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I am Albert Einstein, and I heartily approve of this blog, insofar as it seems to believe both in science and the importance of intellectual imagination, uncompromised by out of date emotions such as the impulse toward conventional religious beliefs, national aggression as a part of patriotism, and so on.   As I once remarked, the further the spiritual evolution of mankind advances, the more certain it seems to me that the path to genuine religiosity does not lie through the fear of life, and the fear of death, and blind faith, but through striving after rational knowledge.   Certainly the application of the impulse toward blind faith in science whereby authority is treated as some kind of church is to be deplored.  As I have also said, the only thing that ever interfered with my learning was my education. I am Freeman Dyson, and I approve of this blog, but would warn the author that life as a heretic is a hard one, since the ignorant and the half informed, let alone those who should know better, will automatically trash their betters who try to enlighten them with independent thinking, as I have found to my sorrow in commenting on "global warming" and its cures.
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Galileo said it, Durban proved it: science is no democracy

May 31st, 2005

The Durban Declaration was a farcical episode in the history of AIDS politics which spoke volumes about the mediocrity and political nature of the defenders of the AIDS paradigm

A reminder, of a principle that seems largely lost in paradigm debate these days, from Galileo Galilei tonight (in the well scripted PBS documentary Galileo’s Battle for the Heavens, based on Galileo’s Daughter : A Historical Memoir of Science, Faith, and Love, Dava Sobel’s excellent book.

The number of people that can reason well is much smaller than those that can reason badly.
If reasoning were like hauling rocks, then several reasoners might be better than one. But reasoning isn’t like hauling rocks, it’s like racing, where a single, galloping Barbary steed easily outruns a hundred wagon-pulling horses.

And as the same script has him saying soon afterwards,

A good philosopher flies alone, like an eagle, not in a flock, like starlings.

Why is this relevant to scientific disputes today? Because it seems that we have a new breed of scientist rampant that has entirely forgotten that science, being based on reason and evidence, is not a democracy either.

One of the most absurd moments in the two decade saga of AIDS as a science, which early on established the self-satirical style of a Rowlandson cartoon, was the appearance of a one page ad in the New York Times at the time of the AIDS Conference in Durban, South Africa.

President Thabo Mbeki had arranged a review panel, that met before the conference opened, to debate the justification for assuming that HIV caused AIDS, since he had been alerted to material on the Web, including Peter Duesberg’s peer reviewed articles in the top literature, that entirely rejected this notion. Qualified scientists on both sides of the isue would exchange reason and evidence.

Here is what he said as the panel began. Anyone who believes that Thabo Mbeki is a fool who has fallen into cheap suspicion of the racism of the white man should read this statement, which shows how an independent minded politician reasonably concluded that we need to review the science of AIDS in Africa.

VIRUSMYTH HOMEPAGE

FIRST MEETING OF PRESIDENTIAL ADVISORY PANEL ON AIDS

Opening Speech by President Thabo Mbeki

Pretoria 6 May 2000

I am indeed, very, very pleased that we have arrived at this moment and would like to welcome Stephen Owen and other distinguished people from outside our country, as well as the scientists from within our own country who are here. Welcome to what for us is a very important initiative.

I am going to read a few lines from a poem by an Irish poet, Patrick Pearce. It will indicate some of what has been going through my mind over the last few months. The poem is entitled, ‘The Fool’ and it says:

“Since the wise men have not spoken, I speak but I’m only a fool; A fool that hath loved his folly, Yea, more than the wise men their books or their counting houses or their quiet homes, Or their fame in men’s mouths; A fool that in all his days hath never done a prudent thing, … I have squandered the splendid years that the Lord God gave to my youth In attempting impossible things, deeming them alone worth the toil. Was it folly or grace?”

I have asked myself that question many times over the last few months: whether the matters that were raised were as a result of folly or grace.

You will remember the letter we sent inviting you to this meeting. It included a quotation from a report by the WHO on the global situation of the HIV/AIDS pandemic. It said that of the 5.6 million people infected with HIV in 1999, 3.8 million lived in Sub-Saharan Africa, the hardest hit region. There were an estimated 2.2 million HIV/AIDS deaths in the region during 1999, being 85% of the global total, even though only one-tenth of the world population lives in Sub-Saharan Africa. In addition, the report said there are now more women than men among the 22.3 million adults and one million children estimated to be living with HIV/AIDS in Sub-Saharan Africa.

It was this situation, communicated to us by organisations such as the WHO and UN AIDS, which clearly said that here we have a problem to which we have to respond with the greatest seriousness.

And, of course, among the Sub-Saharan Africans are the South African Africans, with millions of people said also to be HIV positive and also many people dying from AIDS. The Minister has indicated our response to this, so I won’t go over that ground. But it is important, I think, to bear it in mind because some have put out the notion that our asking certain questions in order to understand better and therefore be able to respond better, constituted an abandonment of the fight against AIDS.

What the Minister has said indicates what we have indeed done. There are other things she didn’t mention including the allocation of dedicated funds in our annual budget specifically to address this issue. That is from the point of view of the national government, in addition to what other layers of government are doing. We believe that that response is important, and it is being carried out in an aggressive way, in a sustained way, and in a comprehensive way so that we do indeed respond to the picture that is painted by these figures.

It was because it seemed that the problem was so big, if these reports were correct, that I personally wanted to understand this matter better. Now as I’ve said, I’m only a fool and I faced this difficult problem of reading all these complicated things that you scientists write about, in this language I don’t understand. So I ploughed through lots and lots of documentation, with dictionaries all around me in case there were words that seemed difficult to understand. I would phone the Minister of Health and say, ‘Minister, what does this word mean?’ And she would explain.

I am somewhat embarrassed to say that I discovered that there had been a controversy around these matters for quite some time. I honestly didn’t know. I was a bit comforted later when I checked with a number of our Ministers and found that they were as ignorant as I, so I wasn’t quite alone.

What we knew was that there is a virus, HIV. The virus causes AIDS. AIDS causes death and there’s no vaccine against AIDS. So once you are HIV positive, you are going to develop AIDS, and you are bound to die. We responded with that part of the response the Minister was talking about – public awareness campaigns, encouraging safe sex, use of condoms, all of those things.

But as one read on, one noted that we had never said anything in all of this public awareness campaign, that people need to practice safe sex and use condoms in order to stop the other sexually transmitted diseases – syphilis, gonorrhoea and so on – as though these did not really matter. What mattered was this virus.

As one read all of these things, one discovered what, as far as I know, was the first report published in our medical journals in this country about the incidence of HIV among our people in this part of the world. It was published in the South African Medical Journal in 1985. Among other things, that article said that groups at high risk of developing the acquired immune deficiency syndrome – AIDS – in the United States and Europe include homosexual and bi-sexual males; those who abuse intravenous drugs and haemophiliacs.

The article further says that AIDS has been reported in Central Africa. However, homosexuality, drug addiction or blood transfusion have not been reported as risk factors in these patients. It has therefore been suggested that the agent causing AIDS is endemic in Central Africa. However, our preliminary data show that although individuals with antibodies directed against HIV are to be found in South Africa, these positive individuals only come from a high-risk group comprising male homosexuals. Individuals who did not belong to any of the known high risks groups did not have HIV antibodies. Our data, says the article, therefore suggests that the agent implicated in the causation is not endemic in Southern Africa.

That was in 1985. And of course all of the other documentation that I’ve seen suggests that what was reported here in 1985 to be the risk group in this part of the world, remained the risk group in the United States and Western Europe with a preponderance of these infections being among homosexuals and therefore by homosexual transmission, as it is said, of the virus.

But according to these reports, clearly something changed here. In a period of maybe five, six, seven years after 1985, when it was said that such transmission in this region was not endemic in Southern Africa, there were high rates of heterosexual transmission. Now as I was saying, being a fool I couldn’t answer this question about what happened between 1985 and the early 1990s. The situation has not changed in the United States up to today, nor in Western Europe with regard to homosexual transmission. But here it changed very radically in a short period of time and increased very radically in a short period of time. Why?

This is obviously not an idle question for us because it bears very directly on this question: How should we respond? There has been this change, for reasons I can’t explain but you, as scientists, surely would be able to explain. Why this change? What therefore is our most appropriate response? And so we started communicating with some of the people in this room, to ask what is the cause?

There is a whole variety of issues that the Minister of Health has just said she will not comment upon, which also I will not comment upon because they are very much part of the subject of your discussions. We were looking for answers because all of the information that has been communicated points to the reality that we are faced with a catastrophe, and you can’t respond to a catastrophe merely by saying I will do what is routine. You have to respond to a catastrophe in a way that recognises that you are facing a catastrophe. And here we are talking about people – it is not death of animal stock or something like that, but people. Millions and millions of people.

Somewhat of a storm broke out around this question, which in truth took me by surprise. There is an approach which asks why is this President of South Africa trying to give legitimacy to discredited scientists, because after all, all the questions of science concerning this matter had been resolved by the year 1984. I don’t know of any science that gets resolved in that manner with a cut-off year beyond which science does not develop any further. It sounds like a biblical absolute truth and I do not imagine that science consists of biblical absolute truths.

There was this very strong response saying: don’t do this. I have seen even in the last few days, a scientist who I’m quite certain is eminent who said that perhaps the best thing to do is that we should lock up some of these dissidents in jail and that would shut them up. It is a very peculiar response but it seemed to me to suggest that it must surely be because people are exceedingly worried by the fact that large numbers of people are dying. In that context any suggestion whatsoever that dealing with this is being postponed because somebody is busy looking at some obscure scientific theory, is seen as a betrayal of people. Perhaps that is why you had that kind of response which sought to say: let us freeze scientific discourse at a particular point; and let those who do not agree with the mainstream be isolated and not spoken to. Indeed it seems to be implied that one of the important measures to judge whether a scientific view is correct is to count numbers: how many scientists are on this side of the issue and how many are on the other – if the majority are on this side, then this must be correct.

In the end, what I’m saying is that as Africans we want to respond to HIV/AIDS in a manner that is effective, a manner that does indeed address the fact of these millions of lives that are threatened.

As I noted, the WHO says that in Sub-Saharan Africa, 2 million people died in 1999 alone.

It is truly our hope that this process will help us to get to some of the answers, so that as public representatives we are able to elaborate and help implement policies that are properly focused, and that actually have an effect. I’m quite certain that given the people who are participating in this panel, we will get to these answers.

And so you see why I’ve been thinking over this matter over the last few months that perhaps I should have allowed the wise men to speak. Indeed when eminent scientists said: “You have spoken out of turn,” it was difficult not to think that one was indeed a fool. But I am no longer so sure about that, given that so many eminent people responded to the invitation of a fool to come to this important meeting.

Welcome and best wishes.

Thank you very much.

Thabo Mbeki, President of South Africa

The home team apparently were somewhat nervous of the outcome of the panel’s deliberations (they were right, it turned out) and arranged a counter move in the always active game of AIDS politics. Email was sent far and wide begging lab heads and academic faculty to gather the signatures of any persons in their vicinity of any scientific qualifications at all at the graduate level or above, regardless of field and regardless of their knowledge of AIDS or lack of it.

Many of you will say that HIV/AIDS is not your area. However, over the years you have heard enough of the arguments to understand the association. Furthermore, many of you know well infectious diseases and understand Koch’s postulates. If you have colleagues in the laboratory or in the clinic who you feel would like to sign, please ask them. The more the better. However, please note that in order to be authoritative we feel it necessary to restrict the list to those with major university qualifications.

The names were added to what amounted to a “believe us” petition to the public, a profession of faith of 5,000 people of varying qualifications from leadership of the field to none at all save a science degree of some kind. Nobel prize winners were included, though none in AIDS, where due to either the obtuseness or the canny worldliness of the Stockholm committee no Nobel has yet been awarded (possibly they are awaiting a genuine cure or even vaccine).

The message of the ad was simple: we all believe that HIV is the cause of AIDS. Therefore you should, too.

To all those who contemplate the sorry state that some of science has fallen into in the last half century, this document was without doubt the most blatant and disturbing evidence that something was wrong in Denmark. With hundred of billions of dollars of AIDS health work governed by this scientific belief, what on earth did it mean that it had to be bolstered by numbers, and vouched for by a crowd? Since when was a scientific hypothesis of any importance a religious matter, founded on faith and decided by ballot? And if the faith was justified, why did it need an ad in the New York Times? Wasn’t the scientific literature good enough?

For many surprised readers of the Times, it must have seemed rather like opening their daily guide to the world to find a one page ad from 5,000 astronomers professing their fervent belief that the sun was the center of the solar system.

Here is the text of this AIDS tablet if you wish to read it. Notice that the belief in the HIV=AIDS scheme (“HIV-1, the retrovirus that is responsible for the AIDS pandemic”) as “clear-cut, exhaustive and unambiguous” (“The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous. This evidence meets the highest standards of science.”) pushes aside the plain fact that the reviews which unambiguously reject HIV as the cause survived intense and hostile expert peer review at the highest level in the leading science journals of the US.

And notice that the theme which emerges at the end is one of social solidarity,

Science will one day triumph over AIDS, just as it did over smallpox. Curbing the spread of HIV will be the first step. Until then, reason, solidarity, political will and courage must be our partners.”

which nicely betrays the fact that the motivation of the paradigm defenders was as far from scientific truthseeking as it is possible to go.

A Declaration by Scientists and Physicians Affirming HIV is the Cause of AIDS

A Declaration by Scientists and Physicians Affirming HIV is the Cause of AIDS

“Seventeen years after the discovery of the human immunodeficiency virus (HIV), thousands of people from around the world are gathered in Durban, South Africa to attend the XIII International AIDS Conference. At the turn of the millennium, an estimated 34 million people worldwide are living with HIV or AIDS, 24 million of them in sub-Saharan Africa. Last year alone, 2.6 million people died of AIDS, the highest rate since the start of the epidemic. If current trends continue, Southern and South-East Asia, South America and regions of the former Soviet Union will also bear a heavy burden in the next two decades.

Like many other diseases, such as tuberculosis and malaria that cause illness and death in underprivileged and impoverished communities, AIDS spreads by infection. HIV-1, the retrovirus that is responsible for the AIDS pandemic, is closely related to a simian immunodeficiency virus (SIV) which infects chimpanzees. HIV-2, which is prevalent in West Africa and has spread to Europe and India, is almost indistinguishable from an SIV that infects sooty mangabey monkeys. Although HIV-1 and HIV-2 first arose as infections transmitted from animals to humans, or zoonoses, both are now spread among humans through sexual contact, from mother to infant and via contaminated blood.

An animal source for a new infection is not unique to HIV. The plague came from rodents. Influenza and the new Nipah virus in South-East Asia reached humans via pigs. Variant Creutzfeldt-Jakob disease in the United Kingdom came from ‘mad cows’. Once HIV became established in humans, it soon followed human habits and movements. Like other viruses, HIV recognizes no social, political or geographic boundaries.

The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous. This evidence meets the highest standards of science. The data fulfill exactly the same criteria as for other viral diseases, such as poliomyelitis, measles and smallpox:

* Patients with acquired immune deficiency syndrome, regardless of where they live, are infected with HIV.

* If not treated, most people with HIV infection show signs of AIDS within 5-10 years. HIV infection is identified in blood by detecting antibodies, gene sequences or viral isolation. These tests are as reliable as any used for detecting other virus infections.

* Persons who received HIV-contaminated blood or blood products develop AIDS, whereas those who received untainted or screened blood do not.

* Most children who develop AIDS are born to HIV-infected mothers. The higher the viral load in the mother the greater the risk of the child becoming infected.

* In the laboratory HIV infects the exact type of white blood cell (CD4 lymphocytes) that becomes depleted in persons with AIDS.

* Drugs that block HIV replication in the test tube also reduce viral load and delay progression to AIDS. Where available, treatment has reduced AIDS mortality by more than 80%.

* Monkeys inoculated with cloned SIV DNA become infected and develop AIDS.

Further compelling data are available. HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives.

In different regions of the world HIV/AIDS shows altered patterns of spread and symptoms. In Africa, for example, HIV-infected persons are 11 times more likely to die within 5 years, and over 100 times more likely than uninfected persons to develop Kaposi’s sarcoma, a cancer linked to yet another virus.

As with any other chronic infection, various co-factors play a role in determining the risk of disease. Persons who are malnourished, who already suffer other infections or who are older, tend to be more susceptible to the rapid development of AIDS following HIV infection. However, none of these factors weaken the scientific evidence that HIV is the sole cause of AIDS.

In this global emergency, prevention of HIV infection must be our greatest worldwide public health priority. The knowledge and tools to prevent infection exist. The sexual spread of HIV can be prevented by monogamy, abstinence or by using condoms. Blood transmission can be stopped by screening blood products and by not re-using needles. Mother-to-child transmission can be reduced by half or more by short courses of antiviral drugs.

Limited resources and the crushing burden of poverty in many parts of the world constitute formidable challenges to the control of HIV infection. People already infected can be helped by treatment with life-saving drugs, but high cost puts these treatments out of reach for most. It is crucial to develop new antiviral drugs that are easier to take, have fewer side effects and are much less expensive, so that millions more can benefit from them.

There are many ways to communicate the vital information about HIV/AIDS. What works best in one country may not be appropriate in another. But to tackle the disease, everyone must first understand that HIV is the enemy. Research, not myths, will lead to the development of more effective and cheaper treatments, and hopefully a vaccine. But for now, emphasis must be placed on preventing sexual transmission.

There is no end in sight to the AIDS pandemic. By working together, we have the power to reverse the tide of this epidemic. Science will one day triumph over AIDS, just as it did over smallpox. Curbing the spread of HIV will be the first step. Until then, reason, solidarity, political will and courage must be our partners.”

Anyone overly impressed with this document, whcih to put it politely somewhat exaggerates the perfection of its case, should read the rebuttals copiously available from the AIDS disbelievers on VirusMyth.com.

Here is the letter that the most prominent skeptics immediately sent to Nature after Nature published the Durban Declaration in its pages, which John Maddox was good enough to publish, unlike many of their offerings.

Compare the quality of both documents in scientific reasoning and references and it is hard not to be staggered by the intellectual mediocrity of the Declaration, and the fact that this is the sum total of the justification used to threaten the peace of mind, health and even lives of millions around the world:

Letter published by Nature. Vol. 407 / 21 Sept 2000 / www.nature.com

The Durban Declaration is not accepted by all

By Gordon Stewart et al.

Sir

In response to recent action by President Thabo Mbeki of South Africa and in advance of the International Conference on HIV/AIDS held in Durban on 9-14 July, the Durban Declaration (1) was prepared by a committee representing a consensus of “181 scientists and front line physicians” Before publication in Nature, it was circulated: “To get as many names of scientists and doctors to sign on. Names of signatories will appear on the Nature website. If you would like to sign on, we would be delighted. Send me an e-mail confirming this. To economize space on the website, we have to name people in a single line. Many of you will say that HIV/AIDS is not your area. However, over the years you have heard enough of the arguments to understand the association. Furthermore, many of you know well infectious diseases and understand Koch’s postulates. If you have colleagues in the laboratory or in the clinic who you feel would like to sign, please ask them. The more the better. However, please note that in order to be authoritative we feel it necessary to restrict the list to those with major university qualifications.” This is an extract from the circular distributed on behalf of the organizing committee which included Luc Montagnier, Catherine Wilfert, David Baltimore, Sir Aaron Klug (as President of the UK Royal Society), and many other well-known names and organi-zations from developing countries as well as from the West.

Briefly, the authors of the declaration state that AIDS/HIV is spreading as a pandemic now affecting 34 million people, of whom 24 million are in sub-Saharan Africa. They say the disease began there as a viral infection of chimpanzees and monkeys conveyed somehow to humans, and is now spreading worldwide by heterosexual and mother-to–infant transmission. The authors consider that their evidence supporting this hypothe-sis is “clear-cut, exhaustive and unambiguous”; that most people with these infections will develop AIDS within 5-10 years unless treated; and that “there is no end in sight” until research based on their hypothesis leads to a vaccine to supplement safe sex, health education and other, simpler approaches to avoidance and prevention.

With no end in sight after 17 or more years of intensive research, priorities and incentives, one might think that this consensus would be open to alternative approaches, but the authors of the declara-tion are emphatic that this is not needed because the evidence that HIV is the cause of AIDS has met or exceeded the “highest standards of science” By implication, any other evidence is therefore a deception, even less likely to lead to a successful vaccine, curative drug or hypothesis.

Our objection to the Durban Declaration is factual and verifiable from data published in the early 1980s (2-4). We believe that World Health Organization (WHO) figures produced since then (5) can be interpreted to say that AIDS first appeared and spread, not in Africa but in US urban clusters of mainly white, affluent, promis-cuous homosexual men and drug addicts, and then spread, on a lesser scale, in Europe and Australasia but hardly at all in Asia. Disastrous epidemics due to heterosexual transmission of HIV were confidently predicted in general populations of developed countries (6) but they never happened. AIDS has diminished in incidence and severity though it is continuing in female partners of bisexual men and some other communities engaging in or subjected to behaviours which carry high risks of infections, various assaults and misuse of drugs.

In sub-Saharan Africa, AIDS was reported later (7-8), with an alarming frequency in mothers and infants not seen in the United States or Europe. Sentinel surveillance by the WHO shows correlation between this frequency and the seroprevalence of HIV, but there are unmeasured overlaps with other major diseases and deprivations which, anomalies in classification, distribution, transmission and country-specific pathogenesis, and especially cross-reactions in serological tests (6-9), raise questions about the accuracy of diagnosis and approaches to control.

In the absence of satisfactory answers, or of any, answers from the consensus to his specific questions on this matter, President Mbeki invited us to join other experts with differing viewpoints in a panel to explore the way forward to control AIDS in Africa. Unlike the signatories to the Durban Declaration, we claim no exhaustive and unambiguous unanimity. There are differences between ourselves and with other panellists, and we are happy to acknowledge possible convergence with certain priorities favoured by the declaration’s authors. But we reject as outrageous their attempt to outlaw open discussion of alternative viewpoints, because this reveals an intolerance, which has no place in any branch of science. Our viewpoints could also explain the failure to prevent the spread of AIDS in high-risk populations in the West, amounting, in the United States now, to almost 700,000 registrations – an unbeaten score in the global tally of this disease.

Gordon T. Stewart, MD

3 Lexden Terrace, Tenby, Pembrokeshire SA70 7BJ, UK

(Emeritus Professor of Public Health, University of Glasgow)

E-mail:

Other signatories to this letter; full addresses available from G.T.S.

Sam Mhlongo, MB, BS Professor of Medicine, MEDUNSA, Johannesburg South Africa

Etienne de Harven, MD Emeritus Professor of Pathology, University of Toronto, Canada

Christian Fiala, MD Obstetrician, Vienna, Austria

Claus Kohnlein, MD Physician, Stadisches Krankenhaus, Kiel, Germany

Herxheimer, MD Pharmacologist, London, UK

Peter Duesberg, PhD Professor of Molecular Biology, University of California at Berkeley, USA

David Rasnick, PhD Research Fellow, Dept of Molecular Biology, University of California at Berkeley, USA

Roberto Giraldo, MD Physician, New York City

Manu Kothari, MD Pathologist, Seth GS Medical College, Bombay, India

Harvey Bialy, PhD Research Scholar, National University, Mexico City, Mexico

Charles Geshekter, Professor of African Studies, California State University, Chico, California.

References:

1. Durban Declaration, Nature 406, 15-16 (2000).

2. Morbidity Mortality Weekly Reports 30, 250 (US CDC, Atlanta, 1981).

3. Morbidity Mortality Weekly Reports Update on Acquired Deficiency Syndrome (AIDS), USA 3 1, 507-5 1 4 (1981).

4. Gottlieb, M. S. et al N Eng Med J. 305,1425-31(1982).

5. Weekly Epidemiological Records (WHO, Geneva, 1981-2000).

6. Cox, D., Anderson, R. M., Hillier, H. C. (eds.) Phil. Trans R. Soc 325, 37-1 87 (1989).

7. International Classification of Diseases, I0th revision (WHO, Geneva, 1992).

8. Root-Bernstein, R. Rethinking AIDS (MacMillan, New York, 1993).

9. Kashala, O., et al J Inf. Dis. 109, 296-304 (1994).

The signatories were the panelists convened by Mbeki, and as they correctly put it in their last paragraph, the attempt to stifle their scientific voices was an outrage by the standards of good science.

Sentinel surveillance by the WHO shows correlation between this frequency and the seroprevalence of HIV, but there are unmeasured overlaps with other major diseases and deprivations which, anomalies in classification, distribution, transmission and country-specific pathogenesis, and especially cross-reactions in serological tests (6-9), raise questions about the accuracy of diagnosis and approaches to control.

In the absence of satisfactory answers, or of any, answers from the consensus to his specific questions on this matter, President Mbeki invited us to join other experts with differing viewpoints in a panel to explore the way forward to control AIDS in Africa. Unlike the signatories to the Durban Declaration, we claim no exhaustive and unambiguous unanimity. There are differences between ourselves and with other panellists, and we are happy to acknowledge possible convergence with certain priorities favoured by the declaration’s authors. But we reject as outrageous their attempt to outlaw open discussion of alternative viewpoints, because this reveals an intolerance, which has no place in any branch of science.

Galileo said it, Durban proved it: reason is not a democracy

May 31st, 2005

The Durban Declaration was a farcical episode in the history of AIDS politics which spoke volumes about the mediocrity and political nature of the defenders of the AIDS paradigm

A reminder, of a principle that seems largely lost in paradigm debate these days, from Galileo Galilei tonight (in the well scripted PBS documentary Galileo’s Battle for the Heavens, based on Galileo’s Daughter : A Historical Memoir of Science, Faith, and Love, Dava Sobel’s excellent book.

The number of people that can reason well is much smaller than those that can reason badly.
If reasoning were like hauling rocks, then several reasoners might be better than one. But reasoning isn’t like hauling rocks, it’s like racing, where a single, galloping Barbary steed easily outruns a hundred wagon-pulling horses.

And as the same script has him saying soon afterwards,

A good philosopher flies alone, like an eagle, not in a flock, like starlings.

Why is this relevant to scientific disputes today? Because it seems that we have a new breed of scientist rampant that has entirely forgotten that science, being based on reason and evidence, is not a democracy either.

One of the most absurd moments in the two decade saga of AIDS as a science, which early on established the self-satirical style of a Rowlandson cartoon, was the appearance of a one page ad in the New York Times at the time of the AIDS Conference in Durban, South Africa.

President Thabo Mbeki had arranged a review panel, that met before the conference opened, to debate the justification for assuming that HIV caused AIDS, since he had been alerted to material on the Web, including Peter Duesberg’s peer reviewed articles in the top literature, that entirely rejected this notion. Qualified scientists on both sides of the isue would exchange reason and evidence.

Here is what he said as the panel began. Anyone who believes that Thabo Mbeki is a fool who has fallen into cheap suspicion of the racism of the white man should read this statement, which shows how an independent minded politician reasonably concluded that we need to review the science of AIDS in Africa.

VIRUSMYTH HOMEPAGE

FIRST MEETING OF PRESIDENTIAL ADVISORY PANEL ON AIDS

Opening Speech by President Thabo Mbeki

Pretoria 6 May 2000

I am indeed, very, very pleased that we have arrived at this moment and would like to welcome Stephen Owen and other distinguished people from outside our country, as well as the scientists from within our own country who are here. Welcome to what for us is a very important initiative.

I am going to read a few lines from a poem by an Irish poet, Patrick Pearce. It will indicate some of what has been going through my mind over the last few months. The poem is entitled, ‘The Fool’ and it says:

“Since the wise men have not spoken, I speak but I’m only a fool; A fool that hath loved his folly, Yea, more than the wise men their books or their counting houses or their quiet homes, Or their fame in men’s mouths; A fool that in all his days hath never done a prudent thing, … I have squandered the splendid years that the Lord God gave to my youth In attempting impossible things, deeming them alone worth the toil. Was it folly or grace?”

I have asked myself that question many times over the last few months: whether the matters that were raised were as a result of folly or grace.

You will remember the letter we sent inviting you to this meeting. It included a quotation from a report by the WHO on the global situation of the HIV/AIDS pandemic. It said that of the 5.6 million people infected with HIV in 1999, 3.8 million lived in Sub-Saharan Africa, the hardest hit region. There were an estimated 2.2 million HIV/AIDS deaths in the region during 1999, being 85% of the global total, even though only one-tenth of the world population lives in Sub-Saharan Africa. In addition, the report said there are now more women than men among the 22.3 million adults and one million children estimated to be living with HIV/AIDS in Sub-Saharan Africa.

It was this situation, communicated to us by organisations such as the WHO and UN AIDS, which clearly said that here we have a problem to which we have to respond with the greatest seriousness.

And, of course, among the Sub-Saharan Africans are the South African Africans, with millions of people said also to be HIV positive and also many people dying from AIDS. The Minister has indicated our response to this, so I won’t go over that ground. But it is important, I think, to bear it in mind because some have put out the notion that our asking certain questions in order to understand better and therefore be able to respond better, constituted an abandonment of the fight against AIDS.

What the Minister has said indicates what we have indeed done. There are other things she didn’t mention including the allocation of dedicated funds in our annual budget specifically to address this issue. That is from the point of view of the national government, in addition to what other layers of government are doing. We believe that that response is important, and it is being carried out in an aggressive way, in a sustained way, and in a comprehensive way so that we do indeed respond to the picture that is painted by these figures.

It was because it seemed that the problem was so big, if these reports were correct, that I personally wanted to understand this matter better. Now as I’ve said, I’m only a fool and I faced this difficult problem of reading all these complicated things that you scientists write about, in this language I don’t understand. So I ploughed through lots and lots of documentation, with dictionaries all around me in case there were words that seemed difficult to understand. I would phone the Minister of Health and say, ‘Minister, what does this word mean?’ And she would explain.

I am somewhat embarrassed to say that I discovered that there had been a controversy around these matters for quite some time. I honestly didn’t know. I was a bit comforted later when I checked with a number of our Ministers and found that they were as ignorant as I, so I wasn’t quite alone.

What we knew was that there is a virus, HIV. The virus causes AIDS. AIDS causes death and there’s no vaccine against AIDS. So once you are HIV positive, you are going to develop AIDS, and you are bound to die. We responded with that part of the response the Minister was talking about – public awareness campaigns, encouraging safe sex, use of condoms, all of those things.

But as one read on, one noted that we had never said anything in all of this public awareness campaign, that people need to practice safe sex and use condoms in order to stop the other sexually transmitted diseases – syphilis, gonorrhoea and so on – as though these did not really matter. What mattered was this virus.

As one read all of these things, one discovered what, as far as I know, was the first report published in our medical journals in this country about the incidence of HIV among our people in this part of the world. It was published in the South African Medical Journal in 1985. Among other things, that article said that groups at high risk of developing the acquired immune deficiency syndrome – AIDS – in the United States and Europe include homosexual and bi-sexual males; those who abuse intravenous drugs and haemophiliacs.

The article further says that AIDS has been reported in Central Africa. However, homosexuality, drug addiction or blood transfusion have not been reported as risk factors in these patients. It has therefore been suggested that the agent causing AIDS is endemic in Central Africa. However, our preliminary data show that although individuals with antibodies directed against HIV are to be found in South Africa, these positive individuals only come from a high-risk group comprising male homosexuals. Individuals who did not belong to any of the known high risks groups did not have HIV antibodies. Our data, says the article, therefore suggests that the agent implicated in the causation is not endemic in Southern Africa.

That was in 1985. And of course all of the other documentation that I’ve seen suggests that what was reported here in 1985 to be the risk group in this part of the world, remained the risk group in the United States and Western Europe with a preponderance of these infections being among homosexuals and therefore by homosexual transmission, as it is said, of the virus.

But according to these reports, clearly something changed here. In a period of maybe five, six, seven years after 1985, when it was said that such transmission in this region was not endemic in Southern Africa, there were high rates of heterosexual transmission. Now as I was saying, being a fool I couldn’t answer this question about what happened between 1985 and the early 1990s. The situation has not changed in the United States up to today, nor in Western Europe with regard to homosexual transmission. But here it changed very radically in a short period of time and increased very radically in a short period of time. Why?

This is obviously not an idle question for us because it bears very directly on this question: How should we respond? There has been this change, for reasons I can’t explain but you, as scientists, surely would be able to explain. Why this change? What therefore is our most appropriate response? And so we started communicating with some of the people in this room, to ask what is the cause?

There is a whole variety of issues that the Minister of Health has just said she will not comment upon, which also I will not comment upon because they are very much part of the subject of your discussions. We were looking for answers because all of the information that has been communicated points to the reality that we are faced with a catastrophe, and you can’t respond to a catastrophe merely by saying I will do what is routine. You have to respond to a catastrophe in a way that recognises that you are facing a catastrophe. And here we are talking about people – it is not death of animal stock or something like that, but people. Millions and millions of people.

Somewhat of a storm broke out around this question, which in truth took me by surprise. There is an approach which asks why is this President of South Africa trying to give legitimacy to discredited scientists, because after all, all the questions of science concerning this matter had been resolved by the year 1984. I don’t know of any science that gets resolved in that manner with a cut-off year beyond which science does not develop any further. It sounds like a biblical absolute truth and I do not imagine that science consists of biblical absolute truths.

There was this very strong response saying: don’t do this. I have seen even in the last few days, a scientist who I’m quite certain is eminent who said that perhaps the best thing to do is that we should lock up some of these dissidents in jail and that would shut them up. It is a very peculiar response but it seemed to me to suggest that it must surely be because people are exceedingly worried by the fact that large numbers of people are dying. In that context any suggestion whatsoever that dealing with this is being postponed because somebody is busy looking at some obscure scientific theory, is seen as a betrayal of people. Perhaps that is why you had that kind of response which sought to say: let us freeze scientific discourse at a particular point; and let those who do not agree with the mainstream be isolated and not spoken to. Indeed it seems to be implied that one of the important measures to judge whether a scientific view is correct is to count numbers: how many scientists are on this side of the issue and how many are on the other – if the majority are on this side, then this must be correct.

In the end, what I’m saying is that as Africans we want to respond to HIV/AIDS in a manner that is effective, a manner that does indeed address the fact of these millions of lives that are threatened.

As I noted, the WHO says that in Sub-Saharan Africa, 2 million people died in 1999 alone.

It is truly our hope that this process will help us to get to some of the answers, so that as public representatives we are able to elaborate and help implement policies that are properly focused, and that actually have an effect. I’m quite certain that given the people who are participating in this panel, we will get to these answers.

And so you see why I’ve been thinking over this matter over the last few months that perhaps I should have allowed the wise men to speak. Indeed when eminent scientists said: “You have spoken out of turn,” it was difficult not to think that one was indeed a fool. But I am no longer so sure about that, given that so many eminent people responded to the invitation of a fool to come to this important meeting.

Welcome and best wishes.

Thank you very much.

Thabo Mbeki, President of South Africa

The home team apparently were somewhat nervous of the outcome of the panel’s deliberations (they were right, it turned out) and arranged a counter move in the always active game of AIDS politics. Email was sent far and wide begging lab heads and academic faculty to gather the signatures of any persons in their vicinity of any scientific qualifications at all at the graduate level or above, regardless of field and regardless of their knowledge of AIDS or lack of it.

Many of you will say that HIV/AIDS is not your area. However, over the years you have heard enough of the arguments to understand the association. Furthermore, many of you know well infectious diseases and understand Koch’s postulates. If you have colleagues in the laboratory or in the clinic who you feel would like to sign, please ask them. The more the better. However, please note that in order to be authoritative we feel it necessary to restrict the list to those with major university qualifications.

The names were added to what amounted to a “believe us” petition to the public, a profession of faith of 5,000 people of varying qualifications from leadership of the field to none at all save a science degree of some kind. Nobel prize winners were included, though none in AIDS, where due to either the obtuseness or the canny worldliness of the Stockholm committee no Nobel has yet been awarded (possibly they are awaiting a genuine cure or even vaccine).

The message of the ad was simple: we all believe that HIV is the cause of AIDS. Therefore you should, too.

To all those who contemplate the sorry state that some of science has fallen into in the last half century, this document was without doubt the most blatant and disturbing evidence that something was wrong in Denmark. With hundred of billions of dollars of AIDS health work governed by this scientific belief, what on earth did it mean that it had to be bolstered by numbers, and vouched for by a crowd? Since when was a scientific hypothesis of any importance a religious matter, founded on faith and decided by ballot? And if the faith was justified, why did it need an ad in the New York Times? Wasn’t the scientific literature good enough?

For many surprised readers of the Times, it must have seemed rather like opening their daily guide to the world to find a one page ad from 5,000 astronomers professing their fervent belief that the sun was the center of the solar system.

Here is the text of this AIDS tablet if you wish to read it. Notice that the belief in the HIV=AIDS scheme (“HIV-1, the retrovirus that is responsible for the AIDS pandemic”) as “clear-cut, exhaustive and unambiguous” (“The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous. This evidence meets the highest standards of science.”) pushes aside the plain fact that the reviews which unambiguously reject HIV as the cause survived intense and hostile expert peer review at the highest level in the leading science journals of the US.

And notice that the theme which emerges at the end is one of social solidarity,

Science will one day triumph over AIDS, just as it did over smallpox. Curbing the spread of HIV will be the first step. Until then, reason, solidarity, political will and courage must be our partners.”

which nicely betrays the fact that the motivation of the paradigm defenders was as far from scientific truthseeking as it is possible to go.

As the second Durban AIDS Conference is coming up in a week, it is as well to remember the first, and how little has changed since to separate science from politics.

A Declaration by Scientists and Physicians Affirming HIV is the Cause of AIDS

A Declaration by Scientists and Physicians Affirming HIV is the Cause of AIDS

“Seventeen years after the discovery of the human immunodeficiency virus (HIV), thousands of people from around the world are gathered in Durban, South Africa to attend the XIII International AIDS Conference. At the turn of the millennium, an estimated 34 million people worldwide are living with HIV or AIDS, 24 million of them in sub-Saharan Africa. Last year alone, 2.6 million people died of AIDS, the highest rate since the start of the epidemic. If current trends continue, Southern and South-East Asia, South America and regions of the former Soviet Union will also bear a heavy burden in the next two decades.

Like many other diseases, such as tuberculosis and malaria that cause illness and death in underprivileged and impoverished communities, AIDS spreads by infection. HIV-1, the retrovirus that is responsible for the AIDS pandemic, is closely related to a simian immunodeficiency virus (SIV) which infects chimpanzees. HIV-2, which is prevalent in West Africa and has spread to Europe and India, is almost indistinguishable from an SIV that infects sooty mangabey monkeys. Although HIV-1 and HIV-2 first arose as infections transmitted from animals to humans, or zoonoses, both are now spread among humans through sexual contact, from mother to infant and via contaminated blood.

An animal source for a new infection is not unique to HIV. The plague came from rodents. Influenza and the new Nipah virus in South-East Asia reached humans via pigs. Variant Creutzfeldt-Jakob disease in the United Kingdom came from ‘mad cows’. Once HIV became established in humans, it soon followed human habits and movements. Like other viruses, HIV recognizes no social, political or geographic boundaries.

The evidence that AIDS is caused by HIV-1 or HIV-2 is clear-cut, exhaustive and unambiguous. This evidence meets the highest standards of science. The data fulfill exactly the same criteria as for other viral diseases, such as poliomyelitis, measles and smallpox:

* Patients with acquired immune deficiency syndrome, regardless of where they live, are infected with HIV.

* If not treated, most people with HIV infection show signs of AIDS within 5-10 years. HIV infection is identified in blood by detecting antibodies, gene sequences or viral isolation. These tests are as reliable as any used for detecting other virus infections.

* Persons who received HIV-contaminated blood or blood products develop AIDS, whereas those who received untainted or screened blood do not.

* Most children who develop AIDS are born to HIV-infected mothers. The higher the viral load in the mother the greater the risk of the child becoming infected.

* In the laboratory HIV infects the exact type of white blood cell (CD4 lymphocytes) that becomes depleted in persons with AIDS.

* Drugs that block HIV replication in the test tube also reduce viral load and delay progression to AIDS. Where available, treatment has reduced AIDS mortality by more than 80%.

* Monkeys inoculated with cloned SIV DNA become infected and develop AIDS.

Further compelling data are available. HIV causes AIDS. It is unfortunate that a few vocal people continue to deny the evidence. This position will cost countless lives.

In different regions of the world HIV/AIDS shows altered patterns of spread and symptoms. In Africa, for example, HIV-infected persons are 11 times more likely to die within 5 years, and over 100 times more likely than uninfected persons to develop Kaposi’s sarcoma, a cancer linked to yet another virus.

As with any other chronic infection, various co-factors play a role in determining the risk of disease. Persons who are malnourished, who already suffer other infections or who are older, tend to be more susceptible to the rapid development of AIDS following HIV infection. However, none of these factors weaken the scientific evidence that HIV is the sole cause of AIDS.

In this global emergency, prevention of HIV infection must be our greatest worldwide public health priority. The knowledge and tools to prevent infection exist. The sexual spread of HIV can be prevented by monogamy, abstinence or by using condoms. Blood transmission can be stopped by screening blood products and by not re-using needles. Mother-to-child transmission can be reduced by half or more by short courses of antiviral drugs.

Limited resources and the crushing burden of poverty in many parts of the world constitute formidable challenges to the control of HIV infection. People already infected can be helped by treatment with life-saving drugs, but high cost puts these treatments out of reach for most. It is crucial to develop new antiviral drugs that are easier to take, have fewer side effects and are much less expensive, so that millions more can benefit from them.

There are many ways to communicate the vital information about HIV/AIDS. What works best in one country may not be appropriate in another. But to tackle the disease, everyone must first understand that HIV is the enemy. Research, not myths, will lead to the development of more effective and cheaper treatments, and hopefully a vaccine. But for now, emphasis must be placed on preventing sexual transmission.

There is no end in sight to the AIDS pandemic. By working together, we have the power to reverse the tide of this epidemic. Science will one day triumph over AIDS, just as it did over smallpox. Curbing the spread of HIV will be the first step. Until then, reason, solidarity, political will and courage must be our partners.”

Anyone overly impressed with this document, whcih to put it politely somewhat exaggerates the perfection of its case, should read the rebuttals copiously available from the AIDS disbelievers on VirusMyth.com.

Here is the letter that the most prominent skeptics immediately sent to Nature after Nature published the Durban Declaration in its pages, which John Maddox was good enough to publish, unlike many of their offerings.

Compare the quality of both documents in scientific reasoning and references and it is hard not to be staggered by the intellectual mediocrity of the Declaration, and the fact that this is the sum total of the justification used to threaten the peace of mind, health and even lives of millions around the world:

Letter published by Nature. Vol. 407 / 21 Sept 2000 / www.nature.com

The Durban Declaration is not accepted by all

By Gordon Stewart et al.

Sir

In response to recent action by President Thabo Mbeki of South Africa and in advance of the International Conference on HIV/AIDS held in Durban on 9-14 July, the Durban Declaration (1) was prepared by a committee representing a consensus of “181 scientists and front line physicians” Before publication in Nature, it was circulated: “To get as many names of scientists and doctors to sign on. Names of signatories will appear on the Nature website. If you would like to sign on, we would be delighted. Send me an e-mail confirming this. To economize space on the website, we have to name people in a single line. Many of you will say that HIV/AIDS is not your area. However, over the years you have heard enough of the arguments to understand the association. Furthermore, many of you know well infectious diseases and understand Koch’s postulates. If you have colleagues in the laboratory or in the clinic who you feel would like to sign, please ask them. The more the better. However, please note that in order to be authoritative we feel it necessary to restrict the list to those with major university qualifications.” This is an extract from the circular distributed on behalf of the organizing committee which included Luc Montagnier, Catherine Wilfert, David Baltimore, Sir Aaron Klug (as President of the UK Royal Society), and many other well-known names and organi-zations from developing countries as well as from the West.

Briefly, the authors of the declaration state that AIDS/HIV is spreading as a pandemic now affecting 34 million people, of whom 24 million are in sub-Saharan Africa. They say the disease began there as a viral infection of chimpanzees and monkeys conveyed somehow to humans, and is now spreading worldwide by heterosexual and mother-to–infant transmission. The authors consider that their evidence supporting this hypothe-sis is “clear-cut, exhaustive and unambiguous”; that most people with these infections will develop AIDS within 5-10 years unless treated; and that “there is no end in sight” until research based on their hypothesis leads to a vaccine to supplement safe sex, health education and other, simpler approaches to avoidance and prevention.

With no end in sight after 17 or more years of intensive research, priorities and incentives, one might think that this consensus would be open to alternative approaches, but the authors of the declara-tion are emphatic that this is not needed because the evidence that HIV is the cause of AIDS has met or exceeded the “highest standards of science” By implication, any other evidence is therefore a deception, even less likely to lead to a successful vaccine, curative drug or hypothesis.

Our objection to the Durban Declaration is factual and verifiable from data published in the early 1980s (2-4). We believe that World Health Organization (WHO) figures produced since then (5) can be interpreted to say that AIDS first appeared and spread, not in Africa but in US urban clusters of mainly white, affluent, promis-cuous homosexual men and drug addicts, and then spread, on a lesser scale, in Europe and Australasia but hardly at all in Asia. Disastrous epidemics due to heterosexual transmission of HIV were confidently predicted in general populations of developed countries (6) but they never happened. AIDS has diminished in incidence and severity though it is continuing in female partners of bisexual men and some other communities engaging in or subjected to behaviours which carry high risks of infections, various assaults and misuse of drugs.

In sub-Saharan Africa, AIDS was reported later (7-8), with an alarming frequency in mothers and infants not seen in the United States or Europe. Sentinel surveillance by the WHO shows correlation between this frequency and the seroprevalence of HIV, but there are unmeasured overlaps with other major diseases and deprivations which, anomalies in classification, distribution, transmission and country-specific pathogenesis, and especially cross-reactions in serological tests (6-9), raise questions about the accuracy of diagnosis and approaches to control.

In the absence of satisfactory answers, or of any, answers from the consensus to his specific questions on this matter, President Mbeki invited us to join other experts with differing viewpoints in a panel to explore the way forward to control AIDS in Africa. Unlike the signatories to the Durban Declaration, we claim no exhaustive and unambiguous unanimity. There are differences between ourselves and with other panellists, and we are happy to acknowledge possible convergence with certain priorities favoured by the declaration’s authors. But we reject as outrageous their attempt to outlaw open discussion of alternative viewpoints, because this reveals an intolerance, which has no place in any branch of science. Our viewpoints could also explain the failure to prevent the spread of AIDS in high-risk populations in the West, amounting, in the United States now, to almost 700,000 registrations – an unbeaten score in the global tally of this disease.

Gordon T. Stewart, MD

3 Lexden Terrace, Tenby, Pembrokeshire SA70 7BJ, UK

(Emeritus Professor of Public Health, University of Glasgow)

E-mail:

Other signatories to this letter; full addresses available from G.T.S.

Sam Mhlongo, MB, BS Professor of Medicine, MEDUNSA, Johannesburg South Africa

Etienne de Harven, MD Emeritus Professor of Pathology, University of Toronto, Canada

Christian Fiala, MD Obstetrician, Vienna, Austria

Claus Kohnlein, MD Physician, Stadisches Krankenhaus, Kiel, Germany

Herxheimer, MD Pharmacologist, London, UK

Peter Duesberg, PhD Professor of Molecular Biology, University of California at Berkeley, USA

David Rasnick, PhD Research Fellow, Dept of Molecular Biology, University of California at Berkeley, USA

Roberto Giraldo, MD Physician, New York City

Manu Kothari, MD Pathologist, Seth GS Medical College, Bombay, India

Harvey Bialy, PhD Research Scholar, National University, Mexico City, Mexico

Charles Geshekter, Professor of African Studies, California State University, Chico, California.

References:

1. Durban Declaration, Nature 406, 15-16 (2000).

2. Morbidity Mortality Weekly Reports 30, 250 (US CDC, Atlanta, 1981).

3. Morbidity Mortality Weekly Reports Update on Acquired Deficiency Syndrome (AIDS), USA 3 1, 507-5 1 4 (1981).

4. Gottlieb, M. S. et al N Eng Med J. 305,1425-31(1982).

5. Weekly Epidemiological Records (WHO, Geneva, 1981-2000).

6. Cox, D., Anderson, R. M., Hillier, H. C. (eds.) Phil. Trans R. Soc 325, 37-1 87 (1989).

7. International Classification of Diseases, I0th revision (WHO, Geneva, 1992).

8. Root-Bernstein, R. Rethinking AIDS (MacMillan, New York, 1993).

9. Kashala, O., et al J Inf. Dis. 109, 296-304 (1994).

The signatories were the panelists convened by Mbeki, and as they correctly put it in their last paragraph, the attempt to stifle their scientific voices was an outrage by the standards of good science.

Sentinel surveillance by the WHO shows correlation between this frequency and the seroprevalence of HIV, but there are unmeasured overlaps with other major diseases and deprivations which, anomalies in classification, distribution, transmission and country-specific pathogenesis, and especially cross-reactions in serological tests (6-9), raise questions about the accuracy of diagnosis and approaches to control.

In the absence of satisfactory answers, or of any, answers from the consensus to his specific questions on this matter, President Mbeki invited us to join other experts with differing viewpoints in a panel to explore the way forward to control AIDS in Africa. Unlike the signatories to the Durban Declaration, we claim no exhaustive and unambiguous unanimity. There are differences between ourselves and with other panellists, and we are happy to acknowledge possible convergence with certain priorities favoured by the declaration’s authors. But we reject as outrageous their attempt to outlaw open discussion of alternative viewpoints, because this reveals an intolerance, which has no place in any branch of science.

The emotional politics of facts

May 27th, 2005

John Stossel lobs a grenade into the minds of feminists all over America tonight (May 27 Fri) with a provocative little segment on 20/20, presenting Warren Farrell and his book Why Men Earn More: The Startling Truth Behind the Pay Gap—and What Women Can Do About It.

Farrell is the original Man Who Loves Women. Years ago he hobnobbed with blonde archfeminist Gloria Steinem, appearing at rallies for the cause of women’s rights and female equality of opportunity. He used to wear a 59c button in honor of the outrageous injustice that women earn less than two thirds of men’s pay in the same job, a statistic which is still true even today, according to current wisdom.

Or not. As Warren points out in his book, maybe not in fact. Perhaps women do earn less on average than men, but according to his research it is because they are less willing to put up with certain disadvantages—long commuting, wind and weather, danger, long hours, travel—especially those that keep them away from their family.

So they avoid certain jobs, which are highly paid or paid more than the average because they are physically unpleasant, risky or they take away time from home life.

Warren became curious about the facts of the matter he says, because he was willing to think about it, and it didnÂ’t make sense to him. After all, if women did the same job for less, then anyone could beat the competition by starting a company and hiring just women. He or she would soon drive all the companies preferring males out of business, because their labor costs would be a third higher.

Any businessman willing to hire women can only pray that his or her competitors are stupid enough to be sexist, according to Farrell. Their costs will be much higher for the same product.

When John Stossel points out to Farrell that his new book explaining all this will likely get him in Dutch with his old feminist friends, he agrees cheerfully. “Yes, I am the bad guy”, he says, having. Like Stossel, who when he introduced the segment said he expected a torrent of feminist mail.

Turns out that FarrellÂ’s research proves his logic flawless, or so it appears. The true situation is that men don’t get paid more than women in the same job, it seems. Once again, a myth is punctured by finding out new facts, which undermine it far more effectively than reason.

Reason seems not to have had much influence in this debate. Warren’s plain and simple business logic has evidently not counted for much over the years. We all swallowed what was essentially an absurd idea. How silly. After all, it must have occurred to most people that hiring all women would be the obvious choice if women really were willing to do the same job for less money. But obviously that was not happening, and the statement didn’t make sense.

Shades of AIDS, where reason quickly indicates that so much doesnÂ’t make sense yet, and probably never will. But likewise, the ship sails on without sinking, even though it has so many holes in its hull. This is not to trivialize the issue of AIDS and its cause, which is a global issue involving life and death, and a scientific debate where the reasoning as well as the evidence has run the gauntlet of strict and often hostile peer review.

As far as the pay issue goes, it is easy to predict that toppling the conventional belief will encounter resistance, since the belief that women get paid less is a fact is imbued with a strong sense of injustice, and support for women against injustice.

Not unlike the AIDS discussion. Once again we meet the problem with so much public debate in all-too-human society: beliefs are deeply rooted in emotions as well as facts, and if the facts are challenged, the emotions rush to defend them much faster than logic can move out of the way. So reason takes a back seat in all but the best educated circles.

AIDS of course is no different in this respect than any other hot issue. Except that the range of emotions involved is so huge. A full list would include fear of death, tribal fears, hopes of succor, anxiety caused by lack of knowledge, loyalty to peers, fear and loathing of subgroups , disgust at the symptoms, shame at the stigma, pride in science, love of money and power, appetite for attention, delight in public recognition and awards, religious fervor and God knows what else sloshing around in AIDS’ emotional bloodbath.

The ideas of AIDS are the most highly charged in the health arena, and this is shown by the great success AIDS advocates have scored in attracting attention and funds away from dealing with much larger and fiercer health dragons such as cancer and heart attacks.

All in all, these many highly charged feelings attached to the scientific AIDS debate go a long way towards explaining why simple logic seems to have very little influence in its resolution, even though the list of anomalies and inconsistencies in the theory is unprecedented in science. What happens is that emotions freeze the mind and stop reason dead in its tracks.

But hold on. Maybe there is another, paradoxical lesson in Warren Farrell’s book, and John Stossel’s segment swallowing its thesis whole, which is that reason is a subtle process and those who do think very often don’t think enough. Perhaps Farrell’s common sense logic isn’t good enough.

After all, isn’t there a giant hole in Farrell’s thesis? Doesn’t it overlook the complicating factor that the behavior of business people that the feminists complain about is exactly UNreasonable and illogical. That is, employers in their prejudice may believe that men are better suited to a particular job than women are, so they may prefer to hire men to do the job rather than women, and never find out that women could do the same job as well as men or better.

This is the prejudice that feminists are fighting, with good reason. The issue is equal opportunity, not whether women get equal pay in the same job. Economics would indeed dictate that ceteris parabus, women and men in the same job doing just as well as each other would get the same pay.

The real issue, however, is whether the women are offered the job.

In the larger, and higher stakes issue of AIDS, the same problem of driving reason to its logical conclusion applies. We need to apply reason to the faith of the many, to see if it holds up. It is not merely a question of facts, but whether those facts are correctly arrived at, and the interpretation of facts.

The highly charged political and psychological emotions running rampant in AIDS have defeated the careful analysis in the scientific literature which appears to prove it completely false. The faithful accuse doubters of being “dangerous” at every opportunity, without being ever called to order.

The real danger lies in discussions which generate heat rather than light, diverting attention away from reason and evidence and allowing mob prejudice to bloom against anyone who wants to review the peer-validated objections.

All of it is highly suggestive that the ruling defenders are driven to such tactics because they are scientifically empty handed. The mark of a scientist with a good case he or she believes in is being open to review, and being happy to debate.

Outsiders in AIDS who are trying to decide who is right might take note of this, just as they can note also that the famous Durban declaration of faith in HIV as the cause of AIDS was also a sign of the weakness of the paradigm.

Scientific statements that have been widely adopted on the basis of good reason and evidence are not in need of statements of religious faith.

India welcomes the AIDS-busters

May 27th, 2005

“Spread of AIDS in India Outpaces Scant Treatment Effort” trumpeted page A3 of the New York Times today (Fri May 27), featuring a lurid story by one Somini Sengupta, who appears to be the current Timesperson on the subcontinent forging the narrative which we can all expect over the next year or two. In every anecdotal and statistical respect it matches the conventional AIDS theater staged in the minds of media reporters and readers in New York City and around the world.

Future instalments of this standardized narrative will no doubt detail the expansion of the beachhead AIDS (or perhaps just its testers and storytellers) has now established in India to the tune of 5.1 million believed to be HIV positive among its billion people. Gates and Clinton are enthusiastically financing the expanion of treatment of these unfortunates with the latest antivirals, though luckily these are available in India in their cheaper, generic form costing only $25 a month.

This opening of a second major front in AIDS exports of personnel and promotion also faces a few other obstacles which the AIDS-busters no doubt hope to overcome. The Indian Academy is after all the latest place where Peter Duesberg’s skepticism found a home, in his publication of a massive summary article in the Academy’s Journal of Biosciences in 2003. Are the Indian scientists who vetted the article for publication to be dissed by being ignored?

After all, if they were unable to find any way of rejecting what Duesberg wrote, did they not in effect endorse it, just as the peer reviewers in the US who failed to find fault with Duesberg’s articles in Cancer Research in 1986 and the Proceedings of the National Academy in 1988 also were forced to acknowledge his criticism of HIV was unanswerable?

No doubt the disconnect between the science as established by Indian Academy peer review and the politics and economics of AIDS will continue in India as widely as it has to date everywhere else, with the limited exception of South Africa where Thabo Mbeki has tried to cure this medical-scientific schizophrenia.

After all, since India lacks a leader, as far as we know, comparable to Mbeki, capable of reading the material for himself sufficiently well to perceive the disconnect, and at least call for the scientists to close the gap, it seems unlikely that even Mbeki’s very limited and seemingly crumbling resistance to the invasion of the AIDS busters in South Africa will be repeated in India.

Judging from the narrative of this Times story, even if there is some resistance in India (as there seems to be) it will have no effect on the reporting of Sengupta, which is already in line with the standard tenets of conventional AIDS science. For instance, the death rate of 350 out of 800 in five years mentioned at the end seems in line with the conventional 10 year latent period, at a hospice where the famous cheap antivirals of India have not been available for some reason.

A vast expansion of effort along the conventional lines of AIDS discovery and treatment seems inevitable for India, as TV campaigns help to ferret out the bashful and line them up for service.

In fact, the only question it leaves is one for the HIV skeptics. As the story mentions, it is now an accepted fact in the minds of international AIDS politicians and reporters that AIDS treatment was insufficient in South Africa because the government resisted disputed science, so “the virus exploded”, whereas Brazil is a showcase example of early intervention curbing the spread.

If the skeptics are right, and the spread of the virus is a fantasy induced by the spread of testing, what explanation do they have for Brazil not showing th same “explosion” as South Africa? The answer is that they dispute the testing accuracy and results.

Skeptics would doubt there was ever an “explosion” of any kind in South Africa, where according to journalist-novelist Rian Malan, the statistics are completely untrustworthy extrapolations from a handful of pre-natal clinics, where pregnant women tend to score positive on AIDS tests due to cross-reactions induced by hormones.

No doubt, however, there will certainly be an epidemic of testing in India now.

News: Spread of AIDS in India outpaces scant treatment effort

By Somini Sengupta

New York Times

27 May 2005

***********

MUMBAI – On an ordinary Thursday morning at the city’s largest public hospital, an ordinary group of Indians sat around a table, exchanging advice on life and death.

A video being shown on MTV India, depicting a woman infected by her husband, is part of an effort to combat taboos against discussion of AIDS.

A middle-aged man in a button-down shirt said he had long ago stopped having sex with his wife. A wisp of a woman sat quietly in a black burqa, her large eyes screaming bafflement at what she was being told. A plump woman in a brown sari requested that nothing be mailed to her home, for fear that her family would discover her secret. They were all living with AIDS.

Two counselors issued a stream of instructions. Come to the hospital yourself if you want free medicines. Don’t send relatives. Don’t go to your village for so long this summer that you cannot come back in time for your next dose. Never skip a dose. “There’s no need to be afraid,” one said, though the counselors’ noses were shielded by surgical masks.

The scene in this sunny hallway of J. J. Hospital here in Mumbai, formerly Bombay , offered a front-line snapshot of the first efforts to treat AIDS in India , where stigma, poverty, an anemic public health system and the sheer scale of the pandemic combine in a daunting challenge. The government estimates that India has 5.1 million people infected with H.I.V., second only to South Africa .

Only a year ago did the government start offering free drug therapy. Today, in a country that famously exports low-cost generic AIDS drugs across the world, less than 2 percent of the half-million Indians who are likely to need it receive free treatment.

“Our government works in a snail’s pace,” said Neville Selhore, director of an advocacy group in Delhi called Sahara . “The whole H.I.V. response has been very slow.”

In a country of a billion people, 5.1 million cases are, as the government points out, a drop in the bucket. But as public health workers note, India is at a pivotal moment. It could go the way of South Africa , where a lack of treatment allowed the virus to explode, or that of Brazil , where early and aggressive treatment programs checked the spread of infection.

Given India ‘s population, the AIDS pandemic, if not immediately tackled, could far outstrip the devastation visited on many African countries, AIDS advocates warn. In January the World Health Organization called attention to India , as well as Nigeria and South Africa , for not moving fast enough on treatment.

Among Indians, AIDS already is no longer confined to the high-risk groups who are believed to have been responsible for its early spread: prostitutes, their customers and users of injected drugs. Nor does it remain a city disease. The number of local districts considered high-prevalence areas doubled in 2004.

Perhaps most worrisome, the majority of Indians who are infected do not know that they have the virus or are spreading it. Offering access to treatment, health workers say, is the best way to persuade people to be tested. It is also the only way to quash the stigma still associated with AIDS.

” India is at a real turning point,” said Ira C. Magaziner, chairman of the Clinton Foundation’s H.I.V./AIDS Initiative. “If they can address it now with treatment and prevention programs, they can turn it around.”

[Former President Bill Clinton was in India on Thursday to announce a training program for 150,000 private doctors treating AIDS cases. His visit followed an announcement by the government that it had succeeded in slowing the growth rates of the infection. Compared with 520,000 new infections in 2003, government health officials announced, only 28,000 new cases turned up in 2004.]

Still, the government is behind on its own treatment pledge. Last year, when India began its free drug therapy program, it promised to extend coverage to 100,000 patients by April of this year, but only 8,000 now receive it. The government recently repeated its 100,000 pledge, this time giving itself a deadline of 2007.

The private sector, meanwhile, has proved more aggressive, serving at least 20,000 Indians who have purchased antiretroviral drugs, according to government estimates. But the kinds of doctors treating them, and how well, remains a mystery.

One private practitioner in central Mumbai, Dr. Prakash Bora, said he had tended to 3,500 H.I.V.-positive people in the last 12 years. Patients visit his office, he said, to avoid the crowds, long lines and humiliation associated with the public system. As if on cue one evening, a government clerk walked in. He said he had done everything possible to avoid a public hospital; he had not even disclosed his H.I.V. status to his wife, and he declined to divulge his name to a reporter.

The patient said he had not yet thought about how he would afford antiretroviral therapy if he should need it. At the moment he spends roughly $25 a month for vitamins and the traditional Ayurvedic medicines that Dr. Bora prescribes.

Today, antiretroviral therapy for first-time patients costs about $25 a month at a city pharmacy, a hefty amount for many working-class Indians. Those who develop resistance to the first-line treatment, or those who need an alternative drug “cocktail” pay more than twice that amount. The impact of India’s new patent law, which bars Indian companies from producing new low-cost generic drugs, has yet to be felt.

Sometimes, Dr. Bora said, if patients are buying their own medicines, a crimp in the family budget can force them to go off the medicines, or skip a dose or two to stretch out the prescription.

That so few Indians have gotten government-financed treatment points to a host of problems, from the lack of confidence in public hospitals, to a shortage of trained doctors and supplies in parts of the country, to the scarcity of hospitals and health centers where testing and treatment are available. In short, AIDS has tested the fragility of a public health system financed by less than one percent of the country’s gross domestic product.

In one state, Manipur, the head of the state AIDS agency, Binod Kumar Sharma, said there was simply not enough medicine or money to meet the demand, nor enough equipment for tests. At the moment, he said, 432 people are under treatment, but another 1,500 are eligible.

” India has a long, long way to go in scaling up wide-scale access to testing and treatment,” Dr. Richard Feachem, director of the Geneva-based Global Fund for AIDS, Tuberculosis and Malaria, said in a telephone interview. “Can India afford it? Certainly. Does India have the human resources, the institutional resources to mount an effective response? Certainly.”

Of the $107 million allocated by the Global Fund for AIDS prevention and treatment programs in India , only $12 million has been disbursed. Dr. Feachem said that was because of “a certain slowness in utilization of funds.”

For their part, Indian government officials say a hasty distribution of antiretroviral drugs without proper training and infrastructure would cause other problems, including people dropping out of the treatment program. “You cannot just start everything under a tree,” said Dr. S. Y. Quraishi, chief of India ‘s National AIDS Control Organization.

“This is totally new in India ,” Dr. Quraishi said. “One of the problems is that patients themselves have to come forward. As word is going around, people are coming. Their numbers will go up.”

He said that before the end of the year he hoped to make antiretroviral treatment available in 100 hospitals and health centers across India , up from 25 now.

Why so few Indians are able to get treatment came into sharp relief at a Catholic-run hospice in a far-flung suburb in New Mumbai, about an hour’s drive from J. J. Hospital . Only one of the 38 patients housed there gets free treatment from J. J. Hospital . The Catholic nuns who run the hospice, the Sisters of the Destitute, say they have no means to ferry their patients to the hospital, wait in line and return for follow-up appointments.

The hospital asks each patient to bring a relative to monitor treatment. The hospice’s patients have no one to bring. They have no money to commute to and from the hospital. “There are many thousands in Bombay ,” Sister Bede, the administrator, said. “Many many are in need of it.” Of the 850 patients admitted to the hospice in the last five years, Sister Bede said, 350 have died.

Online at: http://www.nytimes.com/2005/05/27/international/asia/27aids.html

Source: AHRN Daily News Digest

Poland alerted to Scovill film

May 27th, 2005

According to informed sources a Polish correspondent of the weekly magazine Cross Section in Warsaw attended a showing in California of Robin Scovill’s documentary”The Other Side of AIDS”, and has written up the film and the event in the paper’s issue for next week.



Apparently the corrrespondent is not a journalist, however, but a paid up member of the medical/research community who says he has seen it all before and “fortunately” the scientific community has so far managed to block the nefarious opinion that all might not be well with the AIDS paradigm.


Kierkegaard’s walkabout cure

May 27th, 2005

Two new findings sound the theme that an oldtime, simple and free – and drug free – approach to health may work with unexpected power

sorenkierkegaard1.jpgSoren Kierkegaard, the Danish philosopher and author who lived in Copenhagen in the first half of the nineteenth century, was usually so busy writing when he was home that all visitors were generally sent away by his servant.

In the 1840s, for example, the visiting Norwegian author and feminist Camilla Collett (who had earlier been turned away by Hans Christian Anderson) was informed that Kierkegaard was not at home. When she came back down to the street she glanced up at the apartment window and saw Kierkegaard standing there. Their eyes met, and in their mutual surprise, they nodded spontaneously to each other.

But Kierkegaard was no shut-in. A talkative, friendly fellow once he got out, he used to gear up for his writing by walking all over the city and talking to people he encountered in what he called his daily “people bath”.

“I regard the whole of Copenhagen as one great social gathering,” he wrote.

Walking made him feel good and gave him all kinds of ideas, which he would work out as he walked, often taking hasty leave of whoever he was talking to and rushing home to start work at a desk at which he stood, rather than sat.

“No matter what, do not lose the joy of walking,” he wrote to his sister in-law. “I walk my way to health and away from illness every day. I have walked my way to my best ideas, and I know of no thought so burdensome that one cannot walk away from it… If a person just continues to walk like this, things will surely go well.”

Well, modern science is now backing up Kierkegaard on this point, even to the tune of finding that exercise helps fight off cancer. Following many studies over the years showing how beneficial walking is simply as exercise, there have been two in the last week showing it helps cure cancer.

This week in JAMA Harvard assistant professor Michelle D. Holmes revealed that walking for an hour a week reduced the risk of death from breast cancer by 20 percent for women with the disease, apparently because it reduces estrogen and also body fat, which has been linked to breast cancer through diet.

While controls were not tight enough to rule out other factors causing the improvement (because whether women in the study exercised was their own choice, so they might have also been the type to eat more vegetables or visit their doctor more often) the results are generally viewed as convincing.

Exercise a foe of breast cancer

Even walking reduces a patient’s risk of death from the disease, a study says. But post-treatment exercise is easier to suggest than do.

By LISA GREENE, Times Staff Writer
Published May 25, 2005

Most people who exercise for better health think of the obvious advantages: warding off heart disease, diabetes and weight gain.

But exercise has another, more surprising benefit as well: It can help breast cancer patients cheat death, says a study published in today’s Journal of the American Medical Association.

Women don’t have to be triathletes. Even walking for an hour a week reduces the risk of death from breast cancer by 20 percent for women already diagnosed with the disease, the study found.

“I hope women with breast cancer consider that exercise may improve their length and quality of life,” said Dr. Michelle D. Holmes, assistant professor at Harvard Medical School and the study’s lead author.

Exercise also helps prevent breast cancer, other studies have said. But this study found exercise helps women who already have the disease. The news could have a dramatic effect on their lives, since they are likely to exercise less after getting cancer.

Less than one-third of breast cancer survivors get as much exercise as the government recommends.

“The stress of treatment and a life-threatening illness can be very discouraging to women,” Holmes said.

The study is especially important coming just after another study linking lower-fat diets to lower breast cancer recurrence, said Dr. Larry Norton, deputy physician-in-chief for breast cancer programs at Memorial Sloan-Kettering Cancer Center.

“There seems to be a connection between fat in your body, fat in the diet and recurrence of breast cancer,” he said. “It’s very exciting, because it’s something we can do something about.”

More exercise reduces the risk further. The greatest benefit is to women who exercise the equivalent of walking three to five hours per week. Those breast cancer patients reduced their risk of death by 50 percent. Women who exercised harder could spend less time working out for the same benefit.

The study results impressed Clearwater resident Roberta Mindykowski. She has battled breast cancer for nine years. Mindykowski, 60, had a mastectomy nine years ago. Three years ago, her cancer returned, and two years ago she had more surgery.

Exercise after cancer is easier recommended than done. After her latest surgery, Mindykowski said, her energy disappeared.

“It takes a long time to get your stamina back,” she said.

It wasn’t until a few months ago that Mindykowski resumed regular exercise. Now she’s lifting weights, walking on a treadmill, and taking daily breaks to walk in her office parking garage with co-workers.

“Just doing a little bit of exercise makes you feel so well mentally and physically, it can’t do anything but help you,” she said.

The study looked at data from almost 3,000 patients in the ongoing Nurses’ Health Study who were diagnosed with breast cancer between 1984 and 1998, following them until 2002.

Researchers analyzed how much exercise women reported getting after they were treated for breast cancer. They didn’t include women with the worst prognosis, or women undergoing treatment, since both groups would be less likely to exercise.

Of the study participants, 86 percent survived at least 10 years after diagnosis.

Researchers aren’t sure why women who exercised were more likely to survive. Exercise may help because it lowers the level of estrogen circulating in women’s bodies.

The study found that exercise reduced the risk most for women with the most common kind of tumor, which is stimulated by estrogen. That gives more weight to the idea that the benefits come from affecting estrogen levels, Holmes said.

Other factors also may be at work, Norton said. In the recent diet study, lower-fat diets still affected tumors not stimulated by estrogen. That makes him wonder whether some chemical in fat cells affects breast cancer and that chemical is in turn affected by diet and exercise.

The study’s findings are “fairly convincing,” said Dr. Pamela Munster, breast cancer oncologist at H. Lee Moffitt Cancer Center & Research Institute and assistant professor at the University of South Florida.

Still, the study has limits. Because the women chose whether to exercise, rather than being assigned at random to exercise or not, it’s possible that there was some other difference between the two groups, Munster said. Maybe women who exercise visit their doctors more often, or eat more vegetables.

Researchers tried to account for such factors, Holmes said, but “can’t totally rule it out” that something else might have influenced the results.

Munster would like to see the results confirmed in a randomized trial. But in the meantime, the best bet is to hit the gym, she said.

“Even a woman with breast cancer is still at risk of dying from heart disease,” she said.

Holmes agreed.

“There’s not a lot to lose by exercising,” she said.

Cindi Crisci, 45, of St. Petersburg worked out and watched her diet because her family has a history of heart disease.

Six years ago, Crisci was diagnosed with breast cancer. She walked after her surgeries, through her chemotherapy and her radiation treatments.

“It helped in the healing process,” said Crisci, whose cancer prompted her to get a job with the American Cancer Society. “I firmly believe a positive attitude and staying healthy helped me. … Exercise in general helps the mind, body and soul.”
WHY EXERCISE HELPS

Why would exercise keep breast cancer from coming back, or spreading throughout the body? Researchers aren’t sure. But studies have linked exercise to lower levels of estrogen in the body. And today’s study found that women whose tumors are stimulated by estrogen got even more benefit from exercise. So they believe exercise may help prevent cancer because it lowers estrogen levels.

© 2005 ? All Rights Reserved ? St. Petersburg Times© 2005 ? All Rights Reserved ? St. Petersburg Times

Meanwhile at the annual meeting of the American Society of Clinical Oncology.in Orlando, Harvard cancer doctor Jeffrey Meyerhardt announced that an hour’s walk six days a week cut the risk of colon cancer recurrence for patients after surgery by half.

Source: Dana-Farber Cancer Institute
Date: 2005-05-17
URL: http://www.sciencedaily.com/releases/2005/05/050517143749.htm
Exercise Reduces Risk Of Recurrence And Death In Early Stage Colon Cancer Patients

ORLANDO, Fla.–Patients treated for early stage colon cancer fared significantly better if they exercised regularly at the level of an hour’s walk six times a week, according to a study to be presented at the annual meeting of the American Society of Clinical Oncology.

A person’s risk of having a cancer recurrence or dying was lowered by 40 to 50 percent in the 2 1/3 to 3 years following surgery and chemotherapy for stage III colon cancer, reported a team headed by Jeffrey Meyerhardt, MD, MPH, of Dana-Farber Cancer Institute. The data (abstract 3534) is from the Cancer and Leukemia Group B (CALBG) and will be presented during a poster discussion on Tuesday, May 17, 8 a.m. Level 3, 315A.

Although exercise has previously been shown to lower the risk of developing colon cancer, the new findings are the first to demonstrate a benefit for patients who already have the disease.

“There is a growing body of evidence that there are things you can do in addition to chemotherapy for colon cancer survivors to reduce the likelihood that the disease will recur,” says Meyerhardt. “Until now, when doctors were asked by their patients whether they should exercise, some of them probably said it would be a good idea, but it wasn’t a firm recommendation without data to support it.”

The health benefit was found among patients whose activity levels ranked in the top two-fifths of the group, compared to the lowest one fifth. They exercised at a rate of at least 18 MET-hours (metabolic equivalent tasks) per week, which could be attained through jogging two to three hours a week, playing tennis a few times a week, or walking briskly an hour a day six times a week, explains Meyerhardt, who is an assistant professor of medicine at Harvard Medical School.

The study involved patients reporting leisure-time physical activity approximately 12-18 months after surgery. The patients belonged to the same group in which a separate study headed by Dana-Farber researcher Charles Fuchs, MD, MPH, revealed that regular aspirin use reduce recurrence and death risks by about the same magnitude as exercise.

###

In addition to Meyerhardt, the study’s other authors are Fuchs, Denise Heseltine, BA, and Robert Mayer, MD, Dana-Farber; Donna Niedzwiecki, PhD, and Donna Hollis, MS, CALGB Statistical Center at Duke University Medical Center; Leonard Saltz, MD, Memorial Sloan-Kettering Cancer Center; and Richard Schilsky, MD, University of Chicago.

Dana-Farber Cancer Institute (www.danafarber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

This is the original press rekease:

Press Releases

May 17, 2005
Exercise reduces risk of recurrence and death in early stage colon cancer patients
Photo of Jeffrey Meyerhardt, MD, MPH
Jeffrey Meyerhardt, MD, MPH

ORLANDO, Fla.?Patients treated for early stage colon cancer fared significantly better if they exercised regularly at the level of an hour’s walk six times a week, according to a study presented at the annual meeting of the American Society of Clinical Oncology.

A person’s risk of having a cancer recurrence or dying was lowered by 40 to 50 percent in the 2 1/3 to 3 years following surgery and chemotherapy for stage III colon cancer, reported a team headed by Jeffrey Meyerhardt, MD, MPH, of Dana-Farber Cancer Institute. The data (abstract 3534) is from the Cancer and Leukemia Group B (CALBG) and will be presented during a poster discussion on Tuesday, May 17, 8 a.m. Level 3, 315A.

Although exercise has previously been shown to lower the risk of developing colon cancer, the new findings are the first to demonstrate a benefit for patients who already have the disease.

“There is a growing body of evidence that there are things you can do in addition to chemotherapy for colon cancer survivors to reduce the likelihood that the disease will recur,” says Meyerhardt. “Until now, when doctors were asked by their patients whether they should exercise, some of them probably said it would be a good idea, but it wasn’t a firm recommendation without data to support it.”

The health benefit was found among patients whose activity levels ranked in the top two-fifths of the group, compared to the lowest one fifth. They exercised at a rate of at least 18 MET-hours (metabolic equivalent tasks) per week, which could be attained through jogging two to three hours a week, playing tennis a few times a week, or walking briskly an hour a day six times a week, explains Meyerhardt, who is an assistant professor of medicine at Harvard Medical School.

The study involved patients reporting leisure-time physical activity approximately 12-18 months after surgery. The patients belonged to the same group in which a separate study headed by Dana-Farber researcher Charles Fuchs, MD, MPH, revealed that regular aspirin use reduces recurrence and death risks by about the same magnitude as exercise.

In addition to Meyerhardt, the study’s other authors are Fuchs, Denise Heseltine, BA, and Robert Mayer, MD, Dana-Farber; Donna Niedzwiecki, PhD, and Donna Hollis, MS, CALGB Statistical Center at Duke University Medical Center; Leonard Saltz, MD, Memorial Sloan-Kettering Cancer Center; and Richard Schilsky, MD, University of Chicago.

Dana-Farber Cancer Institute (www.danafarber.org) is a principal teaching affiliate of the Harvard Medical School and is among the leading cancer research and care centers in the United States. It is a founding member of the Dana-Farber/Harvard Cancer Center (DF/HCC), designated a comprehensive cancer center by the National Cancer Institute.

Actually, even Kierkegaard’s habit of standing at his desk was a very good thing, exercise-wise. As Denise Grady reported in the New York Times Tuesday, a study of a group of couch potatoes fitted out with speecial underwear to record their every movement, published by James Levine, a nutritionist at the Mayo Clinic in January in Science made that pretty clear, for it revealed that surprising amounts of calories can be burned off by fidgeting, or simply getting up from the couch.

In January, the scientists here who designed the underwear reported a striking difference in activity levels between lean people and overweight ones. Their study, published in the journal Science, did not involve deliberate exercise, but it measured with the help of the sensors how much people moved about naturally and spontaneously.

The heavier ones tended to sit, while the lean ones were more restless and spent two or more hours a day on their feet standing, pacing and fidgeting. The difference translated into 350 calories a day, enough for the heavy people to take off 30 to 40 pounds a year, or 14 to 18 kilograms a year, if they would get moving.

Standing takes more energy than sitting, and strolling along at just a mile an hour, or 1.6 kilometers an hour, burns twice the calories of sitting.

The New York Times
May 24, 2005
New Weight-Loss Focus: The Lean and the Restless
By DENISE GRADY

ROCHESTER, Minn. – If you move, they will measure it. If you don’t move, they will measure that, too, along with what you eat. There are no secrets here, at least no metabolic ones. Not only do they have your number – they have 25 million of your numbers.

They, in this case, are scientists at the Mayo Clinic here. And they learn your secrets only if you have been one of the select few to wear a set of underwear with racy-looking cutouts at the crotch and backside, and pockets holding position and motion sensors dangling a half dozen tangled wires.

In January, the scientists here who designed the underwear reported a striking difference in activity levels between lean people and overweight ones. Their study, published in Science, did not involve deliberate exercise, but it measured – with the help of the sensors – how much people moved about naturally and spontaneously.

The heavier ones tended to sit, while the lean ones were more restless and spent two more hours a day on their feet – standing, pacing around and fidgeting. The difference translated into 350 calories a day, enough for the heavy people to take off 30 to 40 pounds a year, if they would get moving.

The researchers believe the tendency to sit still or move around is biological and inborn, governed by genetically determined levels of brain chemicals. And that tendency influences weight – not the other way around, the researchers say.

The Mayo researchers call the type of movement and calorie burning that they study NEAT, for nonexercise activity thermogenesis. The leader of the research team, Dr. James Levine – a nutritionist, an endocrinologist and a professor of medicine – has defined the term as “the energy expenditure associated with all the activities we undertake as vibrant, independent beings.” Those activities include “occupation, leisure, sitting, standing, walking, toe-tapping, guitar playing, dancing and shopping,” he writes. His team has even measured the energy burned in gum-chewing (11 calories an hour, if you chew six pieces at a time).

“This is probably the only place in the world that can do this kind of research,” Dr. Levine said.

Other researchers have praised the work, particularly the team’s painstaking and precise measurements of calories consumed and the way they are burned.

Dr. Rudolph Leibel, an obesity researcher at Columbia University, called the Science paper “great,” and added, “I believe the data; it’s done correctly and an interesting set of findings.”

Nonexercise activity can account for a significant portion of the calories burned in a day, anywhere from 15 percent in a sedentary person to 50 percent in someone who is very active. Standing takes more energy than sitting, and strolling along at just one mile an hour burns twice the calories of sitting.

Dr. Levine and his colleagues believe that if scientists can understand nonexercise activity better and identify what drives it, what makes people want to move around, they may be able to harness it to help the millions who are struggling to control their weight.

“Can we really find something to help people?” Dr. Levine asked. “We want to examine how to change people’s NEAT. There is this gap. Can we close it?”

He advocates this approach because the usual weight loss remedies usually fail. People have a hard time sticking with exercise programs and diets, and Dr. Levine argues that the very number of diet books and weight-loss plans is proof in and of itself that none of them work. “If one worked, we’d all be following it,” he said.

Studying activity and metabolism in people and animals has been a lifelong fascination, Dr. Levine said, explaining that he started measuring movement in snails and bacteria during his boyhood in London. He trained in medicine there, came to the Mayo Clinic as a resident in 1992 and then joined the faculty.

Today he runs a research group with a dozen scientists, specialists in physiology, nutrition and computing. They study nonexercise activity not only in obese adults and children, but also in the elderly, people with anorexia nervosa and populations threatened by starvation in Africa and India.

They have even investigated the significance of chubby cheeks, noting that people who deposit fat in their faces tend also to build up harmful stores inside the abdomen, which are linked to heart disease. Some members of the team also work with animals, trying to characterize the rich palette of brain chemicals that control activity levels and weight.

Although he spends most of his time on research, Dr. Levine is still a practicing endocrinologist who treats patients one afternoon a week, and he says he sees firsthand how intractable obesity can be, and what physical and emotional suffering it can cause.

Many of his patients are very obese. One was so heavy she could barely get out of a wheelchair, he said. He suggested an initial goal of simply standing up three times a day, and then trying to walk for 15 seconds at a time. For her, working her way up to two minutes of walking was a major milestone, he said.

Obese people are so stigmatized that even some doctors, perhaps unconsciously, withdraw from them, Dr. Levine said, noting that patients have told him he was the first physician who ever shook their hand or actually examined them.

“The key is to provide a nonjudgmental, compassionate environment,” he said.

The study published in January included 10 lean men and women and 10 slightly obese ones, all of whom described themselves as “couch potatoes” who did not exercise much. The object was to measure and compare their nonexercise activity, and also to determine whether it changed when they were put on special diets that made them gain or lose weight.

They wore the special underwear, which measured posture and movement every half second around the clock for 10 days in a row on several occasions, yielding 25 million points of data on each participant.

To make sure the researchers knew exactly how many calories the subjects were eating, dietitians prepared all their food for weeks at a time, a total of 20,000 meals.

“These studies cost a fortune,” Dr. Levine said. Each costs hundreds of thousands of dollars, paid by grants from the National Institutes of Health.

“Every food item is weighed to within a gram, and each meal costs $30,” he said.

In addition, the 20 participants were paid $6,000 each for their time. And the overweight ones were given advice and personalized plans to help them lose weight.

This was the study that found that the lean subjects spent much more time on their feet than did the obese ones.

What convinced the researchers that the tendency to be inactive led to obesity, and not the other way around, was that the activity levels did not change when the diets were altered to make the obese people lose weight and the lean ones gain it. If the common wisdom were true – that being heavy is what makes people sluggish – then the overweight people should have acted more energetic when they lost weight, and the lean ones should have slowed down when they gained.

But that did not occur.

If activity levels are governed by biology, then it may seem hopeless to try to change them, Dr. Levine acknowledged.

“But the counterevidence to that is, our biology as a species really hasn’t changed in decades and centuries, and yet obesity rates have dramatically increased in the last 15 years,” he said.

Activity levels have declined, and he and many other obesity researchers say that decline, more than increases in eating, is to blame for rises in obesity.

What has changed is the artificial environment: there is far more opportunity today than in the past to be sedentary. And some people may be genetically predisposed to seize that opportunity.

“We all like and dislike different things,” Dr. Levine said. “None of us can quite quantify it.”

In a biological way, not a personal one, he said, obese people seem to like inactivity.

“Given an environment that lets people sit for hours and hours a day, they will,” he said.

A solution, then, may be to change the environment, to make moving around easier and sitting still less convenient.

The team’s recent paper in Science noted, for instance, that in 1920 before cars were common, people in Rochester walked an average of 1.6 miles a day to and from work, which burned about 150 calories a day. Few people do that today; many live too far away to talk to work, but, Dr. Levine suggests, many could build short walks into the day.

This is not a new idea, he acknowledges. Plenty of experts have been advising people to find small, relatively painless ways to burn extra calories, like taking the stairs instead of the elevator and parking at the far end of the lot to make themselves walk a bit.

But for this kind of thing to make a real difference, people would have to commit to changing their habits and their environment. When it comes to this mission, Dr. Levine may be his own best guinea pig.

“If anyone in the world is going to do this it’s obviously going to be me,” he said.

At meetings, he stands instead of sitting. Talking on the telephone, he paces around. In his office he has a treadmill in place of a desk. He got it last year when he saw the data from the study comparing lean people and obese ones.

“My computer is stationed over the treadmill,” he said. “I work at 0.7 miles an hour.”

A stand-up desk might seem simpler, but he prefers the treadmill.

“Standing still is quite difficult,” he said. “You have a natural tendency to want to move your legs. Zero point seven is the key. You don’t get sweaty, you can’t jiggle too much. It’s about one step a second. It’s very comfortable. Most people seem to like it around 0.7.”

He has installed a second treadmill alongside his own, and he encourages visitors to hop on and stroll while they talk to him. It takes some getting used to, but, he says, envious colleagues at Mayo have been clamoring for treadmill desks.

“Walking at work, first of all it’s addictive,” he said. “It’s terribly good fun. I actually feel happier, particularly in the afternoon. You might think you come home exhausted, but you don’t. You come home energized.”

For him, the treadmill has eliminated the afternoon slump, when a lot of people feel sleepy and crave candy bars or caffeine.

“I’ve become convinced we really can generate an office environment where people are on the move and are happier,” he said.

* Copyright 2005 The New York Times Company

All in all, Kierkegaard probably spent more time at his desk than the average office worker today. Yet, although he ignored sports and knew nothing of gyms, he evidently knew how to keep trim and healthy.

Poland alerted to Scovill film

May 26th, 2005

According to informed sources a Polish correspondent of the weekly magazine Cross Section in Warsaw attended a showing in California of Robin Scovill’s documentary”The Other Side of AIDS”, and has written up the film and the event in the paper’s issue for next week.



Apparently the corrrespondent is not a journalist, however, but a paid up member of the medical/research community who says he has seen it all before and “fortunately” the scientific community has so far managed to block the nefarious opinion that all might not be well with the AIDS paradigm.



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