Sep 26
Posted by: benvincent  

At the end of April this year, a 90 minute film was released directed by a man called Brent Leung. This film was titled ‘House of Numbers’, and is shot in a documentary format with the claim of ‘objectively investigating whether HIV exists, and whether HIV causes AIDS’. The narrative soothingly reassures the audience that an objective and balanced approach is being taken, whilst the presentation in fact hugely attempts to lead viewers to a conclusion questioning scientific fact. The film gives credence to entirely invalidated arguments, and demands debate over subject matter long since resolved.

Mr. Leung claims on the ‘House of Numbers’ website in response to criticisms of the film by Huffington Post blogger Thomas DeLorenzo that:

“I am not a denialist. Posing questions is very different than denying something. Using that word and comparing it to holocaust denialists is nonsense — pure ad hominem which serves to only polarize a reasonable debate”

However as rightly pointed out by Jeanne Bergman at aidstruth.org, there is no ‘reasonable debate’ and as such Leung’s inquiries are operating with a presupposed agenda. This is supported by the fact that Dr. John Moore (one of the experts who was duped into appearing in the film) along with over a dozen other scientists who appeared have signed a letter rejecting denialist claims and stating they were misled about Leung’s intentions in making the film. (2)

It seems highly suspect to me that Leung, who advertises having had an interest in HIV and AIDS since his high-school days and has been ‘investigating’ the area full time, should make certain fairly basic errors. Firstly in a debate-turned furore which Leung attended, there appeared to be some confusion as to whether he knew AZT to be an antiretroviral – a rather basic fact given his so-called inquisitive role.

Secondly, in the trailer to his film Leung appears stunned at the idea of questions being asked about a patient’s sex life being used in the diagnostic process. As any medical student (or even avid fans of medical dramas such as ‘House’) could tell you, taking a history is an important and routine part of essentially every diagnostic investigation. Even this brief clip gives a distorted view of HIV testing, implying this quick finger-prick test is what doctors do as “a piece of theatre” with diagnosis resting only on the background questions asked. A nice little article giving some clarifying background on quick HIV tests such as the one Leung experienced can be found here.

These tests have the advantage of giving a result quickly, though are less reliable than ‘long’ tests and so are not used to provide a definitive HIV diagnosis. If a quick test is positive this would usually lead to a highly sensitive and specific ‘long’ test, and if this is positive, a Western Blot is performed for confirmation.

The fact that Leung officially takes a ‘neutral’ position demonstrates two major points. Firstly a position of supposed neutrality requires a person to not accept the scientific consensus. Because of the fact that this is exhaustive and as I said in my previous post at blue-genes is as certainly established as our heliocentric solar system, his stance is invalidated. Secondly his position allows him to skirt responsibility for any actions people may take as a result of conclusions they may erroneously draw from watching his film. It is also important to add that Leung has not divulged who funded his film. Whilst he has denied that most of them support AIDS denialism (perhaps they are merely ‘re-thinkers’?), it is highly suspect as this could potentially present a huge conflict of interest allowing even further criticism of Leung’s claims of objectivity.

An approach which denialists seem to like taking is to provide a distorted caricature of legitimate experts and reputable members of the scientific community. The device of presenting themselves as ‘innocent question-askers seeking truthful information’ is used to attempt to justify their claims of censorship ( see page 2 of the document linked) by the scientific community and also to win empathy with a lay-audience. The attempts by the academic community to prevent poisonously ignorant denialist messages from causing harm without validating their movement with ‘debate’ is re-hashed into what denialists try to pedal as a vast conspiracy theory. For more information I recommend Seth Kalichman’s wonderfully clear book ‘Denying AIDS’. Also, check out his blog.

When one approach doesn’t work, it seems standard fare for a denialist to simply bash on with another tack. When not acknowledged by the scientific community as ‘experts with a difference in opinion’, highly charged claims of attempts to repress the right free speech are bandied about. The scientific community is not concerned with repressing free speech as part of some farcical cover-up whilst some lord of big pharma laughs madly, stroking a white cat in his volcano lair. They are concerned with minimising the amount of illness and death caused by misinformation over what should be a non-issue.

Sep 22
Posted by: benvincent  

Hello readers, my name is Ben and I’m a new member of the Blue-Genes team. I’ve been friends with Nico and Colin during our time at university, but was  busy moving during the time the blog was founded. Now I’m here as a contributor, and will be posting again soon!

For scientists working in the field of HIV and AIDS, discussion of denialists can be at best tiring and at worst infuriating. This isn’t because a (‘good’) scientist can’t engage in a meaningful debate about their field with an honest dissident. It is because denialists of established science are not truly interested in objective examination of evidence. This may sound harsh, but it is important to realise that we’re not talking about any issues which have real controversy. The issue that I’m particularly talking about, the fact that HIV is the causative agent of AIDS, has over 25 years of medical science behind it, and is the subject of tens of thousands (1) of peer-reviewed research papers. The evidence is as irrefutable as that demonstrating that the earth orbits the sun, albeit perhaps less accessible to your average layperson.

Many may also dismiss denialist ramblings as the views of paranoid conspiracy theorists that have negligible influence on public perceptions. Unfortunately, undue attention has been given to the HIV and AIDS denialist movement due to the influence of particularly vocal leaders. The man generally regarded as the pole star of HIV denialism is the academic Peter Duesberg, who holds a Professorship with the department of Molecular and Cell biology at the University of California, Berkley. He is known for having performed work on the study of oncogenes, and was elected to the American National Academy of Science. Many people falsely see it as evidence for denialism that this impressive man holds views which would seem anathema compared to how one would expect a highly trained scientific mind to operate. One could indeed rhapsodise as to the reasons for this, but these reasons make not a jot of difference to the fact that his claims that the cause of AIDS is still controversial, and that the ‘Duesberg Hypothesis’ (claims that illegal drug abuse and antiretroviral medications themselves are the causes of AIDS) are demonstrably untrue (2).

HIV and AIDS denialism has had a painful influence on the governmental policies of South Africa. The previous Prime Minister Thabo Mbeki invited Duesberg and other denialists to sit on a 44-member ‘Presidential Advisory Panel’ to address the reliability of HIV test kits. The health minister at the time, Manto Tshabalala-Msimang rejected the use of antiretrovirals favouring an infamous approach based on eating beetroot, lemon, garlic and African sweet potatoes to save lives. It is concluded that hundreds of thousands of deaths (3) could have been avoided if a more rational approach to the issue could have been executed. The shady involvements of vitamin salespeople offering alternative respite has also tragically resulted in further confusion and death, with support from the government at the time.

An important concept to understand when considering a scientific issue is that of trust. Trust, slightly non-intuitively for some, is completely essential when engaging in scientific research or understanding issues said to be demonstrated by science. The scientific method (that is how scientists go about making new discoveries and ensuring they are well controlled, objectively conducted and concluded, and repeatable) is iterative in that it builds upon previously done work. Even to disagree with the interpretation of an experimental result or a potential theory necessitates allocation of trust, due to a previous benchmark of understanding of the field being required from which the dissidence can nucleate (4). The only way in which trust could hypothetically be avoided is to work from first principles – impossible in science unless you have an infinitely funded lab and the useful property of immortality and the patience to repeat well over a century of iterative experimentation.

It may be difficult to accept that trust in science isn’t particularly risky. Public suspicion rises with every less-than-satisfactory experience with one’s doctor or hospital, and most people in the know will confess that peer review is “flawed but the best we’ve got”. This highlights the importance of dissidence in relation to the system. It is important for people to question ideas which do not make sense to them, and to be able to have access to work done that has lead to the scientific community accepting the truth of particular issues. The earth is round. Vitamin C is required to prevent the onset of scurvy. HIV is the causative agent of AIDS. The difference between ‘dissidence’ and ‘denialism’ is that denialists maintain their stance (be it in regard to HIV and AIDS or any of many issues including the holocaust, or 9/11 as further highly emotionally charged examples) in the face of exhaustive and irrefutable evidence. It is not melodramatic to say that vocalisation of these particular falsehoods have been responsible for many deaths.

Sources and footnotes

  1. A search for ‘HIV’ in the PubMed database provides over 200,000 hits. Of course far from all of these will be connected to the HIV-AIDS link, my point is simply the amount of accredited research in this area is huge, only paling in comparison to cancer.
  2. Ascher, M., Sheppard, H., Jr, W., & Vittinghoff, E. (1993). Does drug use cause AIDS? Nature, 362 (6416), 103-104 DOI: 10.1038/362103a0 – Apologies that the full article is not available for free. However this gives one of many potential examples that peer reviewed examinations of Duesberg’s claims are out there, and if you note the date, were theoretically laid to rest a long time ago.
  3. Nattrass, N. (2008). AIDS and the Scientific Governance of Medicine in Post-Apartheid South Africa African Affairs, 107 (427), 157-176 DOI: 10.1093/afraf/adm087
  4. Recommended reading: Impure Science – AIDS, activism and the politics of knowledge, Stephen Epstein, 1996