2 August 2010
ETV must stop airing dangerous Christ Embassy commercials
ETV is promoting quackery by airing Christ Embassy’s weekly info commercial at 7:30 on Sunday mornings. During the commercial the pastor who runs the church claims to faith-heal a number of diseases including cancer, heart disease and arthritis. Christ Embassy's website claims that Pastor Chris Oyakhilome, the proprietor of this church, can faith-heal HIV.
‘ETV's 3rd Degree has been outspoken against AIDS quackery and denialism and so it is disappointing that the station runs Christ Embassy adverts, which are quackery and a threat to public health,’ says Nathan Geffen, TAC Treasurer.
Many religious organisations are playing a critical role in the fight against HIV and TB in South Africa, raising awareness, providing spiritual and emotional support to people with these conditions and thereby helping them to adhere to the medications which cure TB and suppress HIV in the blood to restore people's health.
This is not the case with Christ Embassy. By claiming to heal life-threatening conditions, Christ Embassy is leading people to believe that they no longer have to adhere to treatment or seek appropriate medical care. Read more »
We recommend this article, "Conspiracy theories in science" by Ted Goertzel in EMBO reports.
Conspiracy theories that target specific research can have serious consequences for public health and environmental policies
Conspiracy theories are easy to propa gate and difficult to refute. Fortu nately, until a decade or so ago, few serious conspiracy theories haunted the nat ural sciences. More recently, however, con spiracy theories have begun to gain ground and, in some cases, have struck a chord with a public already mistrustful of science and government. conspiracy theorists—some of them scientifically trained—have claimed that the HiV virus is not the cause of aiDS, that global warming is a manipulative hoax and that vaccines and genetically modified foods are unsafe. these claims have already caused serious consequences: misguided public health policies, resistance to energy conservation and alternative energy, and dropping vaccination rates.
Read the rest of the article (PDF).
New England Journal of Medicine 363(3) July 15, 2010
Early versus Standard Antiretroviral Therapy for HIV-Infected Adults in Haiti
Patrice Severe et al.
For adults with human immunodeficiency virus (HIV) infection who have CD4+ T-cell counts that are greater than 200 and less than 350 per cubic millimeter and who live in areas with limited resources, the optimal time to initiate antiretroviral therapy remains uncertain.
We conducted a randomized, open-label trial of early initiation of antiretroviral therapy, as compared with the standard timing for initiation of therapy, among HIV-infected adults in Haiti who had a confirmed CD4+ T-cell count that was greater than 200 and less than 350 per cubic millimeter at baseline and no history of an acquired immunodeficiency syndrome (AIDS) illness. The primary study end point was survival. The early-treatment group began taking zidovudine, lamivudine, and efavirenz therapy within 2 weeks after enrollment. The standard-treatment group started the same regimen of antiretroviral therapy when their CD4+ T-cell count fell to 200 per cubic millimeter or less or when clinical AIDS developed. Participants in both groups underwent monthly follow-up assessments and received isoniazid and trimethoprim–sulfamethoxazole prophylaxis with nutritional support. Read more »
The paper that cost the editor of Medical Hypotheses his job will have no further consequences for its main author, molecular virologist Peter Duesberg of the University of California (UC), Berkeley. The university has ended its misconduct investigation after concluding that Duesberg was within his rights when he wrote that there is no evidence of a deadly AIDS epidemic in South Africa.
Duesberg's paper, published online on 19 July 2009, triggered a storm of protests from AIDS scientists and activists. Elsevier, the publisher of Medical Hypotheses, has retracted the article and has terminated the contract of the journal's editor, Bruce Charlton of Newcastle University in the United Kingdom, who declined to introduce a peer review system at the 35-year-old journal.
The doctor who sparked the "MMR scare" and a hero of the anti-vaccination movement, Andrew Wakefield, has been struck from the medical register in the United Kingdom by the General Medical Council after being found guilty of serious misconduct. The GMC found that he had "abused his position of trust" and "brought the medical profession into disrepute" through "multiple separate instances of serious professional misconduct". The Guardian reports:
Andrew Wakefield, the doctor at the centre of the MMR scare, has been struck off the medical register after being found guilty of serious professional misconduct.
He was not at the General Medical Council (GMC) hearing to receive the verdict on his role in a public health debacle which saw vaccination of young children against measles, mumps and rubella plummet.
The GMC said he acted in a way that was dishonest, misleading and irresponsible while carrying out research into a possible link between the measles, mumps and rubella (MMR) vaccine, bowel disease and autism.
AIDS Denialism, Medical Hypotheses, and The University of California’s Investigation of Peter Duesberg
AIDStruth.org, April 2010
AIDS denialist and U.C. Berkeley Professor Peter Duesberg has recently received media coverage following the withdrawal of a paper of his by the publisher, Elsevier, and an investigation into his conduct by the University.  Here, we provide some background and a timeline of events in the unfolding drama.
AIDS denialism, which Peter Duesberg has promoted tirelessly for the past quarter century, has claimed many victims from the ranks of HIV-positive people who believe in its tenets: that HIV is harmless or non-existent, antiretroviral drugs (ARVs) cause AIDS, and lifestyle choices and alternative therapies can prevent AIDS-related illness and death.  These deaths, caused by the fusion of ignorance and lies, are regrettable and tragic. They are dwarfed in scope, however, by what happened at the end of the millennium in South Africa. There, hundreds of thousands of people died when the apparatus of state was placed in service of Duesberg’s theories on HIV and AIDS. Read more »
AIDS:15 May 2010 - Volume 24 - Issue 8 - p 1095–1105; doi: 10.1097/QAD.0b013e3283377a1e
HIV+ elite controllers have low HIV-specific T-cell activation yet maintain strong, polyfunctional T-cell responses
Owen, Rachel E; Heitman, John W; Hirschkorn, Dale F; Lanteri, Marion C; Biswas, Hope H; Martin, Jeffrey N; Krone, Melissa R; Deeks, Steven G; Norris, Philip J; the NIAID Center for HIV/AIDS Vaccine Immunology
Objective: HIV+ elite controllers are a unique group of rare individuals who maintain undetectable viral loads in the absence of antiretroviral therapy. We studied immune responses in these individuals to inform vaccine development, with the goal of identifying the immune correlates of protection from HIV.
Methods: We compared markers of cellular activation, HIV-specific immune responses and regulatory T (Treg) cell frequencies in four groups of individuals: HIV-negative healthy controls, elite controllers (HIV RNA level <75 copies/ml), individuals on HAART and individuals with HIV RNA level more than 10 000 copies/ml (noncontrollers). Read more »
Two media articles create the impression that I complained anonymously about Peter Duesberg to the University of California Berkeley. These are:
There was nothing anonymous about my complaint. I believe that Duesberg failed to declare a conflict of interests of one of his co-authors in an article published in a journal called Medical Hypotheses. I consequently lodged a complaint with the University. I believe high quality journals should hold the first author responsible for a failed declaration of conflict of interests by co-authors (unless the co-author hid the conflict from the first author which is definitely not the case here). Duesberg was the first author of this article. Admittedly, Medical Hypotheses is not a high quality journal.
On 9 April 2010 UCB emailed me asking if I was prepared to have my complaint given to Duesberg in full with my name on it. I unhesitatingly answered yes immediately upon receipt of the email. My complaint has never been anonymous. Read more »
British Chiropractic Association drops libel action against science writer after losing key issue in Appeals Court
We reported previously on the libel action the British Chiropractic Association won in a lower court against esteemed British science writer Simon Singh after he called their claims that chiropractic could treat childhood diseases "bogus". The lower court had found that his statements were statements of fact, and that he therefore had to prove that the BCA knew that their claims were false when they made them. They have now abandoned their case against Singh after he won a key argument on appeal, namely that his article constituted comment and not statements of fact. Read more »
Maternal mortality for 181 countries, 1980—2008: a systematic analysis of progress towards Millennium Development Goal 5
Maternal mortality remains a major challenge to health systems worldwide. Reliable information about the rates and trends in maternal mortality is essential for resource mobilisation, and for planning and assessment of progress towards Millennium Development Goal 5 (MDG 5), the target for which is a 75% reduction in the maternal mortality ratio (MMR) from 1990 to 2015. We assessed levels and trends in maternal mortality for 181 countries.
We constructed a database of 2651 observations of maternal mortality for 181 countries for 1980—2008, from vital registration data, censuses, surveys, and verbal autopsy studies. We used robust analytical methods to generate estimates of maternal deaths and the MMR for each year between 1980 and 2008. We explored the sensitivity of our data to model specification and show the out-of-sample predictive validity of our methods.
We estimated that there were 342 900 (uncertainty interval 302 100—394 300) maternal deaths worldwide in 2008, down from 526 300 (446 400—629 600) in 1980. The global MMR decreased from 422 (358—505) in 1980 to 320 (272—388) in 1990, and was 251 (221—289) per 100 000 livebirths in 2008. The yearly rate of decline of the global MMR since 1990 was 1·3% (1·0—1·5). During 1990—2008, rates of yearly decline in the MMR varied between countries, from 8·8% (8·7—14·1) in the Maldives to an increase of 5·5% (5·2—5·6) in Zimbabwe. More than 50% of all maternal deaths were in only six countries in 2008 (India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo). In the absence of HIV, there would have been 281 500 (243 900—327 900) maternal deaths worldwide in 2008.
Substantial, albeit varied, progress has been made towards MDG 5. Although only 23 countries are on track to achieve a 75% decrease in MMR by 2015, countries such as Egypt, China, Ecuador, and Bolivia have been achieving accelerated progress.
Bill & Melinda Gates Foundation.
by Lesley Odendal
First published by health-e. This article is republished by AIDSTruth because it deals with political support for AIDS denialism.
OPINION:Nathan Geffen’s book Debunking Delusions reminds us what can go wrong when AIDS denialists are given the time of day. The book also documents clearly how we can fight denialism in a manner that saves lives and respects science. What is clear given the resurgence of AIDS denialist propaganda is that now is not the time to sit back.
As Geffen argues in his book, underlying the Treatment Action Campaign’s success in fighting denialism and quackery was the almost unsung treatment education programme. Knowledge truly is power in this case. Read more »
In a stunning indictment of the pseudoscience published in Medical Hypotheses, the journal's publisher has issued an ultimatum to the editor: implement peer review or resign. This comes after the retraction of two AIDS denialist papers that the journal published, which were unanimously rejected by five reviewers in a process managed by The Lancet. The papers, “HIV-AIDS hypothesis out of touch with South African AIDS: A new perspective” by Peter Duesberg and “AIDS denialism at the ministry of health” by Marco Ruggiero, caused great concern in the scientific community and several prominent AIDS researchers wrote to the publisher expressing their concern. The retractions and Elsevier's decision to implement peer review at the journal will no doubt be held up by denialists as evidence of "censorship," but in fact illustrates that "dissident science" does not stand up to the scrutiny of peer review. Medical Hypotheses does not conduct peer review and had under the leadership of its present editor, Bruce Charlton, become a haven for pseudoscience of various kinds, including AIDS denialism.
Below are two reports on the publisher's steps to reform Medical Hypotheses.
Zoë Corbyn writes in Times Higher Education:
The editor of the journal Medical Hypotheses has been given until 15 March either to implement changes to adopt a traditional peer-review system, or to resign.
He has also been told that even if he stays with the journal, his contract will not be renewed at the end of the year.
As Times Higher Education reported in January, publisher Elsevier is attempting to rein in its unorthodox journal, which publishes papers on the basis of how interesting or radical they are rather than using peer review, after it published a paper last July that denied the link between HIV and Aids.
AidsTruth contributor and a leader of the Treatment Action Campaign, Nathan Geffen, has published a new book documenting AIDS denialism and the related quackery in South Africa titled Debunking Delusions: The Inside Story of the Treatment Action Campaign. We will publish a full review soon. More information can be found at the book's website. Below is the publisher's summary of the book.
One of the great, iconic struggles for social justice in the 21st century has been the campaign of the TAC against state-supported Aids denialism in South Africa. This struggle between activists, scientists and health workers, on the one hand, and a strange alliance of dissidents, quacks and political leaders, on the other, is here recounted in absorbing and dramatic detail for the first time by an insider. In his book Nathan Geffen, one of the TAC leaders, describes how early on in its life the organisation discovered that the greatest obstacle to AIDS treatment was in fact the South African government’s denialism. Not only did this extend to a reluctance to provide antiretroviral treatment to AIDS patients but also to support of a host of quacks and denialists who operated freely in the country to sow suspicion and confusion about the efficacy of standard medical treatment of AIDS. The most notorious of these were the German vitamin seller, Dr Matthias Rath, who along the way sued The Guardian of London and lost his case, and the Dutch nurse Tine van der Maas. It was the TAC that, as a result of a court case it brought against Rath, managed to stop his operations in South Africa; and it was the TAC, once again through legal means, that put pressure on the South African government to roll out an antiretroviral programme throughout the country. Geffen describes not only the TAC’s response to the puzzling intransigence of government and the spellbinding nonsense of dissidents, but the thought, strategy and discussion that lay behind the organisation’s major decisions. The story of the TAC’s campaign is one of the great triumphs of citizen activism for social justice and human rights. Read more »
Elizabeth M. Whelan writes in the New York Post:
The media gave big headlines to this week's stories on a prestigious British medical publication's retraction of an article that had claimed to show a causal link between standard childhood vaccinations (measles, mumps and rubella) and autism.
Yet the coverage of the Lancet affair didn't truly convey the outrageousness of the original publication or the gravity of its consequences -- consequences long festering, since the paper was published not last week but 12 years ago.
Many of us in the scientific community recognized the "study" as junk when it appeared in 1998. Even before we learned of then-unknown ethical failings by its lead author, we knew the study was based on a tiny population of only 12 children. More, it relied on a novel methodology that assumed some bizarre, previously unheard of, association between children's autism and their manifestation of intestinal problems.
Nonetheless, the media back then seized on this story from a prestigious medical source -- and the scare picked up steam when TV appearances by actress Jenny McCarthy and a Rolling Stone article by Robert Kennedy Jr. blared word of the putative dangers of vaccines.
Rahul K. Parikh, M.D. writes on Salon.com:
The media trumpeted an irresponsible study, ensuring that its nasty legacy thrives
Feb. 05, 2010
This week, Dr. Andrew Wakefield's now infamous study linking the MMR vaccine to autism was finally retracted by the prestigious Lancet medical journal. The move came days after medical officials in the United Kingdom found the doctor guilty of multiple ethics violations. For doctors, this is a victory -- but a bittersweet one.
As a pediatrician, I grapple daily with what Wakefield wrought: parents who are twisted in knots -- to the point of tears -- about whether to immunize their child. In the 12 years since the publication of Wakefield's study, 10 of his fellow co-authors have denounced him, and an unremitting series of revelations have exposed just how corrupt his motives and methods were. Most important, multiple studies verified there is no link between the MMR (or any other) vaccine and autism. Meanwhile, infectious diseases once confined to medical history have broken out in our communities. To say the retraction is criminally overdue is an understatement.
Further, even as Wakefield's research is expunged from the scientific record, what he spawned -- a well-funded, vocal, even rabid movement -- will remain. Without him, poster girl Jenny McCarthy would have been abandoned in the MTV archives instead of smugly crowing to Time magazine, "I do believe sadly it's going to take some diseases coming back to realize that we need to change and develop vaccines that are safe. If the vaccine companies are not listening to us, it's their f___ing fault that the diseases are coming back. They're making a product that's s___ ." And anti-vaccine darling David Kirby would split his time between running a P.R. firm and writing pithy articles about art and aircraft instead of turning speculation and rumor into a Kennedy-esque vaccine-autism conspiracy theory. Finally, Wakefield himself stands to be completely unaffected by both the U.K. medical community (which could revoke his license to practice there) and the Lancet's decision. He long ago settled here in the U.S. and successfully peddles his views through his Thoughtful House autism center in Texas.
This documentary was produced by the non-profit health news agency Health-e and was recently broadcast on an independent television channel in South Africa. View Part I:
(If you do not see the video above, your browser does not support HTML5 video playback. Download the video or visit this page in Firefox or Chrome.) Download Part I in ogg/theora or in mp4. Part II after the jump. Read more »
The anti-vaccine movement, which shares characteristics with AIDS denialism (both like to blame pharmaceutical conspiracies) and which was originally based on claims by British surgeon Andrew Wakefield, has been dealt a decisive blow by a finding against Wakefield by the General Medical Council. Caims that the MMR vaccine was linked to autism have since been shown to be baseless, but are still promoted by some, including by groups linked to AIDS denialism. The Guardian reports:
Dr Andrew Wakefield, the expert at the centre of the MMR controversy, "failed in his duties as a responsible consultant" and showed a "callous disregard" for the suffering of children involved in his research, the General Medical Council (GMC) has ruled.
Wakefield also acted dishonestly and was misleading and irresponsible in the way he described research that was later published in the Lancet medical journal, the GMC said. He had gone against the interests of children in his care, and his conduct brought the medical profession "into disrepute" after he took blood samples from youngsters at his son's birthday party in return for payments of £5.
DART results show majority of HAART benefits can be achieved even without routine laboratory monitoring
The results from the DART trial, reported this week in The Lancet, provide important evidence for HAART programmes in resource-constrained settings. From commentary by Phillips & Oosterhout published alongside the results:
In much of sub-Saharan Africa, the scale-up of use of antiretroviral therapy has been so far achieved without routine laboratory monitoring of drug toxicity and efficacy. Until now, there has not been substantive evidence about the consequences of delivering antiretrovirals without such routine monitoring.
In The Lancet today, the DART Trial Team present the Development of AntiRetroviral Therapy in Africa (DART) trial. In DART at enrolment, all participants started triple-drug antiretroviral therapy and were randomised to clinically driven monitoring versus laboratory plus clinical monitoring for toxicity (haematology and biochemistry) and efficacy (CD4-cell counts). Over 5 years, the proportions who had one or more serious adverse events were almost identical, while there was a somewhat higher proportion in the group on clinically driven monitoring who had disease progression or death (28%, compared with 21% in the other group; hazard ratio 1·31, 95% CI 1·14—1·51). This benefit of laboratory plus clinical monitoring is probably due to the use of CD4 count rather than presence of clinical symptoms alone to decide on when to switch to a second-line regimen. This criterion for switching on the basis of CD4 count is just one of the CD4-count switch criteria recommended by WHO; the other criteria (on the basis of CD4-count change from baseline and from peak) are problematic to implement without a baseline CD4 count and frequent CD4 counts being available thereafter.
The other particularly striking result from DART is the 5-year survival in both groups: 87% for clinical monitoring and 90% for laboratory plus clinical monitoring. Such rates of survival are for people in whom the initial median CD4-cell count was 86 cells per μL. For comparison, the survival in the Entebbe cohort of untreated HIV-positive people in 5 years was below 10% (data presented in the DART report), which emphasises the huge clinical benefits of antiretroviral therapy. The DART Trial Team concluded from their results that antiretroviral therapy can be delivered safely with good-quality clinical care, which would allow treatment delivery to be decentralised, and that there is a role for CD4 testing from the second year on antiretrovirals to guide the switch to second-line therapy, which should encourage accelerated development of simpler and cheaper point-of-care CD4 tests. The DART investigators should be complimented for exceptional achievement by completing this important trial with such a low loss to follow-up (7%) in challenging circumstances, which shows that excellent trials can be done in Africa.
The results from DART are very important for antiretroviral programmes, no matter what their current level of routine laboratory monitoring. Programmes that currently deliver antiretrovirals without any laboratory monitoring can be reassured that the vast majority (but not all) of the potential survival benefit of such therapy can be realised with the use of such a simple approach (albeit with particularly intensive and high-quality clinical monitoring, which is a substantial challenge to achieve in routine settings throughout sub-Saharan Africa). Similarly, no antiretroviral programme should enhance laboratory monitoring at the expense of putting more people in need on these drugs. Those clinics that do use routine measurement of biochemistry and haematology can reduce their laboratory costs to enable spending on other aspects of the programme (which has already started in some programmes). Programmes that monitor people on antiretrovirals with CD4 counts should consider adopting the switch criterion used in DART of CD4 count below 100 cells per μL (ie, only this one of the WHO-recommended criteria, rather than all three), and apply this criterion to people who have been on therapy for at least 2 years. Such a delay should help to reduce the number of people in whom a switch is made when viral load is actually suppressed.
Details on the main paper below: Read more »
Also see the comment piece Still Crazy After All These Years (open access) by Nicoli Nattrass that appears in the same issue of AIDS & Behavior.
Update (22/01/2010): See AIDS Denialism Under Fire From Researchers by Nora Proops in The AIDS Beacon.
AIDS & Behavior. 2010 Jan 8. [Epub ahead of print]
AIDS Denialism and Public Health Practice
Chigwedere P, Essex M.
In this paper, we respond to AIDS denialist arguments that HIV does not cause AIDS, that antiretroviral drugs are not useful, and that there is no evidence of large-scale deaths from AIDS, and discuss the key implications of the relationship between AIDS denialism and public health practice. We provide a brief history of how the cause of AIDS was investigated, of how HIV fulfills Koch's postulates and Sir Bradford Hill's criteria for causation, and of the inconsistencies in alternatives offered by denialists. We highlight clinical trials as the standard for assessing efficacy of drugs, rather than anecdotal cases or discussions of mechanism of action, and show the unanimous data demonstrating antiretroviral drug efficacy. We then show how statistics on mortality and indices such as crude death rate, life expectancy, child mortality, and population growth are consistent with the high mortality from AIDS, and expose the weakness of statistics from death notification, quoted by denialists. Last we emphasize that when denialism influences public health practice as in South Africa, the consequences are disastrous. We argue for accountability for the loss of hundreds of thousands of lives, the need to reform public health practice to include standards and accountability, and the particular need for honesty and peer review in situations that impact public health policy.
Read the full article on SpringerLink (open access)
New myth debunked: The fact that some HIV-positive people live in good health without treatment for many years proves that HIV is harmless
Fact: A small percentage of people infected with HIV do live for many years without developing AIDS. They are often known as long-term non-progressors. But such individuals are rare: without proper medical care, including antiretroviral drugs when needed, most HIV-positive people will eventually develop AIDS.
As putative evidence that HIV is harmless, some HIV/AIDS denialists point to examples of HIV-infected people who survive for many years, even decades, without receiving antiretroviral treatment. HIV denialists often claim that these people survived because they avoided antiretroviral therapy, and that diet, exercise, nutritional supplements or herbal therapies, stress reduction, hypnosis, and other interventions prevent progression to AIDS. These claims are untrue and dangerous.