Inventing more epidemics; the Research Trough; and “peer review”

Kevin De Cock, director of HIV/AIDS at the World Health Organization, famously let slip the fact, demonstrated by a quarter century of assiduous but unsuccessful searching for epidemics, that there had not been and would not be any epidemic of heterosexually spread “HIV” outside Africa [WHO SAYS that WE’VE BEEN VERY WRONG about HIV and AIDS? (Clue: WHO = World Health Organization), 10 June 2008;  More De COCK AND BULL stuff and nonsense, 15 June 2008].

Not even so authoritative a statement can compensate, though, for decades of propaganda and loose, ignorant talk about “everyone is at risk”. Nor can anything curb the appetite for grants among HIV/AIDS researchers. Thus

“Jeffrey Samet, professor of medicine and public health at Boston University Medical Center, is lead investigator on . . . [a] study on HIV and hospitalized Russian drinkers. Samet’s $3 million, five-year grant from the National Institute on Alcohol Abuse and Alcoholism, which is already in its third year, is designed to show that a program of HIV intervention aimed at alcohol and drug users getting in-patient substance abuse treatment settings bolsters safe sex practices. Russia is in the midst of a significant HIV epidemic” (Doug Lederman, “One-Man Peer Review”, 28 July 2009).

Given that the specifically legislated concern of the National Institutes of Health is the health of American citizens, Congressman Darrell Issa, a California Republican, was moved to question whether this study could conceivably further the Institute’s mission. Possibly channeling the late Senator Proxmire, who was wont to assign “Golden Fleece” awards for such taxpayer-funded make-work-for-researchers projects, Issa’s staff also pointed to grants for “Substance Use and HIV Risk among Thai Women” and “Venue-based HIV and alcohol use risk reduction among female sex workers in China”.

Connoisseurs of the academic Research Trough will relish such not-so-disinterested ensuing comments as

“’NIH’s peer review system is the envy of the world because it ensures only the highest quality science is supported through federal funding,’ said Mark O. Lively, president of the Federation of American Societies for Experimental Biology. ‘Any short-term compromise of the peer-review process, through Congressional micro-management of the grant-making process, is a grave threat to biomedical research, the quality of U.S. science, and the health of our fellow citizens.’”

Worth a chuckle as well is Professor Samet’s explanation of the study’s potential benefits to American taxpayers:
“the techniques used to study Russian alcoholics are aimed less at protecting the drinkers themselves than their ‘unknowing partners,’ . . . ; the HIV epidemic is one of many factors that could further destabilize Russia, which could have significant political and economic implications for the U.S.; HIV can lead to the spread of tuberculosis, which is not contained within borders, etc.”

“Samet joked that the House ‘thoughtfully considered the issue’ for ‘about three seconds’”.

I didn’t time myself, but I might even have beaten that 3-second record in my thoughtful consideration of the thoughtful reasons offered thoughtfully by Samet in explaining the potential value of his study to America and its citizens.

Add to that the absurdity of the “study” itself. The question is, if you subject hospitalized alcoholics to safe-sex indoctrination, using the fear of HIV/AIDS as emphasis, will they practice safer sex later?  Or will they at least say in subsequent surveys that they did so? After all, there’s no other way to check on their sexual behavior than questioning them. This would be a waste of money even were it carried out with solely American alcoholics.

If only it didn’t cast so revealing a light on what our “medical science” has come to, all the foregoing would be funny enough in itself without the added titillation that there is no HIV epidemic in Russia, never has been, and never will be, according not only to Kevin De Cock but also to the data published by European authorities. For example, the incidence of newly identified “HIV infections” in Russia was running at <300 per million in 2006, that is 3 per 10,000, which can be accounted for quite adequately by the “false positives” induced by flu vaccinations and the like, together with the veritably growing epidemic of testing:

(From “Prevalence of HIV and Other Infections and Risk Behaviour among Injecting Drug Users in Latvia, Lithuania And Estonia in 2007”, brought to my attention by a good friend in Estonia. More data from Estonia will be presented and discussed in future posts)

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But what do facts matter when propaganda is called for? As yet another not-so-disinterested group (USAID) would have us believe,

“Russia has the largest AIDS epidemic in Eastern Europe and Eurasia, accounting for approximately 66 percent of the region’s newly reported HIV cases in 2006. According to UNAIDS, the 2005 national HIV prevalence estimate was 1.1 percent, and an estimated 940,000 people in Russia were living with HIV (although the officially diagnosed caseload is considerably lower). Russia’s HIV prevalence was very low until 1996, when 1,515 new cases were suddenly reported. While its pace has slowed since the late 1990s, the country’s HIV epidemic continues to grow. According to UNAIDS, a decline in new cases occurred between 2001 and 2003, but new cases are now increasing again, with 39,000 new HIV diagnoses officially recorded in 2006, bringing the total number of HIV cases diagnosed and registered with health officials to 370,000, according to EuroHIV. Officially documented HIV cases only represent people who have been in direct contact with Russia’s HIV reporting system.
USAID’s initial HIV/AIDS activities in Russia focused on HIV prevention among high-risk groups during 1998– 2000. In fiscal year 2008, USG programs continued to support HIV/AIDS awareness, prevention, research, access to treatment, and technical guidance for Global Fund AIDS programs. These programs are creating models to provide assistance in measuring the evolving and growing HIV epidemic and increase local and national government capacity to respond to the epidemic in an organized and sustainable way.”

Note the usual offering of UNAIDS estimates that are much greater — in this case nearly 3-fold — than the actually available data; the determined emphasis on intermittent stochastic increases as a way of masking the lack of any overall upward, let alone any epidemic trend; the citing of “66%” of the region’s numbers of cases without mentioning that Russia also has by far the largest population in that region.

Books like How to Lie with Statistics (by Darrell Huff, W.W. Norton, 1954), Damned Lies and Statistics: Untangling Numbers from the Media (by Joel Best, University of California Press, 2001),and More Damned Lies and Statistics: How Numbers Confuse Public Issues Politicians, and Activists (by Joel Best, University of California Press, 2004) were clearly intended to forewarn consumers about the devious tactics of advertisers and PR gurus. It would seem that HIV/AIDS propagandists have chosen instead to use them as manuals for how best to deceive without appearing to be actually lying.

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Despite my attempts at mood-lightening levity in pointing to these absurdities and corruptions and deceits, I am actually very sad about all this. More than half a century ago, my cohort of science students had the idealistic attitude that remains characteristic of so many young people, and moreover the history of science into the middle of the 20th century gave us good grounds for believing that we were entering a profession outstanding for its honesty and potential service to humankind.

After one of my closest friends from that period had read the MS of my HIV/AIDS book, he remarked that an unfortunate side-effect of debunking HIV/AIDS theory would be a loss of trust in science. It’s very sad indeed that such lack of trust has been so thoroughly earned through conflicts of interest personal and institutional, not to say sheer greed, cutting of corners, and general corruption. To what have we come when Marcia Angell, former editor of the New England Journal of Medicine, is moved to write that the pharmaceutical industry has co-opted “every institution that might stand in its way, including the U.S. Congress, the Food and Drug Administration, academic medical centers, and the medical profession itself” (Angell 2004: xviii); “[C]onflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of The New England Journal of Medicine” (Angell 2009; emphasis added).
[Marcia Angell, 2004, The Truth About the Drug Companies: How They Deceive Us and What To Do About It, Random House; 2009, “Drug companies & doctors: a story of corruption”, New York Review of Books, 56 #1, 15 January].

As for Mark O. Lively’s remark that “NIH’s peer review system is the envy of the world”, he should have said “the envy of researchers around the world”, because the peer reviewers are at the same time those who themselves benefit from the grant system. Those who are reviewers this time are the grant applicants the next time, and it’s a matter of mutual back-scratching. Nowadays “peer review” in science bears the same relationship to objective assessment as did the “financial analysis” by Wall Street reviewers that pronounced a bunch of worthless paper to be AAA-OK reliable investments.