Peter J Flegg,
Blackpool Victoria Hospital, UK FY3 8NR
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I never cease to be amazed at the degree of rampant paranoia and victimisation that threads through HIV dissidents' discussions about HIV research, its funding and its publication.
Since David Rasnick is involved in this discussion within the pages of the BMJ, perhaps he can ask Richard Smith what the journal's policy is on approving papers for publication, and what the view of other similar journals may be. I doubt that a Pubmed search for publications "for" and "against" HIV will tell us anything of note. Rasnick implies the numerical lack of papers "against" would corroborate his theory of a pro-HIV conspiracy. However, this would no more vindicate him than the lack of publications espousing a "flat earth" in geophysics journals would indicate a conspiracy against flat-earthers.
Apart from the allegations in Duesberg's book and some other indirect evidence Rasnick mentions, is there any real evidence that research concerning "alternative" theories on AIDS is deliberately not funded, or results unpublished? (Or is there only anecdote? - As a scientist I assume Rasnick would wish to see irrefutable evidence before making accusations - are there any controlled trials??? Any double-blind studies???) ;)
Let me remind everyone how we have arrived at our current state of knowledge concerning HIV. The initial years were full of uncertainties and a number of theories concerning the aetiology, epidemiology and transmission of the agent that causes AIDS competed for dominance. There are still contentious areas of debate, and such areas are fruitful targets for research (along with funding, and if appropriate, publication). Progress has been made largely through a process of inductive reasoning in keeping with the modern scientific method. The fact that there is now near -universal acceptance of HIV's existence and role in the pathogenesis of AIDS is the result of scientific consensus achieved because of the results of this research accrued over the years.
I know Rasnick refuses to accept it, but HIV causes AIDS. Why should precious funding be diverted to now try and disprove this fact? HIV ranks among the main threats to mankind, yet Rasnick seems to bemoan the fact that $118 billion has been spent on it. How much has the space programme consumed? How much does a war in Iraq cost? How much money poured into Duesberg's research coffers when he was fruitlesley chasing viral causes of cancer? Did he complain then that someone's research proposal on the wherabouts of Elvis was unable to get funding? Rasnick alleges that not a single penny has gone to fund those who dispute the orthodox view of HIV, but his letters are seemingly filled with references to publications supporting his views. (In my opinion these are usually incorrectly cited, but either way can Rasnick not see the inconsistency of his position here?)
Rasnick states: "It would require superhuman courage and integrity on the part of numerous government officials and the directors of the National Institutes of Health, the Medical Research Council, the World Health Organization, and the Centers for Disease Control, and of countless physicians, scientists, health care workers, journalists, celebrities and average citizens, to admit that they made a big mistake--that they got it all wrong about AIDS".
Has Rasnick never, ever contemplated the far more likely scenario, namely that he is the one who has got it all wrong, and that everyone else is right?
Rasnick again accuses me of ignoring his questions on the nature of HIV. He is ignoring my answers. I have shown him where to look, and pointed out that others before me such as Brian Foley have provided numerous references and sources. It becomes frustrating when the horse that one has led to water will not drink, but Rasnick, for all his proclaimed thirst, seems reluctant to even take the first few few steps towards the river.
Rasnick brings up the "simple" questions that President Mbeki asks. These are:
1) Why is AIDS in Africa so completely different from AIDS in the USA and Europe?
Answer: because differences in environment and pathogen prevalence determine the different manifestations of immunosuppression. For example, leukaemic children in Africa get different infections to leukaemic children in Norway. However they both still have leukaemia.
2) How does a virus know to cause different diseases on different continents?
Answer: see answer to 1) above. Remember, the virus causes immunodeficiency, and not the infections/diseases directly. And the diseases are not different; they just vary in geographic prevalence.
3) How does a virus know if you are male or female, gay or straight, white or black?
Answer: It doesn't. Its just a microorganism, like hepatits B, or syphilis, or malaria. The different prevalences for HIV depend upon many factors such as host genetic susceptibility, population demographics and dynamics, coinfection with other STDs, variation in sexual behavioural, variation in exposures through non-sexual routes, viral transmission dynamics,etc.
I can only presume that because hepatits B's epidemiology is similar to that of HIV, Rasnick/Mbeki must dispute its existence also. Or that because syphilis rates differ between races this means it is not sexually spread. Or because malaria affects Africans more than Europeans it must have a predeliction for dark skin.
Rasnick says (of HIV antibodies) "When you protest this absurdity and point out to health care workers that antibodies are the very essence of anti- viral immunity your objections are met with either contempt or embarrassed silence."
I am afraid that I have to meet this objection with contempt. I have lost count of how often Rasnick has had it explained to him, but antibodies merely indicate immune recognition. For chronic or latent infections they indicate ongoing infection (mainly because the immune response is not fully effective at eradicating the infection), and do NOT represent a cure. The repeated failure of a biomedical scientist to grasp this point after several attempts at explanation displays either a deliberate intent to remain in denial of the facts, or stupidity. Since Rasnick is obviously not stupid, I suspect the former explanation in his case. The embarrassed silence he experiences when raising his theory about antibodies with other health care workers is probably because they are too polite to correct the glaring errors in his logic.
Competing interests: None declared