled by a black president, and are like the ones Fassin and Schneider describe as rejoicing in parliament “over the possible elimination of black people by disease”1. These racists require a mental paradigm shift about the black man. The process can be very painful, as was manifested in the case I once described46 of a British university Reader who confessed his racism to a Ghanaian pre-Clinical medical student he had misled in order to deprive him of a First Class Honours Degree. He “could not bear to think that a black African would learn English as a second language, study in the language, and beat all comers.”46 But after he was deprived of what he deserved, that African went on to emerge in the Finals with Honours and Distinctions, to top the whole university of more than 200 newly qualified doctors, and was rewarded by a non-racist Lord Max Rosenheim FRS PRCP, who picked him to be his House Physician. The Ghanaian went on to achieve exploits. I know many white South Africans who are as colour blind as Lord Rosenheim was, and who will not rejoice as their parliamentarian did, because the African population was being decimated.

RETRORACISM: I met this phenomenon in several countries I visited in sub-Saharan Africa. “‘Retroracism’” I once wrote, “is a term I coined to mean reverse racism. A retroracist is usually a black man who is consumed with hatred for the white man.”13[page 196] As white racists are best dealt with by white people, so retroracists are most efficiently controlled by fellow Africans. Black South Africans (and all the non-white population), have an obligation to help those among themselves who are retroracists because genuine, non-racist, white people feel intimidated by retroracists, and this can prevent South Africa from dealing with the AIDS epidemic properly and collectively without mistrust raising its ugly head on either side.

Meaningful Interventions

If one does not accept the multi-faceted nature of the HIV/AIDS problem1 plus the role of soiled needles23 24, then even the most elaborate interventions will miss the mark. If the effects of behaviour change and condom use “were not translated into any measurable reduction in HIV-1 incidence”50, then perhaps non-sexual parameters of HIV transmission needed looking at seriously. “Evaluation of promising interventions” as has recently been pointed out, “is essential to the success of HIV prevention”51. To assume that sex is the overwhelming cause of the havoc in South Africa will leave unexplained the HIV-Positive virgins whose mothers are HIV-Negative.23 Meaningful interventions at the grass-roots using appropriate technology in Kenya have been emphasized by Professor Thairu52, and domiciliary management of AIDS in Ghana by Professor Quartey and team53, without resort to anti-retroviral drugs, has been shown to be cost effective. They proved the value of a decentralized approach to the epidemic. For instance, in my Manya Krobo tribe in Ghana where we have clearly worked out the local clinical epidemiology to perfection4 13, we know that only targeting the main local cause of the epidemic can be of any use. Yet, the centralized National AIDS prevention campaign appears not to be tackling root causes, and the problem just gets worse and worse despite the “wear condoms” slogans recommended from abroad by those who supply funds to the tribe.

We need the kind of comprehensive approach which looks at everything3 4 12 20. Girls trading in sex within the tribe got much less than one Dollar per client, but if they went across Ghana’s boundaries to nearby Ivory Coast, or Togo, or Burkina Faso (all ex-French colonies) one coital act fetched them 25 Dollars. Not once have I heard the catastrophic role of international prostitution mentioned as a factor in the spread of HIV/AIDS. To distribute condoms to these girls in a survey to see the effect on HIV spread is to betray ignorance of what happens at the grass roots. These girls are not in a position to give ‘wear condom’ instructions to their clients? Even when ‘abnormal sex’6 which they themselves confess is “very harmful”3 4 13 is demanded of them they acquiesce but, as one girl informed me in Burundi “mais je le demande une grande somme d’argent14. A meaningful intervention against HIV/AIDS for such a girl in Hotel Source du Nil in Bujumbura was not a generous supply of condoms, but a sewing machine. “If I get a sewing machine, Monsieur le Docteur, or a type writer, or both, I shall stop this dirty job”3 13[page 143], she told me in tears. By the time I could send her the sewing machine from England, Anna-Marie was dead.

If South Africans do not quantify each single contributing cause of their epidemic, identifying whether there is an iatrogenic dimension or not, then little progress will be made. If in any country, interventions meant to help, are rather producing a deteriorating situation, then remember Tuskegee, and hidden agenda cannot be ruled out. The so-called interventions must somehow be contributing to the deteriorating situation. Unthinkable, yes, but one requires a brain paradigm shift to make it thinkable. The same NGO can contain foreign helpers where the left hand does not know what the right hand is doing. While the left is working for “The planet in 2050”, and must needs rejoice “over the possible elimination of black people by disease”1 the right hand is relieving pain and suffering of the African here and now.

I did ward rounds with a remarkable ‘white lady doctor’, as she was called in Uganda. “Dr Miriam Duggan, the obstetrician-gynaecologist medical superintendent of the large St Francis Hospital, Nsambya, in Kampala”, I revealed, “was saddened by the way that external research agencies lost interest whenever she mentioned the need for strengthening her clinical epidemiological research base to enable her go round the villages to follow up and treat patients with AIDS who had been discharged, and to measure longevity”4. I am delighted to learn that Sister Duggan, who is a practising Christian, has managed to remain in Africa, toiling at the grass roots. Many other good ‘white doctors’ who also took me on ward rounds in sub-Saharan Africa, have left the continent. Some of them did so suddenly. I often wondered whether they saw what was happening, raised objections, and were asked to leave by the NGO’s that sent them there. But no one can force godly missionaries to leave. How successful an NGO is in controlling disease, suffering, and death of the African depends not on the “organization” but on the philosophy of the brains behind it. Godly missionaries have one philosophy: they slave away to relieve suffering in 2003 AD. Others prefer to talk about Africa’s population in 2050 AD.

Even ‘Malaria Control’ in Africa (preventing the death of 3 million children every year) would also not succeed if those in charge of the programme were some population-control-by-hook-or-by-crook experts, leading me once to remark: “But would averting a malaria disaster not upset the population control lobby?”54. Population containment achieved ethically to enable Africans have enough food to eat and maintain a reasonable standard of living is a good thing, as Professor Fred Sai has always maintained55 56, but population control by hook or by crook, ie through man-made epidemics19 is very wrong – to use President Clinton’s phrase.26

Action, please, before it is even more too late

Alas, it is all too late because no scientist was prepared to heed Lancet’s warning 35 years ago, and defuse the Biological Bomb. There are more explosions to come, “lying at the heart of the cellular nucleus, ticking us to destruction.”19 The experiments for ‘hidden agents’ have not stopped. Scientists are still doing what they like with the human genome, entering a realm of great potential for evil. Lake Superior State University invited some 21 of us to produce a Symposium on the “Human Genome Diversity Project”57 and published it in one volume with another Symposium titled “Is Humanity destined to self-destruct?”57

We were asked to comment on David Resnik’s earlier contribution on the ethical aspects of the HGDP58. Professors Alper and Beckwith discussed the potential for racism in the project59, and Professor Frank Dukepoo, “a full blooded Hopi/Laguna American Indian”60 mentioned how “the potential for ‘scientific racism’ is high and potentially explosive”60. Dukepoo underlined the same fear Lancet expressed 35 years ago: “If we race forward with biomedical/biogenetic research and ignore ethical, legal, social, and other issues, we will suffer the consequences”60. Scientists are capable now of fashioning and modifying genes to produce specific ‘hidden agents’ for different ethnic groups. So when we hear that a new HIV vaccine is bad for whites, but good for Africans and Asians61 what is a suspicious and paranoid African supposed to think? Dukepoo continues: “When recombinant DNA technology became a reality, eleven of the leading scientists in the new field of molecular biology published an open letter on July 26, 1974, asking their colleagues to initiate a self-imposed moratorium on conducting high-risk DNA recombinant experiments (Rifkin 1998).62 In the end, the moratorium was lifted as moral responsibility was trampled by financial interests. Will history repeat itself?”60

How much of that work could have been going on in South Africa which allowed the country to have “the highest number of people with HIV in the world”1? When Joseph Chamie, director of UNDP, was quoted in Lancet last month as saying “HIV/AIDS is a disease of mass destruction”63 what else do we want to hear before we take some kind of action? And, looking around, The Third World (“the unfavoured races”) is where this destruction is greatest. Richard and Rosalind Chirimuuta64 have always maintained that AIDS is linked to racism. Close to tears, I once pleaded: “Finally if, God forbid, it is proven that this whole AIDS mess began in a laboratory with scientists tinkering with genes of baboons and humans, then the most powerful nations on earth should call a conference and halt such research forthwith.”13[page 160] Nobody heard me.

Conclusion

What is happening in South Africa is more than meets the eye. With scientists confessing to what they had been doing in molecular biology laboratories during the apartheid regime1, it is difficult to escape the conclusion that the hyper-escalation of the HIV/AIDS problem from zero incidence in the black population less than 20 years ago, to being the world’s leading problem is not a natural phenomenon. Oxford’s Professor George Fraser has translated from the German edition Benno Muller-Hill’s “Murderous Science: Elimination by Scientific Selection of Jews, Gypsies, and Others, Germany 1933-1945.”65 The evil of Nazism could be going on surreptitiously right now to get rid of the “less favoured races”. World Democracies, please help! Sometimes we are told: “These things are matters of National Security, and cannot be probed”. Can’t they?

Epidemiology of HIV/AIDS varies from place to place3 4 13 so if we get the methods of propagation wrong in a particular place, we shall get our “interventions” wrong as well, and the situation will get worse and worse. We have just been told: “A group convened by the World Health Organization has reiterated its view that unsafe sex is the principal route by which HIV spreads in Africa.”66 The account went on: “The group rejected the idea put forward recently in an AIDS journal that the careless use of injections was a major factor in spreading AIDS”. Then comes the usual expert opinion: “Such suggestions ‘are not supported by the vast majority of evidence’, the group said, adding that unsafe sexual habits continue to be responsible for the majority of infections. But it did acknowledge the dangers of dirty needles”66. But this statement begs the question. How can any expert explain scientifically how South Africa had negligible HIV/AIDS incidence just before apartheid was overthrown, but has since climbed to overtake the whole world to be Number One? Would the group assembled by the WHO explain in simple epidemiological terms how it was possible for the Zevenfontein community in South Africa to be 85% sero-Positive? Could this WHO group exclude Murderous Science65? If, as these experts claim, “careless use of injections”66 cannot be blamed for much of what is happening in South Africa and the rest of sub-Saharan Africa, what about the “careful use” of injections as happened in Nazi Germany65? Have we proven beyond all reasonable doubt that there are no present-day scientists with Nazi proclivities? Even when some such have confessed in South Africa1? Fassin and Schneider’s article1 would be utterly useless, if it did not wake us up to do something about this catastrophe. Paranoid Africans need urgently to be freed from their fear.

Secretary General of the UN, Mr Kofi Annan, finished his Foreword67 to a recent book co-authored by a German and a Ghanaian68 thus: “While not everyone will agree with the specific strategies proposed by the authors, I believe that this book will stimulate constructive debate which will bring us closer to the objective of worldwide HIV/AIDS prevention and control.”67 The book, with a ‘Question & Answer Format’ has provided answers to scores of questions, the very first of which is:

“Are current concepts for combating HIV/AIDS in developing countries adequate?” and the answer they give in bold letters is this:

“Absolutely not! There is an urgent need to change the paradigms of thought and action”68.

If we do not urgently “change the paradigms of thought”68 and look beyond sex and the African’s alleged hyper-sexuality, we shall be unable to change our “action”68, and we shall plunge the continent into deeper and deeper catastrophe, with the continuing victim-blaming repertoire produced by the world media – if these Africans do not change their sexual habits, they will all be wiped out, and “Africa left to the lions”69.

If the main problem, as I see it, is that of ‘Human Immune Deficiency DNA’ genetically engineered and purpose-built to wreak havoc on the immune system, then the approach, therapeutically, must be emphasis on immune boosters. Such immune enhancing products are available among some African traditional healers the success of at least one of whom was verified and reported to the WHO in Geneva21 70. If the ultimate aim of AIDS patient- management is to help ameliorate the circumstances of ailing Africans and, as Kofi Annan said, “bring us closer to the objective of worldwide HIV/AIDS prevention and control”67, then anything that enables sufferers to improve so that they can go back to their farms should be encouraged. Control of the epidemic needs to be left in the hands of those who want to relieve suffering, and not of those who secretly or openly rejoice1 when they hear the horrendous figures of the dead being broadcast weekly by the world’s media.

Please, let the reaction of readers of this article not be: “But O, we have heard it all before. There is nothing new in it. These Conspiracy Theories will go on and on. Let these Africans just stop being promiscuous, and the problem will be solved. The majority of the available evidence shows that all this is total nonsense.” And so on. We shall otherwise be stuck in the AIDS calamity hole.

I am praying hard for a 21st Century William (or Williama) Wilberforce who will be bold enough to help save the African from this predicament. My William Wilberforces would need the staunch support of the three British Editors who had the integrity to publish statements that called a spade a spade: Lancet [“The Biological Bomb19…public health in reverse19…HIV/AIDS is a disease of mass destruction”63], Nature [“Artificial HIV?”17], BMJ [“Issues of race hinder public health29…and they even publicly rejoiced over the possible elimination of black people by the disease, as one member of parliament did in 1992”1]. I appeal to any godly person reading this communication: Please, pray that the conscience of even the most ungodly and Nazi-like scientists involved in such evil research and programmes for “elimination by scientific selection”65 will be smitten, to make them confess, and repent. Things are going to be much, much, worse. If such research continues, then more viruses will be announced from time to time as just having “emerged” [HIDDNA-1, HIDDNA-2, HIDDNA-3, etc]. And Central Africa is always a convenient place whence they do emerge. There could be as many HIDDNA viruses as there were laboratories, capable of fashioning the ‘hidden agents’ to match different ethnic groups globally. Things are unlikely to get better until the required population reduction is reached after 2010, according to the “projections”. Meanwhile, for little symptomatic mercies, perhaps the last paragraph of my Editorial to The AIDS Letter of The Royal Society of Medicine might help some people re-examine their ‘Intervention Programmes’:

“Finally, the kind of research that will help Africans curtail AIDS does not have to be the vaccine-oriented research of the developed countries. Public health methods and clinical epidemiology are the best tools. Ultimately, modification of sexual behaviour through secular and spiritual education, backed by provision of light industries to generate the kind of foreign exchange in search of which the girls go into prostitution, is by far the best approach to AIDS prevention in Africa. I know that in addition to the multitude of Africans living abroad, there are many non-African friends of the continent who, when told what is happening, are prepared to donate their help at the grass roots level on the lines mentioned above.”12

F I D Konotey-Ahulu MD(Lond) DSc(UCC) FRCP(Lond) DTMH(L’pool) FWACP Fellow of The Ghana Academy of Arts & Sciences and Fellow of The Third World Academy of Sciences Kwegyir Aggrey Distinguished Professor of Human Genetics Faculty of Science, University of Cape Coast, Ghana, and Consultant Physician, Tropical Medicine Dept., Cromwell Hospital, London SW5 0TU [E-mail: felix@konotey-ahulu.com]

Acknowledgements: I thank my wife Rosemary for agreeing that I could borrow money to travel to African countries to study AIDS at the grass roots. I am grateful to all the people who agreed to see me including Ministers of Health, Directors of Medical Services, and Doctors who took me on ward rounds. I also thank Ghana’s Professor John Kwashie Quartey and his Domiciliary Management Team who tackled AIDS in my tribe, and Kenya’s Professor Kihumbu Thairu who taught me the importance of using appropriate and affordable means for tackling the problem. I also thank no less than 118 ladies of the sex trade who agreed to talk to me privately even while on duty in many of the sub-Saharan African countries. I am grateful to the Editors of the medical journals, especially the British ones, who agreed to publish almost anything I sent to them. Finally, I thank my GOD, who delivered me from a terrible accident while traveling by car from Kigali to Butare in Rwanda, and who was able to make me dodge coups from one country to another.

Funding: None

Competing Interests: Presently in search of Funds (1). To help reduce the burden of Sickle Cell Disease in the next generation in Ghana, and in Ghanaians in the UK and USA, with Genetic Counselling and Ethical Family Planning: www.sicklecell.md and (2). To reduce HIV/AIDS incidence in my tribe by helping the Paramount Chief, King Nene Sakitey II tackle the roots of the epidemic in Manya Krobo in south-east Ghana, and teach the Krobos to read Literature in their Mother Tongue: www.aidsinafrica.co.uk

1 Fassin D, Schneider H. The politics of AIDS in South Africa: beyond the controversies. British Medical Journal 2003; 326: 495-97. (1 March.)

2 Stewart GT, de Harvey E, Fiala C, Herxheimer A, Kohntein K. The debate on HIV in Africa. Lancet 2000; 355: 2162-63.

3 Konotey-Ahulu FID. Some thirty features of AIDS in Africa. Annales Universitaires des Sciences de la Santé 1987; 4: 541-44.

4 Konotey-Ahulu FID. Clinical epidemiology, not seroepidemiology, is the answer to Africa’s AIDS problem. Briitsh Medical Journal 1987; 294: 1593-1594.

5 Konotey-Ahulu FID. Group specific component and HIV infection, Lancet 1987; 1: 1267.

6 Konotey-Ahulu FID. Origin and transmission of AIDS. Journal of Royal Society of Medicine 1987; 80: 720.

7 Konotey-Ahulu FID. Extensive palatal echymosis from felatio – a note of caution with AIDS at large. British Journal of Sexual Medicine 1987; 14: 286-87.

8 Konotey-Ahulu FID. Surgery and risk of AIDS in HIV-positive patients. Lancet 1987; 2: 1146

9 Konotey-Ahulu FID. AIDS in Africa: Misinformation and Disinformation. Lancet 1987; 206- 08.

10 Konotey-Ahulu FID. AIDS in Sub-Saharan Africa. Lancet 1988; 2: 163-164.

11 Konotey-Ahulu FID. HIV-2 in West Africa. Lancet 1989; 1: 553.

12 Konotey-Ahulu FID. An African on AIDS in Africa. (Guest Editorial). The AIDS Letter – Royal Society of Medicine 1989; No 11, Feb/March, 1-3.

13 Konotey-Ahulu FID. What Is AIDS? Tetteh-A’Domeno Company, Watford, England, 1989.

14 Konotey-Ahulu FID. HIV antibody positive sub-Saharan African patients in UK. Lancet 1990; 335: 46-47.

15 Duesberg PH, Ellison BJ. Is the AIDS virus a Science Fiction? Immunosuppressive behaviour, not HIV, may be the cause of AIDS. Policy Review (The Heritage Foundation). Summer 1990, Washington DC.

16 Konotey-Ahulu FID. AIDS in Africa. Policy Review (The Heritage Foundation). Fall 1990, Number 54: 78-79, Washington DC.

17 Seale J. “Artificial HIV?” Nature 1988; 335: 391

18 Daniels VG. AIDS – The Acquired Immune Deficiency Syndrome. Lancaster 1987. MTP Press, UK, Second Edition.

19 Annotations. The Biological Bomb. Lancet 1968 (March 20); 1, 465.

20 Konotey-Ahulu FID. Slowing HIV contagion among Africans. International Journal of Sexually Transmitted Disease & AIDS 1991; 2:139

21 Konotey-Ahulu FID. AIDS in Africa: Another Perspective. International Pharmacy Journal 1992; 6: 92-99 (English & French).

22 Konotey-Ahulu FID. African AIDS through African eyes (Guest Editorial). AIDS Analysis Africa 1991; no 1 p 11, March/April.

23 Gisselquist D, Rothenberg R, Potterat J, Drucker E. HIV infections in sub-Saharan Africa not explained by sexual or vertical transmission. Int J STD & AIDS 2002 Oct; 13:657-66.

24 Science In Action. The ravages of AIDS in Africa. BBC World Service 1987 18 October, GMT 09.15 to 09.45.

25 Hawkes N, Dynes M. Botched vaccinations blamed for AIDS in Africa. Times; Thursday February 20 2003, p 3, London.

26 Clinton President W J. Apology on behalf of the American government to survivors of the Tuskegee Syphilis Experiment victims. Worldwide radio & Telvision. May 16 1997.

27 Jones JH. Bad Blood: The Tuskegee Syphilis Experiment. New York: Free Press, 1981.

28 Financial Times. AIDS in South Africa. Friday, 20 September 2002, page 14.

29 BMJ. Understanding AIDS in South Africa: Issues of race hinder public health. 1 March 2003; 326, outer cover.

30 Konotey-Ahulu FID. AIDS in Africa. Lancet 2002; 360: 1424

31 Njuma Times. Ssali escapes panga attack. January 27 1998, p2.

32 Konotey-Ahulu FID. Black people’s red faces and AIDS prevention. Lancet 2000; 355: 1559

33 Robinson M. The last miracle of Nana Drobo. The African Chief and his Miracle Cure for AIDS. The City Magazine, Tokyo; Dec 1992, pp24-31.

34 BBC Radio 4. The World This Weekend: AIDS Conference, Spain, July 7 2002 - 1 pm .

35 Neequaye AR, Neequaye J, Mingle JA, Ofori-Adjei D. Preponderance of females with AIDS in Ghana. Lancet 1986; 2: 978.

36 Times (Editorial). The World in 2050. Gains and strains as population growth slows. Saturday March 1, 2003 p 29, London.

37 Shenton Joan. Positively False. Exposing the Myths around HIV and AIDS. London I B Taurus. 1998.

38 Hooper Edward. The River. A Journey Back To The Source of HIV and AIDS. London. Allen Lane. Penguin Press. 1999.

39 Karpas Abraham. Origin of the AIDS virus explained? New Scientist. July 16 1987.

40 Eales L-J, Nye KE, Parkin JM, Weber JN, Forster SM, Harris JRW, Pinching AJ.Association of different allelic forms of group specific component with susceptibility to and clinical manifestation of human immunodeficiency virus infection. Lancet 1987; 1: 999-1002. 41 Eales L-J, Nye E, Pinching AJ. Group-specific component and AIDS: Erroneous Data. Lancet 1988; 1: 936.

42 PANOS. AIDS and the Third World. The Panos Institute. London 1986.

43 Essex M, Kanki P. Comparison of simian immunodeficiency virus isolates. Nature 1998; 331: 621-22.

44 Mulder C. A case of mistaken non-identity. Nature 1988; 331: 562- 63.

45 Darwin Charles. The Origin of Species By Natural Selection Or The Preservation Of Favoured Races In The Struggle For Life. London 1859. Reprinted, Penguin Books 1968.

46 Konotey-Ahulu FID. The Human Genome Diversity Project: Cogitations of An African Native. Politics and the Life Sciences (PLS) 1999; Volume 18: No 2, 317-322

47 Bowman J, Murray RF. Genetic Variation and Disorders in Peoples of African Origin. Baltimore/London: The Johns Hopkins University Press.

48 TIME Magazine. How well do you share? Ricoh Image Communication Advert featuring Aficio solutions. (Inside Cover) December 16, 2002.

49 ACTS of The Apostles. Conversion of Ethiopian Eunuch through Apostle Philip. Chapter 8 verses 26-40.

50 Kamali A, Quigley M, Nakiyingi J, Kinsman J, Kengeya-Kayondo J, Gopal R, Ojwiya A, Hughes P, Carpenter LM, Whitworth J. Syndromic management of sexually -transmitted infections and behaviour change interventions on transmission of HIV- 1 in rural Uganda: a community randomized trial. Lancet 2003; 361: 645-52.

51 Stephenson Judith M, Cowan Frances M. Evaluating interventions for HIV prevention in Africa. Lancet 2003; 361: 633-634.

52 Thairu K. Appropriate Technologies for AIDS Management in Africa, Editor. Kenya Medical Research Institute, Nairobi, 3-7 September 1990. Commonwealth Secretarait, London.

53 Quartey JKM, Konotey-Ahulu FID. The domiciliary management of AIDS in a rural community in Africa. In: Appropriate Technologies for AIDS Management in Africa, 3-7 September 1990. Editor Thairu K. Kenya Medical Research Institute, Nairobi. Commonwealth Secretariat London, pp 42-44.

54 Konotey-Ahulu FID. Averting a malaria disaster. Lancet 1999; 354: 258.

55 Sai FT. Dr Fred Sai speaks out. International Planned Parenthood Federation, London 1994.

56 Sai FT, Chester LA. The role of the World Bank in shaping Third World Population policy. In: Population Policy – Contemporary Issues. Editor G Roberts, New York, Praeger 1990.

57 SYMPOSIA: First Symposium: Is Humanity Destined to Self Destruct? Second Symposium: The Human Genome Diversity Project. Politics and The Life Sciences (PLS) September 1999, Volume 18, Number 2, pages 201-284; 285-340.

58 Resnik DB. The Human Genome Diversity Project: Ethical Problems and Solutions. Politics and the Life Sciences 1999; 18; 15-23

59 Alper JA, Beckwith J. Racism: A central problem for the Human Genome Diversity Project. Politics and the Life Sciences 1999; 18: 285-288.

60 Dukepoo Frank C. More than the Human Genome Diversity Project. Politics and the Life Sciences 1999; 18: 293-297.

61 McCarthy Michael. HIV vaccine fails in phase 3 trial: Sceptics question subset analysis that suggests HIV vaccine could be protective in non-white people. Lancet 2003; 361: 755- 756.

62 Rifkin J. The Biotech Century. New York: Penguin Putnam, 1998.

63 Schlagenhauf Patricia, Ashraf Haroon. HIV/AIDS lowers UN’s global population estimates. Lancet 2003; 361: 841 [8 March].

64 Chirimuuta Rchard C, Chirmuuta Rosalind J. AIDS, Africa and Racism. London, Free Association Books, 1987/1989.

65 Müller-Hill Benno. Murderous Science: Elimination by Scientific Selection of Jews, Gypsies, and Others - Germany 1933-1945. [Translated from German by G R Fraser] Oxford. Oxford University Press, 1988.

66 Times (London). Unsafe sex “is main HIV danger”. Saturday 15 March 2003, page 8.

67 Annan Kofi. Foreword to HIV/AIDS: Knowledge Protects: New and Specific Approaches To Contain the Spread of HIV in Developing Countries, HH Repke, E S Ayensu. I Strauss Verlag GmbH, Postdam, Germany, 2001.

68 Repke Heinrich H, Ayensu Edward S. HIV/AIDS: Knowledge Protects – New and Specific Approaches to Contain the Spread of HIV in Developing Countries. I Strauss Verlag GmbH, Postdam, Germany, 2001.

69 Veitch Andrew. How do you avoid catching AIDS? The Guardian, November 21, 1986, page 21 [Medical Corresspondent].

70 Konotey-Ahulu FID. Probing anecdotes in traditional African therapeutics. African Journal of Health Sciences 1994;1:53-56

Competing interests:   Competing Interests: Presently in search of Funds (1). To help reduce the burden of Sickle Cell Disease in the next generation in Ghana, and in Ghanaians in the UK and USA, with Genetic Counselling and Ethical Family Planning: www.sicklecell.md and (2). To reduce HIV/AIDS incidence in my tribe by helping the Paramount Chief, King Nene Sakitey II tackle the roots of the epidemic in Manya Krobo in south-east Ghana, and teach the Krobos to read in their Mother Tongue, thus facilitating Health Education: www.aidsinafrica.co.uk