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Deadly Quackery




 

H.I.V. causes AIDS. This is not a controversial claim but an established fact, based on more than 20 years of solid science. It is as certain as the descent of humans from apes and the falling of dropped objects to the ground.

So why reiterate the obvious? Because lately, a bizarre theory has gained ground -- one that claims that H.I.V. is harmless, and that the antiretroviral drugs that curb the growth of the virus cause rather than treat AIDS. Such talk sounds to most of us like quackery, but the theory has emerged as a genuine menace to public health in the United States and, particularly, in South Africa.

The theory, which we call AIDS denialism, has gained such currency with President Thabo Mbeki of South Africa that his administration is reluctant to expand access to antiretroviral drugs. Despite generous allocations from the country's Treasury and substantial assistance from foreign donors, only a quarter of those needing antiretrovirals receive them. This response is poor by the standards of middle-income countries, but it is especially troublesome in South Africa, which has more H.I.V.-positive people than any other country.

American AIDS denialists are partly to blame for South Africa's backsliding AIDS policy. Manto Tshabalala-Msimang, the health minister, has described antiretrovirals as poisons. She is supported in these views by Roberto Giraldo, a New York hospital technologist who says AIDS is caused by deficiencies in the diet, and who served on President Mbeki's AIDS advisory panel in 2000. The minister promotes nutritional alternatives like lemons, garlic and olive oil to treat H.I.V. infection. Several prominent South Africans have died of AIDS after opting to change their diets instead of taking antiretrovirals.

Another American AIDS denialist, David Rasnick, a regular letter-writer to South African newspapers, absurdly claims that H.I.V. cannot be transmitted between heterosexuals. Mr. Rasnick now works in South Africa for a multinational vitamin company, the Rath Foundation, conducting clinical trials in which AIDS patients are encouraged to take multivitamins instead of antiretrovirals.

In the past, South Africa's Medicines Control Council acted swiftly to curb such abuses, and the Medical Research Council condemned AIDS denialism. But recent high-level political appointments of administration supporters to both bodies have neutered their influence. In South Africa, AIDS denialism now underpins a lucrative nutritional supplements industry that has the tacit, and sometimes active, support of the Mbeki administration.

By courting the AIDS denialists, President Mbeki has increased their stature in the United States. He lent credibility to Christine Maggiore, a Californian who campaigns against using antiretrovirals to prevent transmission of H.I.V. from mothers to children, when he was photographed meeting her. Two years later, Ms. Maggiore gave birth to an H.I.V.-infected daughter, Eliza Jane, who acquired an AIDS-related infection last year and died at age 3.

Mother-to-child H.I.V. transmission is now rare in the United States, thanks to the widespread use of preventive therapy and the activities of organizations like the National Institutes of Health and the Elizabeth Glaser Pediatric AIDS Foundation. Sadly, this is not so in South Africa, where many children are born infected and then face short, painful lives. The health and lives of American children are also still under threat: a small clique of AIDS denialists is trying to block the provision of antiretrovirals to H.I.V.-infected children in the New York City foster care system.

Until recently, AIDS researchers and activists in the United States tended to regard the denialists with derision, assuming they would fade away. Unfortunately, this has not happened. Harper's Magazine recently published an article by Celia Farber promoting the denialist view. There is a real risk that a new generation of Americans could be persuaded that H.I.V. either doesn't exist or is harmless, that safe sex isn't important and that they don't need to protect their children from this deadly virus. A resurgence of denialism in the United States would have far reaching effects on the global AIDS pandemic, just as it already has in South Africa.

The AIDS denialists use pseudoscience and non-peer-reviewed Internet postings to bolster their false claims about H.I.V. The real facts about this virus have been uncovered by scientists supported by the National Institutes of Health, the British and South African Medical Research Councils, the Pasteur Institute and many other national research organizations. The public should seek AIDS truth from the latter sources.

It is sad when selling magazines and vitamin supplements is considered more important than promoting public health and scientific truth. The truth is that H.I.V. does exist, that it causes AIDS and that antiretroviral drugs can prevent H.I.V. transmission and death from AIDS. To deny these facts is not just wrong -- it's deadly.

John Moore is a professor of microbiology and immunology at Cornell University. Nicoli Nattrass is the director of the AIDS and Society Research Unit at the University of Cape Town.



 


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Information in this article was accurate in June 4, 2006. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.