Medical students in Africa need not fear HIV

I drew attention in March (Medical students in Italy need not fear “HIV” when dissecting cadavers, 2010/03/06) to the demonstration that there is negligible risk of HIV infection or AIDS during dissections that are part of medical education (“On the risk of contracting AIDS at the dissection table”, Italian Journal of Anatomy and Embryology, 114 (2-3, Apr-Sep 2009) 97-108, by M. Ruggiero, M. P. Galletti, S. Pacini, T. Punzi, G. Morucci, & M. Gulisano). The data reviewed there pointed to the lack of any documented cases of such infection during the whole AIDS era, by now about three decades; the fact that “HIV-positive” — the presence of antibodies regarded as associated with HIV — does not necessarily denote active infection; and the related fact that many “HIV-positive” individuals never get AIDS. Although there are undoubted risks associated with medical dissection from other sources, the fear of contracting HIV and developing AIDS is not warranted.
The significance of this article is underscored by its publication in a mainstream venue, the  Italian Journal of Anatomy and Embryology, official journal of one of the most prestigious Italian and international scientific societies, the Italian Society of Anatomy and Histology. The Society’s founders in 1929 included such distinguished individuals as Professor Giulio Chiarugi, scion of Vincenzo Chiarugi, the founder of modern psychiatry. The journal is in English, is peer reviewed, and is listed in major indexing systems including PubMed.
Of course in Italy, as in the rest of Europe and indeed the rest of the world outside southern Africa and the Caribbean, the rate of “HIV-positive” is quite low, well within 1% and frequently even an order of magnitude less. So it seemed worth considering whether medical students in regions of higher “HIV-positive” frequency should perhaps worry about contracting HIV/AIDS even as students in Italy need not.
South Africa is a most appropriate locale for such an investigation on at least two counts: The prevalence of “HIV-positive” people is high, and the status of medical practice, medical education, and medical statistics is better, more reliable, than in most other high-prevalence regions.
The conclusions of such a study have now been published, again in the Italian Journal of Anatomy and Embryology: “Safety issues in didactic anatomical dissection in regions of high HIV prevalence”, 114 #4 [2009] 179-92, by Matteo Prayer Galletti & Henry H. Bauer. It turns out that South African medical students have no need to fear contracting HIV and AIDS, just as in Italy. To the arguments and data presented in the article by Ruggiero et al., this publication adds estimates of the rate of false positives, with special attention to the racial bias of existing “HIV” tests, a bias that stems from a failure to base the tests on appropriate control groups. That bias causes Africans to test “positive” about 20 times more often than they would under properly calibrated tests, and people of recent African ancestry also test positive about an order of magnitude more frequently than they would with appropriately calibrated assays.
Another feature of this article is an estimate of the proportion of long-term non-progressors or elite controllers among “HIV-positive” individuals. Official data indicate that this proportion is much higher than commonly assumed, perhaps as great as 50%.

Big Science & commercial science publishing = corruption of peer review & science

The conventional wisdom about science is half-a-century or more out of date. Up to roughly World War II, it was not too wide of the mark to see scientific activity as driven by the curiosity of dedicated individuals who collaborated and competed to tease out a comprehensive understanding of the natural world. No one chose a career in science as a way to wealth, because it wasn’t. By and large, mutual critiquing was based on evidence and logic, and controversies became resolved reasonably soon after the evidence became objectively compelling. Personal unpleasantries did arise, notably in disputes about priority of discovery, but they were between individuals and their close cohorts, not the guardians of a mainstream dogma branding dissenters as denialists, pseudoscientists, or criminals who should be jailed. Of course there was always resistance to new ideas, but it involved ignoring the intellectual challenge rather than seeking to kill the messengers. In the late 1930s, sociologist Robert Merton described the scientific landscape as displaying an ethos (nowadays referred to as the Mertonian Norms) in which scientists were producing a public good, sharing their work openly, conscious of and accepting the universality of scientific knowledge, and working disinterestedly to advance science rather than their own private, personal interests.

World War II brought science and its applications into high public importance: the Manhattan Project that created atomic bombs, radar that crucially helped Britain against Nazi air strikes, sonar that was invaluable in combating submarines, penicillin that revolutionized the treatment of bacterial infections, and much else. Science became prominent in political and social policy-making as never before, and scientific advice came to influence significant portions of national budgets. Governments distributed largesse to produce more scientists and more science. Universities found ways to benefit from the largesse. Business and industry also found ways to profit from this burgeoning growth of research activity.

So science became transformed from a public good to a thoroughgoingly for-profit enterprise. Scientists increasingly owed fealty to patrons, sponsors, employers, and the aims of research focused increasingly on what would be profitable, preferably in the short term, instead of on what would most advance human understanding. Scientific publication exploded and its costs rose; journals, traditionally controlled by scientific societies, came increasingly to be taken over or established by commercial publishers. As with commercial publishing in general, there was consolidation and striving for higher profits. Libraries were increasingly unable to cope with the rising costs. Before World War II, manuscripts for publication were judged without regard to fiscal matters, but nowadays costs are a salient factor. Journals of such non-profit associations as the American Chemical Society began to levy “page charges”: authors were asked to pay if their manuscripts were accepted for publication, initially perhaps $50 per page (I seem to recall), but that would seem a remarkable bargain nowadays where the charges are typically ≥$100 per printed page. Because publications constitute a researcher’s career portfolio, the stakes are high and researchers scramble for means to pay page charges, usually via research grants that allow page charges as legitimate costs of research. Entrepreneurs have realized that they can profit by putting out publications whose costs plus overhead (= profit for publisher and publisher’s employees) are borne by the authors themselves or by their research grants, and new publications are springing up at a great rate, primarily to make financial profit for the entrepreneurs and career profits for the publishing authors. It is to the advantage of authors, editors, and publishers of these for-profit ventures to put out as great a volume of material as possible, so quality has gone by the board and “peer review” tends to allow through anything that fits the prevailing viewpoint, no matter how banal, insignificant, useless. Scientific publication has become what used to be called “vanity publishing” not so long ago: Among the general public, and also to some extent in the humanities and social sciences, people who wanted to have their books published but could not meet the standards of existing publishers could pay the costs themselves. The natural inference about such “self publication” judged it as of inferior merit (though a small percentage of such works lived to prove the publishers wrong who had rejected the manuscripts). The contemporary bubble of paid-for, profit-centered scientific publication constitutes nothing short of vanity publishing.

Hand in hand with rushing to produce anything that doesn’t rock the boat goes a fierce determination to exclude anything that threatens the bandwagon and gravy train. Peer review, like other aspects of science, has become thoroughgoingly corrupted by the change from “little science” to “Big Science”, which means commercial science, for-profit science. It has become routine for editors to choose manuscript reviewers with a view to getting the advice they want, namely, something that will not rock the profitable mainstream boat. Don’t try to publish anything that questions HIV/AIDS theory, or Big-Bang theory, or human-caused global warming theory, or Darwinian evolution, or string theory, or an asteroid cause of dinosaur extinctions, or any other prevailing contemporary consensus.

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The foregoing repeats much of what I talked about at the Oakland Rethinking AIDS Conference,  but I do so not to repeat myself but as an introduction to recommending a pertinent series of essays by Suzan Mazur. They are based on interviews with scientists and observers of science who have specific experiences to recount of the corruption of peer review. I was alerted to these by an interview of Suzan Mazur on the Jeff Farias Show (“Danger! Big Science Peer Review“).
Links there lead to these other excellent and pertinent items:
The Peer Review “Fig Leaf”: Vera Hassner Sharav, 2010/04/01
Free Science Peer Review From Cultish Conspiracy, 2010/02/03
David Noble: Peer Review, Where Are The Scholars?, 2010/02/26
Margulis: Peer Review Or “Cycle Of Submission”?, 2010/01/05
Jeff Farias Show: Altenberg 16 – Evolution Exposé, 2009/11/26
The Altenberg 16: An Exposé Of The Evolution Industry,  2009/08/26

Peer review is no better than in-house reports — OFFICIAL!

When you’re in a hole, and you head the International Panel on Climate Change, dig yourself in deeper, and incidentally give continuing comfort to your critics, as well as to critics of other  official international boondoggles (“IPCC’s Parchauri [sic] says climate body must ‘listen and learn’”, by Richard Black, 14 May 2010):
“He [Rajendra Pachauri, head of IPCC] . . . defended the principle of using non-peer-reviewed materials, such as the WWF report wherein the Himalayan error originated, which said the mountain range’s glaciers could disappear by 2035. ‘I’d like to highlight what non-peer-reviewed literature constitutes: reports from the International Energy Agency, the OECD, the UN Food and Agriculture Organization, the World Bank, the Asian Development Bank and organisations of this nature. ‘There are some highly prestigious NGOs that are doing detailed academic work, and you cannot ignore this.’ But, he observed, people working on assessment had to follow scrupulously the procedures on when and how to use such material and occasionally, as with the Himalayan episode, human error had crept in. . . .
Although Friday’s contributions at the initial hearing here in Amsterdam all come from IPCC and UN personnel, Dr Robbert Dijkgraaf, co-chair of the InterAcademy Council, said the panel would be looking to draw on different shades of opinion over the next few months. . . .
Roger Piekle Jr, a professor of environmental studies at the University of Colorado who has researched the likely costs of natural disasters, remains dissatisfied with the IPCC’s response, and maintains that the review must listen to critical voices if [it] is to be effective. . . .
’However, there are risks here as well, as a poorly conducted review could irreparably damage the institution.’ He also said the review should look at conflicts of interest within the IPCC.”

Note:
1. Alert observers of scientific activities will relish Dr. Pachauri’s concession that “occasionally” human error creeps into scientific matters. Who would have thought that? It’s almost as though scientists were human — when everyone knows, surely, that they are not fallible like politicians or journalists, say.
2. Supporters of Medical Hypotheses and of its editor, Dr. Bruce Charlton,  will accept graciously this confirmation from on high that peer review is by no means the best avenue to getting the most worthwhile material disseminated.
3. People familiar with “reports from the International Energy Agency, the OECD, the UN Food and Agriculture Organization, the World Bank, the Asian Development Bank and organisations of this nature” will be astonished that anyone would regard these biased, agenda-driven, in-house publications as in any way to be relied upon. After all, the organizations producing these reports share the practice of themselves disclaiming responsibility for the accuracy of what is in their reports, e.g.
“The findings, interpretations, and conclusions expressed in this paper are entirely those of the author(s) and should not be attributed in any manner to the World Bank, to its affiliated organizations, or to members of its Board of Executive Directors or the countries they represent. The World Bank does not guarantee the accuracy of the data included in this publication and accepts no responsibility for any consequence of their use” (World Bank, Intensifying Action Against HIV/AIDS in Africa–Responding to a Development Crisis–AFRICA REGION–THE WORLD BANK, 1999); yet the authors of the report, which was issued by the World Bank, are employees of the World Bank and produced the report as part of their employment there.
More succinctly,
“UNAIDS does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use” (UNAIDS, Report on the global HIV/AIDS epidemic 2008; UNAIDS/08.25E / JC1510E).
4. AIDS Rethinkers will note that IPCC has the same approach to “reviewing” as does Elsevier: namely, make sure that all “reviewers” are people who are already in your camp and of your opinion.
5. Dr. Piekle’s warning that an honest, unbiased review carries risks is unnecessary. IPCC, Elsevier, and other such organizations are perfectly well aware of that. That’s why they avoid unbiased reviewing.
As to conflicts of interest, in their absence the IPCC, Elsevier, and their kin would be out of business.

The LAZARUS EFFECT in HIV/AIDS

HIV/AIDS dogmatists and HAART enthusiasts like to cite anecdotes about “HIV-positive” people who disdained antiretroviral drugs, then found themselves sinking into life-threatening illness, finally saw the light, started on medications, and immediately, overnight began to regain their health.

I’ve noted in a number of places that any such rapid response cannot be owing to antiretroviral action, because inhibiting the supposed virus is only supposed to allow the immune system to slowly regenerate. The blurb for a recent documentary underscores that point. The following announcement was forwarded to me (emphases added):

“HBO & (RED) present The Lazarus Effect

NEW YORK PRESS DAY

When:            Friday, May 7 – times TBD

Where:          HBO, 1100 Ave of Americas
(b/w 42nd & 43rd Streets)

What:             Print, Radio & Online Roundtable Interviews
Select 1:1 Interviews

Who:              Lance Bangs (Director)
Constance Mudenda (Documentary Subject)
Susan Smith Ellis (CEO, (RED))

HIV/AIDS is a preventable and treatable disease, yet it has killed more than 20 million people in Africa. In 2002, more than 29 million people in Sub-Saharan Africa had HIV, yet only 50,000 people could afford the $10,000 a year treatment they needed to stay alive. Today, thanks to increased political support, a push by global health organizations, and contributions from the private sector, the cost of ARV drugs is now around 40 cents a day and more than three million people in Africa, are now receiving treatment.  The availability of antiretroviral (ARV) drugs, which block HIV’s assault on the body’s immune system, can transform the lives of people from near death to health in as little as three months.  This has been dubbed The Lazarus Effect after the story in the Bible when Jesus resurrected Lazarus from the dead.

(RED), with Anonymous Content and HBO Documentary Films present The Lazarus Effect, a half hour documentary airing on HBO Monday, May 24th, 2010 at 9:00 pm which is at the center of a multi-media campaign by (RED) to raise awareness about the impact of large scale AIDS programs at work in Sub-Saharan Africa. Directed by Lance Bangs and executive produced by Spike Jonze and Susan Smith Ellis, THE LAZARUS EFFECT follows the stories of four individuals whose lives have been transformed from a near death existence to a healthier, more stable life in as little as three months.

THE LAZARUS EFFECT debuts on HBO, May 24th at 9 pm ET/PT

To RSVP to the press day, and request a DVD of the film, please contact Jayna Zelman at jzelman@rubenstein.com or 212/843-8044.

Jayna Zelman
Vice President
Rubenstein Communications
1345 Avenue of the Americas
New York, NY 10105
p 212.843.8044
jzelman@rubenstein.com”

Dr. Juliane Sacher and Dr. Claus Köhnlein have treated AIDS patients successfully by “alternative” or “complementary” or at any rate non-HIV/AIDS-mainstream means. They report that short antiretroviral treatments can sometimes be effective to treat occult inflammations or infections, because antiretroviral drugs are such excellent indiscriminate antibiotics, protease inhibitors being particularly effective against fungal infections.

A genuine Lazarus effect would presumably mimic Jesus’s resurrection of the dead Lazarus which was, according to the Gospel of John, immediate, not a three-month-long process. There’s a world of difference between such an instantaneous response, which can result plausibly from antibiotic destruction of fungal agents or other microbes, and the purported slow resurrection of immune systems by highly toxic medicaments that need to be taken until death.