Figure 1. The incidence of AIDS cases and HIV antibody carriers in Africa according to the WHO. [39,40]
by David Rasnick and Christian Fiala
David Rasnick - Visiting Scholar in Peter Duesberg’s lab, 353 Donner Laboratory, UC Berkeley, Berkeley, CA 94720, phone 408-857-3505 fax 510-588-4596 email drasnick@comcast.net
Christian Fiala - Gynaecologist
and obstetrician who has been involved in the discussion over the spread of
HIV/Aids for 15 years. In 1997 his book on the subject of HIV, “Are we loving
dangerously,” was published (Deuticke Verlag Wien). He is a member of the expert
panel on HIV/Aids set up by the President of South Africa.
Last year he was working in Mulago hospital in Kampala, Uganda.
e-mail: christian.fiala@aon.at
ABSTRACT
These days, a presentation of the arguments and evidence against the contagious/HIV hypothesis of AIDS is usually interrupted with the supposedly show-stopping question—“But, what about Africa?” A variant: “But—aren’t people living longer because of the drugs? The virus-AIDS hypothesis was burdened from its inception with numerous paradoxes, none of which has been resolved by 2003:
1) Why is there no HIV in most AIDS patients, only antibodies against it?
2) Why would HIV take 10 years after infection to cause AIDS?
3) Why is AIDS not self-limiting via antiviral immunity?
4) Why is there no vaccine against AIDS?
5) Why is AIDS in the US and Europe not random, making it different from all other viral epidemics?
6) Why did AIDS not rise and then decline exponentially owing to antiviral immunity like all other viral epidemics?
7) Why is AIDS not contagious?
8) Why would only HIV carriers get AIDS who use either recreational or anti-HIV drugs or are subject to malnutrition?
9) Why is the annual mortality of HIV-antibody-positives treated with anti-HIV drugs 7-9%, but that of all, (mostly) untreated HIVpositives globally only 1.4%? Pointing out these and many other problems with the contagious/HIV hypothesis of AIDS invariably leads to: “But, what about Africa?” According to the WHO, the African epidemic increased from 1984 until the early 1990s, similar to the American/European epidemics, but has since leveled off to generate about 75,000 cases annually. By 2001, Africa had reportedly generated a cumulative total of 1,093,522 AIDS cases. However, during this period the population of Sub-Saharan Africa had grown (at an annual rate of about 2.6% per year) from 378 million in 1980 to 652 million in 2000 [1]. Therefore, even if the 1 million Africans died from AIDS it would be statistically hard to verify for two reasons:1) the loss would be dwarfed by the overwhelming, simultaneous gain of 274 million people (the equivalent of the population of the USA), and
2) the African AIDS-defining diseases are indistinguishable from conventional African morbidity and mortality. Because of the many epidemiological and clinical differences between African AIDS and its American/European namesake, and because of the many uncertainties about the statistics on African AIDS, both the novelty of African AIDS and its relationship to American/European AIDS have recently been called into question. Indeed, all available data are compatible with a perennial African epidemic of poverty-associated diseases under the new name AIDS.
These days, a presentation of the arguments and evidence against the contagious/HIV hypothesis of AIDS [2,3] is usually interrupted with the supposedly show-stopping question: “But—what about Africa?” A variant: “But—aren’t people living longer because of the drugs?”
I. “Can Africa be saved?”
“Can Africa be saved?” the cover of Newsweek asked as far back as 1984 [4] reflecting the old Western belief that Africa is doomed to starvation, terror, disaster and death. This was repeated two years later in an article in the same journal in a story about Aids in Africa. The title set the scene: “Africa in the Plague Years.” [5] It continued: “Nowhere is the disease more rampant than in the Rakai region of south-west Uganda, where 30 percent of the people are estimated to be seropositive.” The World Health Organisation (WHO) confirmed “by mid-1991 an estimated 1.5 million Ugandans, or about 9% of the general population and 20% of the sexually active population, had HIV infection.” [6] Similar reports were repeatedly published during the last 15 years, declaring as much as 30% of the population doomed to premature death, with dire consequences for families and society as a whole? The predictions announced the practically inevitable collapse of the country in which the world-wide epidemic supposedly originated.
Today, however, one reads little about Aids in Uganda because all the prophesies have proved false, as evidenced in the ten-year census of September 2002. [7] Summing up, the Uganda Bureau of Statistics says, “Uganda’s Population grew at an average annual rate of 3.4% between 1991 and 2002. The high rate of population growth is mainly due to the persistently high fertility levels (about seven children per woman) that have been observed for the past four decades. The decline in mortality reflected by a decline in Infant and Childhood Mortality Rates as revealed by the Uganda Demographic and Health Surveys (UDHS) of 1995 and 2000-2001, have also contributed to the high population growth rate.” In other words, the already very high population growth in Uganda has further increased over the past 10 years and is now among the highest in the world. [8]
Even if Uganda has so far escaped the apocalypse that was predicted in 1984, the popular media continue to inform us that the whole of Sub-Saharan Africa has suffered massive devastation and depopulation as a result of two decades of AIDS. Notwithstanding the claims of the media, it is extremely difficult to document an Africa AIDS catastrophe that some have compared to the European plague of the Middle Ages.
A new AIDS epidemic was claimed to have emerged in Sub-Saharan Africa in 1984. [9-14] In sharp contrast to its America and European namesakes, the African AIDS epidemic is randomly distributed between the sexes and not restricted to behavioural risk groups. [15-17] The African epidemic is also a collection of long-established, indigenous diseases, such as chronic fevers, weight loss (alias “slim disease”), diarrhoea and tuberculosis. [18-23] In addition, the African AIDS-defining diseases differ from the American/European AIDS diseases significantly in their prevalence among AIDS patients. For example, the predominant American/European AIDS disease, Pneumocystis carinii pneumonia, is almost never diagnosed in Africans. [24,25]
According to the WHO, the African epidemic increased from 1984 until the early 1990s, similar to the American/European epidemics, but has since levelled off to generate about 75,000 cases annually ([26] and back issues)(Fig. 1).
Figure 1. The incidence of AIDS cases
and HIV antibody carriers in Africa according to the WHO. [39,40]
(By way of comparison, the plague epidemic of London in 1665 had eliminated 1/3 of the population with plague-specific symptoms in a few weeks to months (Fig. 2)[29] and the flu epidemic of 1918 eliminated 20 million in one season. [27]
Figure 2. The plague in London of
1665 shows the classical bell-shape time-course (on the order of weeks) for
a contagious epidemic. [67]
By 2001, Africa had reportedly generated a cumulative total of 1,093,522 AIDS cases. [26] But, during this period the population of Sub-Saharan Africa had grown (at an annual rate of about 2.6% per year) from 378 million in 1980 to 652 million in 2000. [1] Therefore, a possible, above-normal loss of 1 million lives to AIDS is statistically hard to verify for two reasons: 1) the loss would be dwarfed by the overwhelming, simultaneous gain of 274 million people (the equivalent of the population of the USA), and 2) the African AIDS-defining diseases are indistinguishable from conventional African morbidity and mortality. [3]
Because of the many epidemiological and clinical differences between African AIDS and its American/European namesake, and because of the many uncertainties about the statistics on African AIDS [28] both the novelty of African AIDS and its relationship to American/European AIDS have recently been called into question. [29-37] Indeed, all available data are compatible with a perennial African epidemic of poverty-associated diseases under the new name AIDS. [19,22]
Because the WHO decided in 1985 to accept AIDS diagnoses without an HIV-test, there is no reliable documentation for even an HIV epidemic in Africa. [30,38] Such presumptive diagnoses were approved because the cost of the HIV-antibody test is prohibitive for most Africans. As a result, there are huge discrepancies in African AIDS statistics. For instance, based on WHO information, the Durban Declaration claimed in 2000 that, “24.5 million...are living with HIV or AIDS in Sub-Saharan Africa.” However, the WHO had reported no more than 81,565 new cases AIDS for the whole African continent in that year (obtained by subtracting the cumulative total of 794,444 in 1999 from the cumulative total of 876,009 in 2000). [39,40]
African AIDS is assumed to be sexually transmitted
The assumptions 1) that HIV is sexually transmitted and 2) there are “24.5
million...living with HIV or AIDS in Sub-Saharan Africa” [41]
produce a sexual paradox. The fact that mainstream HIV researchers have agreed
that it takes on average 1000 unprotected sexual contacts with HIV-positive
partners to transmit HIV [37,42,43]
means that an extraordinary degree of sexual promiscuity is necessary in
order to sustain a sexually transmitted AIDS epidemic. Therefore, the level
of sexual promiscuity in Africa must be significantly greater than that in
the USA and Europe where the promised heterosexual AIDS epidemics never materialized.
[44] Thus, in order to produce an African AIDS epidemic on the scale repeatedly reported in the New York Times,
by the WHO and UNAIDS requires massive, random sexual promiscuity, far beyond
that seen in the USA and Europe. The number of random sexual contacts needed
to spread a sexually transmitted HIV epidemic in Sub-Saharan Africa is a
straight forward calculation. Since only 1 in 26 (24.5 million per 652 million)
of Sub-Saharan Africans was HIV-positive in 2000, each of the 24.5 million
must have had an average of 1000 x 26 = 26,000 sexual contacts to reach the
1000 HIV-positive contacts needed to acquire HIV and to spread an epidemic.
It strains credulity to accept that poor, hungry Sub-Saharan Africans are engaging in such levels of sexual promiscuity. Indeed, the evidence is strongly against it. A recent thorough epidemiological study of sexual transmission of HIV in Africa found the same “low rates of heterosexual transmission [of HIV], as in developed countries [and] no correlation between the percent of adults...reporting non-regular sexual partners...and HIV prevalence.” [37] These and other anomalies led Brewer et al. to “propose that existing data can no longer be reconciled with the received wisdom about the exceptional role of sex in the African epidemic.” [45] Thus, either the assumption of the Durban Declaration that HIV is sexually transmitted, or its claim that 24.5 million are HIV-positive, or both are flawed. Nevertheless, we continue to read in newspapers and hear on television that 25 million people have died of AIDS, and there are upwards of 40 million people infected with HIV—and most of these are said to be in Africa.
5 South Africa is the richest country in sub-Saharan Africa and has the most reliable statistics on the continent. Statistics South Africa (Stats SA) reports a constant growth in the population of South Africa from 38 million in 1994 to 43 million in 2001. [46,47] Furthermore, the rise in the number of deaths from all causes during the same period was also constant, growing as the population grows—but no faster (Fig. 3).
Figure 3. The increase in the number
of deaths in South Africa parallels and is explained by the growth in the population.
[46,47]
There was even a slight drop in the number of deaths for 2000 and 2001. There
is clearly no indication that AIDS (or anything else for that matter) is depopulating
South Africa.
The latest antenatal screening survey in South Africa [48] also failed to support the hypothesis that HIV is sexually transmitted but instead confirms the conclusion of Brewer et al. that, “HIV is not transmitted by ‘sex’.” [45] The survey included testing pregnant women for syphilis and antibodies to HIV in order to see how the two diseases were correlated by geographical location and over time. But, there was no correlation. On the contrary, KwaZulu-Natal, which is leading when it comes to HIV, has the lowest rate of syphilis in all provinces (Fig. 4).
Figure 4. No correlation between
syphilis & HIV prevalence among antenatal attendees in South African Provinces.
KwaZulu-Natal (KZN), Mpumalanga (MP), Gauteng (GP), Free State (FS), North West
(NW), Eastern Cape (EC), Limpopo province (LP), Northern Cape (NC), Western
Cape (WC). [48]
Western Cape, on the other hand, had the highest rate of syphilis in 2000 but the lowest HIV prevalence. Northern Cape had the highest rate of syphilis in 2001 but the third lowest prevalence of HIV antibodies in that year. Paradoxically, then, there is an inverse geographical correlation between syphilis and HIV (Fig. 4) although both are said to be transmitted by heterosexual intercourse. An even more extraordinary result is the divergence over time between an increasing prevalence of antibodies to HIV and a declining rate of syphilis (Fig. 5). This is also difficult to understand given the assumption that both are sexually transmitted.
Figure 5. The divergence over time
between an increasing prevalence of antibodies to HIV and a declining rate of
syphilis in South Africa. [48]
A recent study in Uganda produced similar results. The intention of the study had been to reduce HIV incidence by mass treatment of STDs with conventional antibiotics. The rationale behind the study was that reducing STDs (which was assumed to be a co-factor in the transmission of HIV) should reduce the transmission of HIV. However, the result of the study was paradoxical. While the investigators were very successful in significantly reducing STDs, their intervention had “no [effect] on incidence of HIV-1 infection... .” [49]
The data from Thailand show that these paradoxical results are not peculiar to Africa. Even though Thailand is said to be severely hit by a heterosexually transmitted HIV-epidemic, we find yet again the same scenario presented by South Africa and Uganda. Bangkok has the highest rate of STDs but low HIV prevalence. Conversely, the so called Golden Triangle of northern Thailand has the highest rate of HIV but the second lowest STD morbidity of all regions. And, even within the different provinces of the Northern Region there is a negative correlation between HIV and syphilis. [50] The conclusion from these observations is obvious: HIV cannot be heterosexually transmitted.
African AIDS numbers are based on HIV-antibodies in pregnant women
Before 1998, two HIV-antibody tests had been performed for the South African
surveys: one screening test and a confirmation test on the positive samples.
The second test was skipped from 1998 onwards, except in Western Cape, even
though generally it is the accepted standard to do at least two tests. Furthermore,
the manufacturer of the HIV-antibody test that was used in the surveys specifically
warns that, “non-specific reactions may be seen in samples from some people
who, for example, due to prior pregnancy...have antibodies to the human cells
or media in which HIV-1 is grown for manufacture of the EIA.” [51]
In other words the test, which may show false positive reactions in women
with “prior pregnancy,” is being used in pregnant women without further confirmation
or adjustment. The insert that comes with the antibody test also warns that,
“at present there is no recognized standard for establishing the presence
or absence of HIV-1 antibody in human blood.” This probably explains why
“Studies from seven African countries over the last 15 years show rates of
HIV incidence during antenatal and/or postpartum periods exceeding what could
be expected solely from sexual transmission.” [52]
Yet, these problematic, unconfirmed results from pregnant women are then
used to estimate the frequency of HIV in the general population [53] and eventually the whole of Sub-Saharan Africa.
Thus, there is no evidence that HIV is spreading through sexual intercourse (or any other way) in Africa or anywhere else. Combined with the evidence that Africa is not currently being devastated and depopulated by an AIDS epidemic, the inability to document a sexually transmitted epidemic of HIV shows that a future HIV-caused AIDS apocalypse in Africa is unlikely.
AIDS Incorporated at war with South African President Thabo Mbeki
The inability to document massive devastation and depopulation of Africa
due to AIDS plus the lack of evidence for a sexually transmitted epidemic
of HIV has made Africa—especially South Africa—the biggest roadblock impeding
the expansion of American-dominated AIDS Incorporated throughout the developing
world. The most significant battle to determine the future of AIDS Inc. is
being waged right now in South Africa.
South African President Thabo Mbeki continues to receive intense personal attacks because he included on his AIDS Advisory Panel in 2000 a number of scientists and physicians from around the world who question the mainstream dogma on AIDS. Having failed to silence Mbeki, the AIDS establishment has orchestrated an international campaign to undermine his presidency and neutralize his influence because he insists on getting answers to some very basic questions:
1) Why is AIDS in Africa so completely different from AIDS in the USA and Europe?
2) How does a virus know to cause different diseases on different continents?
3) How does a virus know if you are male or female, gay or straight, white or black, rich or poor, urban or rural?
4) Where is the evidence that AIDS is devastating and depopulating South Africa?
5) Why treat immune deficiency with highly immunosuppressive anti-HIV drugs?
Until satisfactory answers to these questions are provided, Thabo Mbeki’s government is justifiably suspicious of the rush to get the highly toxic anti-HIV drugs into South African bodies.
The South African government is currently conducting trials in 18 centres across the country to determine the safety and efficacy of administering the anti-HIV drug nevirapine to pregnant women and their babies. The trial was to have been completed in December 2002 but not enough women have volunteered. However, AIDS Inc. cannot afford to let this trial go to completion for two reasons: 1) the results may show that the drug is neither safe nor efficacious, and 2) the government of South Africa cannot be permitted to set the example of acting independently of AIDS Inc. when it comes to AIDS.
On July 30, 2003, the government of South Africa sent a clear message that the people of South African will determine their own future, independent from outside pressures. The Medicines Control Council (MCC) rejected HIVNET012, the Ugandan clinical trial that is the sole basis for using nevirapine to prevent the transmission of HIV from mother to child. MCC gave Boehringer Ingelheim (the manufacturer of nevirapine) 90 days to provide “further evidence of nevirapine when used on its own in reducing the risk of mother-to-child transmission of HIV.” [54] Responding to the criticism of the MCC action, president Mbeki said that, “This announcement illustrated the challenge we face, to ensure that even on this vexed question...(we refuse) to allow the never-ending search for scientific truth to be suffocated by self-serving beliefs. … We must free ourselves of the ‘friends’ who populate our ranks, originating from the world of the rich, who come to us, perhaps dressed in jeans and T-shirts, as advisers and consultants, while we end up as the voice that gives popular legitimacy to decisions we neither made, nor intended to make, which our ‘friends’ made for us, taking advantage of an admission that perhaps we are not sufficiently educated.” [55]
Realizing that South Africa is crucial to its expansion, AIDS Inc. drafted former president Jimmy Carter and billionaire Bill Gates to do battle with Thabo Mbeki in March, 2002. Carter said he and Gates believed South Africa had not made “adequate progress” in preventing new cases of Aids, which were increasing “by leaps and bounds every day.”
Jimmy Carter urged President Mbeki to learn the lessons from poorer African countries that have been much more effective in fighting AIDS—which translated means those African countries that have submitted to the hegemony of AIDS Inc. Former president Mandela joined Carter and the other drugsinto- bodies enthusiasts saying that, “We can’t afford to be conducting debates while people are dying. We have to ensure that our people are given the drugs which are going to help them. This is a war.” War, indeed! President Clinton declared AIDS a national security threat to the USA in 2000, right before Mbeki’s State visit to the Whitehouse.
On March 10, 2002, Smuts Ngonyama of the African National Congress (ANC) lashed out at Jimmy Carter’s attempt to pressure Mbeki’s government.
“We are also surprised at the comments made by the [Carter] delegation about anti-retrovirals drugs in general and Nevirapine in particular.
We do not understand why US citizens urge this drug upon us when the health authorities in their own country do not allow its use for mother-to-child transmission [of HIV]. One of the reasons for this is that these health authorities say that there is insufficient data about issues of the safety of the drug.
We find it alarming that President Carter is willing to treat our people as guinea pigs, in the interest of the pharmaceutical companies, which he would not do in his own country.
The comments he and others made after meeting with President Mbeki indicate the true purpose of his visit to our country, which was arranged without the knowledge of the government.
Once more, we would like to assure President Carter that our government is firmly committed to meet the health challenges facing our people, including AIDS, STD’s, TB, cholera, malaria and others.
For this, we do not need the interference and contemptuous attitude of President Carter or anybody else. As South Africans, we have the possibility to find solutions to our problems, as the people of the US have.
We are not arrogant to presume that we know what the US should do to respond to its many domestic challenges. Nobody from elsewhere in the world should presume they have a superior right to tell us what to do with our own challenges.”
George W. Bush’s $15 billion AIDS package and his recent trip to South Africa (among other stops) was just the latest attempt to either bribe or pressure Mbeki to toe the US line on AIDS. If AIDS Inc. can pry open the drugs-into-bodies floodgates in South Africa, then billions of dollars will pour through Africa, India, and China on their way to the bank accounts of American and other drug companies. The giant corporations will get richer beyond measure whether or not giving nevirapine to women and children (or anybody else for that matter) is a good idea as Jimmy Carter, Bill Gates, Nelson Mandela, and George Bush claim, or insane and criminal as the black box warning labels that come with nevirapine, AZT, 3TC, d4T, ddI, etc. makes clear.
II. But—aren’t people are living longer because of the drugs?
When confronted with the fact that the evidence from Africa actually refutes the predictions of the contagious/HIV hypothesis of AIDS, the mainstream quickly retorts: “but—people are living longer because of the drugs.” Speaking for AIDS Inc., Martin Delaney of Project Inform says that, “the multidrug combinations have dramatically reduced death rates and greatly extended the lives of those [HIVpositive people] using such therapies.” [56] This is a very common assertion made these days about the wonderful life-saving benefits of the admittedly highly toxic anti-HIV drugs. However, even a quick look at the evidence shows that Delaney's unrestrained enthusiasm for the anti-HIV drugs is not justified.
The CDC's HIV/AIDS Surveillance Reports document how AIDS has changed in the USA over the past two decades. The CDC data show that AIDS peaked in 1992 and has been going down steadily ever since (Fig. 6).
Figure 6. The CDC data show that
AIDS peaked in 1992 and has been going down steadily before the introduction
of Highly Active AntiRetroviral multi-drug combinations (HAART) in 1996. [57]
The mortality rate from AIDS is dropping because AIDS had been declining. The
apparent life-saving benefits of the HIV-protease inhibitor cocktails is a consequence
of the simple fact that these drugs have appeared on the scene long after AIDS
peaked in the USA, during a period when the mortality due to AIDS was naturally
in decline. However, the widespread use of HAART has stopped the decline in
AIDS and deaths. HAART is now the leading cause of AIDS and AIDS deaths in the
USA. Note that US taxpayers continue to fund AIDS at ever increasing amounts
for a total of $132 billion through 2004. [68-70]
The mortality from AIDS is dropping because AIDS has been declining in the USA since 1992, years before the introduction in 1996 of Highly Active AntiRetroviral multi-drug combinations (HAART) that Delaney touts. The apparent life-saving benefits of the HIV-protease inhibitor-containing cocktails is a consequence of the simple fact that these drugs have appeared on the scene long after AIDS peaked in the USA, during a period when the mortality due to AIDS was naturally in decline. [57]
Another reason for the decline in AIDS deaths is the CDC's re-definition of what constitutes AIDS in the USA. As of 1993, all you needed to qualify as an AIDS case were results from two lab tests: be immune to HIV, that is have antibodies to the virus, and have fewer than 200 CD4 cells per microliter of blood or a CD4 percentage less than 14. [58] The CDC has a rule that an AIDS case is classified according to the earliest definition that applies. Consequently, in 1997, 36,634 people (61% of all new AIDS cases) were classified under this non-disease category. [57] Because the majority of new AIDS cases in the USA are classified according to the non-disease criteria of the CDC’s 1993 definition change, they do not have any of the colossal list of AIDS diseases—from diarrhoea to dementia, pneumonia to Kaposi’s sarcoma—required by earlier definitions. Thus, the majority of new AIDS cases since the mid 1990s are disease-free (healthy) people. However, we can no longer follow the nationwide trend of including healthy people as AIDS cases after 1997 because the CDC stopped listing the AIDS-indicator diseases and conditions (formerly Table 12 [57]) in its HIV/AIDS Surveillance Reports.
Nevertheless, San Francisco continues to report AIDS cases according to specific AIDS-defining diseases. The San Francisco Quarterly AIDS Surveillance Report for 2000 shows in Table 10 on page 8 that 47.7 percent of all AIDS cases from 1980 through 2000 were diagnosed with AIDS according to the two lab tests of the 1993 definition change. [59] Since this is a cumulative number, which combines all AIDS cases under four different definitions of AIDS, well over half of all people (mostly gay men) in San Francisco that are currently being labelled as AIDS cases have no AIDS-defining disease. In spite of the 1993 definition change, with its inclusion of large numbers of healthy people as AIDS cases, the figure on page one of reference [59] reflects the national picture showing that the number of new AIDS cases in San Francisco has steadily declined since a peak of 760 in 1992 to below 50 in 2000, the same low level as in 1982. The new AIDS cases in San Francisco are now so few you could know them all by name.
As a consequence of the CDC's 1993 definition of AIDS, over half of the people now being treated with the anti-HIV drug cocktails since 1996 (the year the HIV protease inhibitor cocktails became available) were healthy when they started taking the drugs. Delaney, mainstream AIDS researchers and the AIDS press are crediting HAART with prolonging the lives of these healthy people. Sadly, these healthy people taking HAART don't stay healthy long. They eventually get sick from the drugs and die if they stay on them long enough. [2,60-63] “Hepatotoxicity…can occur with any antiretroviral regimen currently in use. Most remarkably, longitudinal surveys have not only reported an increased incidence of hepatic injury in HAART-treated patients but also identified life-threatening hepatotoxic events and end-stage liver disease in patients on antiretroviral treatment.” [64,65] Indeed, a recent study ”found that end-stage liver disease has become the leading cause of death of HIV-seropositive patients” in a Boston hospital. [66]
References