AIDS in Africa: Reassessing a Crisis

The Washington Post last week enters the extremely controversial debate about how trustworthy are the standard figures regarding an AIDS crisis in Africa with a front-page story. The Post story's conclusion is that the epidemic was overhyped in west and east Africa, though not in southern Africa.

An earlier, and far more detailed, discussion of the hows and whys of the apparent overstatement of an AIDS crisis in Africa in American mainstream media appeared in Rolling Stone back in November 2001 by Rian Malan. The Malan story emphasizes a wider variety of possible reasons for misleading AIDS stats; the Post's story mostly discusses how surveys based almost entirely on pregnant women at prenatal clinics overstated overall prevalence; though it does touch on how UNAIDS

produced reports that increasingly were subject to political calculations, with the emphasis on raising awareness and money.

"It's pure advocacy, really," said Jim Chin, a former U.N. official who made some of the first global HIV prevalence estimates while working for WHO in the late 1980s and early 1990s. "Once you get a high number, it's really hard once the data comes in to say, 'Whoops! It's not 100,000. It's 60,000.' "

Chin, speaking from Stockton, Calif., added, "They keep cranking out numbers that, when I look at them, you can't defend them."

Malan's old story from Rolling Stone casts a wider net--for example, questioning the reliability of the ELISA test on which so many AIDS diagnoses in Africa depend. For those interested in the complicated dimensions of assessing AIDS in Africa, both stories are worth reading in full.

Comments

[Angela Keaton]

Intuitively, we should have known that all along. I'm still waiting for the white middle class aids epidemic we were promised 17 years ago.

[Paul]

1 in 5 of us has aids... at least Oprah said we would...

[complexisomorphism]

What kills me is that, because of the political hype, HIV research receives a disproportionate amount of dollars. AIDS activists say to not give ever increasing government funds to fight AIDS is tantamount to murder. This statement breaks down when we look at the simple economics of the matter: if we are forced spend $1000 dollars to stave off AIDS in one person when we could have spent $100 to save ten people from other diseases, who are the murderers then?

If we want to help the people in sub-saharan Africa, coming down hard on corrupt governments, enforcing property rights and upholding contract law would be a start. You need money to fight disease, and you need legally secure markets to produce money. The rest will handle itself. A billion dollars dumped down a humanitarian hole produces no lasting results, not to mention the assured bureaucratic squandering and corrupt kickbacks.

[Akira MacKenzie]

If we want to help the people in sub-saharan Africa, coming down hard on corrupt governments, enforcing property rights and upholding contract law would be a start.

Ahhhh... but just who will come down hard on corrupt governments, enforce property rights and uphold contract law? The UN? Bloody unlikely. The U.S.? We seem to be preoccupied and I don't think you can sell this sort of foreign adventurism to the American public no matter how worthy the goal.

Not to sound flip, but who is this "we" you're talking about?

[Herrick and His Balls]

It sounds shady, but might not we bribe our way to good government? That is, could the US, UK, & Friends buy off the corruptocrats to hold free and fair elections and strong anti-corruption laws? Or does that create a moral hazard of sorts?

[joshua corning]

what is really crapy is that per dollar milaria is far cheaper to fight then aids. More lives saved per buck...so any money spent on aids in africa is by default irational until malaria is eradicated or so small a problem that the cost is above that of preventing aids....another point is that malaria is not a desease that can be avoided simply by changeing ones sex habits.

Maybe we should spend 50,000$ per person in Africa to make sure none of them jump off a cliff. barriors and education programs and such. we could hand out parachutes.

why the hell are we spending money on this crap.

[Olowow]

Yeah, I feel sorry for the kids who get AIDS from prenatal transmission, but I really have no sympathy at all for anyone anywhere who got AIDS from sex, because they could have easily chosen not to have unprotected sex, yet they still did. I really would rather that my tax dollars not support their treatment.

[Gimme Back My Dog]

I read an article once by a guy who went to Africa looking for the AIDS epidemic. One doctor he talked to said that they always diagnosed AIDS because the international community gave them twenty five cents for every malaria case, a dollar for every TB case and one hundred dollars for every AIDS case. (I don't remember the exact money amounts, but that was the gist of it). Basically, if anyone came in with malaria or TB, the only way they could get the money to treat it was to call it AIDS.

[matthew hogan]

Anytime huge amounts of government aid are directed by piled-on ideological agenda, there should be banners of red flags demanding skepitcism.

Some problems: one of the discussions seems to imply that the skepticism about HIV causing AIDS has merit. No. Further alot of testing for HIV in Africa is done with Western blot confirmation, which makes it sounder than just ELISA.

The problems that exist are: a) exaggeration of AIDS (not HIV) based on fund-seeking misdiagnosis of symptoms, b) the assumption (recently cracking slighty) that most HIV is spread in Africa via sex, specifically standard heterosexual intercourse and prostitutes (female to male), rather than the commonly done injections with reused needles or other iatrogenic penetrations (phlebotomy -- blood drawing) which can leada to false positives and active spread -- a new study from Cameroun for example shows i.v. injections on HIV+ patients leave high chance of retained RNA in syringe.

[DEAN BERRY - REAL AMERICAN]

I?LL BET MY COPS ARE MORE CHICKENSHIT THAN YOURS ARE. WELLS & ELKO, NEVADA: NOBODY MORE CHICKENSHIT.
http://chickenshitwellsandelko.blogspot.com/

[Celia Farber]

Rian Malan's piece in Rolling Stone was indeed stunning. Thank you, Brian, for correcting yesterday's error calling it the "first" article that questioned AIDS in Africa stats and bubbles in the "mainstream media." I did not want to have to appear to be competing with Rian Malan, whose work I adore.

My series in SPIN, "Out of Africa," (http://www.deanesmay.com/posts/1144624164.shtml)
ran in 1993, eight years prior to Malan's, so his was not "first," though as I have said to Rian himself, I consider it superior, as a piece of writing and reportage-- a landmark in long form investigative journalism.

What made the piece so exceptional and original was that the writer turned his own beliefs inside out; It began as a pitch to Rolling Stone that offered to dismantle Mbeki's foolishness on HIV/AIDS. We can read for ourselves where it wound up, after a year of careful and increasingly desperate searching for an "epidemic" Malan never could locate. Hence, the story was about what was not found, and how it left the writer.

Its editor chose to reassure Rolling Stone's readers that soundness of mind would be secured by a We-Didn't-Inhale promise that Rolling Stone was by no means questioning HIV's pathogenesis in Africa--only its prevalence.

Epidemiologists know that "spread" and "cause" are indelibly linked.

What lies at the root of all of these games of Twister in the white, Western media, is the HIV test itself, and beliefs about its spread, (gleaned from the clouded lens of said test.)

Matthew Hogan states: "Alot of HIV testing in Africa is done with Western Blot confirmation, which makes it sounder than just ELISA."

Let's review some facts:

--First of all, "alot" of HIV testing on the continent does not take place at all. In most countries an HIV test is not necessary for an AIDS diagnosis, according to the Bangui definition.

--The notion that a WB, which follows two pairs of positive ELISAs over two days, increases accuracy is false. That a total of five blood tests are required for a single diagnosis of "positive" is in fact a classic example of paranormalism in HIV science. No other infectious diagnostic test requires more than ONE positive, because of a phenomenon known as a GOLD STANDARD.

HIV tests detect antibodies against what were said to be (in 1984, by Gallo et al) proteins or antigens specific to HIV, but have subsequently been found outside of HIV, particularly in regions where any number of the up to 70 cross reacting antigens proliferate. These include Malaria, TB, pregnancy hormones, etc. None of the HIV tests detect HIV "itself," and each manufacturer of the tests acknowledges this in their lawsuit-protecting package inserts. To wit:

Abbott states: "At present there is no recognized standard for establishing the presence and absence of HIV-1 antibody in human blood. Therefore sensitivity was computed based on the clinical diagnosis of AIDS and specificity based on random donors." (Abbott, 1997)

"Elisa testing alone cannot be used to diagnose AIDS, even if the recommended investigation of reactive specimens suggests a high probability that the antibody to HIV-1 is present."

The insert for Western Blot warns: "Do not use this kit as the sole basis of diagnosis of HIV-1 infection." (Epitope Organon Teknika)

But PRC is supposed to be the really accurate marker, right?

The inventor of PCR, Kary Mullis, expressed profound anguish in several interviews with me, over the heinous manipulative uses of his discovery in HIV research. He now refuses to discuss PCR at all. Let us see what the package insert says:

"The Amplicor HIV-1 Monitor test is not intended to be used as a screening test for HIV or as a diagnostic test to confirm the presence of HIV infection." (Roche 2003)

Hence, neither Elisa, WB, nor Viral Load tests are able to diagnose "HIV infection."

Why?

Because there is no Gold Standard. That would be the Virus Itself, isolated, purified and separated from all else.

Instead, the tests were built around Reverse Transcriptase activity, and RT was asserted to be a unique feature of retroviruses. We have here a grave problem that will require years of deconstruction, back through time, politics, hysteria, emerging industries, and bio-tech presumptions.

All of this is, fortunately, going on, well outside of the blessings of mainstream media.

About Thabo Mbeki's quest into these and other questions, one can expect reflexive condescenion.

Might it reassure some to turn instead to the European Parliament's debates on AIDS in Africa that took place a few years ago in Brussels?

All is available online, if minds are open enough to read, and keep reading.

Let me in parting address the core assumption that HIV "spreads" this way or that, in this or that part of the world.

In the by now famous Padian study, "Heterosexual Transmission of Human Immunodeficiency Virus (HIV) in Northern California," (American Journal of Epidemiology 1997, Aug 15; 146 (4): 350-7)
which was "the largest and longest study of the heterosexual transmission of HIV in the United States," provided no evidence that HIV is sexually transmitted. Of a total of 82 "infected women" and their male partners and 360 "infected men" and their female partners "...no seroconversions were observed after entry into the study." The study period start to finish was ten years.

But what about Africa?

Reporting on the "Probability of HIV-1 transmission per coital act"...in similarly HIV discordant couples in Rakai Uganda, authors Gray et al, publishing in the Lancet in 2001 (Lancet 357 (9263): 1149-53, embarassingly, found that black Africans don't transmit HIV sexually any more readily than Americans in Northern California.

In a letter to the British Medical Journal, 2002, April 27 (324 (7344): 1035, Eleni Papadopolous-Eleopulos et al helped clarify their findings, titling the (unpublished) letter, blasphemously:
"Heterosexual Transmission of HIV in Africa is no higher than anywhere else."

The Perth-based HIV research team calculated: "...it would take 770 or 3333 sexual contacts [male to female] to reach a 50% or 95% probability of becoming infected...Based on the estimate of Padian et al, it would require 6200 and 27000 contacts and a period of 51 and 222 years, respectively." (Culled from letter to Dr. Olive Shashana, Cape Town, from Anthony Brink, of Treatment Information Group, Cape Town, 31 December 2005)

The HIV Prevalence, according to Dr. Shishana, is 13.3 % among black South Africans, yet only 0.6 % among whites.

"You can't be serious," Brink implores, calling her report a "grotesque and obscene calumny against Africans based on the worst sort of American junk science, and a monumental waste of time and money..."

--As a final point, please note that the population on the continent of Africa has grown overall by nearly 300 million people since the mid-1980s.

Clearly, it is the HIV test ITSELF and the sex-pious, pharma-crazed "care" industries that have sprung up around it that requires reform--not African sex practices.

It would be very gratifying if REASON would join the mass journalistic clean-up effort required to sweep away the mountainous debris of error, terror, damage and destruction set in motion by the so-called HIV-AIDS orthodoxy since 1984.

Let the reader be reminded that the HIV-AIDS theory was the ideological product of the US Government. Only a third of Gallo's original cohort showed signs of HIV, at the time, in 1984.

No proof of causation was ever established, not even a solid correlation. The 100% correlation between HIV antibodies and AIDS came years later, as the definitions shifted.

Thanks for listening, and I hope this won't trigger anything ugly. Nobody is at fault for not knowing this horrible stuff--it takes years and years of reading. Nobody has all the answers, etc etc. But posing the questions is at long last permissible in this Prague Spring we find ourselves in, on the tortured subject of AIDS.

With abiding respect,

Celia Farber