An exchange of letters on AIDS/HIV
26 August 2000
The World Socialist Web Site has received the following letter from a reader on HIV/AIDS, to which Chris Talbot replies below.
I am writing to take issue with your stand on AIDS and HIV [see: South Africa: The ANC government and the AIDS crisis]. I would argue that, as socialists, you are abrogating your responsibility to the world, and to the working class, by your stance.
It is the role of the socialist to oppose all oppression, and find the democratic solution to the structures of oppression. This arises out of the socialist ethic, which has always held that if there was democracy, then private property, corporate hegemony, and the profit motive would be voted out of existence in favor of a society that took responsibility for its citizens. (It hardly works out that way, but that is the ideal that drives the socialist project in its harder and more direct activities.) In your stand on AIDS, you obviate this ideal.
What are the problems with the HIV theory?
1- The conclusion that HIV causes AIDS is arrived at by definition, not because a real process of biological causation has been discovered, investigated and described. Science discovered a correlation between the presence of HIV and AIDS in most AIDS cases, but no description of how it works.
2- The correlation was never absolute, so it was defined as absolute, to pretend to scientificity. One of the early embarrassments of the HIV theory was that AIDS occurred without the presence of HIV in 8 percent of the cases studied (1990). AIDS is a syndrome characterized by a dysfunctional immunological system, in which opportunistic diseases kill the person because s/he [has] no defenses against it. HIV doesn't kill the person. In order to define HIV as the virus that causes AIDS, science defined AIDS as a devastated immunological system in which HIV is present. Those cases in which the immunological system is devastated, but HIV is not present, were declared, by definition, not to be AIDS. Such cases were simply immuno-deficient. This is not science. It is really a form of sociology.
3- There is still no data to conclusively, scientifically, biologically prove that HIV causes AIDS. When the AIDS conference wanted to convince Mbeki that he was wrong, all they could say was the 5,000 scientists had "declared" that HIV causes AIDS. It was a political move.
4- The HIV test does not test for HIV, but for HIV antibodies. Leaving aside the central inversion incurred here (namely, that the presence of antibodies in every other disease indicates that the body has the disease under control, except for AIDS, in which the presence of antibodies means the body does not have the disease under control), the HIV test has not been shown to be specific for HIV antibodies. In fact, the HIV test shows positive for a number of other disease antibodies — in particular, malaria.
5- All scientists (and politicians) who have questioned the HIV theory have had their funds cut off, been denied a forum in the pages of scientific literature, and been essentially suppressed.
The role of the socialist is not to take a stand on a scientific controversy in its own terms, especially if it is being decided politically by a process of ideological definition. The role of the socialist is to oppose oppression. In this case, it would mean opposing the suppression of the scientists who question the HIV theory, and welcoming that questioning. It would mean calling for an opening of the debate and dialogue. If HIV causes AIDS, then opening the space to questioning will eventually prove it, and make for a stronger approach to the disease. If HIV does not cause AIDS, then suppressing those scientists who raise that question will insure that it will take a long time to find out what causes AIDS, during which time, millions will have died — thus, being a double act of oppression. (It is ironic, though consistent with the logic of suppression, that the suppression of certain scientific questions might cause millions to die, but they are being suppressed with the claim that millions are dying.)
You have to ask yourself why the west, the US government, and the US media got so upset about Mbeki asking questions about AIDS. After all, that is all he did. He made a phone call to Duesberg and it made the front page [Peter Duesberg, professor of molecular biology at the University of California, Berkeley, is generally regarded as the leader of the AIDS "dissidents" or more accurately "denialists", i.e. scientists who deny that HIV causes AIDS—editor]. What is the west afraid of? Well, we all know. AIDS has become, over the last decade, the predominant means of cultural control of Africa. The west makes a claim to data on African AIDS cases that it does not have — it arrives at it through computer projection. The west then uses this to cover up the fact that starvation devastates the immunological system — such starvation being produced by the IMF's SAPs. [Structural Adjustment Programs—editor] Thus, it blames the resulting deaths on AIDS without testing for it, uses this to put these countries further into debt to the IMF, and insures its cultural position in African through its "humanitarian" concerns, voiced through all the institutions of the world. (We must not forget that "humanitarian" for the US means dropping bombs on civilians.) And in Africa, the term "humanitarian" is the brightly colored billboard that sits in front of, and hides, threats of economic embargo.
You have accepted the theory that HIV causes AIDS, in your writing on South Africa and AIDS. You have therefore joined forces with oppression, and in particular, with those who are suppressing scientists who question the HIV theory, and with those who seek to defend the IMF's position in Africa.
Dear Mr Martinot,
In your desire to oppose the "structures of oppression" and your haste to accuse the World Socialist Web Site of abrogating its responsibility to the working class, you have uncritically accepted the arguments of the AIDS dissident scientists. For someone who claims to be a socialist, accepting these arguments without reviewing the vast amount of scientific evidence and detailed analysis which refutes their claims is light minded and—given the serious nature of the issue—extremely irresponsible. (Some of the material available on the web refuting the dissidents is listed at http://www.niaid.nih.gov/spotlight/hiv00/default.htm).
I will come back to your definition of socialism, but to address your other points in order:
1. It is true that scientists have much to learn about the mechanism by which HIV causes AIDS. But your demand for knowledge of "a real process of biological causation" — presumably in the sense of molecular processes within the human cell—before accepting that the cause of a disease is known is frankly ridiculous. In most of medical science, such processes are not yet known or fully understood. The standard approach used to establish the cause of a disease is whether Koch's postulates are satisfied. As well as a high statistical correlation, this requires that the pathogen can be isolated outside the host and that the transfer of the pathogen to an uninfected host (man or animal) produces the disease. There are dozens of scientific papers establishing that HIV causes AIDS in this sense.
2. It is true that the standard medical definition of AIDS includes infection with the HIV virus. There is nothing unscientific or “sociological” about this approach—it is done to make accurate diagnosis possible. If AIDS is defined in your terms as “a syndrome characterized by a dysfunctional immunological system, in which opportunistic diseases kill the person because s/he [has] no defenses against it”, then how does one detect this condition in practice? (Incidentally, your definition is not as broad as Duesberg's. He takes a definition of immunodeficiency that is so mild; it contains people who are not dying). A low count of CD4+ T-lymphocyte cells is the usual choice. This is probably where your 8 percent figure comes from, because there are some people with low CD4+ counts who are not HIV infected. For a case of AIDS, however, the CD4+ count must remain low for a period (over years it steadily declines). A number of detailed studies have failed to find people in this latter category who are HIV-negative, unless they are suffering from classic diseases (cancer, tuberculosis, etc.) that were on the scene before AIDS.
3. Gathering the signatures of 5,000 scientists was not just making a “political move”, but asserting a case, which is backed up by a huge amount of detailed research.
4. Your remark that the presence of antibodies in every other disease aside from AIDS indicates that the body has the disease under control is not correct. There are diseases in which serious illness only occurs years after the initial infection—such as herpes and hepatitis. Such infections can stimulate the body to produce antibodies, in some cases for years without signs of obvious clinical illness.
Your statement on HIV testing is a myth put about in AIDS dissidents' material based on one or two examples where the test has failed to work. In fact, current HIV antibody tests are more reliable both in sensitivity (giving a positive test when the person has the disease) and specificity (giving a negative result when the person is free of the disease) than tests for most other infectious diseases—giving a figure of over 98 percent for both. Since the tests are usually carried out more than once the results are extremely accurate.
5. You present no evidence for funds being cut off or forums in the scientific literature being denied. Duesberg certainly claims that this has happened to him. But neither of these occurrences is unusual in modern scientific practice and is not specific to AIDS dissidents. Government funds are increasingly allocated on the basis of whether the research will produce results of immediate use to business or commerce. Scientific journals are often edited by a conservative clique who rejects papers that do not conform to their conceptions. To say that the thousands of scientists who have experienced such problems are suffering "essential suppression" is pure hyperbole.
In most branches of science there are individuals or groups of individuals who challenge the accepted viewpoint or evaluation of the evidence. The free flow of information and debate is essential for scientific progress and in the natural sciences at least—where the demand for technological innovation predominates—even the present corporate climate with the demand for intellectual property rights has not stopped it taking place. Unorthodox views, if they have a rational basis, do eventually get taken seriously by the scientific establishment. All that usually happens to ideas that have insufficient credibility is that they get ignored. In the case of the theories put forward by Duesberg and his supporters, this is what happened.
Even with Duesberg's own history—he made a major contribution to cancer research—and with his combative style, he failed to make much of an impact in scientific circles. However, given the enormous public interest in AIDS and the feeling in the 1980s and early 90s that medical science had failed to deal with the epidemic, he and others found that their ideas were given considerable attention—by the mainstream media, by the gay rights community in the 1980s (who had hoped that HIV infection did not inevitably lead to AIDS), and by the religious right (who wanted to show that the cause of AIDS was a “dissolute lifestyle” and not an infection that could affect anyone). As anti-retroviral drugs became available, interest in the dissident views has perhaps waned, but the huge crisis over AIDS in Africa and now Mbeki's intervention has served to revive them.
To speak of the suppression of views in relation to the dissident scientists is nonsense. By using the media interest, and now a 750-page web site, Duesberg and his group of supporters have attracted substantial financial backing for their cause and widespread publicity for more than a decade. A series of articles in the London Times supported Duesberg and the ABC News medical correspondent Nicholas Regush, who recently gave support to the dissidents' views. According to the South African Mail and Guardian, in July 1999 copies of Duesberg's book, Inventing the Aids Virus, together with documents calling for an audit of government research spending, were circulated by a right-wing lobby to all members of the US Congress.
Your demand for an "opening of the debate" on this question is also somewhat ridiculous given the amount of material available on this issue, including thousands of pages on the Internet.
Neither is it true that socialists do not take sides in scientific controversies. Of course when scientific theories are still at the stage of a hypothesis that would be correct. But in dealing with a theory—such as the HIV cause of AIDS—which has been subjected to rigorous analysis, testing and practical applications, it is in the socialist tradition to defend it as part of a materialist outlook opposed to mysticism and superstition. This was the position which Marx himself took in relation to Darwin's theory of evolution. It is especially the case when the truth of the scientific theory, as you have observed, affects the lives of millions of people.
In this context, it should be noted that whilst the use of anti-retroviral drugs is not a cure for AIDS—and our position is certainly that research to produce a vaccine should receive massive funding and be taken out of the hands of the drug corporations—the suggestion by the dissident scientists that AIDS cannot be held in check by these drugs and deaths prevented is simply not true. Statistics for the US shows the dramatic decline of deaths from AIDS from 1996 onwards, the year in which three-drug combinations became widely used. More than anything else these figures refute Duesberg and co.
Your argument that AIDS has become the "predominant means of cultural control of Africa" is in the tradition of wild conspiracy theories on AIDS which have been put forward in both middle class radical and extreme right wing circles since the 1980s. For example, the nationalist demagogue Louis Farrakhan has put forward the idea that AIDS is part of a US government plan to eliminate blacks. Whilst such X-files -type theories have won support in the present climate of political confusion and antipathy towards Western governments, as well as distrust of the scientific and medical establishment, they have no connection with the tradition of scientific socialism.
In revealing conspiracies, such as the cover-up organised by the British government in relation to BSE (Mad Cow Disease), we have always insisted on a scrupulous examination of the evidence. It was certainly true in the case of BSE that government scientists, under pressure to keep their jobs and maintain funding, and under pressure to defend the beef industry, covered up the truth that the disease in cattle can spread to humans. However, there were scientists who did speak out against the cover-up and in some cases lost their jobs as a consequence. The material presented by these scientists was used by the British Socialist Equality Party at the time in exposing the threat to public health. (In contrast with the BSE case there is no suggestion, certainly not on the dissidents' web sites, that scientists have lost their jobs over the AIDS issue).
You are suggesting an approach to AIDS in Africa where Western governments, the United Nations, the World Health Organisations, as well as tens of thousands of scientists and aid workers are all involved in a conspiracy, which includes inventing the statistics about millions dying of AIDS. (I presume that by making "a claim to data" which the West "does not have" you mean that the figures are grossly exaggerated). That such a distortion of the statistics could be made on a global scale without any dissension from the thousands of professionals—working for various governments, including African governments as well as Non Governmental Organisations—who collect the statistics is inconceivable. But in any case, why go to such extremes to cover up poverty—the motive that you suggest for this collective lying operation? The West, (for example the World Bank and the UN), regularly makes figures available that demonstrate the rise in poverty and social decay in Africa resulting from IMF Structural Adjustment Programmes. Western politicians respond by blaming African regimes and leaders for their failure to sufficiently apply the free market prescriptions that are supposed to generate the wealth to overcome the poverty.
As well as disregarding the need for making a rational argument, you again avoid any discussion of the evidence. There are plenty of statistics that show the extraordinary rise in death rates of young people in countries like Zimbabwe and Botswana, which are by no means amongst the poorest in Africa. You may of course put forward the argument that statistics throughout sub-Saharan Africa are unreliable and "culturally controlled". (In fact this could be easily challenged—scientific papers presenting carefully collected data and computer calculations based on that data, i.e. standard statistical methods in use everywhere, are available for a number of African countries). But you cannot challenge recent data from South Africa, which is incontrovertible. Even Mbeki has to admit there is an AIDS crisis in South Africa because the figures show huge increases in death rates from AIDS, which even affect people in areas not overwhelmed by poverty.
Mbeki's problem is that as a capitalist politician, and a strong supporter of free market policies, he has to divert attention from the fact that he has no intention of seriously challenging the Western governments over this issue; of demanding the huge mobilisation of international resources and finance that would be needed to address the AIDS crisis in Africa and throughout the underdeveloped countries. Promoting the dissident scientists and making demagogic remarks about poverty being the "real problem"—without advancing any policies to combat this—have been a useful ploy. Mbeki and the ANC government, who are carrying through drastic cut backs in state spending as part of a privatisation programme—which in turn increases poverty and unemployment—are hardly in a position to demand public finance to deal with the AIDS epidemic. So far they have refused to pay for anti-retroviral drugs even for HIV positive pregnant mothers or victims of rape. Since their whole economic programme is based on attracting Western investment they are also unable to seriously oppose the transnational corporations' huge profits made from drugs that combat AIDS.
Finally, permit me a brief comment on your approach to socialist politics. Your definition of socialism, which is based on vague and abstract conceptions of democracy and oppression, is as lacking in critical thought and serious study of the questions involved as your approach to AIDS. It is probable that your ideas are derived from the radical protest milieu. Can I suggest that rather than wasting your time further, you make a study of the scientifically derived approach to socialism, based on an understanding of the class character of capitalist society, developed by Marx, Lenin, Luxemburg, Trotsky and others, which you will find elaborated in the WSWS.