Document:Drugs, Disease, Denial
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New York Press
22 June 2005
Last July, New York Press published an article by Liam Scheff entitled “Orphans on Trial.” The piece sparked a slow-building wave of media interest in the children of Incarnation Children’s Center in Washington Heights, who have since become a lightning rod for a larger debate on HIV/AIDS drugs. A small but increasingly influential faction, commonly known as AIDS denialists, claims that HIV does not cause AIDS, and that the drugs used to treat HIV/AIDS are worse than the disease. We have invited longtime human-rights activist Jeanne Bergman and Celia Farber, a journalist and self-described “AIDS dissident,” to discuss the positions of their respective camps. We hope the heat generates some light. — the editors of New York Press
The hysteria-laden question of whether anti-HIV drugs are “life-saving,” as the AIDS orthodoxy holds, or “deadly,” as the HIV dissidents claim, is unanswerable in the currently available language, which was blunted and rendered incoherent by political forces as early as 1981. Language is the only interface between phenomena and our comprehension of them, and I have grown weary of being forced to use AIDS language that is itself inaccurate and loaded. First of all, lives can’t really be “saved” – they can only be extended. To prove that a life has indeed been extended one must first know, with absolute certainty, that without intervention, the life would have ended. In order to know that, one must know the natural history of the disease, and then one must examine the fate of the untreated population.
The unified voice of the AIDS establishment has claimed thunderous victory for the post-1996 drug regimens that came to be known as ‘cocktails,’ which came into vogue about three years after death rates began declining, but nonetheless got full-trumpet credit for turning the tide.
Let me say, first, that I have been told and have reported and have imprinted upon my soul that for some people, at some stages of immune collapse, these drugs have helped, and maybe even prevented a slide into death. Roberto Giraldo, a doctor and expert in infectious and tropical diseases who crosses the world treating AIDS, tells me this is probably due to their anti-oxidant, anti-viral and anti-microbial properties. He also tells me that in his experience, severe immune deficiency – which may be a more useful term than “AIDS” – occurs only where severe depletion of vital nutrients has occurred; reversing the illness starts with restoring those nutrients.
“Biochemically speaking, people who are malnourished, whether because they are poor, or because they are drug addicts, suffer from oxidization, and lack vitamins A, B, E, zinc and selenium. This is true of all AIDS patients I have ever seen,” he said via telephone. “We cannot say that protease inhibitors are useless. In 1996 when they started to use protease inhibitors, there is no doubt that there was a change. Before 1996, all the people who used AZT, they were killed. There was no benefit there. Protease inhibitors – they are also very toxic – but they have benefits – they are antioxidants. No doubt they are poison and in the long run they kill the person, but you need proteases in the process of oxidation. Besides that, these drugs are also antibiotics.” Giraldo believes that AIDS is a disease “of poverty,” primarily, meaning of extreme depletion of the cells, and that those who have been middle- or upper-class, who have gotten sick, depleted their bodies through drug use and prolonged exposure to toxins. “HIV by itself causes nothing,” he says.
Giraldo has written and published voluminously on how to reverse the condition of severe immune suppression through intensive nutritional supplementation and orthomolecular medicine, combined with modified antibiotic and other targeted drug regimens. I am well aware of how scorned these ideas are among those who feel that they and they alone know what AIDS is, and how to “fight” it, i.e., the orthodoxy and the pro-drug activists. Since 1986, when I began reporting on AIDS, I have compensated for this scorn, ridicule and censure by quoting the Roberto Giraldos of this world – not because I know these voices are “right,” but because I feel they must be represented against the relentless chorus of the new-and-better-drugs-into-all-bodies-in-all-nations crowd. I am not a doctor and have never treated an AIDS patient. I’ve known dozens if not hundreds of people though, in my 20 years studying this and listening to people, who have been HIV-antibody positive and stayed healthy for up to 20 years and probably more. I wish somebody was counting them, listening to them, logging them in the official history. Nobody is; they are not supposed to exist.
Each of the 26 anti-HIV drugs currently on the market, combined in infinite combinations, or “cocktails,” is, by admission of the manufacturers, potentially lethal. One of the unexpected effects of Protease Inhibitors, or so-called HAART therapy (Highly Active Antiretroviral Therapy) seen in recent years was a disruption of the body’s fat-distribution mechanisms. This in turn (in addition to the fatty deposits on the upper neck and various parts of the body) has caused strokes and heart attacks in many patients, at the very moment when the drugs were theoretically "working," meaning so-called surrogate markers (CD4 cells and viral load) were going the right way. The other significant danger of HAART proved to be liver and kidney failure, which, according to a study done at the University of Colorado Health Sciences Center, “surpassed deaths due to advanced HIV,” in 2002. In 2005 the Wall Street Journal reported that, according to a Danish study, AIDS drug cocktails “may double the risk of heart attacks.” In 2004, the journal AIDS reported, with characteristic lack of alarm, “All 4 classes of antiretrovirals (ARVs) and all 19 FDA approved ARVs have been directly or indirectly associated with life-threatening events and death.” The paper was titled “Grade 4 Events Are as Important as AIDS Events in the Era of HAART,” and “grade 4 events” referred to “serious or life-threatening events.”
The conclusion: More than twice as many people (675) had a drug-related (grade 4) life-threatening event as an “AIDS event” (332). The most common causes of grade 4 events (drug toxicities) were “liver related.” The greatest risk of death was not an AIDS “event” but a drug event – heart attacks (“cardiovascular events”). The authors wrote: “Our finding is that the rate of grade 4 events is greater than the rate of AIDS events, and that the risk of death associated with these grade 4 events was very high for many events. Thus the incidence of AIDS fails to capture most of the morbidity experienced by patients with HIV infection prescribed HAART.” (Italics mine) In plain English, AIDS drugs cause AIDS and death far more effectively than “AIDS” itself.
Any triumph or victory claimed by the AIDS lobby for these drugs must be measured against a phenomenon they continue to deny exists, namely the untold number of people who are, to use their language, “living with HIV.” This includes those invisible, uncounted, unloved people who are HIV-antibody positive, taking no drugs, not getting sick, not dying at a faster rate than HIV negatives. This begs the question of whether HIV causes AIDS. Currently, we have one camp – which I will call the “orthodoxy” – that argues that although current HIV drugs have frightful side effects and are difficult to take, they have nonetheless reversed a tide of death, which was seen throughout the 1980s and into the mid 1990s in people who were diagnosed with severe immune dysfunction. This camp, since it views AIDS as “HIV disease,” meaning caused singularly by HIV, concentrates its efforts to “fight AIDS,” on high tech drugs that in various ways are meant to disable HIV in the blood. They are extremely mechanistic in their view of the human body and the immune system. It’s all numbers.
The much-maligned contraries camp, which I will call the “dissidents,” have argued since the early 1980s that AIDS has multiple causes, and that its resolution should be rooted in a direct address to all these root causes. These include a cessation of recreational drug use, avoidance (when possible) of the most toxic anti-HIV drugs, a strong focus on reversing malnutrition, (particularly in Africa) and a treatment approach that treats the specific opportunistic infection a person manifests, with the state of the art treatment for that infection.
PCP pneumonia, for example, is utterly treatable, yet thousands of people died in the 1980s of it. Why? Because fighting AIDS meant “attacking” HIV, period. Never the specific diseases; never the underlying causes – only the virus. David Ho, Time’s Person of the Year, sported a button at a conference that summed up this ideology. The button said, “It’s the virus, stupid.”
How that came to be the dominant scientific religion is a subject of infinite complexity and tragedy. The virus (which is actually a retrovirus, of a class that was never thought to be pathogenic prior to 1984, and which we all harbor shards of in our germline) provided an absolute measure, a clear delineation, a battleground, and above all, a focus for a gigantic industry, as well as an international corporation called AIDS Inc. The natural and true history of AIDS is only beginning to be told, or rather, retold. When AIDS Began: San Francisco and The Making of An Epidemic (Routledge) by Michelle Cochrane traces the earliest intersection between what was being observed, those who were doing the observing, and how the “truth” fared in the process. Cochrane weaves a rigorously detailed semantic, medical, and sociological examination of the first cases as they were charted and described by the San Francisco Department of Public Health in 1981. She explodes the myth of the first cases of AIDS having appeared, as the New York Times famously phrased it, in “previously healthy,” and even upwardly mobile, gay men, and shows that quite the contrary, the first nine cases were in men who had a range of immune assaults. All were recreational drug users, many were IV drug users, and some were even homeless. They suffered from diseases that had been seen in IV drug users since the 1930s, primarily fungal infections and lung diseases. That they were “gay,” was perhaps the least significant detail. Because the federal research effort ($36 billion so far) has been 100 percent HIV-centric, and because AIDS was presumed to be sexually transmitted as opposed to “acquired,” we are essentially 20 years behind in our intelligence gathering on AIDS. One of the most astonishing things about the politics of AIDS is the way in which the left repudiated any explanations of disease causation that could be predicted by poverty and social marginalization.
One of the hallmarks of the AIDS orthodoxy’s language is that coiled within each word and phrase is the answer, as well as the shaming of the question itself. George Orwell (in 1984) described the orthodox style as, “...at once military and pedantic,” characterized by a trick of “...asking questions and then promptly answering them.” Anti-HIV drugs, for example, are always called “life-saving drugs.” Why not just call them “drugs” and allow their merits to be debated? Because at the root of the AIDS orthodoxy is a relentless urge to control all thought on AIDS.
All people who question any facet of orthodox AIDS theory are “murderously irresponsible,” and dripping with the psychic blood of millions. In this gladiatorial atmosphere, it is a wonder anybody speaks out at all. If only we could agree that most people are not, by nature, homicidal, and that dissenting views are productive to a search for truth, we might get somewhere. But I know, as surely as I know anything, that my opponent in these pages will have characterized my position as “denialist.” I am not denying anything. People have died of AIDS and the matter at hand is what they died from. A retroviral infection? A host of immuno-compromising factors? An absence of AIDS drugs – or indeed, the AIDS drugs themselves?
In 1984, when the US government announced at a press conference that one of its scientists – Robert Gallo – had found the “probable cause of AIDS,” the official theory held that HIV caused AIDS by eating CD4 cells at a rapid clip. HIV was said to cause AIDS in a year or two, at best. Today, this theory has morphed into a range of possibilities; HIV causes AIDS in 10 to 15 years, in most people, but a small minority, so-called “long-term non-progressors,” might be spared due to a genetic fluke.
To my mind, if we are to stick to the orthodoxy’s own measure, one cannot begin to speak of “saving” life until one has surpassed these ten or fifteen years. In the 1980s, AZT was claimed, with the same high dudgeon by the same orthodoxy, to “save” lives, yet few survived for more than a year on the earliest AZT regimens. The word “denial” comes to mind.
When people make dramatic claims for current drug regimens, the death rates they are actually comparing are not drugs vs. no drugs, but rather extremely toxic drugs of the early years compared to less toxic drugs of today. The earliest AIDS cases, marked by Kaposi’s Sarcoma, were treated with chemotherapy (1981 to 1986) followed by AZT monotherapy in doses ranging from 1800 milligrams to 500 milligrams (1986 to 1989) followed by combinations of AZT, ddi, ddc and d4t (1989 to 1996) followed by protease inhibitors in various combinations, from 1996 to the present day. The one era I have no question resulted in deaths from the treatment itself, is the early AZT era, (circa 1986 to 1989) particularly when the common dosage was 1200 to 1800 milligrams. A German AIDS physician named Klaus Koehnlein told me in 2000, “We killed a whole generation of AIDS patients with AZT.”
My friend Richard Berkowitz, author of Stayin Alive: The Invention of Safe Sex, A Personal History (Westview), said: “Every friend I had that went on AZT in those early years is dead.” He says that they lasted on average nine months on the drug. HIV positive since the early 1980s, Berkowitz credits his survival to two things: 1) having avoided AZT, and 2) safe sex.
What he means by “safe sex,” a concept and term he himself developed and coined, together with the late activist Michael Callen, is far more complex than mere condom use. Drawing on the pioneering observations and warnings of Dr. Joseph Sonnabend, it involves an avoidance of many STDs and parasitic infections, coupled with a belief in life rather than a belief in the death sentence of HIV. Berkowitz has also mitigated my repudiation of cocktail therapy by stressing that a moderate regimen pulled him back from the brink of death a few years ago.
Paul King, a Brit who runs a dissident website called Dissident Action Group in the U.S., counters the establishment’s claim that dissenting views on AIDS, HIV and drug regimens are still “fringe.”
“From the very beginning in the 1980s, the AIDS dissident movement faced a level of censorship unrivaled since the anti-birth control information Comstock Law of the early 20th century,” he said in an email. “Every day,” King claims, “almost without exception, we attract another PhD or doctor and now have well over 4,000 doctors and scientists endorsing our views.”
“The public has had enough of exaggerated stories of epidemics that never materialize and [that diminish] personal freedom.”