AIDS Denialist Crank Convention: Gearing Up for Oakland

"They are all prostitutes, most of them, my collogues, to some degree, including myself. You have to be prostitutes to get money for your research. You are trained a little bit to be a prostitute. But some go all the way." Peter Duesberg

I don’t know about you, but I am getting pretty excited about the Rethinking AIDS conference. What a great opportunity to meet all of the AIDS Denialists and learn about their latest delusions! I am familiar with the venue – same place Peter Duesberg held his Aneuploidy Conference. Truth is the Aneuploidy meeting attempted to present some science. There were some real scientists there, albeit not very comfortably. The Rethinking AIDS Conference promises to be even better. Just look at what the AIDS Deniers are saying…

Who Should Attend? — Anyone who has questions about the connection between HIV and AIDS should attend. If you are already convinced that the HIV=AIDS dogma is broken come and expand your understanding. If you aren't sure about it come and perhaps you will be by the end of the conference. If you are convinced that HIV is the cause of AIDS and want to understand why some people disagree, you are still welcome to come, listen, and participate in discussions.

Why Should you Come? — To learn about the history of the AIDS dogma, scientific flaws in the dogma, treatment of immune deficiency, legal issues and the human impact on HIV-positives.

What Can You Expect — You will see from the program that there will be many talks, with opportunities to ask questions and have group and individual discussions. Social events will allow networking with other people concerned about the science of HIV, the social and legal consequences of an HIV diagnosis and the censorship of science and the media.

PLUS…there will be a special showing of House of Numbers. Now wont that be special?
UPDATE: See Rethinking AIDS Program Below!
Mimicking scientific conferences is not unique to AIDS Denialism. In fact, conferences are an important part of creating a façade of legitimacy for pseudoscience. David Gorski has a great post at Science-Based Medicine on crank conferences. Here is an excerpt.
Crank “scientific” conferences: A parody of science-based medicine that can deceive even reputable scientists and institutions

If there’s one thing that purveyors of pseudoscientific medical modalities crave, probably above all else, it’s legitimacy. They want to be taken seriously as Real Scientists. Of course, my usual reaction to this desire is to point out that anyone can be take seriously as a real scientist if he is able to do science and that science actually shows that there is something to his claims. In other words, do his hypotheses make testable predictions, and does testing these predictions fail to falsify his hypotheses? That’s what it takes, but advocates of so-called “complementary and alternative medicine” (CAM) or “integrative medicine” (IM, or, as I like to refer to it: “integrating” quackery with scientific medicine) want their woo to be considered science without actually doing the hard work of science.

There are several strategies that pseudoscientists use to give their beliefs the appearance of science, a patina of “science-y” camouflage, if you will. One, of course, is the cooptation and corruption of the language of science, which has been a frequent topic on this blog, particularly in posts written by Drs. Atwood and Sampson. Another is to produce journals that appear to be science, but are anything but. I’ve discussed one example, the Journal of American Physicians and Surgeons and Medical Acupuncture, but others include Homeopathy, the Journal of Alternative and Complementary Medicine, and Medical Hypotheses, which recently was forced to retract a horrible paper by arch-HIV/AIDS denialist Peter Duesberg. What’s worse is that some of these journals are even published by what are considered major publishers, such as Mary Ann Liebert, Inc., and Elsevier.

There is, however, a third strategy. How do scientists communicate their findings to other scientists, as well as meeting and mingling with other scientists? Why, they hold scientific meetings, of course! These meetings can be small or even as large as the American Association for Cancer Research meeting, which is attended by around 15,000 cancer researchers each year. So, too, do cranks hold meetings. These meetings often have all the trappings of scientific meetings, with plenary sessions, smaller parallel sessions, poster sesssions, and an exhibition hall, complete with exhibits by sponsoring companies. Sometimes these meetings can even appear so much like the real thing that they take in legitimate researchers and legitimate universities. Here, I present two examples of such conferences. [to read the rest of Gorski’s post visit Science-Based Medicine]


Watch the Rethinking AIDS 2009 conference video.

RETHINKING AIDS CONFERENCE PROGRAM

Friday

3:00 Check-in6:00 Welcome and introduction of Keynote Speaker (David Crowe) 6:15

Keynote Lecture (Michael Tracey)
7:15 WELCOME COCKTAIL

Saturday
Morning Session

8:00 Opening remarks (David Crowe)
8:10 History of the AIDS controversy spanning three decades (John Lauritsen)
8:50 HIV-AIDS hypothesis out of touch with South African AIDS—a new perspective (Peter Duesberg)
9:30 Questioning the Existence of HIV (Etienne De Harven)
10:10 Coffee Break
10:30 The Deception and Dishonesty of African AIDS Statistics (Charlie Geshekter)
11:10 Aids in Africa—a call for sense not hysteria (Christian Fiala)
11:50 The role of the inner pharmacy in the prevention and treatment of AIDS (Roberto Giraldo)

12:30 Lunch

Afternoon Session

2:00 HIV drugs causing AIDS (Dave Rasnick)
2:40 The treatment dilemma of HIV-positive patients as a result of the HIV-AIDS hypothesis: The illusion of antiviral treatment (Claus Koehnlein)
3:20 HIV/AIDS blunder is far from unique in the annals of science and medicine (Henry Bauer)
4:00 Coffee Break
4:30 Screening of House of Numbers
Evening
7:00 BANQUET

Sunday
Morning Session
8:00 The Criminalization of Illness (Chris Black)
8:30 Rethinking Legal Aspects of AIDS in Colombia (Universidad Libre Pereira Colombia Law Group)
9:00 Censorship in the AIDS debate—the success of stifling, muzzling and a strategy of silence (Joan Shenton)
9:30 Coffee Break
9:45 Religion, Politics, and AIDS in Italy: curious paradoxes from the Ministry of Health (Marco Ruggiero)
10:15 The Italian epidemiology supports the chemical AIDS theory (Daniele Mandrioli)
10:45 How I fell victim to the AIDS machine (Karri Stokely)
11:00 AIDS, Big Deal, Next!: A journey to hell and back with AIDS (Noreen Martin)
11:15 Challenges faced by gays who question HIV/AIDS with implications for dissidents (Tony Lance)
11:30 Panel discussion
12:00 Close

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Duesberg's Medical Hypotheses Article Makes the Case for Peer Review

Having just posted my simulated peer review of Peter Duesberg’s shameful and retracted article where he once again proclaims that HIV is harmless, I could not resist sharing this. The UK’s premiere debunker of medical fraud and Bad Science, Ben Goldacre, writes about Duesberg’s retracted article in his weekly Guardian column. Once again, Goldacre delivers a very insightful piece. By the way, if you have not read Ben’s book Bad Science get it now… The chapter on AIDS Denialism and Matthias Rath is a real gem. If you are ever in London and have a chance to hear Ben Goldacre lecture, don’t miss him. The guy is a genius.

UPDATE: New article on retracted paper at AIDS Beacon

Peer review is flawed but the best we've got
Ben Goldacre The Guardian, Saturday 12 September

This week the peer review system has been in the newspapers, after a survey of scientists suggested it had some problems. That is barely news. Peer review – where articles submitted to an academic journal are reviewed by other scientists from the same field for an opinion on their quality – has always been recognised as problematic. It is time-consuming, it could be open to corruption, and it cannot prevent fraud, plagiarism, or duplicate publication, although in a more obvious case it might. The problem with peer review is, it's hard to find anything better.

Here is one example of a failing alternative. This month, after a concerted campaign by academics aggregating around websites such as Aidstruth.org, academic publishers Elsevier have withdrawn two papers from a journal called Medical Hypotheses. This journal is a rarity: it does not have peer review, and instead, submissions are approved for publication by its one editor.

Articles from Medical Hypotheses have appeared in this column quite a lot. They carried one almost surreally crass paper in which two Italian doctors argued "mongoloid" really was an appropriate term for people with Down's syndrome after all, because they share many characteristics with oriental populations (including: sitting cross-legged; eating small amounts of lots of types of food with MSG in it; and an enjoyment of handicrafts). You might also remember two pieces discussing the benefits and side-effects of masturbation as a treatment for nasal congestion.

The papers withdrawn this month step into a new domain of foolishness. Both were from the community who characterise themselves as "Aids dissidents", and one was co-authored by their figureheads, Peter Duesberg and David Rasnick.

To say a peer reviewer might have spotted the flaws in their paper – which had already been rejected by the Journal of Aids – is an understatement. My favourite part is the whole page they devote to arguing that there cannot be lots of people dying of Aids in South Africa because the population of the country has grown in the past few years.

We might expect anyone to spot such poor reasoning but they also misrepresent landmark papers from the literature on Aids research. Rasnick and Duesberg discuss antiretroviral drugs that have side-effects but which have stopped Aids being a death sentence, and attack the notion their benefits outweigh the toxicity: "contrary to these claims", they say, "hundreds of American and British researchers jointly published a collaborative analysis in The Lancet in 2006, concluding treatment of Aids patients with anti-viral drugs has 'not translated into a decrease in mortality'."

That is a simple, flat, unambiguous misrepresentation of the Lancet paper to which they refer.

What does this tell us about peer review? The editor of Medical Hypotheses, Bruce Charlton, has repeatedly argued – very reasonably – that the academic world benefits from having journals with different editorial models, that peer review can censor provocative ideas, and that scientists should be free to pontificate in their internal professional literature.

But there are blogs where Aids dissidents, or anyone, can pontificate wildly and to their colleagues: from journals we expect a little more.

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Peer Reviewing Peter Duesberg – REJECTED—RETRACTED—REJECTED Again

This summer’s saga of Peter Duesberg’s Medical Hypotheses retracted article should probably be put to rest. The sad story of this broken scientist has been told many times. Here though Duesberg reaches an all time low as he teams up with pseudoscientist Henry Bauer to yet again claim that HIV is harmless.

Duesberg and his long time accomplice David Rasnick along with Loch Ness Monster Scholar Henry Bauer published the article “HIV-AIDS hypothesis out of touch with South African AIDS – A new perspective” in the non-peer reviewed journal Medical Hypotheses. The article focused on the South African AIDS epidemic and research reported by Harvard scientist Dr. Pride Chigwedere in the respected Journal of AIDS. Duesberg disputes the death of over 300,000 South Africans and 30,000 babies unnecessary infected with HIV. Duesberg and Rasnick have a stake in denying AIDS in South Africa because they advised former President Thabo Mbeki to deny AIDS and delay HIV treatments. Duesberg’s ideas were so flawed that the publisher, Elsevier Science, took the unusual step of retracting the article.



The authors first tried to publish the article in the Journal of AIDS as a commentary on the Harvard study. But Duesberg was rejected after peer review. Of course Duesberg accuses the review process of corruption and unfairness. The authors said the following, “A precursor of this paper was rejected by the Journal of AIDS, which published the Chigwedere et al. article, with political and ad hominem arguments but without offering even one reference for an incorrect number or statement of our paper (available on request).”

Not surprisingly, requests for the reviewer comments are not honored; leaving us to imagine what the peer reviewers said about Duesberg's article. I decided to undertake a simulated peer review of the Duesberg article.
As the Editor in Chief of a peer reviewed journal, I figured, why not?

I took several steps to perform as close to a true peer review as possible. I stripped the text of all identifying information – the authors' names were removed from the paper. The text, tables and figures were cut and pasted to create a double spaced manuscript document suitable for blind review. I asked three leading researchers with expertise in South African AIDS to review the paper. None of the reviewers had any interest in AIDS denialism and none was aware of the Duesberg article. Here are my instructions:

"The attached manuscript is not under consideration at the journal which I edit, AIDS and Behavior. The paper is a critique of a modeling study of AIDS in Africa. This critique is a real manuscript and I am seeking peer reviews. Once you complete the task, I will inform you of what this is all about. I am asking that you, (1) Review the paper as if it were submitted to a journal of the caliber of Journal of AIDS or an equal level public health journal. (2) Provide written comments for the authors (no more than 1 single spaced page). (3) Recommend a decision to reject outright, reject with the option to resubmit, or accept the paper.”

All three reviewers recommended rejection. The simulated reviews offer a glimpse of what may have been raised by the Journal of AIDS. The consistency of our three independent reviews is remarkable.

Medical Hypotheses would probably have rejected the paper if only they sent it out for peer review.

Why Peter Duesberg continues to humiliate himself by ignoring science and affiliating with pseudoscientists remains a mystery.

The unedited blind reviews follow.

Review #1

This paper is an attempt to rebut a recently-published estimation of the lost benefits of antiretroviral therapy (ART) use in South Africa. The original paper essentially argued that by failing to implement an ART program that was “reasonably feasible” at the time, the South African government failed to prevent 330,000 deaths and 2.2 million person-years. The authors of the current article believe that the estimate is overblown and unrealistic; furthermore they argue that HIV does not cause AIDS. For the latter argument, apart from a very few scientists who believe HIV does not cause AIDS, there is broad scientific agreement and decades of scientific evidence that contradicts this claim of the authors. I cannot see why JAIDS would want to (re) engage in this obviously dead-end debate.

In addition, the paper has a number of methodological flaws, as noted below. I would therefore recommend rejection.

Major comments:
You fault Chigwedere and colleagues for overestimating the number of deaths averted, but the data that you use to revise (downward) his estimate is obviously wrong. Who but an AIDS denialist would believe that a) the South African mortality registration system would yield an accurate count of deaths due to HIV/AIDS and b) that 1 death per 1000 HIV-positive people per year were anything close to an accurate measure of the rate at which people with HIV/AIDS die. Even a back of the envelope calculation is enough to show that this estimate is off by several orders of magnitude: If the average person, untreated, with HIV/AIDS in South Africa lives 10 years as has been roughly shown in several other African natural history studies, then on average (assuming constant rates of infection) about 10% will die per year. This number is clearly much closer to the truth and 1 death per 1000 HIV-positive person per year is obviously wildly off target. In short, mortality registration is a very poor and inaccurate measure of HIV/AIDS deaths and cannot and should not be trusted to estimate how many people with HIV are likely to die per year.

You make much of the fact that the population in South Africa actually increased during the time period under consideration, but fail to realize that population can increase even in the face of large number of HIV/AIDS deaths; these two things are not mutually exclusive as you imply. The question is not whether the population increased – you can still have an increasing number of deaths accompanied by and increased size of the total population if there are more births or more immigration. Rather, the question is whether deaths from HIV/AIDS increased and how many could have been averted if treatment had started earlier than it did. Further, you state that “since the African HIV-epidemics coincided with steady and massive growths if the affected populations, we conclude that HIV-epidemics are not likely causes of AIDS epidemics.” In light of the above, this makes no sense at all. The assertion that because there has been population growth HIV epidemics do not likely cause AIDS epidemics is illogical and unscientific.

You seem to miss the point about vertical transmission, either unwittingly or purposely. When it comes to estimating the rates of vertical transmission, you fail to acknowledge that several randomized clinical trials (RCTs) have shown definitively the positive impact of ART in reducing the probability of vertical transmission. In other words, it is well established that antiretroviral drugs can help prevent a significant amount of vertical transmission, a fact you prefer to ignore.

You mix up population prevalence and antenatal prevalence, which, importantly, measure 2 different things. These things cannot be used interchangeably. Your table 1, 2nd column is “HIV in the South African population” yet the data you display there are the national antenatal statistics, very different indeed from the population prevalence that is implied. The same is true of your 2nd paragraph on page 6.

You further mix up prevalence and incidence, again, basic epidemiological concepts. Page 20, graph b is NOT HIV incidence as labeled at the bottom of that page, but rather annual antenatal prevalence.

You imply that toxicity (in the context of vertical transmission) is universal to all who use ARVs. You fail to mention or quantify the frequency of these events; nor do you meaningfully weigh the pros and cons of receiving ART and avoiding an HIV infection compared to the likelihood of a severe and debilitating side effect. Every drug has side effects and can therefore be toxic. The question is whether the benefits outweigh the risks, something that you ignore by repeatedly raising the “toxicity” alarm without quantifying its frequency or severity. Asprin has side effects and taken at extreme doses can cause toxicity. But that does not mean you shouldn’t use asprin when you have a headache.

Reviewer #2

I think we are long past the issue of whether HIV causes AIDS. I think it is very important to be open to other ideas including controversial ones. But even this primary issue is not taken on in a very convincing manner.

The basic argument is that if HIV is really responsible for so many deaths, why aren't they reflected in the death rates. I'm not a demographer, but the demographic projections I have seen for almost all of the hyperendemic countries still allow for substantial population growth even with AIDS.

South Africa is a country where there is a lot of denial and silence about when and whether someone dies of AIDS, so it would not be surprising to see a lot of underreporting in official cause of death. So the 1 per 1000 reported HIV-death rate (or even 2.5%) is not at all credible.

The rates of HIV prevalence are grossly overstated (given as 25-30%). Actually the overall rate for the population over 2 in South Africa in 2008 in the HSRC survey was only 10.9%. So the author's HIV-attributable mortality is widely off the mark.

As I look at the numbers, it is not unreasonable that a country such as South Africa could be growing at about 600,000 per year while at the same time experiencing 66,000 excess deaths per year from HIV/AIDS.

The authors do make a valid point that we may be underestimating the long-term toxicity of ARVs.

But I do not see value over all in this paper and would not recommend if for publication (i.e. reject outright.)

Reviewer #3

This manuscript responds to a recent study that found that in South Africa, at least 3.8 million person-years were lost due to delays in implementing ARV/prevention of mother to child transmission (PMTCT) programs because of beliefs that HIV was not the cause of AIDS and that ARV were not useful to patients (Chigwedere). The manuscript raises two issues: (1) What evidence exists for the huge loss of lives? And (2) What is the evidence that anyone would have benefited from the ARVs? The manuscript also raises the question as to whether HIV is a passenger virus.

Overall, the manuscript does not provide a convincing or logical argument to counter the assumptions made by the Chigwedere study. For instance, while the manuscript provides some evidence for their hypotheses, the authors do not address some of the claims of the Chigwedere article. For instance, the burden is on the authors to counter Chigwedere’s statement that “HIV satisfies all of Koch’s postulates…and all of…Hill’s epidemiological guidelines for assessing causality.” I would recommend rejecting the manuscript for publication based on its lack of logic in its arguments against the Chigwedere study, but also in the presentation of the authors’ own hypothesis.

In the first section of the manuscript, the authors state that there is no evidence of huge losses of life. The data are presented along with the assumption that population growth could not have occurred concurrently with an HIV epidemic. This assumption does not demonstrate knowledge of basic population dynamics or demography (e.g. a population can grow as long as birth rates are higher than death rates). The authors seem to conclude that HIV-related death and population growth are mutually exclusive, which is not true.

The authors point to data that only 2.5% of total registered mortality were due to HIV-deaths.

The authors do not address (1) issues of quality of these data, and more importantly (2) the attributable fraction of mortality resulting from HIV-related deaths. The counter-factual of how many deaths from TB, for instance, would have been avoided if HIV had been reduced is not considered.

Page 9 – the authors assume that all pathogenic viruses “act” the same in a given population. What is the basis of this assumption? Are there exceptions to this (e.g. other viral STIs?)

In the second section of the manuscript, the authors state that there are unresolved problems with the belief that AZT/Nevirapine inhibit HIV. The authors do not address the evidence (notably those cited by Chigwedere) that indicate (using “gold-standard” epidemiological studies) that AZT/ZDV are effective.

On pages 10-11, the authors point out some of the negative outcomes resulting from ART and PMTCT. However, the authors do not indicate how common these outcomes are and whether the burden of these outcomes are greater than the burden associated with HIV infection. The authors then make a conclusion that the negative impacts of treatment means that they do not have any benefit, which is not a logical conclusion.

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New York Times Reviews AIDS Denialist Crockumentary 'House of Numbers'

AIDS Seen From a Different Angle
By JEANNETTE CATSOULIS
Published: September 4, 2009

Couched as a “personal journey” through the history of H.I.V. and AIDS, “House of Numbers” is actually a weaselly support pamphlet for AIDS denialists. Trafficking in irresponsible inferences and unsupported conclusions, the filmmaker Brent Leung offers himself as suave docent through a globe-trotting pseudo-investigation that should raise the hackles of anyone with even a glancing knowledge of the basic rules of reasoning.



Assembled from interview fragments with doctors, scientists, journalists and others, the film cobbles together an insinuating argument against the existence of H.I.V. as a virus and AIDS as the resulting disease. Among the many inflammatory claims is that diagnosis is a pharmaceutical-industry ruse to sell complex drug therapies (which the film then presents as the real cause of the syndrome we identify as AIDS). Evidence to support this and other highly dangerous contentions is found not in verifiable statistics (house of numbers, my foot) but in the impassioned anecdotes of individuals who have outlived the expectations of an H.I.V.-positive diagnosis.

Rife with fuzzy logic (most people with AIDS live in poverty, therefore poverty causes AIDS) and a relentless fudging of the difference between necessary and sufficient conditions, this willfully ignorant film portrays minor areas of scientific disagreement as “a research community in disarray” and diagnostic testing as a waste of time. A few months ago 18 angry doctors and scientists interviewed in the film issued a statement claiming that Mr. Leung “acted deceitfully and unethically” when recruiting them and that his film “perpetuates pseudoscience and myths.”

Mr. Leung said in a recent interview, “All we do is raise questions.” Perhaps his next film will question the existence of gravity.

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