Hogmanay, as we call New Year’s Eve in Scotland, may seem an odd time to blog about AIDS. Surely there are more positive subjects, at “That hour, o’ night’s black arch the key-stane” when we hear the bells of midnight and look forward to a new year. Yet, for some, Hogmanay is not a happy hour but rather, as Robert Burns goes on, “That dreary hour”, when thoughts of the year ahead are filled with dread.
Nowadays it is de rigueur to be positive about HIV/AIDS. We know that we’re winning the fight, we know that people are living longer, we know that…we know a lot of things about this specialist topic of retrovirology and epidemiology. We’ve just forgotten how we know them. Recently, reviewing Chicago Tribune writer John Crewdson’s exposé of the machinations of the man credited with the (co)discovery of HIV, it struck me that the stubborn refusal of most people (scientists or not) to review all the evidence, for all this positivity and assumed knowledge, had nothing to do with logic.
Because we know, in fact, that AZT (the first anti-HIV drug) was lethal. We know that people on HAART (combination therapy) aren’t dying so quickly and horrifically as others did on AZT – but are dying of major organ failure caused by these drugs. We know that the HIV/AIDS hypothesis has become so convoluted (in the philosophy of science, such distortions of the original theory to fit the empirical evidence are referred to as ‘epicycles’) that it can be conclusively cut down by Occam’s Razor.
So how do we know what we don’t actually know?
Films, movies if you’re American (and most of them are). That’s how. So I’ve been (re)watching some. Here’s what I discovered:
And The Band Played On and Philadelphia both came out in 1993. On the surface, the latter was the soft-focus, feel-good film for strait (sic, deal with it) White, middle-class Americans to stop treating gay men and people-with-AIDS as social pariahs; with an undercurrent of panic about the blood supply that fed in nicely to pressure on the government to release more funds for research that would ultimately end up in the pockets of huge multinational pharmaceutical companies. It worked. For years afterwards, whenever I said to one of my sisters (the trendy one, not the sensible nurse) ‘I have something to tell you’, she’d put on her Philadelphia face. The former is a more complex film in that it focuses on the urgency of finding a cure (understandably as the director died of AIDS shortly after the release) and can be summed up in one quote:
“When your house is burning, you don’t wait for irrefutable scientific proof – you pour on water!”
Yes. But first you make damn sure that it’s water and not petrol (gasoline). Doing just anything at all, rather than sticking to a policy of ‘wait and see’, isn’t always the wisest choice. Scientifically, it alters the variables under study in an uncontrolled way. Watching this film again, despite Crewdson’s exposé, I had more sympathy for the scientists. Being pressured by an angry mob (with very, very good reason to be angry and scared) to urgently come up with results is no good atmosphere in which to conduct research. This film shows a vital clue being missed, one that even Dr Gallo, the subject of Crewdson’s book, acknowledged as linked with Kaposi’s Sarcoma (the iconic AIDS disease causing the famous lesions in the court scene in Philadelphia). One of the cute, White, young, male doctors of the CDC (Centres for Disease Control and Prevention) says:
“You can forget about poppers. We ran every test there is. The worst that ever happened was two mice dancing with the rubber glove.”
This is factually wrong. As Professor Duesberg (who convinced Gallo) points out:
“Recognizing the universal popularity of nitrates among homosexual men in 1981, the CDC was forced to consider this drug as one possible explanation of the emerging AIDS epidemic. […] It did not even occur to them that nitrates could be toxic by themselves. Therefore they searched for a contaminated or bad batch of nitrates. […] The CDC also assumed the effects would show immediately after using poppers, not after years of abuse, the way lung cancer and emphysema follow only after years of smoking tobacco. Naturally, no contaminated batch could ever be found, and the CDC dismissed the hypothesis altogether and thereafter focused its search entirely on infectious agents. (Duesberg & Ellison/1996/272, ellipsis mine)”
I’m not going to debate these rival hypotheses here, as I do that in Silence and Dissent: Expert Doubt in the AIDS Debate. I just want to show the effect of these films. The effect of these two was to create demand for AZT.
By 2013, when The Dallas Buyer’s Club came out, the hippy dippy doctor in Mexico (that old ‘White man travels far, seeks exotic wisdom’ plotline) could confidently say: “AZT will kill you” then give a lot of good advice about nutrition – then hand over ddC, a less toxic version of AZT. Less toxic. The subject of the film died in 1992, 7 years after diagnosis, when most people on AZT barely survived 2 years. So the effect of this film was to confirm the (relative) success of combination therapy.
How to Survive a Plague, released in 2012, was to this film what And The Band Played On was to Philadelphia: more detailed, angrier, less soft-soap. Strangely, the same drug, Interferon, that was damned in the 2012 film is hailed in the 2013 one. One might almost believe in pressure from Big Pharma. Yet How to Survive a Plague is all about resistance to corporate and governmental pressure. The film charts the rise of ACT-UP and the painful split in this collective that led to the creation of TAG (the Treatment Action Group) who started working with the government and with Big Pharma. The most poignant scene is when bereaved people, carrying the ashes of their loved ones, converge at the most famous fence in Washington and throw the contents of these urns onto the White House lawn, shouting “WE BRING THE DEAD TO YOUR DOOR!” I cried at this scene. How could I not? Yet, at the end of the film, the TAG spokesman is saying that, finding out that ddI and ddC had the same effectiveness as AZT, he admits “naïveté on our part” for pressuring research priorities. The film ends up pushing combination therapy.
Combination therapy is the topic of Fire in the Blood, also 2103, but set in South Africa. Harrowing is the only word to describe this documentary. Dr Peter Rost, former vice-president of Pfizer is the big bad wolf but he admits very revealing things:
“The [pharmaceutical] companies are running the US government. They’re pulling the strings!” “Drug companies are not there to protect the third world. They’re there to make money.”
It’s hard to see the corporate angle in this documentary. The CEO of the Indian pharmaceutical company CIPLA does seem caring and cuts costs in a way that is apparently compasionate. The political angel is fairly obvious. Bush bad; Clinton good. With funding from the William J. Clinton Foundation. It was the year that Hillary Clinton reversed her opposition to equal marriage, looking to secure the pink vote in the run-up to the 2016 presidential candidate nomination.
The problem with trying to put across the alternative hypotheses for the phenomena of AIDS (drugs, including poppers and anti-HIV medications; foreign proteins in blood transfusions) is that most people aren’t really interested in either science or facts. They want to get high on emotion. That’s why a hard-to-hear podcast like the 2012 interview with Mark Zuhrbriggen, a South African Health Practitioner (on How Positive Are You?) is not likely to move hearts and change minds. Even when he says that combination therapy is causing African babies to be born blind and deformed. And that people are still dying. The Lazarus effect doesn’t last.
It is true that there are informative documentaries on the alternative hypotheses – such as House of Numbers in 2009, Positively False in 2014 and Positive Hell in 2016 – but, whereas the HIV-AIDS hypothesis films need viewers only to emote, these documentaries rely on the willingness of viewers to think. Maybe, if someone makes an emotive film about corporate greed for money and fame, about blinkered scientific research and actually explores the alternative hypotheses, maybe then we might stop people dying and babies being deformed. Meanwhile, all we have are the facts.
(Thanks to Pixabay and Pexels for the photo)