NATURE leads — in censorship and illogic

NATURE honored World AIDS Day with an editorial, “The cost of silence?” [4 December, 456: 545], that’s classically AIDStruthian. It cites the Chigwere et al. claim of lives lost in South Africa as a result of failure to provide antiretroviral drugs [for deconstruction of that claim, see “Poison in South Africa”, 26 October 2008]. The AIDStruthiness of the piece is underscored by its citation of a Nattrass article that managed to reach the same conclusion as Chigwerde et al.

NATURE’s illogic is stunningly exemplified by the editorial’s concluding paragraph:
“In retrospect, the [Mbeki advisory] panel, constituted as it was, should never have been supported. Yet several of the country’s key scientific institutions explicitly endorsed its establishment, and also desisted from criticizing Mbeki. Along with his cabinet, they bear some culpability for the consequences that have now been documented. There is a moral to this tragic tale that may prove relevant in other contexts. In a young democracy with a historically hierarchical culture, and with attitudes often hardened by a colonial past, scientific institutions need not only to guard their independence fiercely but also to make their reasoned voices heard above the fray of political sycophancy” [emphasis added].

The editorial writer evidently thinks that scientific institutions are fiercely guarding their independence only when they take a stand congenial to the editorial writer, in other words, when they parrot the mainstream consensus. I prescribe a short course in history of science, with special emphasis on the role of unorthodox views in the progress of science [start perhaps with references 24, 25, 35 in “Science Studies 101: Why is HIV/AIDS ‘science’ so unreliable?”, 18 July 2008].  As history of science knows, the mainstream consensus always opposes the most striking progress.

(Note too that “young democracy with a historically hierarchical culture” is not only condescending, it implies that there’s no need, in OUR aged democracies which have no hierarchical structure, to worry about political sycophancy. Course work in social and political science as well as in science studies is evidently needed quite badly by NATURE’s editorial staff.)

NATURE’s exclusion of claims that promise striking progress was summed up nicely by Nobelist Paul Lauterbur: “You could write the entire history of science in the last 50 years in terms of papers rejected by Science or Nature” [cited by Michael Goodspeed, “Science and the Coming Dark Age”, rense.com, accessed  10 October 2004].

Gordon Stewart has experienced NATURE’s censorship perhaps as much as anyone (see “A paradigm under pressure: HIV-AIDS model owes popularity to wide-spread censorship”, Index on Censorship (UK) 3; http://www.virusmyth. net/aids/data/gsparadigm.htm), yet he has continued to offer the magazine the opportunity to live up to scientific ideals of open discussion. Most recently, he sent a calm and measured response to the “Cost of silence” editorial, and was rewarded by an instant rejection by return of e-mail:

“Dear  Dr Stewart
Thank you for your Correspondence submission, which we regret we are unable to publish.  Pressure on our limited space is severe, so we can offer to publish only a very few of the many submissions we receive.
Naturally, I am sorry to convey a negative response in this instance.
Thank you again for writing to us.

Yours sincerely

Jayne Henderson, Correspondence, Nature”.

Stewart then enlisted Christian Fiala, Etienne de Harven and me and re-submitted under our joint signatures. The rejection came again by instant return e-mail, though this time signed (though not necessarily in person, of course) by the chief executive editorial honcho:

“Dear Dr Stewart
Thank you for your letter. We are not prepared to reconsider your Correspondence submission. No doubt you will be able to publish your and your colleagues’ views on AIDS transmission in parts of Africa and elsewhere in the world in some other publication after peer-review, but Nature Correspondence is not an appropriate place for such reports.

Yours sincerely, Maxine Clarke, NATURE”

Here’s the text of the rejected letter:

(00 44) 0131 552 2648                        29/8 Inverleith Place,
Gs2648@aol.com                        Edinburgh  EH3 5QD, UK.

7th December, 2008.
resubmission, 15th December.

To: Dr Philip Campbell,  Editor-in-Chief, NATURE,
By email to nature@nature.com            Confirmatory copy in postal mail.

Response to THE COST OF SILENCE?  Editorial.  NATURE 2008; 456; 545.

The allegations and recent updates in your Editorial about avoidable deaths due to HIV/AIDS in South Africa certainly require attention, but need also to be corrected. In AIDS, of all diseases, silence is surely the wrong word. But noise, in local and increasingly in international medical journals and lay Media, was loud, resonant and viciously ad hominem in the year 2000 when ex-President Mbeki welcomed about fifty international experts to join what NATURE now refers to as “The infamous Presidential advisory panel”. I was invited in 1999 to join that panel in company with Professors Luc Montagnier, Peter Duesberg, Zena Stein, Etienne de Harven, scientists from the US NIH, physicians from the US CDC, the team from Perth (Australia) and experts from severely-affected locations in Africa, South America and elsewhere, and from main centres in South Africa.  Dr Robert Gallo of the US NCI was invited to join but did not do so.

The infamous panel held meetings, at first in Pretoria and then in Johannesburg, chaired by a Canadian Judge, and taped. Observers from local and international Media were admitted to some meetings. Additional American experts, nominated by President Clinton, attended sessions and interviewed panelists individually and confidentially. The Minister of Health and the Chief Medical Adviser to the President attended all sessions, were available, with their staffs and other government officials and local academics, for consultation about transcripts and records, and to enable proposals made by members to be implemented, e.g. for ad hoc surveys and validation of tests. We were encouraged to visit clinics, laboratories, hospitals and, notably, old and new settlements at Soweto, Gauteng and MEDUNSA. To-and-fro activities on this basis continued through personal contacts and on the internet through 2006 when they were abruptly terminated by the sudden death of Professor Sam Mhlongo [footnote 1], who had been coordinating them. For this reason and because of fundamental and often sharp differences within the Panel, the outcome was, as Nature says, inconclusive, to which we would add a third word disappointing, because metropolitan facilities and expertise for investigation were impressive especially when in 2001 Dr Makgoba published a detailed report by the SA Medical Research Council. But their data and conclusions were found to be based [footnote 2] on records which were obsolete or incomplete. Do the recent reports to which Nature now refers correct this fault?

From 2000 onward, the noise increased internationally because seroprevalence of HIV and projections of symptomatic AIDS in Sub-Saharan Africa (SSA) were reported by UN AIDS, all major journals and health authorities as being the highest in the world (1-3). This was indubitable in continental comparisons but, within Africa, there were wide differences between the 50/51 countries where the data recorded in Sentinel Surveillance by WHO (2) showed a mean cumulative seroprevalence [footnote 3] of 126/100,000, higher than in any other continent or region. But this mean ranged from 39/100,000 (median 30) in 37, mainly northern countries, to a mean of 313/100,000 (median 268) in 16/50 countries in SSA, probably the highest in the world even with allowance for “Titanic” exaggerations and other errors, some of which were accepted as “Deliberate” by Nature (447;531-2) in their review in 2007 of disclosures (3) by James Chin, former Chief of AIDS for WHO before he retired to be a professor at UC Berkeley, CA. In South Africa, however, the mean was only 30/100,000. At all levels, these figures included doubts about incidence and projections based upon serotests, raised originally by Harvard field workers (4) in Africa and endorsed by Professor Mhlongo in SSA and in a communication to an open meeting on HIV/AIDS in Africa convened by and at the European Parliament in December, 2004.. However, as in other countries, and not only in Africa, validated data on sensitivity, specificity and consistency are still awaited. The massive registrations in tribal, borderline and backward regions are based largely on the infamous Bangui definition devised by WHO (5) for diagnosis of HIV/AIDS in places where there are no facilities for sampling, surveillance and testing, or even for recognizing and purifying dirty water.

High seroprevalence is not necessarily followed by increase in mortality or decline in population. In Uganda, formerly featured as the epicenter of the projected pandemic of HIV/AIDS, there was an unprecedented increase in population due to a slight decrease in mortality accompanied by a stable and higher birth rate over the period reviewed by the Infamous Panel (10).

These differences within Africa and between Africa and everywhere else require clarification as well as correction. When this was done in UK, USA and other developed countries, registration data from 1986 onward showed beyond reasonable doubt that the main determinants of symptomatic AIDS were and are high risk behaviours and preferences in sex, life styles and drugs (6-9), mainly in males, with transfer to female consorts bisexually and perinatally. In some other countries and especially in Africa, this transfer is complicated and extended (1,3,7,8) by abuse of women and girls in deeply unhygienic settings where all the STD’s and many other diseases  (1,3,7-10) besides HIV/AIDS are endemic, often lethal and difficult or impossible to differentiate by the Bangui definition in the field or even in hospital, especially in infants.

Irrespectively of these desiderata, your editorial asserts that President Mbeki and his Minister of Health lost credit and support primarily because they had implied that HIV did not cause AIDS. Neither did Professor Montagnier in a paper (11) written with collaborators in 1990 and on other occasions ( before and since that important year).

REFERENCES

1    UN AIDS. International Registrations of HIV/AIDS. See also AIDS in Africa. EC Meeting, Brussels, Dec 8th, 2004; and Stewart, GT.   AIDS and hepatitis Digest No 83; 2 (PHLS)
2    WHO: Sentinel Surveillance and wkly epidemiological reports. Geneva,1985-date
3    Chin J   The AIDS Pandemic.  Oxford, Radcliffe: 2007. See also Nature 200
4    Kashala O, Marlink H, Ilunga M et al. J Inf Dis. 1994; 169; 296,
5    The Bangui reclassification of AIDS. WHO, Geneva: 1985.
6    Stewart GT. Uncertainties about AIDS and HIV.  Lancet 1989; 335; 1325.
7    Stewart GT Changing the case definition of AIDS.  Lancet 1992: 340; 1414.
8    Bebe Loff   Africans discuss ethics of biomedical research. Lancet 2002; 359; 956.
9    Stewart GT. Uncertainties about AIDS and HIV. Lancet 1989; 336; 1325
10    Uganda Bureau of Statistics 1995 and 2000-2001. Population Census 2002. …………..
11    Lemaitre M, Henin L, Montagnier L, Zerinal A et al. Res Virology 1990; 141; 5-16.
12    AIDS in Africa. The European Parliament, Brussels, December 2004.
13    See also Bauer HH The Origins, Persistence and Failings of HIV/AIDS Theory. Jefferson NC and London. McFarland Publishing: 2007.
14    De Harven E, Roussez JC. Ten Lies about AIDS. Victoria, BC., Canada. Trafford Publishing: 2008.
15    Other references and correspondence are profusely available, on request.

Footnotes:
1    See obituary, BMJ 2007.
2    See Fiala C et al  Lancet 2001; 358; 1381 and correspondence with Department of Error.
3    Rounded to nearest whole number

Authors, with details for Editor:

Gordon Thallon Stewart, M.D., Emeritus Chair of Public Health at the University of Glasgow. Former consultant physician (Epidemiology and Preventive Medicine), NHS-UK., also to New York City, WHO, AMREF.; Emeritus Fellow, Inf Dis Soc of America and member, Editorial Board.

Etienne de Harven, M.D. Emeritus Professor of Pathology, University of Toronto. Formerly electron microscopist, The Rockefeller University, New York City.

Christian Fiala, M.D. Obstetrician-Gynaecologist in Vienna and Uganda.

Henry H Bauer,  Ph.D. Dean Emeritus of Arts & Sciences, Professor Emeritus of Chemistry &
Science Studies, Virginia Polytechnic Institute & State University, Blacksburg, VA, USA.