Wishful ignorance: “Cure research” on HIV/AIDS

Pundits, politicians, and people almost everywhere are woefully mistaken about how science works and what it can do. Specialist science writers and journalists rarely expose (do they even detect?) the all-too-frequent unrealistic, misleading assertions by public figures — including spokespeople for scientific and medical institutions — about what money can buy in the way of research results. Honest work over time and with some luck, in the activity we call “science”, enabled humankind to progress in understanding how the world works; but science cannot deliver answers on demand to every question we would like to have answered, no matter how much money we throw into the action.

Useful applications of science rest on scientific knowledge and understanding. If an event or a phenomenon is not well understood, no amount of resources including money can be guaranteed to bring a desired application.

Not infrequently, one hears calls for a Manhattan-Project-type initiative to accomplish this, that or the other, for example, to find a cure for cancer. The Manhattan Project was for building an atomic bomb. Only academic specialists appear to know that the Project came about only because the knowledge and understanding were already at hand to know that such a bomb was feasible in principle: it was known that nuclear fission of uranium occurs and that it releases energy far outstripping anything produced by chemical reactions. The Project started because scientists told policy makers that it was feasible. Inventing the atomic bomb was essentially an engineering project rather than a scientific one. Could the fissionable material (a relatively rare isotope of uranium) be isolated from raw uranium in sufficient quantity? Or could an alternative fissionable material, plutonium, be prepared in sufficient quantity in a nuclear reactor? How could the bomb be designed to explode only when and where desired, rather than as soon as the “critical mass” of fissionable material was assembled?
Innumerable technical problems had to be solved to attain the final goal, and some of those did involve the gaining of new scientific understanding; but the point remains that the Project was known to be in principle possible before it was begun; the pertinent laws of Nature were sufficiently understood. That cannot be said for several desired goals that have been hyped by researchers as well as by politicians and pundits. President Nixon declared a war on cancer more than 4 decades ago, and it has gotten nowhere, just as the (relatively few) honest and informed scientists had predicted: Because we still do not know how cancer starts or what it really is in terms of biological mechanisms.
Also much hyped since the human genome was decoded has been the desirable (as most people believe) goal of “gene therapy”: to replace known “bad” genes with good ones. Several decades of trials and errors have killed a number of human guinea pigs but have had none of the promised successes: Because we do not yet understand the workings of the human genome well enough. “Genes” are not immutable entities in their everyday operation; elaborate signaling mechanisms and feedbacks govern “gene” actions. (For an accessible description, see Gil Ast, “The alternative genome”, Scientific American, April 2005, pp. 58-65.)
Moreover, we do not know how to get “good” genes into the right place in the genome.
Those are just a few reasons why it was silly (some might say thoughtless or even criminal) to jump into human trials of “gene therapy”.

Now I read of another such pie-in-the-sky initiative: To provide more resources for “cure research” on HIV/AIDS:

“Congressman Henry Waxman Meets on Cure for HIV [26 February 2013]
(Sent by AHF on behalf of the campaign for a Cure for HIV)
LOS ANGELES — On January 31st, 2013, a team comprised of leading cure scientists and AIDS support group leaders met with Congressman Henry Waxman . . . to address a cure for HIV and the problem of inadequate funding” [emphases added].

I was dumbfounded by “cure scientists” and “inadequate funding”.

The implication is unavoidable, that the Campaign for a Cure for HIV believes that there are presently researchers on HIV/AIDS whose ambition does not include finding a cure. What then are they doing? Quite a lot else, evidently, since “the National Institutes of Health (NIH) allocates a mere 3% of its 3 billion dollar HIV research budget to cure research” — according to “Gerald Gerash, . . . a longtime gay rights advocate whose recent passion has turned toward a cure for HIV/AIDS”.
The absurdity should be apparent if just a few moments are devoted to thought. Unlimited fame, glory, wealth awaits anyone who comes up with a “cure” for HIV. No researcher is unaware of that. They will follow any inspiration that offers a hope for that, and they would be given grant funds without stint to pursue that hope — so long as their peers agree that the hope seems reasonable and the method feasible. But the current proposals fail the test of plausibility rather obviously and badly.

What “cure research” means here was explained by the (grant-seeking) scientists present at the meeting with Waxman:
“Drs. Mitsuyasu and Cannon . . . discussed their ongoing, extraordinary and promising efforts in the area of anti-HIV gene and stem cell therapy . . . . Inspired by ‘the Berlin patient’ . . . who was cured of HIV by the use of blood stem cells from a person who was born with T-cells lacking CCR5, they hope to duplicate his result in a safe way for people with HIV. Their novel approaches are at the forefront of AIDS cure research, one already at the early stage of human testing” [emphases added].
As already remarked, gene therapy has gotten nowhere. Stem cell therapy has not yet gotten even that far. The “human testing” cannot possibly be at the level of actually trying out the “cure” as such (or at least it shouldn’t be); it will just be early preliminaries — otherwise the call would not be for research funds but for resources to provide the cure to all “HIV-positive” people.

As for inadequate funding . . . . What has been provided for HIV/AIDS research is enormously in excess of what has been devoted to the ailments that most people suffer from and eventually die of, for instance cardiovascular disease, COPD (chronic obstructive pulmonary disease), diabetes (Open Letter to my Representatives in Congress).

As to “cure research”, I had evidently missed an earlier (26 July 2012) Media Release by the International AIDS Society on the occasion of their XIXth International Conference:
“Last week the Inaugural Global Scientific Strategy Towards an HIV Cure was launched amid renewed optimism from the world’s leading HIV/AIDS scientists that the future prospects for finding an HIV cure are increasing. . . . Towards an HIV Cure identifies seven important priority areas for basic, translational and clinical research and maps out a path for future research collaboration and funding opportunities” [emphasis added].

If further comment seems needed, see “The Research Trough — where lack of progress brings more grants”;
“From Dawn to Decadence: The Three Ages of Modern Science”;
“80% unemployment?! The research system is broken”;
“Dishonesty and dysfunction in science”.
As a general rule, it is good to bear in mind that just because words can be put together doesn’t mean that a feasible reality is being described. “Gene therapy”, “cure research”, “stem cell therapy” and many more are just words and wishes. They are perfectly suited to science fiction but not (at present; yet?) to science policy.

History of HIV/AIDS, and Seth Kalichman

I had just finished the previous post about the PBS documentary rewriting history when the Office of Medical and Scientific Justice posted a really excellent account of the early history of the suppression of dissenting views together with an analysis of Kalichman’s book Denying AIDS.

Highly recommended reading:
“Book Review: Denying AIDS”

 

 

Mainstream HIV PSEUDO-science

When at long last researchers find out how to keep HIV in check, that naturally makes news:

“Secret of HIV’s natural born killers out”
“Revealed: Secret of HIV’s natural born killers”
“SFU scientists contribute to HIV breakthrough — Natural resistance to AIDS may be key in developing a vaccine”
“Study digs into secrets of keeping HIV in check”
“People with rare natural ability to fight AIDS virus have potent ‘killer’ cells that recognise and destroy infection”

That’s just a sampling of what Google turns up about this just-announced phenomenal breakthrough. I was inspired to get the research article itself, published on-line ahead of print in Nature Immunology, 10 June 2012; doi:10.1038/ni.2342.
It’s a highly technical 12 pages long, with a rather technical title: “TCR clonotypes modulate the protective effect of HLA class I molecules in HIV-1 infection”.
There are 21 authors from 6 laboratories in 4 countries (Canada, Germany, Japan, USA).
The number of authors is greater than the number of studied subjects, who totaled 10: 5 of them “elite controllers”, the other 5 “HIV-positive” people on HAART.

Even the news reports cited researchers not involved in the work who pointed out that this in itself means nothing at all, given not only the small number of subjects but also the fact that “elite controllers” have never been found to be all alike in the immunological characteristics that seem to matter.

It is no mystery, of course, why such an inconclusive little bit of possible progress would be published: the vast majority of research articles are like this, adding no more than tiny bits of possibly useful information — LPUs, least-publishable units.
It is also no mystery, why the media would trumpet about it: Their attention was drawn to it by the paper’s authors, so that further grants and kudos would flow in their direction. After all, this work would not have been possible without grants from:
“Harvard University Center for AIDS Research . . . , the Bill and Melinda Gates Foundation . . . , the Doris Duke Charitable Foundation . . . , the US National Institutes of Health . . . , the Howard Hughes Medical Institute . . . , the Mark and Lisa Schwartz Foundation . . . , the Intramural Research Program and the Office of AIDS Research of the US National Institutes of Health . . . , the Canadian Institutes for Health Research . . . and the Canada Research Chair in Viral Pathogenesis and Immunity . . . .”

The lead author, cited in the news stories, appears to be Bruce D. Walker, “professor at Harvard School of Public Health”.
One can only hope that he was not quoted correctly to the effect that “One person has been fending off AIDS since 1978”.

It would be a nice trick, after all, to have diagnosed “HIV infection” some 6 years before the purported discovery of HIV.
Not, of course, that reporters who cover such stories need know anything about the subject.
Nor, of course, that researchers studying elite controllers need know anything about the history of the discovery of “HIV”.

What’s next for the HIV/AIDS vigilantes at Treatment Action Campaign?

Just a couple of months ago, I noted that the Treatment Action Campaign in South Africa had urged the Gates Foundation not to proceed with trials comparing stavudine to tenofovir because stavudine is so much more toxic and should simply be replaced by tenofovir forthwith. I noted too how strange this seemed, given that the toxicity of tenofovir is high and well known, as I had noted in several posts; see “HAART is toxic: Mainstream concedes it, in backhanded ways” (2011/12/30).
What will TAC do next, given that the toxicity of tenofovir is becoming talked about increasingly?

“In their analysis of comprehensive VA electronic health records, the study authors found that for each year of exposure to tenofovir, risk of protein in urine — a marker of kidney damage — rose 34 percent, risk of rapid decline in kidney function rose 11 percent and risk of developing chronic kidney disease (CKD) rose 33 percent. The risks remained after the researchers controlled for other kidney disease risk factors such as age, race, diabetes, hypertension, smoking and HIV-related factors. . . . Patients were tracked for an average of 1.2 years after they stopped taking tenofovir. They remained at elevated risk for at least six months to one year compared with those who never took the drug, suggesting that the damage is not quickly reversible . . . . ‘We do not know the long-term prognosis for these patients who stop tenofovir after developing kidney disease’”.
(Of course the authors of the reported study pointed out that HIV itself increases the risk of kidney damage. HIV itself is blamed by HIV/AIDS believers for every ill that antiretroviral drugs bring, for example “HIV-associated lipodystrophy”. Strange that all this supposed harm done by “HIV” was first noted only after antiretroviral drugs came into use.)

I confess that my query, what’s next for TAC, is replete with unashamed and undisguisable Schadenfreude.
The Treatment Action Campaign (TAC) in South Africa exemplifies as actively virulent a set of HIV/AIDS groupies and vigilantes as one could find anywhere. It is not too easy, though, to find out who exactly are the individuals who staff TAC. The website identifies only the “Leadership” of Vuyiseka Dubula, TAC General Secretary, and Nonkosi Khumalo, TAC Chairperson; and the Contact page gives the name only of the PR person (“Media Comment”), Caroline Nenguke. In this type of organization, these positions are figureheads, the real work being done by full-time staff.
The Annual Report for 2010 like the website gives no names of staff, not even who wrote the Report. It does mention — as had earlier news items — that funding has declined in a way that has made it necessary to retrench. Were I a donor, I would be unhappy at the Annual Report’s acknowledgement that the budget shows “General and Administrative” expenses at 21.7 million, not much below what was spent on “Programmes and Projects” at 27.6 million (currency is not indicated, presumably SA Rand). However, the Report does give a link  for the full financial reports, and the 2011 one has the names of 5 directors: NAC Khumola, V Dubula-Majola, N Geffen, MJ Heywood, and TT Diamini, as well as two who had resigned in 2010: A Achmat and TGP Klaas. Compensation for the 5 directors is shown as 777,019 (if in South African Rand, a bit over US$100,000), a very small part of the 21,700,000  “General and Administrative” expenses. What were the other parts?
Nathan Geffen is a member of “AIDStruth.org”, co-authored Edwin Cameron’s book, “Witness to AIDS”, and himself has written “Debunking Delusions: The Inside Story of the Treatment Action Campaign” (2010). He is active not only in HIV/AIDS matters but also politically, active among Jews who are critical of Israeli policies and actions. Mark Heywood is Director of the AIDS Law Project, whose website is as lacking in individuals’ names as is the TAC website.
I am irrevocably suspicious of organizations that do not give up front the names of all their significant staff and that do not in public documents itemize expenditures on salaries and associated benefits, just as I’m not interested in the views of bloggers and commenters who hide their identities. When things are not revealed, it seems reasonable to infer that revealing those things would discredit whoever wants them to remain hidden.

RA 2011 to be re-scheduled

The proposed meeting in Washington DC beginning of December has had to be postponed:

 

Rethinking AIDS regrets to inform you that RA 2011 will not be held on December 1-3, 2011. Many Rethinkers experienced difficulty raising adequate travel and lodging funds in these tough economic times and, in some cases, were unable to obtain visas in time. Without access to support from governments, foundations and corporations, Rethinking AIDS has decided to postpone the conference and to consider alternative formats that can involve more rethinkers at less cost.

We appreciate the support provided by both our volunteer speakers and by those of you who did register. All registrants will be contacted soon to arrange a refund. We apologize for any inconvenience this may cause.

- David Crowe, Conference Chair and President, Rethinking AIDS
mailto:David.Crowe@rethinkingaids.com