Bolstered by President Thabo Mbeki’s prevarication, the Aids dissidents’ arguments are fuelling confusion in South Africa – but they have little scientific merit Belinda Beresford HIV does not exist. If it does exist it does not cause Aids. The disease Aids does not exist. There is no epidemic nor are there deaths. There is just mass hysteria caused by a conspiracy among pharmaceutical multinationals, aided and abetted by political and medical self-interest. These are some of the beliefs held by the disparate and international group of dissidents, whose area of unity is that they disagree with the mainstream argument that HIV causes Aids. The views of the dissidents – or rethinkers as some like to call themselves – appear to be backed by an impressive range of scientific citations from reputable journals and leading scientists, including at least one Nobel Prize winner. But close examination of the sources dissidents cite often reveals extremely selective quotations from articles, or use of research that is many years old. There are only a tiny minority of dissident scientists in the world, and they have few publications, compared to the more than 140 000 articles published by orthodox scientists over the past five years. The dissidents’ views have thrived in South Africa because of President Thabo Mbeki’s public and repeated statements that have given credence to the doubters. The main dissident website, www.virusmyth.com, has a “support Mbeki” petition, suggesting that they, like many other scientists and doctors both locally and internationally, also believe that the president has expressed doubts about the correlation between the illness and the virus. On the orthodox side, there is also no “status quo” on Aids. Rather there is a rapidly expanding foundation of scientific and medical understanding that rests upon a detectable virus, in various strains (sometimes known as clades) – and massively documented evidence of the impact of this virus on the human immune system. Here too there is an impressive array of leading scientific names – the signatories to the Durban Declaration include many Nobel laureates.
There are still many grey areas – that too is in the nature of science when it addresses new issues and a new virus. It is impossible to be absolute about medicine since the complexity of the human body, and imperfect understanding means doctors and scientists sometimes encounter exceptional cases. For example, human cancers sometimes regress spontaneously for no understandable reason, even though the vast majority of people with the same kind of tumour will die. To find a handful of people who are not detectably HIV- positive but who appear to have Aids does not outweigh the millions of people who have Aids and where the only common link is HIV. The result is confusion among the general public: after all, lay-people tend to give weight to theories advanced by Nobel Prize winners, and all sides tend to be highly articulate, persuasive, and at times rude about each other. However, the debate over whether HIV causes Aids is not an academic one. It affects how people behave with respect to the disease and those people who have it. Believing in the orthodox position suggests that things can be done to prevent people catching, and dying, of Aids. These include using condoms, abstinence, preventing mother- to-child transmission of the virus, being careful about blood transfusions and using anti-retroviral drugs to help the immune systems of HIV-positive people hold off the ravages of the virus. Belief in the dissident view tends to suggest that since there is no epidemic, nothing needs to be done. People are dying of diseases exacerbated by poverty, as they have always done. It is simply that these are being recorded more often. However, this flies in the face of epidemiological research showing that people – especially young women – are dying. Not to mention the losses suffered by thousands of people who have seen their loved ones die, and the experience of doctors and nurses who repeatedly see patients come to them for care displaying the same range of symptoms, which were rare or unheard of just a couple of decades ago.