http://www.cdc.gov/ncidod/eid/vol2no4/farmer.htm

AIDS has always been a strikingly patterned pandemic. Regardless of the message of public health slogans—”AIDS is for Everyone”—some are at high risk for HIV infection, while others, clearly, are at lower risk. Furthermore, although AIDS eventually causes death in almost all HIV-infected patients, the course of HIV disease varies. Disparities in the course of the disease have sparked the search for hundreds of cofactors, from Mycoplasma and ulcerating genital lesions to voodoo rites and psychological predisposition. However, not a single association has been compellingly shown to explain disparities in distribution or outcome of HIV disease. The only well-demonstrated cofactors are social inequalities, which have structured not only the contours of the AIDS pandemic, but also the course of the disease once a patient is infected (30-33). The advent of more effective antiviral agents promises to heighten those disparities even further: a three-drug regimen that includes a protease inhibitor will cost $12,000 to $16,000 a year (34).

==========

Dr. Farmer has made great contributions to lowering the costs of treatments (not just for HIV, but also for multi-drug resistant tuberculosis), so that these figures from 1996 are no longer applicable. But his other points about social inequalities and HIV epidemiology (which parallels the epidemiology of tuberculosis and many other transmissible diseases) unfortunately are still very accurate to this day.

http://www.biocompare.com/video/science/aidsamericas/

It is interesting how different programs have dealt with HIV/AIDS in different ways.

Partners In Health http://www.pih.org/index.html has had huge successes in Haiti, and now has also set up several programs in Africa. They stress a whoistic approach which makes a lot of sense for many reasons. It makes little sense to test for and treat HIV without also testing and treating tuberculosis and dozens of other problems. Likewise, testing for and treating tuberculosis without also taking care of HIV is not a good idea.

Dr. Paul Farmer is a medical anthropologist and physician who co-founded Partners in Health. He has written several books, and several books have been written about him and his programs.
http://www.ucpress.edu/books/pages/9875/9875.auint.html

If Anita were just another “AIDS dissident”, I would not spend energy here with her. However, because she has claimed to be the person who instigated the infamous South African Presidential AIDS Advisory Panel, I think it is important to understand how and why she came to beleive she was an AIDS expert, and how and why the government has been or has not been influenced by her and the people she invited to the panel.

Although South African research on HIV and AIDS has always been very good by any standards, some members of the government, and some journalists in South Africa have become confused, to say the least. I am hoping to point out to journalists, here in this blog, the difference between researching a story to find the truth, and either reporting “both sides” without discussing which side has credible evidence to back up that side, or choosing a side and searching only for people willing to go on record to support that side even if they tell lies to do so.

I do not live in South Africa, so my reading of the news from South Africa is limitted to what I can get from the internet. I see a lot of “Manto bashing” and similar stories without any real substance to back them up. Hundreds of studies have been done to show the relative importance of various aspects of nutrition, from micronutrients and vitamins to protein and carbohydrate intake, in comparison to other factors such as taking antiretorvirals and avoiding overconsumption of alcohol.

It is my opinion that South Africans could greatly benefot for some in depth reporting on HIV and AIDS. There are social factors that are important in prevention of transmissions, such as imbalance of male and female power in relationships, age differences between males and females in relationships, and fidelity or commitment to a single partner. There are difficult choices to be made with regard to costs vs effectiveness of treatments and risks of side effects. If one drug costs a tenth as much as another drug but has twice the rate of adverse side effects, is it wise to take the cheaper drug to see if the side effects will develop? Are any of the side effects permanent, or are they nearly all reversed upon switching therapies? What percentage of these side effects are minimal and tollerable such as a tingling sensation in the fingertips, and what percentage are very serious such as liver damage? Most of these issues are well-discussed in the medical literature, but not even most doctors have the time and energy to fully research it all. Journalists play a very important role in society by researching and reporting on topics of importance. It is possible to distill and simplify biomedical research without mis-reporting on it. Calling HIV a “germ” is simple bu not inaccuate. Calling HIV a bacteria is inaccurate. Claiming that HIV has not been isolated is innacurate.

Perhaps there is good reporting on all aspects of HIV and AIDS in South Africa, and I am just not seeing it. Please forgive my ignorance if that is the case. I have not seen many reports spelling out what government and nongovernmental assistance programs are available to help people. What organizations are avialable, such as:
Health Systems Trust
http://www.hst.org.za/
The Institute for Democracy In Action South Africa:
http://www.idasa.org.za/
which has a whole section HIV, AIDS and the Media.
And how can people get involved in helping all of these organizations work better together? What are the blocks preventing services from reaching people? It is not always a lack of the service itself, sometimes it is a problem of access to the service.

But I wish Dr Wouter Basson would shed light on his research on HIV.

I wonder what Maathi’s reply would have been if she had been asked does she believe (or feel) HIV is an artifact of the laboratory process, that should have stayed in the laboratory till clarity emerged?

Anyway, any one can GOOGLE her and find out she is as puzzled as most of us. Us poor confused sods are the majority. And quite right, too. There is wholesale confusion in virology. It’s the Follies of this world who are in the minority with their insistence on closing down the book of virology - and write insulting letters to the President of South Africa telling him he is an idiot and so is his minister of health.

Gallo signed the Treatment Action Campaign Open Letter to the President as “MD, Professor and Director, Institute of Human Virology; Co-Discoverer of HIV as the cause of AIDS; Developer of the first HIV blood test. University of Maryland, USA”

Dr Foley shouldn’t then have trouble in referencing the paper where Gallo establishes HIV as the cause of AIDS. Because on that depends the reliability of his blood test and others based on his HIV “isolate”.

Gallo, of course, was invited to take part on the Presidential AIDS Advisory Panel. He declined. Now he enters via an open letter to the President of South Africa which states, a-la Foley, “To deny that HIV causes AIDS is farcical in the face of the scientific evidence”.

I’m not denying anything. Show me first who said whatever it is I am accused of denying.

HIV may cause AIDS, but what is HIV? What is AIDS, for that matter? But let’s stick to HIV for now - is it an infectious taxonomically distinct particle, which sets off a train of acute conditions leading to death? Is it a homogenate of pooled blood from AIDS humans injected into the brains of primates? Is it one of the many isolates derived from tedious cultures, and all the rest that goes into the process in vitro? Is it a chimera created as a result of contaminated polio vaccines cultured in various monkey renal cells? Is it a homologous entry on Los Alamos genebanks?

Of course, there’s always the good old Institutes for the Taxonomy of Viruses http://www.ncbi.nlm.nih.gpv/ICTVdb/ictv/index.htm - where only HIV-1 is listed - and it is the only species under genus lentivirus of the family Retroviridae so far listed. No Gallo HTLV (whatever the “L” stands for). Donald Burke (1) talks about 3 HIV species, and 17 different “clades” and the difficulties of managing this taxonomically.

It’s become so fuzzy, that different schools in different countries are setting up their own taxonomies in which whole families change and some recognise only one order and others three as taxonomically distinct.

Semiologists and nosologists, represented on the Presidential AIDS Advisory Panel by the Republic of Germany’s science laureate Dr Heinz Spranger, do not recognise HIV as a pathogen nor AIDS as a disease. He received the highest award of science in Germany, after he accepted to serve by invitation of President Mbeki on his panel. I actually phoned the Germany Embassy to check that it, too, considered it an honour for one of its scientists to serve on the President of South Africa’s panel.

Gallo and others like Judge Edwin Cameron can be foolish enough as to think the Presidential Panel was a shame and sham, but I don’t have that choice. I want the truth to come out whatever it takes amd where ever one can serve it is an honour, clearly.

(Incidentally, Spranger, and the school from which he comes and represents, means that the foundation of South African policy on HIV and AIDS “based on a premise of an internationally accepted assumption that HIV causes AIDS” is not international at all.)

The book on taxonomy of viruses is primitive to say the least. And now 82 scientists are insisting it must be closed, on their word for “it”, whatever “HIV” turns out to be and not to be. With “HIV” we have in addition a new taxonomic class enumerable “isolates”, including 106 genetically distinct variants in an asymptomatic AIDS patient (2) and more than 108 in a symptomatic one.(3) No wonder it is so easy for my fingers to find in a few minutes of googling thousands of guru’s debating and publishing research and discussing whether viruses in toto can be separated from other biological entities and into distinct biological entities.

It’s fascinating. I didn’t make all this up. There is much dispute. This is the reality.

The Deputy President of South Africa, Cosatu who listened to her, the Health Minister and the Deputy-Minister of Health have a united message - one I agree with - TAC and their supporters must join the suitable forums already set up and discuss improvements to the Comprehensive Plan on HIV and AIDS.

Somewhere in the plan there must be a sub-committee on aetiology, that Dr Foley/Los Alamos and Gallo et al can join and debate with their peers on research interpretations. The reigning doyen among Comprehensive Plan compilers would be Prof Barry Schoub, also a member of the Presidential Aids Advisory Panel, and Prof Carolyn Williamson, also a member of the Presidential Aids Advisory Panel and Prof Lyn Morris and Prof Saliem Kariem - all members of the panel.

I know research has been continuing - Foley gives some more of these from a single source and school of thinking. There is much much more from other sources and schools of thinking. I know the Health Minister agrees her department must take a lead in this, because I asked her on radio live and she answered work was continuing and there were unanswered questions and debate.

Just one of the problems seems to be a dearth of academics who read, to say nothing about politicians, and media commentators.

In the meantime, a deadline for the five-year plan on HIV and AIDS has been given by the Deputy President of South Africa - December 2006. I hope funding will be distributed so that traditional and naturapathic approaches are implemented in clinical trials, including the lemons, garlic, olive oil programme choice the minister punts. Look how quickly the TB bacillus mutates on contact with synthetic drugs. Will a little mutant bacteria emerge in this foolish race against evolution that culls the human race? Should my taxes really be going into taking the word of Prof Schoub, Robert Gallo et al, and now Dr Foley?

That’s my message from first hand experience of the AIDS debate now going back to 1999, backed by boxes and databases full of data, and a life time fascination with things scientific. - Anita Allen anita@theallens.co.za

1. Burke, DS. Recombination in HIV: An Important Viral Evolutionary Strategy. Emerging Infectious Diseases. Vol 3 No 3. July-September 1997. http://www.cdc.gov/ncidod/eid/vol3no3/burke.htm
2. Vartian JP, Meyerhans A, Henry M, et al. High-resolution structure of an HIV-1 quasispecies: Identification of novel coding sequences. AIDS 1992;6:1095-1098.
3. Wain-Hobson S. Virological mayhem. Nature 1995;373:102.

http://democracynow.org/article.pl?sid=05/03/08/1444212
“…
AMY GOODMAN: Do you feel many feel that it is a biological agent that was unleashed to destroy black people in Africa?

WANGARI MAATHAI: I don’t know of anyone who really believes that. I don’t know of anyone who believes that. Most of us don’t know. And part of the responsibility that we have is to educate people so that they are not given misinformation, and there is a lot of misinformation that goes around about the disease, as you know.
…”

The answer of course is that they are not on the wrong track. It has just never occurred to Anita to do a little research to find the truth. Instead she starts with a conviction that AIDS cannot be caused by HIV, and then looks for anyone who is willing to go on record supporting that idea, even if they tell lies to do so.

The Durban Declaration was passed around by e-mail for about 3 or 4 days to collect the 5,000 signatures. I have no information about who was offered the chance to sign on for firing Manto Tshabalala-Msimang. Do you know for sure that the Williamson’s were offered the chance, and refused to sign?

It is rather trivial to do a PubMed search and find that Carolyn Williamson has in fact published papers on HIV isolation:

Williamson C, Morris L, Maughan MF, Ping LH, Dryga SA, Thomas R, Reap EA, Cilliers T, van Harmelen J, Pascual A, Ramjee G, Gray G, Johnston R, Karim SA, Swanstrom R.
Characterization and selection of HIV-1 subtype C isolates for use in vaccine development.
AIDS Res Hum Retroviruses. 2003 Feb;19(2):133-44.
PMID: 12639249

Bures R, Morris L, Williamson C, Ramjee G, Deers M, Fiscus SA, Abdool-Karim S, Montefiori DC.
Regional clustering of shared neutralization determinants on primary isolates of clade C human immunodeficiency virus type 1 from South Africa.
J Virol. 2002 Mar;76(5):2233-44.
PMID: 11836401

van Harmelen J, Williamson C, Kim B, Morris L, Carr J, Karim SS, McCutchan F.
Characterization of full-length HIV type 1 subtype C sequences from South Africa.
AIDS Res Hum Retroviruses. 2001 Nov 1;17(16):1527-31.
PMID: 11709097

Carolyn’s sister Anna-Lisa is not as involved in HIV research, her work is on human papilloma viruses:

Varsani A, Williamson AL, Jaffer MA, Rybicki EP.
A deletion and point mutation study of the human papillomavirus type 16 major capsid gene.
Virus Res. 2006 Aug 26;
PMID: 16938363

Varsani A, van der Walt E, Heath L, Rybicki EP, Williamson AL, Martin DP. Evidence of ancient papillomavirus recombination.
J Gen Virol. 2006 Sep;87(Pt 9):2527-31.
PMID: 16894190

I wonder if Anita denies all evidence of existence of papilloma viruses?

Now he offers references from - 2006; 2003, 1997 - and none of them qualify - and he well knows it.

How is it possible that Robert Gallo and partners across the world, including Luc Montagnier, could be on the wrong track, along with everyone who co-signs with them? Such as the 82 that signed Treatment Action Campaign’s Open Letter to President Mbeki calling for Health Minister Manto Tshabalala-Msimang MD’s firing. There was Robin Weiss and David Baltimore along with 11 South Africans - down from the 5000 of the Durban Declaration issued in 2000. If you remember the president’s spokesperson stated to SAPA that “it would find a comfortable place in the dustbin”.

So while Prof Ed Rybicki is among the 11 South Africans, neither his wife Prof Lisa Williamson, nor her sister Carolyn Williamson signed (all co-authors of the 1997 mode of HIV transmission study quoted by Foley in his latest post).

All are involved in HIV vaccine research. But none of them, nor the 82 who signed TAC’s Open :Letter, has published a paper or set of papers establishing viral isolation. Not Montagnier who seems to be playing all sides in this one. Certainly not not Gallo. Not Weiss who somehow managed to make quite a nest egg out of HIV test patents after his lab samples were contaminated with Luc’s. Nor Baltimore, Nobel Prize winner with Howard Temin for discovery of RT, proposed as HIV specific and now known to be ubiquitous. They were wrong on that. Arguably, so were the Nobel Committee - and there’s been other mistakes but no one hands back a Nobel Prize.

Were they wrong in 2004, when TAC was nominated for the Peace Prize to give it to Kenya’s Wangari Mathi, who besides her global-warming solution, outspokenly supports the view that HIV was a laboratory artifact?

Why the long delay on conferring a Nobel Prize on the scientist(s) who “discovered” HIV? Maybe, like Dr Foley, the committee just can’t find any references to published papers. - Anita Allen anita@theallens.co.za

Although Anita pretends to want me to be her personal tutor, this is not my job. I can lead her to papers such as:

Rodriguez MA, Chen Y, Craigo JK, Chatterjee R, Ratner D, Tatsumi M, Roy P, Neogi D, Gupta P.
Construction and characterization of an infectious molecular clone of HIV-1 subtype A of Indian origin.
Virology. 2006 Feb 20;345(2):328-36. Epub 2005 Nov 9.
PMID: 16289184

van Harmelen J, Wood R, Lambrick M, Rybicki EP, Williamson AL, Williamson C.
An association between HIV-1 subtypes and mode of transmission in Cape Town, South Africa.
AIDS. 1997 Jan;11(1):81-7.
PMID: 9110079

Schrofelbauer B, Senger T, Manning G, Landau NR.
Mutational alteration of human immunodeficiency virus type 1 Vif allows for functional interaction with nonhuman primate APOBEC3G.
J Virol. 2006 Jun;80(12):5984-91.
PMID: 16731937

Virology 2003 Mar 15;307(2):328-40
Analysis of the functional relationship between V3 loop and gp120 context with regard to human immunodeficiency virus coreceptor usage using naturally selected sequences and different viral backbones.
Bagnarelli P, Fiorelli L, Vecchi M, Monachetti A, Menzo S, Clementi M.
Istituto di Microbiologia, Universita di Ancona, Ancona, Italy.
ABSTRACT:
The human immunodeficiency virus type 1 (HIV-1) gp120 V3 loop plays a predominant role in chemokine receptor usage; however, other linear and nonlinear gp120 domains are involved in this step of the HIV-1 replication cycle. At present, the functional relationship between V3 and these domains with regard to coreceptor usage is unclear. To gain insights into the nature of this relationship in naturally selected viral variants, we developed a recombinant strategy based on two different gp120 backbones derived from CXCR4 (X4)- and CCR5 (R5)-tropic viral strains, respectively. Using this recombinant model system, we evaluated the phenotype patterns conferred to chimeric viruses by exogenous V3 loops from reference molecular clones and samples from infected subjects. In 13 of 17 recombinants (76%), a comparable phenotype was observed independently of the gp120 backbone, whereas in a minority of the recombinant viruses (4/17, 24%) viral infectivity depended on the gp120 context. No case of differential tropism using identical V3 sequence in the two gp120 contexts was observed. Site-directed mutagenesis experiments were performed to evaluate the phenotypic impact of specific V3 motifs. The data indicate that while the interaction of HIV-1 with chemokine receptors is driven by V3 loop and influenced by its evolutionary potential, the gp120 context plays a role in influencing the replication competence of the variants, suggesting that compensatory mutations occurring at sites other than V3 are necessary in some cases.
PMID: 12667802

but I can’t make her read or comprehend them. I cannot even get her to accept the idea that hundreds of papers like these represent more than “anecdotal evidence”.

He claims “several hundred different isolates of HIV-1 M group viruses, several dozen more closely related lentiviruses (HIV-1 O group, HIV-2, SIV-SMM, SIV-MAC, SIV-AGM, etc.) and several more distantly related lentiviruses (FIV-housecat, FIV-lion, FIV-cougar, BIV, EIAV, Visna, CAEV, etc.) have in fact been properly isolated and studied in great detail.” END QUOTE.

Fine. Then he should have no trouble choosing where this was achieved from among the references in the NIAID fact sheet which HE gave as the overwhelming and unambiguous evidence of the HIV cause of AIDS.

What exactly is being isolated by which ever criteria you use - the 1973 Perth Group, the Durban Declaration, or the February 2003 NIAID Fact Sheet - is contested. Foley just endlessly it seems postpones the moment of posting those seminal references among hundreds he now claims exist.

It’s because I am not pretending that I say (yet again): just post the references - and make sure they are from the NIAID FACT Sheet, because the entire health and Human Services of the US policy is based on this. While here in South Africa, it seems that Themba Maseko, CEO of Government Communications, has stated that HIV and AIDS policy is based on the “belief” that HIV causes AIDS. So now it’s a religion is it? I must suspend my disbelief, deny all the evidence I have for how wrong the assumption is, shut up, join the believers and assumers - and bow down in faith that the majority is on the right road.

Never.

In the presidential panel the great minds clashed on the record and under video cameras. It was members of the Foley/Los Alamos group which made confidentiality a prerequisite to participation. The rest were quite prepared to have live TV present.

And remember the Interim Report of the Presidential AIDS Advisory Panel is interim because it wasn’t final. It was the summing-up report of the Chief Moderator Dr Khotso Mokhele, president of the National Research Foundation. Every word composed by him, to the best of his abilities as a graduate of Harvard, doctorate in microbiology and leading science administrator. It was a great achievement, by an honest man.

Pity his recommendations on the isolation thing have not yet been fulfilled, though Foley claims it has been achieved hundreds of times. Then when I ask for more than anecdotal evidence - data in published research which is quoted on the NIAIAD Fact Sheet titled: “Evidence for HIV causes AIDS” , at least 5000 words from Foley by now, but no references. And this from a fact sheet which he said contained exhaustive and overwhelming evidence. - Anita Allen anita@theallens.co.za