In 'Thabo Mbeki, HIV/AIDS and bogus scientific controversies', published on Moneyweb on 19 March 2009, Martin Weinel calls the question Mbeki publicly raised in late 1999 over 'the safety of AZT when used to reduce the risk of mother-to-child transmission of HIV' an 'inauthentic scientific controversy'.
He means that giving AZT to pregnant women is incontestably safe, and no informed person would suggest that it may harm or even kill their babies. Let's examine this.
AZT (azidothymidine, now zidovudine) is a nucleoside analogue, a class of chemical cell-poison routinely used to kill human cells in cancer chemotherapy. I've written the history of its first synthesis in 1961 for this purpose, related to me by its inventor Professor Richard Beltz, in 'Inventing AZT', posted at my Treatment Information Group website, www.tig.org.za (all documents secure PDFs).
So it won't surprise you to learn that GlaxoSmithKline itself warns in an FDA-mandated Black Box toxic hazard warning at the top of its package insert that AZT slaughters blood, muscle and liver cells and that it can kill you. (Actually it destroys brain cells, bone cells and every other kind of cell too.)
AZT is so extraordinarily poisonous that when supplying a miniscule 25 mg of it for research use – one quarter the quantity in a single 100 mg capsule supplied by GlaxoSmithKline – the chemical company Sigma-Aldrich bottles it with a label bearing a bright orange stripe imprinted with a skull and crossbones icon to signify potentially fatal toxic chemical hazard to the handler – spelt out in six languages: 'Toxic Giftig Toxique Toxico Tossico Vergiftig' – and the warning: 'TOXIC Toxic to inhalation, in contact with skin and if swallowed. Target organ(s): Blood Bone marrow. In case of accident or if you feel unwell, seek medical advice immediately (show the label where possible). Wear suitable protective clothing.' Spurred by findings in several published studies, Sigma-Aldrich also warns on its latest label that accidental exposure to AZT may give you cancer.
It shouldn't surprise you either then that 'a large volume of scientific literature' has been published concerning 'the toxicity of this drug' and demonstrating it to be 'harmful to health', a 'danger to health' as Mbeki matter of factly pointed out in the National Council of Provinces on 28 October 1999.
In his foreword to my book Debating AZT, the manuscript of which moved Mbeki to investigate the drug, South Africa's finest investigative journalist Martin Welz, editor and publisher of noseweek, recorded correctly that I'd 'tracked and digested every important reference to AZT in contemporary medical literature. The result is a comprehensive and alarming review of the findings of medical researchers on the clinical use of the drug.' Based on the research literature I'd reviewed, the 'argument' against it, he found, 'is devastatingly clear'. (My leaflet 'Why do President Mbeki and Dr Tshabalala-Msimang warn against the use of ARV drugs like AZT?' will give you a quick overview.)
England's leading investigative journalist in his day, the late Paul Foot, also thought it 'Very good. Convinced me completely.'
Another journalist of outstanding courage, ability and integrity, the late Donald Woods, who sacrificed his career to expose the murder of Steve Biko, phoned me from London after reading it to tell me he thought it 'Deserves serious treatment. More strength to your arm.'
On the other hand journalist David Beresford, who's highly respected by the white middle class in South Africa, and who obviously writes for the Mail&Guardian, judged it 'the ravings of [a] drivelling conspiracy-theorist, loony, crackpot, fruitcake. … I'm a professional at spotting weirdos'.
But since Welz, Foot and Woods are 'merely … journalist[s]' by profession (and let's not waste time on Beresford with his own tragic mental problems), and by Mr Weinel's measure incapable for that reason of forming and expressing a valid opinion in a medical subject, here's what some top-ranking scientists had to say – including the inventor of the drug.
Dr Etienne de Harven, Emeritus Professor of Pathology at the University of Toronto, thought it 'excellent … the best, most comprehensive review on AZT currently available'.
Dr Harvey Bialy, founding scientific editor of the leading scientific journal Nature/biotechnology, similarly judged it 'Absolutely spectacular … superb … the definitive refutation.'
Dr Peter Duesberg, Professor of Cell and Molecular Biology at the University of California at Berkeley, and member of the National Academy of Sciences of the United States of America, found it 'superb, extremely well researched, analyzed, written. … I could not have done a better job. … Are you a scientist or do you collaborate with one? How could you survey so many scientific publications as an attorney?' 'I still can't believe he wrote that. He's really a molecular biologist pretending to be a lawyer.'
Similar accolades from many other big-time gents poured in, most notably from the inventor of AZT Professor Richard Beltz: 'you are justified in sounding a warning against the long-term therapeutic use of AZT, or its use in pregnant women, because of its demonstrated toxicity and side effects. Unfortunately, the devastating effects of AZT emerged only after the final level of experiments was well underway … Your effort is a worthy one. … I hope you succeed in convincing your government not to make AZT available.'
You'll understand from phrases like 'so many scientific publications' and 'the best, most comprehensive review on AZT currently available' that there is indeed, as Mbeki put it, 'a large volume of scientific literature alleging that, among other things, the toxicity of this drug is such that it is in fact a danger to health' – a profusion of published research findings concerning 'the devastating effects of AZT' due to its 'demonstrated toxicity and side effects'.
If the latter statement by the very inventor of AZT doesn't do it for you, here are a couple of the more pithily expressed 'dire warnings' to which Mbeki referred concerning the exceptionally dangerous toxicity of AZT that 'medical researchers have been making':
Hayakawa et al. urged in Biochemical and Biophysical Research Communications 176:87-93 that 'for AIDS patients, it is urgently necessary to develop a remedy substituting this toxic substance, AZT'.
Lewis and Dalakas stated the reason in 1995 in Nature Medicine 5:417-22: 'Clinical manifestations of ANA [antiretroviral nucleoside analogues, such as AZT] toxicity: It is self-evident that ANAs, like all drugs, have side-effects. However, the prevalent and at times serious ANA mitochondrial toxic side-effects are particularly broad ranging with respect to their tissue target and mechanisms of toxicity: Haematological; Myopathy; Cardiotoxicity; Hepatic toxicity; Peripheral neuropathy.'
A report in Adverse Drug Reaction Bulletin, No.178 summed up the following year: 'The antiretroviral drugs currently licensed in the United Kingdom are zidovudine (azidothymidine), zalcitabine (ddC) and didanosine (ddI). … All are very toxic. Suppression of bone marrow elements can occur with any of the three, as can peripheral neuropathy.'
The world's leading HIV experts concur, and in even stronger terms:
Professor Robin Weiss wrote in Positively Healthy News in January 1989: 'I don't see why people who are well should take a drug [AZT] which pretty reliably will make them sick.'
Newsday quoted Professor Jay Levy on 12 June the following year: 'I think AZT can only hasten the demise of the individual. It's an immune disease and AZT only further harms an already decimated immune system.'
None other than the vaunted co-discoverers of HIV Dr Robert Gallo and Professor Luc Montagnier noted in Science 298(5599):1730-1 in 2002 that 'there are severe limitations to antiretroviral therapy, including toxic side effects (lipid deposition, increased risk of diabetes and cardiac infarcts, muscular and neurological toxicity). Therefore, it is imperative to launch clinical trials to test additional treatments that are less toxic.'
Oh, and useless as well as very poisonous: in Patent Application No. 245259 filed for a new drug on 17 May 1994, Gallo swore: 'There is a critical need to develop effective drug treatments to combat RT dependent viruses such as HIV. Such efforts were recently urged in the United Kingdom-Irish-French Concorde Trial conclusions which reported that the nucleoside analog zidovudine (AZT), a mainstay in the treatment of patients infected with HIV-1, failed to improve the survival or disease progression in asymptomatic patients.' In fact it kills you. Phillips et al. reported in the New England Journal of Medicine 336:958-959 in 1997: 'Extended follow-up of patients in one [AZT] trial, the Concorde study, has shown a significantly increased risk of death among the patients treated early.'
But that's when AZT is used alone, you might say, and these days it's combined with other drugs. It makes no difference. In 2006 the Antiretroviral Therapy (ART) Cohort Collaborative reported a massive study in Lancet 368:451-458: 'The results of this collaborative study, which involved … over 20 000 patients with HIV-1 from Europe and North America, show that the virological response after starting HAART [Highly Active Antiretroviral Therapy] has improved steadily since 1996. However, there was no corresponding decrease in the rates of AIDS, or death, up to 1 year of follow-up. Conversely, there was some evidence for an increase in the rate of AIDS in the most recent period. [We noted a] discrepancy between the clear improvement we recorded for virological response and the apparently worsening rates of clinical progression.' A covering editorial commenting on 'these somewhat paradoxical trends' noted: 'The major findings are that, despite improved initial HIV virological control … there were no significant improvements in early immunological response as measured by CD4-lymphocyte count, no reduction in all-cause mortality, and a significant increase in combined AIDS/AIDS-related death risk in more recent years.' So what's the point then in giving people ARV drugs, if they're so toxic they give you AIDS and kill you?
One month before Mbeki raised the dangerously harmful toxicity of AZT in Parliament, Brinkman et al. reported in Lancet 354(9184):1112-5 that drugs in the AZT-class 'are much more toxic than we considered previously. … The layer of fat-storing cells directly beneath the skin, which wastes away … is loaded with mitochondria … other common side effects of [AZT and similar drugs are] nerve and muscle damage, pancreatitis and decreased production of blood cells … all resemble conditions caused by inherited mitochondrial diseases.'
In June, a couple of months before that, Papadopulos-Eleopulos et al. recorded in their monumental investigation, 'A Critical Analysis of the Pharmacology of AZT and its Use in AIDS' in Current Medical Research and Opinion 15, Supplement 1, 'AZT underwent clinical trials and was introduced as a specific anti-HIV drug many years before there were any data proving that the cells of patients are able to triphosphorylate the parent compound to a level considered sufficient for its putative pharmacological action. Notwithstanding, from the evidence published since 1991 it has become apparent that no such phosphorylation takes place and thus AZT cannot possess an anti-HIV effect. However, the scientific literature does elucidate … a number of biochemical mechanisms which predicate the likelihood of widespread, serious toxicity from use of this drug. … Based on all these data it is difficult if not impossible to explain why AZT was introduced and still remains the most widely recommended and used anti-HIV drug. [The continued administration of AZT] either alone or in combination … to HIV sero-positive or AIDS patients warrants urgent revision.' (According to an article published about it in May 2000 in Nature, the world's most prestigious scientific journal, the paper had been subjected to especially rigorous peer-review in light of its radical conclusions and immense implications, and it had been found scientifically flawless. Mbeki circulated copies among several prominent South African scientists, but none exhibited the brains necessary to make sense of it.)
Mbeki's warning about AZT in 1999 was supported by 1993 Chemistry Nobel Laureate Kary Mullis PhD, considered by some to be the Einstein of modern biology. Two years earlier, in the preface to Professor Duesberg's book Inventing the AIDS Virus, he wrote: 'We have not been able to discover why doctors prescribe a toxic drug called AZT (Zidovudine) to people who have no other complaint than the presence of antibodies to HIV in their blood. In fact, we cannot understand why humans would take that drug for any reason.'
Mr Weinel says of the authors of the research reports in the medical and scientific literature that I reviewed, 'The contributors to this body of literature were apparently “medical researchers”.' But his derisory use of inverted commas is disingenuous, because whether he likes their findings or not, which is to say whether they fit into his neat academic argument or not, they were indeed 'medical researchers', and they were 'medical researchers' of unimpeachable professional competence and integrity.
Mr Weinel's unfounded aspersion on these scientists and their professional acumen was calculated to mislead you into thinking that the AZT toxicity reports Mbeki had in mind were dubious, if not junk. He wants you to conclude, as GlaxoSmithKline (then GlaxoWellcome) insisted at the time, 'The President has been gravely misinformed.' By me. (Also, 'GlaxoWellcome are a reputable company. We do not lie to people.')
Then he repeats his false insinuation that their reliability and relevance is suspect: 'The real problems start, however, when it comes to judging the credibility of a paper and its relative importance to a scientific field.' Since the papers in question were all published in peer-reviewed medical and scientific journals of the highest reputation, in which only the most 'credib[le]' and 'important' papers find space, and were directly relevant to an assessment of the utility and safety of AZT as a medicine, we can pull the chain on these 'problems' of his. Especially since, in their reading of the AZT toxicity literature, and 'judging the credibility of a paper and its relative importance', the inventor of AZT Richard Beltz and the world's top AIDS experts Gallo, Montagnier, Levy and Weiss all accepted the accuracy and cogency of the AZT toxicity papers they'd seen, and found no reason to doubt the professional honesty and ability of the 'medical researchers' who'd authored them. As Mr Weinel would trick you into doing with his dishonest word games.
Next Mr Weinel contends that 'science is predominantly an oral culture' and 'attribution of credibility and importance [to published papers] is much harder to outsiders to pick up as it takes place in the personal encounters between scientists at conferences, workshops and other meetings'. Indeed so, and this is especially true concerning AIDS orthodoxy.
Since conventional AIDS experts have built their careers and have earned their status, power and wealth, especially their wealth, on the official American dogmas, no published research findings, literature reviews and critical analyses adverse to their opinions are accorded any 'credibility and importance' at their 'conferences, workshops and other meetings', where they clap hands at each other's speeches and clink their whiskey glasses together afterwards at their 'personal encounters'. As Mullis put it in Harper's Magazine in March 2006, 'In the AIDS field, there is a widespread neurosis among scientists … there's just so much slowly accumulating evidence against them. It's really hard for them to deal with it. They made a really big mistake and they're not ever going to fix it. They're still poisoning people.'
The easy way is not 'to deal with it' at all, not to 'attribut[e] credibility and importance' to papers presenting 'evidence' damaging to their creeds. For instance, the AZT-promoting orthodoxy cannot and will not 'deal with' the staggering conclusions drawn by Papadopulos-Eleopulos and her scientific colleagues following their meticulous 30,000-word investigation, 'A Critical Analysis of the Pharmacology of AZT and its Use in AIDS', showing that AZT is not triphosphorylated as the manufacturer claims it is; so it can't terminate proviral DNA and can't act as an antiretroviral drug as alleged; by all conventional measures of efficacy it doesn't do so; and more than just being utterly useless, it's also extremely toxic and harmful to people given it. Faced with these facts, Mr Weinel's '[in]siders' just look the other way.
Mr Weinel claims that 'to know which papers and results to trust and to judge their relative importance in a scientific field, one needs to immerse oneself into the “culture” of a particular scientific community' to recognize the 'markers of credibility' such as 'prestige of a lab, a research group or institution, the standing and reputation of the co-authors'. But no one else has suggested that any of the peer-reviewed scientific papers that Mbeki considered – reviewed in my book and/or archived on the internet – aren't trustworthy, so this 'problem' of Mr Weinel's can join his other ones down the tube as well.
He suggests that the higher up his professional tree, and accordingly the more invested he is in the paradigm he feeds off, the more trustworthy a scientist is. This sort of argumentum ad verecundiam (Roma locuta ergo finita est), namely that one should uncritically trust medical authority, especially high authority, and not exercise an independent discretion, will obviously appeal to the more childlike readers of his article and also to his fellow academics playing the same ridiculous blinkered game in 'science studies' that win them their degrees and pats on the back from each other.
The history of medicine is replete with lessons in the importance of inquisitiveness, scepticism, openness to novel views and the dangers of uncritically nodding at a reigning consensus. Or we'd still be believing in the four humours, that a plethora of black bile causes melancholy, and so on.
Take the case of Dr Ignatius Semmelweis in the 19th Century, driven out of his profession by his medical colleagues for suggesting that it might actually be a good idea to wash and disinfect one's hands before delivering babies to prevent puerperal fever, and then beaten to death in a lunatic asylum to which his medical colleagues had committed him.
Take the case of Drs Widukind Lenz and William McBride in the early sixties, lone voices warning that thalidomide was crippling unborn children at a time when doctors were eagerly prescribing millions of doses (literally; it was a best-seller) on the basis of the drug manufacturer's claims that it 'can be given with complete safety to pregnant women and nursing mothers without adverse effect on mother or child. ... Outstandingly safe, Distavel [thalidomide] has been prescribed for nearly three years in this country [the UK]. ... a harmless, safe and effective sedative with no side effects. ... Harmless even over a long period of use ... completely harmless even for infants.'
Mr Weinel writes: 'Without immersion an isolated reader simply lacks the necessary, often tacit, knowledge needed to know what to read and whom to trust. … Had the President done what politicians usually do when they are confronted with technical matters that are well beyond their own expertise – seeking the advice of experts on the matter – he would have discovered at least two things. First, he would have learned that the vast majority of scientists with expertise on AZT and other anti-retroviral drugs shared the view that the benefits of anti-retroviral drugs largely outweigh the risks when it comes to the prevention of mother-to-child transmission.'
No doubt he would. But interviewed in the Sunday Times on 6 February 2000, Mbeki identified a 'real problem' that 'simply' never entered Mr Weinel's academic head: 'What do you do if ... university people, professors and scientists ... haven't read ... won't read? What do you do?'
The point is richly illustrated by the reaction to his public statement about AZT by South African AIDS scientists and doctors who really know the score, according to Mr Weinel, because they hob-knob at 'conferences, workshops and other meetings', and whose opinions should be relied upon because they have that essential credibility you get from the 'prestige of a lab, a research group or institution, the standing and reputation of the co-authors'.
Professor Jerry Coovadia, Head of the Department of Paediatrics and Professor of HIV-AIDS Research at Nelson R Mandela Medical School, University of KwaZulu-Natal, is South Africa's most senior academic AIDS expert in the 'the scientific community'. And as chairman of the 13th International AIDS Conference in Durban (funded of course by the pharmaceutical industry) he's the king of 'conferences, workshops and other meetings'. On 4 June 2000 he told the Sunday Independent: 'There is no question in the minds of scientists that the government contributes to a climate that raises the possibility that … antiretrovirals are toxic.' On 8 May 2005 he said in the same newspaper: 'I am surprised by the manner [in which Tshabalala-Msimang] draws up her amazing beliefs [about ARV toxicity] … to speak of side effects is contrary to what the scientific evidence suggests. … Her actions could have severe implications for people and the image of the nation. Some form of censure should emerge [for her] careless and dangerous statements.'
Professor William Makgoba, then president of the Medical Research Council, now Vice-Chancellor of the University of KwaZulu-Natal, wrote to me around the time the AZT controversy broke; he agreed with Mr Weinel that it was an 'inauthentic scientific controversy': 'I do not intend to engage in nonsensical debates on AZT or other AIDS-related matters. I find the issues you raise a total waste of energy but perhaps more exciting for ignorant people in the field. … Remember that I am the scientist and not you.' The same fellow – who we must remember is the scientist, not us – boasted in Nature 402(6759):225 in November 1999: 'I've read nothing in the scientific or medical literature indicating that AZT should not be provided to people.'
Dr Salim Abdool Karim, Medical Research Council director of HIV Prevention and Vaccine Research, Deputy Vice Chancellor at the University of KwaZulu-Natal, Professor in Clinical Public Health, Columbia University, US, and, as chairman of the Scientific Programme Committee of the 13th International AIDS Conference in Durban 2000, prince of 'conferences, workshops and other meetings', crowed equally ignorantly in the Sunday Independent on 14 November 1999: there is 'no new evidence in the medical literature in the last year on the adverse effects of AZT'. Right after the publication of a whole lot.
Professor Gary Maartens, head of the HIV/AIDS Unit at Groote Schuur Hospital in Cape Town was quoted in the Financial Mail on 9 November 1999: 'AZT is being singled out because government is trying to defend its decision not to provide it for mother-to-child transmission. It's pathetic; the MCC is toadying to the President. There's no medical or scientific reason whatsoever for the MCC to review the material. I'm sure the MCC will come out with a balanced report, but it's nauseating that they're even looking at it. … In Uganda, they're winning the war against the epidemic because they had the political will to do so, not by believing in conspiracy theories.'
Professor Glenda Gray, co-director of the Perinatal HIV Research Unit at Chris Hani Baragwanath Hospital in Soweto summed up the 'scientific consensus' about AZT in South Africa (Mr Weinel's phrase) in Nature 441(7092): 406 the following year. It was 'harmless', she said. Yes, and it saves little babies' lives, and without it they'll surely die, she told the Washington Post in as many words on 16 May 2000: 'If they're not going to provide us with AZT, then the best thing that the government can do is to ask us to strangle them all at birth.'
Professor Cecil Karabus of the Department of Paediatrics and Child Health, Red Cross Children's Hospital in Cape Town, responded in the Mail&Guardian on 18 November 2005 to two statements I'd repeated in a letter to the paper a week before (having first made them a year earlier) – 'Hundreds of studies have found that AZT is profoundly toxic to all cells of the human body, and particularly to the blood cells of the immune system' and 'Numerous studies have found that children exposed to AZT in the womb and after birth suffer brain damage, neurological disorders, paralysis, spasticity, mental retardation, epilepsy, other serious diseases and early death' – by suggesting I was 'a liar' and that the studies I was referring to were 'garbage', since 'in my reading of the mainstream literature I have failed to come across the “hundreds of studies indicating the profound toxicity to all human cells of AZT” and the numerous studies showing that babies exposed to AZT in the womb suffer brain damage et cetera'.
Professor Robin Wood, co-director of the Desmond Tutu HIV Centre at the University of Cape Town, stated on oath in an affidavit he filed in the Cape High Court in Case 2807/05: 'Children exposed to AZT in the womb are not at high risk of “brain damage, neurological disorders, paralysis, spasticity, mental retardation, epilepsy, other serious disorders and early death.” The opposite is true. When AZT is used by a pregnant woman to reduce the risk of transmitting HIV to her child, the child is much less likely to contract HIV and much more likely to live a healthier, longer life.' Why, he added in Health-e News on 13 May 2005, regarding AZT and similar, 'the toxicity of these drugs is very low indeed'.
Dr Desmond Martin, president of the Southern African HIV-AIDS Clinicians Society, described AZT in the Citizen on 31 March 1999, a few months before Mbeki's announcement, as 'a medicine from heaven'.
So had Mbeki 'immersed himself in the community of experts on anti-retroviral drugs and prevention of mother-to-child transmission of HIV' in 1999 and 'asked [the] experts directly', what he 'would have learned' from these 'leading South African scientist[s]' is that AZT is not profoundly toxic; it doesn't have dangerous, sometimes lethal side effects; his Health Minister's misunderstanding that it does is just amazing; AZT's extreme toxicity hadn't been the subject of hundreds of published research papers, with its harmful toxicity for unborn and newly born babies noted in dozens of them; nothing had been published in the scientific literature in this regard, particularly not in the preceding year; his suggestion that AZT is a danger to health is a pathetic, nauseating conspiracy theory; the toxicity of drugs like AZT is very low indeed; AZT saves babies' lives and without it they'll surely die, so it would be better to strangle them rather than deny them the life-saving medicine; AZT is harmless; exposing babies to AZT in the womb and after birth doesn't cause them brain damage, neurological disorders, paralysis, spasticity, mental retardation, epilepsy, other serious diseases and early death; on the contrary, AZT affords babies a healthier, longer life; and only a liar would contend otherwise, and any research reports to which the liar might be referring, to the effect that AZT is extremely toxic and harmful both to adults and to unborn and newly born children, are garbage fit only for tearing up and turfing out along with the potato peels, the egg shells and the Mail&Guardian. Since actually AZT is the next best thing to manna from heaven.
Mr Weinel says: 'By relying on the reading of scientific literature to make a judgement about AZT's safety, President Mbeki made a mistake.' Even if it was 'admirable … to read scientific literature himself', he should never have 'assumed that reading alone gave him enough expertise to declare AZT a “danger to health”'. He should have gone 'seeking the advice of experts on the matter', the mostly white and Indian AIDS experts in South Africa, to tell him their 'scientific consensus' that contrary to the findings of all the studies reviewed in Debating AZT, the AZT they give impoverished Africans, including pregnant women, isn't really 'a danger to health'; and he should have adopted their expert opinion as his own, without any further reflection, since this was a 'technical matter … well beyond [his] own expertise'.
But Mbeki was not coming to and pronouncing a judgement on an abstruse medical question, the preserve, Mr Weinel says, of such medical luminaries as Professors Coovadia, Makgoba, Carrim, Maartens, Gray, Wood, and Karabus. And Dr Martin. He was stating a simple fact: 'There also exists a large volume of scientific literature alleging that, among other things, the toxicity of this drug is such that it is in fact a danger to health. These are matters of great concern to the Government as it would be irresponsible for us not to heed the dire warnings which medical researchers have been making.'
Mbeki was stating his government's 'great concern' about what had been 'alleg[ed]' about this – allegations which he allowed might turn out not to be true: 'I have therefore asked the Minister of Health, as a matter of urgency, to go into all these matters so that, to the extent that is possible, we ourselves, including our country's medical authorities, are certain of where the truth lies.' The matter was duly referred to the relevant statutory authority, the Medicines Control Council, to investigate and adjudicate. (Its reports – I have them – are disgraceful.)
Mr Weinel himself admits that 'well written scientific papers can be unexpectedly accessible and simply reading the abstract might sometimes be enough for even the uninitiated to gain a rough but sufficient understanding of what the paper is about'.
Where Mbeki came up against an unfamiliar medical term, he looked it up or asked a qualified doctor what it meant. Missing his deep irony, for he'd already discovered the country's top AIDS scientists to be ignoramuses, Mr Weinel quotes (I'm copying his formatting and interpolation) Mbeki's 'welcome speech to members of the Presidential Advisory Panel on AIDS in May 2000 … 'I faced this difficult problem of reading all these complicated things that you scientists write about, in this language I don't understand. So I ploughed through lots and lots of documentation, with dictionaries all around me in case there were words that seemed difficult to understand. I would phone the Minister of Health [who holds a couple of degrees in health-related disciplines] and say, 'Minister, what does this word mean?' And she would explain.''
It bears mentioning that at that stage, like Mbeki, Tshabalala-Msimang was a perfectly conventional subscriber to American AIDS orthodoxy, and indeed had been appointed by him to head the Health Ministry precisely on account of the ardour she shared with him in the national battle against the great sex plague. (That for some reason, according to the white and Indian AIDS experts, only Africans and hardly anyone else seem to contract.)
Was it really necessary for Mbeki to have asked South Africa's most extremely intelligent, grandly qualified and highly respected AIDS experts such as Professors Coovadia, Makgoba, Carrim, Maartens, Gray, Wood, and Karabus, also Dr Martin, to hold his hand and explain to him what the researchers meant when they said, for instance, that 'for AIDS patients, it is urgently necessary to develop a remedy substituting this toxic substance, AZT'; 'the prevalent and at times serious ANA mitochondrial toxic side-effects are particularly broad ranging with respect to their tissue target and mechanisms of toxicity: Haematological; Myopathy; Cardiotoxicity; Hepatic toxicity; Peripheral neuropathy'; 'zidovudine [is] very toxic. Suppression of bone marrow elements can occur with any of the three, as can peripheral neuropathy'; '[nucleoside analogue drugs such as AZT] are much more toxic than we considered previously. … The layer of fat-storing cells directly beneath the skin, which wastes away … is loaded with mitochondria … other common side effects of [AZT and similar drugs are] nerve and muscle damage, pancreatitis and decreased production of blood cells … all resemble conditions caused by inherited mitochondrial diseases'; 'the scientific literature does elucidate … a number of biochemical mechanisms which predicate the likelihood of widespread, serious toxicity from use of this drug. … Based on all these data it is difficult if not impossible to explain why AZT was introduced and still remains the most widely recommended and used anti-HIV drug. [The continued administration of AZT] either alone or in combination … to HIV sero-positive or AIDS patients warrants urgent revision.'
Reader, really I must ask you now: do you agree with Mr Weinel? Do you agree that Mbeki should have consulted the top AIDS experts in South Africa to clue him in – all of them totally invested, personally and professionally, in the standard American approach to AIDS with AZT and similar drugs? If you do, then this might be a good time to stop reading and get on the phone to your doctor and ask him to tell you what you should think about all this, since doctor always knows what's best. Because unless you hang out at conferences and meetings and so on with the local AIDS experts I've been quoting for your edification, and you immerse yourself in their culture, their culture of indolence, ignorance, stupidity and arrogance, Mr Weinel says that you, like Mbeki, just don't have what it takes to make up your mind unassisted about what I'm about to tell you.
But first a couple of further comments on the game Mr Weinel insists Mbeki should have played.
The rules Mr Weinel sets for Mbeki, and insists he broke, presuppose that everything is working as it should; and he assumes without a moment's hesitation that AZT was duly registered by the authorities on the basis of studies proving its safety and efficacy. Actually, AZT was licensed on the basis of a grossly fraudulent trial – a matter forming the subject of a dedicated book, two documentary exposés broadcast in the US and the UK respectively, and other writing; and you can read all the most germane information about this from these sources handily spliced together in my article 'Licensing AZT', posted online at the TIG website.
Even if Mbeki had overstepped the mark by making a statement before consulting South Africa's AIDS experts, and was offside under Mr Weinel's rules in doing so, objectively considered he was quite right in what he said. Whereas had Mbeki followed Mr Weinel's rules, consulted the self-billed AIDS experts, uncritically deferred to them, and publicly repeated what they'd told him, he'd have done the wrong thing, and basically been telling lies.
The irresistible conclusion is that Mbeki did the right thing. And by acting as he did, innumerable Africans in jeopardy of being poisoned by AZT learned the truth from him, namely that AZT is very harmful and should be avoided, and piles of reported studies say so. In many cases, Mbeki's statement literally saved their lives or those of their loved ones.
Mr Weinel invokes the Galileo case while making the unfortunately false claim that the dissident 'theories had been shown to be wrong on many occasions'. Although it sounds nice and smooth, it's not true. If we confine ourselves to the immediate subject of his paper, AZT, Papadopulos-Eleopulos and colleagues' observation, upon a close analysis of the relevant literature (currently about two dozen consistent studies), that AZT is not triphosphorylated to anywhere near its necessary inhibition concentration and so cannot work, and indeed by all conventional biological markers doesn't work either as a therapeutic or prophylactic drug, has never been disconfirmed. On the contrary, the 'AZT triphosphorylation bottleneck problem' has since attracted published comment from other scientists.
It really is most improper of Mr Weinel to say things that aren't true, just because he wants them to be true, in order to make his argument sound good.
He says the composition of Mbeki's Presidential AIDS Advisory Panel was skewed because the 'very tiny minority' of dissidents were over-represented. In Debating AZT I quoted Galileo on the picayune value of head-counting to determine scientific truth: 'But even in conclusions which can only be known by reasoning, I say that the testimony of many has little more value than that of a few, since the number of people who reason well in complicated matters is much smaller than that of those who reason badly. If reasoning were like hauling I should agree that several reasoners would be worth more than one, just as several horses can haul more sacks of grain than one can. But reasoning is like racing and not like hauling, and a single Barbary steed can outrun a hundred dray horses. … I believe that good philosophers fly alone like eagles, and not in flocks like starlings. It is true that because eagles are rare birds they are little seen and less heard, while birds that fly like starlings fill the sky with shrieks and cries, and wherever they settle befoul the earth beneath them.'
After hearing South Africa's top AIDS experts all angrily shouting what they think about AZT, who'll disagree?
But Mr Weinel, the 'science studies' academic, reckons in science you should always go with the majority; that's the best guide.
Mr Weinel says 'that for all practical purposes it was a “certainty” in 1999 (and is still one today) that the benefits of anti-retrovirals in their use to prevent mother-to-child transmission largely outweighed the existent risk'. I understand he means that doctors were then and still are generally agreed that AZT and other ARVs like nevirapine 'prevent mother-to-child transmission of HIV', and that this is the 'life-saving' benefit he has in mind – as journalists on the Mail&Guardian always put it, or just the 'life-extending' one, as George Bush similarly does.
Might I remind you, before we carry on, that medical experts unanimously praised blood-letting once for just about every ill, a treatment still being recommended for pneumonia as recently as 1946 in Sir William Osler's authoritative, standard medical text Principles and Practice of Medicine. And that the highest medical authority in the world at the time, the Health Organization of the League of Nations (now the WHO) blessed the repeated injection of arsenic in 1934 as the right way to go for people, including pregnant women, lighting up the (useless, now abandoned) Wassermann test for syphilis, thereby killing and crippling hundreds of thousands of people, babies included? Yes, arsenic – currently rated by the US National Toxic Substances and Disease Registry, weighted for risk of exposure, as the most deadly substance known to man. But as I was saying, I mean Mr Weinel was saying, doctor always knows best.
The 'benefits of anti-retrovirals in their use to prevent mother-to-child transmission' were exhaustively examined and blown to pieces in a 130,000-word debunk by the Australian bio-physicist Eleni Papadopulos-Eleopulos and her colleagues, mentioned earlier, Mother to Child Transmission of HIV and its Prevention with AZT and Nevirapine: A Critical Analysis of the Evidence. Much too long for inclusion in any journal, it was published as a monograph and delivered to the South African government in October 2001; and if after reading it you still think AZT and nevirapine save babies from getting infected by their mothers who got infected loving their husbands or their boyfriends, then maybe you should think about changing your batteries.
You may cleverly say, 'Ah, but Mbeki didn't have that exhaustive analysis before him completely dismantling the reputations of AZT and nevirapine as perinatal antiretroviral prophylactics when he made his statement about the drug.' This is true, but then he was only addressing the safety of AZT, not its efficacy. If he'd harboured any silent doubts about whether it actually works or not (alluded to when he said, 'among other things') 'to prevent mother-to-child transmission' – and indeed we know for sure he did, because he was already onto the triphosphorylation problem canvassed in Papadopulos-Eleopulos's et al. June 1999 paper, mentioned earlier, 'A Critical Analysis of the Pharmacology of AZT and its use in AIDS' and was later quoted in the media referring to it – the monograph showing that AZT and nevirapine don't 'prevent mother-to-child transmission' of HIV vindicates him completely.
The mother-to-child monograph is accessible at 'Quick links' at the TIG website, where you'll also find the scientists' easy-to-follow slide-show presentation, 'A Critical Analysis of the Evidence Considered Proof that Nevirapine Prevents Mother-to-Child Transmission of HIV', and their pivotal 'A Critical Analysis of the Pharmacology of AZT and its Use in AIDS'.
Whether nevirapine really works 'to prevent mother-to-child transmission' of HIV is a matter also dealt with in my new book lightly written for lay readers, The trouble with nevirapine – likewise available as a free download from the TIG site. The book deals with the innumerable unreported serious adverse events and deaths among African babies experimentally exposed to nevirapine in the HIVNET 012 trial in Uganda, revealed to the world with the support of Associated Press in December 1994 by the highest-ranking whistleblower in the history of US government, Dr Jonathan Fishbein. (As a professional clinical drug trial expert, he considered The trouble with nevirapine 'an expertly written piece on this very dangerous drug'.) It was on the strength of this clinical trial that the TAC got the High and Constitutional Courts to order our government to supply the drug in public maternity wards for administration to mostly poor African mothers and their babies. Having regard to the data now surfaced in HIVNET 012, thousand of African babies are being poisoned with this extraordinarily toxic drug as a result of this tremendous victory for human rights in South Africa. (On account of its severe toxicity it's banned in the US for giving doctors and nurses after accidental syringe needle pricks, and it's not licensed for giving white babies in any first world country.)
The monograph, slideshow, paper, and book, just mentioned, will enable you to evaluate Mr Weinel's conclusion that Mbeki is responsible for 'about 35,000 … unnecessary infection of babies with HIV in South Africa', by 'creating an “inauthentic scientific controversy” and delaying the introduction of a widely supported policy'. The documents will equip you to decide whether drugs like AZT and nevirapine really do prevent poor little African babies from catching HIV from their black mothers with their septic vaginas full of sex germs, as nearly all whites and Indians think, including Germans like Mr Weinel. And whether AZT and nevirapine really do save babies' lives like sacramental wafers.
Reading all this stuff will take some effort, but if it's too much trouble for you, and you're happy with what you know about AZT and nevirapine from what you've read in the newspapers or saw someone saying on TV, probably in a white vestment and dangling an impressive stethoscope in place of a crucifix, please feel free to crack open another beer and wander off to watch the rugger on Supersport.
To return to the real point of all this, which is whether, as Mr Weinel claims, 'the safety of AZT when used to reduce the risk of mother-to-child transmission of HIV' is an 'inauthentic scientific controversy', which is to say beyond serious contention, here's what some of the many studies find.
Before we begin, please understand clearly that not a single properly controlled study shows that babies born to HIV-positive mothers and exposed to AZT in the womb (and nowadays usually after birth too) tend to stay well and live, whereas those that aren't tend to get sick and die. This is a deeply entrenched popular belief, but it's a total myth.
It's the fallacy that Mr Pride Chigwedere of Zimbabwe based his arithmetic on when pointing his finger at Mbeki and claiming that, to quote Mr Weinel, his 'actions have led, according to recent estimates, to the unnecessary infection of about 35,000 babies with HIV in South Africa between 2000 and 2005. … Chigwedere, Pride et al. (2008) “Estimating the lost benefits of antiretroviral drug use in South Africa”, Journal of Acquired Immune Deficit [sic] Syndrome 49(4): 410-415.' It's a classic illustration of applied science's GIGO principle: garbage in, garbage out.
Far from ensuring 'a healthier, longer life', the horrible contrary is the case, as the sample sprinkling of findings cited below demonstrate. Babies exposed to AZT have a much higher death rate, and incidence of serious disease, brain damage, immunological and neurological disorders and other crippling injuries, as you might expect from a toxic substance purpose-designed to kill cells and packaged in the tiniest amount for research use with a skull and crossbones on the label and the warning that you shouldn't sniff it or allow it near your skin, let alone swallow it on purpose.
The foetal and neonatal AZT toxicity literature is comprehensively reviewed in my 175-page book Poisoning our Children: AZT in pregnancy, online at the TIG site. After reading it, Papadopulos-Eleopulos and her colleagues remarked, 'Clearly your knowledge base in this subject extends far beyond ours.' A member of the MCC telephoned Dr Tshabalala-Msimang to say that he had been 'amazed' by my 'detailed research', of which his MCC had been 'unaware'.
A smattering of the 'amaz[ing] … detailed research' of which the MCC had been 'unaware', to give you an idea, is presented in my leaflet, 'Why do Zackie Achmat, Nathan Geffen and Mark Heywood want pregnant African women and their babies to be given AZT? What AZT does to unborn and newly born children'. You'll need a strong stomach or a hard heart to read it: it made a grown man I know cry.
Thanks to the dedication and commitment of Zackie Achmat and his Treatment Action Campaign, funded by millions beyond counting and even spending from foreign governments and foreign corporations (their political executive arm, 'philanthropic foundations'), AZT has been given to pregnant women and their newborn babies, nearly all African, throughout South Africa since the beginning of 2008.
By the way, let Achmat tell you in his own words what very unpleasant things ARVs did to him when he briefly tried them, and the toxic effects he concealed for several weeks because 'I can't let Manto win and I can't let Mbeki win' – which is to say be shown right in their warnings against ARVs by his own pitiful example; I quote him in my Draft Bill of Indictment filed at the International Criminal Court at The Hague in 2007 (a serious joke) posted on the TIG website.
Earlier this month, on 4 March, in her address to the 53rd session of the Commission on the Status of Women at the UN in New York, Dr Tshabalala-Msimang mentioned that 'We are particularly concerned about inadequate drug surveillance and pharmacovigilance capacity, especially in the African region.'
Presumably she wasn't referring to the current Minister of Health among those members of government 'particularly concerned' about this; Ms Hogan is a sensible white woman who's all in favour of dosing pregnant African women and their babies with good strong European disinfectant to burn those sex germs out of them.
The research literature cited in Why do Zackie Achmat, Nathan Geffen and Mark Heywood want pregnant African women and their babies to be given AZT?, and much more reviewed in Poisoning our Children: AZT in pregnancy, predicts that thousands of African babies are currently being poisoned by AZT in South Africa. But like the massive infant mortality rate in the apartheid Bantustans, it's a holocaust taking place among the African poor out of the public eye, because 'inadequate drug surveillance and pharmacovigilance capacity' means no one is monitoring and reporting the extent of the tragedy.
There's another horrible aspect to this. According to Blanche et al. and Barret et al. (see Achmat leaflet), the terrible harm AZT causes is not always visible at birth: unlike the case with thalidomide babies, it's not necessarily immediately conspicuous. It may only become apparent in infancy many months later, worsening as the months and early years pass.
Obviously any distraught African mother who returns to hospital after several months with her child going blind, having fits, becoming spastic, becoming paralysed, having trouble learning, talking and developing normally, and/or just sick all the time, even dying, or just miserable with something indefinably but unmistakeably wrong, which is to say sub-clinically harmed by AZT, and for the rest of his or her life, will be told by AIDS expert doctors such as Professors Coovadia, Makgoba, Carrim, Maartens, Gray, Wood, and Karabus, and also Dr Martin, that's it's just tough luck, since to their brilliant medical minds AZT is 'harmless'.
And this is what Mr Weinel wants you think too, so he can feel he's won his little 'science studies' game, the clever white man showing the befuddled African chief the way.
Chairman: Treatment Information Group
Quoting Mbeki's statement that 'there are legal cases pending in this country, the United Kingdom and the United States against AZT on the basis that this drug is harmful to health', Mr Weinel said, 'Apparently the first argument, related to pending legal cases, turned out to be wrong.' It was.
When GlaxoWellcome's local representatives denied that there were any lawsuits pending, the President's office asked me for details. I referred to the English cases of Threakall and others, and the American Nagel and McDonnell cases, all of which had been reported in the press. A month later however, in a telephone call from Susan Threakall's English solicitor Graham Ross, I was informed that her action, his lead case, had been withdrawn a couple of months earlier. In March 2000, Paul Headlund, the American attorney who had handled the Nagel and McDonnel cases, told me that the claims had not been pursued. A South African case in which I'd been briefed had not reached summons stage, so strictly it was not yet 'pending'. GlaxoWellcome was therefore technically correct in disputing Mbeki's statement that there were cases concerning AZT pending against it at that time.