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From the Townsend Letter for Doctors & Patients
January 2006

Townsend's New York Observer
by Marcus A. Cohen

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AIDS in Africa: Medical Neocolonialism?

There is an approach which asks why is this President of South Africa trying to give legitimacy to discredited scientists, because after all, all the questions of science concerning this matter had been resolved by the year 1984. I don't know of any science that gets resolved in that manner with a cut-off year beyond which science does not develop any further. It sounds like a biblical absolute truth, and I do not imagine that science consists of biblical absolute truths.
—Thabo Mbeki, President, South Africa, opening address, first meeting of Presidential Advisory Panel on AIDS, Pretoria, May 6, 2000

AIDS, HIV, and anti-retroviral drugs had seldom blipped across my healthcare radar before last summer, when I cautiously wrote my first column on these polarized, politicized topics, an interview with medical hypnotist Michael Ellner, president of HEAL (Townsend, Aug./Sept. 2005). The column on Ellner dwelt on his experience during the early period of AIDS, starting in 1981 with the initial CDC report about the appearance of this illness in five gay men in Los Angeles. Oriented toward nutritional treatment for AIDS, Ellner mostly observed a relatively small subculture of the New York City gay community, whose lifestyle included frequent anal sex and heavy use of nitrites ("poppers") and other recreational drugs. The column ended with Ellner's recollections of the effects of AZT on people diagnosed with AIDS, right after treatment with this highly toxic drug became the mainstream regimen (1987), and many patients on the original high dosage died.

An interview with Dr. Roberto Giraldo followed (Townsend, Oct.). Giraldo, a specialist in internal medicine, had predicted the emergence of AIDS among US gays while practicing in his native Colombia in the late 1970s. Giraldo had extensively read studies about the sexual and drug habits of gay men in the U.S. and Europe, and warned that continuation of their lifestyle would result in the complete collapse of the immune system. Giraldo maintained, and still maintains, that the immune deficiency characteristic of AIDS is mainly a toxic reaction to the abuse of recreational drugs and the often-accompanying malnourishment; he's never bought into the theory that HIV is the cause of this condition. My column on Giraldo ended with his relocation to the US in the late 1980s.

My next two columns on AIDS focused on sub-Saharan Africa, mostly in the 1990s (Townsend, Nov. and Dec.). These featured two field reports from Africa by investigative journalist Celia Farber, published in 1993, and Farber's memories and reflections on polarized responses to her efforts to get at the truth about African AIDS. She offered the latter at an interview in Manhattan, her home base, this Sept.

As I begin the fifth in this unexpected series of columns on AIDS, summing up the situation in Africa, my acquaintance with the medical literature and journalism1 about this illness has broadened. Still, I have reservations about the validity of much data for AIDS incidence, transmission, and mortality in Africa. And I'm still stuck on crucial questions concerning the accuracy of the media coverage and analyses of the African AIDS scene, particularly those originating in the West.

The Medical Establishment View of AIDS in Africa
Mainstream medicine's position on the cause and treatment for African AIDS is the same as it is elsewhere around the globe: Since 1984, HIV has been presumed to be the infectious agent. Since 1996, AZT and protease inhibitors, in tandem, have constituted the presumed proper treatment.

How AIDS is defined, diagnosed, and thought to spread in Africa differ markedly from the definition, criteria for diagnosis, and people at greatest risk in the US, Europe, and certain developed nations elsewhere in the world. My third column on AIDS (Nov.
Townsend) detailed these differences.

Here, I must stress that the varying definitions have fostered the AIDS establishment's hypotheses that the illness mainly transmits heterosexually in Africa. Foremost among the reasons put forward: unusual promiscuity, and the supposedly common practice of "dry sex" (see my December column for the latter). Pregnant women and nursing mothers are thought to transmit HIV to fetuses and children.

I must also emphasize that the belief in heterosexual transmission has engendered a corollary belief of sorts: HIV is rampantly epidemic in sub-Saharan Africa, threatening to depopulate a number of countries if unchecked by anti-retroviral drug therapy.

Critiques of Mainstream Positions on African AIDS
Research literature is available on the prevalent views of African AIDS. Were I to review these studies here, it might well lead to yet another column on the subject. Were I to critique the AIDS establishment's positions as briefly as possible, in addition to the likelihood of oversimplifying them, I would plunge myself in a medical, political whirlpool where only adept swimmers should venture. Instead, I'll toss the critiquing to experts who doubt that HIV causes AIDS, contend that the toxicity of anti-retroviral drugs outweighs possible therapeutic benefits, and scoff at the idea of any heterosexually transmitted AIDS pandemic in Africa.

Professor Peter Duesberg is the most frequently cited debunker of HIV causation, the first distinguished scientist to publish a major challenge to the cardinal tenets of AIDS orthodoxy.2 Duesberg presented a paper to the second meeting of the AIDS panel convened by South Africa President Mbeki in Pretoria, June 22, 2000. He titled it, "The African AIDS Epidemic: New and Contagious – Or – Old Under a New Name?"

Before zeroing in on African AIDS, Duesberg described elements that historical microbial and viral epidemics had in common, listed in contrast characteristics of diseases caused by factors which were chemical or non-contagious or physical, and summarized in comparison the characteristics of AIDS in the US and Europe.

He then analyzed AIDS in Africa, to see whether it measures up to the historical and epidemiological literature, basing his analyses on data from the WHO in Geneva, the UN, the US Agency for International Development, and the US Census Bureau. I'll paraphrase some of his most astute points and conclusions.
1. AIDS in Africa is not following the bell-shaped curve of an exponential rise and subsequent steep drop with immunity of historical infectious epidemics. Rather, it "drags on like an environmentally or nutritionally induced disease," evidently affecting a very small segment of the African population.
2. AIDS in Africa accounts for roughly 75,000 out of a total of approximately 12,300, 000 deaths per year, 0.6% of all mortality.
3. "It is impossible to distinguish clinically African AIDS [defined chiefly by the Bangui definition] from previously recognized, concurrently diagnosed, conventional African diseases." Unlike microbial conditions, African AIDS is clinically unspecific, more like certain chemically and nutritionally caused illnesses.
4. Estimated increases in HIV antibody-positive Africans do not seem to correlate with decreases in population in any African nation. They correlate instead with unprecedented simultaneous increases in population. The population of Africa has leaped from 274 million (1960), to 356 million (1970), to 469 million (1980), to 616 million (2000).
5. The WHO reports African AIDS cases cumulatively (since they began tracking AIDS) rather than annually, creating an "impression of an ever growing, almost exponential epidemic, even if annual incidence rates decline."
6. AIDS in African children is highly compatible with malnutrition, parasitic infection, and poor sanitation – not with heterosexual transmission of HIV. Thus, it's inappropriate to treat children symptomatic of illnesses long recognized to be due to these conditions with toxic DNA-chain terminators and other anti-HIV drugs.

I would add about the children that such treatment, lacking at the very least a positive HIV antibody test, is also unethical.

Apart from Duesberg's critique, it's worth calling attention to mainstream studies which show that it requires an average of 1,000 sex acts between discordant heterosexual couples (one HIV-positive, the other negative) to pass along the virus – an impossibly slow, ludicrously ineffective transmission rate.3

Finally, there is the corrosive power of the colossal amount of money invested everywhere in AIDS research and treatment. Celia Farber and other keen observers of the African AIDS scene have supplied examples aplenty of the lavish sums available to AIDS research and treatment facilities, to African MDs for attending AIDS conferences, in comparison with the paltry funds doled out to deal with historical sub-Saharan African diseases related to malnutrition, poverty, and unhealthy sanitation.4 Imagine under such circumstances the temptation for Africans dependant on healthcare for a living to draw the AIDS net around as many people as possible . . .

Comments by Dr. Roberto Giraldo and Michael Ellner
Interviewed in late April and late August of 2005, Dr. Roberto Giraldo and Michael Ellner commented on past and current developments in African AIDS. Ellner and HEAL, the organization he directs, favor immune-boosting nutritional treatments for AIDS, and work to educate patients and doctors worldwide about the benefits of nutritional therapy. Besides internal medicine, Giraldo has specialized in infectious diseases. He's also earned an MS in clinical tropical medicine. Over the years, he's conducted much of his research in the area of secondary or acquired immune deficiencies, especially those occurring in developing nations. Since 2000, he's served as a member of the South African Presidential AIDS Advisory Panel, and served a number of African countries as advisor on nutrition and diseases related to poverty.

Regarding the definition of AIDS by the WHO in Bangui in 1985, both Giraldo and Ellner told me they clearly perceived the hand of the US CDC pulling strings behind the scenes.5 Both were dismayed by official awareness campaigns trumpeting that AIDS was inevitably a death sentence, drummed into the minds of Africans not medically wise enough to shut their ears to the hypnotic drumbeat. Celia Farber observed the same effects of these campaigns in central Africa in the early 1990s: "AIDS Brain," she said, was the term in widest circulation for the terror they aroused, citing instances where patients with typical African illnesses shunned medical clinics for fear that they would be more profitably diagnosed, then treated for AIDS.6

"Out Of Africa" Once More, With Celia Farber
A sense of remoteness overcomes me when I linger over academic discussions of diseases. I've devoted my career in healthcare to helping patients survive life-threatening illness, to exposing conditions and developments which hinder their recovery. Nearing the end of my series of columns on AIDS, I feel an urge to return to excerpts from Celia Farber's reports from the bush in Central Africa: with the shock of a smack in the kisser, her word pictures give us sharp close-ups of Africans – individuals sick, dying, or dead, and their suffering kin – entangled in the mazy AIDS business.

"It was an eerie drive from the airport in Entebbe back to the hotel in Kampala. Prior to Idi Amin, prior to the last three decades, Uganda was known as the 'pearl of Africa,' and was said to be one of the most beautiful places on earth. Some say that the Garden of Eden was in Uganda. Now it is one of the poorest, disease-ridden countries in Africa. It is also known as the AIDS center of the world. The road to Kampala was lined with people building and selling coffins. Simple wooden boxes with black crosses on the front . . .

"Sam and I were looking for a place to have lunch in downtown Kampala. We went to a roadside café and ordered grilled chicken. Upon asking for a toilet, I was shown through the kitchen and into the backyard, where a whole separate world was bubbling. There were chicken parts everywhere – heads, feet, feathers, and live chickens pecking in the mud – women standing over vats of dirty water, rinsing potatoes in them, coils of black smoke, and a rancid, oily stench. The toilet was a shack with a hole in the ground. In fact, every toilet I saw in Uganda, except in the hotel, was a hole in the ground. I went to inspect the toilets at Mulago Hospital, the major hospital in Kampala, and even there – a hole in the floor, covered in excrement and buzzing with flies . . .

"Although the poverty in Uganda was shocking and brutal, it wasn't the most distressing thing about it. The real depressing thing was the lack of any kind of infrastructure. It seemed like chaos on earth, genuine chaos . . . The government had crushed the country, the people, and then vanished, and left a population steeped in lawlessness, chaos, and poverty . . .

"There were power failures constantly. No medical supplies, even in the hospitals. People were crammed throughout the corridors of the hospitals, waiting, maybe for days, to get any attention . . . What medication they had was poor quality, often too strong, unspecific, and ineffective. People bought prescription medications from little shacks called drugstores that had smuggled them from God knows where. Deaths were not counted, except maybe at some hospitals, but many people just died in the villages. It was not known how many people had died in any given year, much less what the cause of death had been. To try to make sense out of AIDS, with HIV tests and T-cell counts and clinical case definitions, in this chaos seemed hopeless . . ." (Celia Farber, "Out Of Africa," Parts One and For the Record Two,
Spin, March, April 1993)

For the Record
In my interview with Celia Farber (
Townsend, Dec.), we touched on a dispatch in The New York Times from correspondent Rachel Swarns.7 Swarns had attended an international AIDS panel convened by South Africa President Thabo Mbeki in Pretoria in 2000, and reported back that Mbeki said he was aware that HIV causes AIDS. Farber attended the same conference, and noted in a report she published that Mbeki said nothing of the sort.8 In my column, I asked how Swarns could attribute a total fabrication to Mbeki. Recently, curiosity compelled me to get Mbeki's speech and Swarns' news story from the library.

Here's what Mbeki really said: "What we
knew (italics added) was that there is a virus, HIV. The virus causes AIDS. AIDS causes death and there's no vaccine against AIDS."9

Swarns' version went: "Today, Mr. Mbeki said that he and his ministers
know (italics added) that the human immunodeficiency virus causes AIDS."

Swarns didn't fabricate. She took Mbeki's statement out of context and changed the tense of the operative verb, misrepresenting him; in essence, Mbeki was expressing a neutral position on HIV.

Again for the record: My reports on NY's Office of Professional Medical Conduct in
Townsend (they began in 2001 and are ongoing), and my four columns in Townsend about censorship in medicine (Aug./Sept. through Dec. 2004) include many instances where theories on disease causation in vogue were dead wrong, where treatments introduced into community practice were later subjected to rigorous trial and proven harmful, where the majority of physicians and medical researchers clamped down dogmatically on free debate over appropriate treatment, where research clinicians with approaches new to or different from the corpus of accepted wisdom were ridiculed and denied funds to pursue and publish their studies.

In light of these instances, and there is in fact a lengthy list of them, eventually acknowledged by the mainstream,10 why should theories about the cause and treatment of AIDS be exempted from reexamination? Why – without question – should the AIDS establishment be handed "blank checks" on defining and managing AIDS and its therapy?

What is there in the nature of AIDS that accords Western governments and non-governmental organizations the right to "dictate" to sovereign African governments policy on controlling AIDS and priorities on healthcare spending?

Closing Thoughts
Morally, the constructive course to follow in sub-Saharan Africa on AIDS would be for the developed nations of the world to provide or lend money to African countries: leave these countries to move forward with desperately needed improvements in sanitation, to rebuild infrastructures that bring adequate medical care to citizens afflicted by poverty-related diseases, to relieve conditions that breed malnutrition (which perpetuates susceptibility to the many illnesses that have ravaged Africa for centuries).

Above all, first wait and see if such improvements lower the death rates among Africans. Then, if the alarming rise in deaths reported in recent years doesn't abate, consider HIV as a possible reason, and lend money on the stipulation that it must be used to block the spread of AIDS. Then, but only then, get on with the condomizing of sub-Saharan Africa, of every "underdeveloped" nation on the globe where AIDS has manifested.

Books have been published on why the more likely course is the one that Western governments and non-governmental organizations have already shamelessly, evangelically taken,11 the one that promises profits for the US and a sprinkle of other high-tech countries through what is essentially a medical form of neocolonialism, the one that portends an immense disaster for black Africans, especially women and children. Note well in this connection: in university studies where Africans clinically diagnosed with AIDS (according to the Bangui definition and its variants) are tested serologically for HIV, the majority of the test results prove antibody-negative!12

1. For example: Laurie Garrett, "The Lessons of HIV/AIDS," Foreign Affairs, July/Aug. 2005; and Laurie Garrett, "HIV and National Security: Where are the Links? A Council on Foreign Relations Report," Council on Foreign Relations, Inc., NY, 2005. Garrett studied immunology in graduate school, and her professional credentials include a Pulitzer Prize. Today, she's a Senior Fellow for Global Health at the Council on Foreign Relations. I dipped into the article and report cited above. Her report depends heavily on secondary and tertiary sources – astonishingly rare is a reference to a medical paper – and the analogy she makes between the bubonic plague that rapidly decimated late medieval Europe and the supposed AIDS pandemic now sweeping sub-Saharan Africa is as strained and thin as boullion. A thorough examination online at, under the title, "The Black Death of the 21st Century – a CFR Report," has this pivotal sentence about Garrett's pieces: "Both are either magisterial or drivel depending on where you stand on the basic scientific assumptions of HIV/AIDS."
2. Duesberg P, Retroviruses as carcinogens and pathogens: expectations and reality,
Cancer Research, 3/1/87. Duesberg is Professor of Molecular Biology, University of California, Berkeley. For additional articles by Duesberg, see his website,
3. For example: Padian NS et al, Heterosexual transmission of human immunodeficiency virus (HIV) in northern California: results from a ten-year study,
American Journal of Epidemiology, 8/15/97; also, Wawer MJ et al, Rates of HIV-1 transmission per coital act, Rakai, Uganda, Journal of Infectious Diseases, 5/1/05.
4. Celia Farber, "Out Of Africa," Part One,
Spin, March 1993; Farber wrote: "AIDS generates far more money than any other disease in Africa. In Uganda, for example, WHO allotted $6 million for a single year, 1992–93, whereas all other infectious diseases combined – barring TB and AIDS – received a mere $57,000." In the same issue, Farber dug deeper into the funding situation: "Where there was AIDS there was money – a brand new clinic, a new Mercedes parked outside, modern testing facilities, high-paying jobs, international conferences." She spoke about the AIDS money with a leading African physician . . . who refused to be named. "'You have no idea what you have taken on,' he said . . . 'You will never get these doctors to tell you the truth. When they get sent on these AIDS conferences around the world, the per diem they receive is equal to what they earn a whole year at home.'"
5. Charles Geshekter, "A Critical Reappraisal of African AIDS Research and Western Sexual Stereotypes," May 1999; accessible via Geshekter, Professor of African History, California State University, Chico, is a member of the South African Presidential AIDS Advisory Panel. Two sections in the paper by Geshekter cited here detailed the CDC's role in the WHO definition of African AIDS at Bangui in 1985 and exposed crude racist myths about African sexuality. Geshekter's documentation is impressive. There's no space here to exemplify it, but an excerpt from one paragraph summed up most of the conclusions Geshekter drew from his profuse sources: "It was upon these grossly unscientific claims, sweeping clinical generalizations, western notions of sexual morality, and 19th century racist stereotypes about Africans that AIDS became a 'disease by definition.' Africa was assigned a central role in promoting the premise that AIDS was everywhere and everyone was at risk." See for published papers by Geshekter.
6. Celia Farber, "Out Of Africa," Part Two,
Spin, April 1993.
7. Rachel Swarns, "Mbeki Details Quest to Grasp South Africa's AIDS Disaster,
The New York Times, 5/7/00.
8. Celia Farber, "AIDS & South Africa: A Contrary Conference in Pretoria,"
New York Press, 5/25/00.
9. Thabo Mbeki, text of the opening speech by the South Africa President, first meeting of his Presidential Advisory Panel on AIDS, Pretoria, 5/6/00; accessible via
10. For example: Lawrence K. Altman, "Nobel Came After Years Of Battling The System,"
The New York Times, 10/11/05; on the bacterial cause of ulcers, "just too wild a theory for most people."
11. For example: Jared Diamond,
Guns, Germs, and Steel: The Fates of Human Societies (1997). Diamond is a MacArthur fellow, evolutionary biologist, and professor of physiology at UCLA. Guns, Germs, and Steel won a Pulitzer Prize. A sizable portion of the book, which dismantles racially-based hypotheses of human history, traces the colonial exploitation of black Africa from its origins to its current aftereffects.
12. For example: Ankrah TC et al, The African AIDS case definition and serology . . . ,
West African Journal of Medicine, April 1994.


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