Friday, August 29, 2008

The AIDS Epidemic? It was a Glorious Myth!

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The authorities have lied, and I am not glad

Dr Michael Fitzpatrick, author of 1987’s The Truth About the AIDS Panic, says it is a shame that AIDS insiders did not expose the myths and opportunism of the AIDS industry earlier. But still, better late than never.


There is a widely accepted view that Britain was saved from an explosive epidemic of heterosexual AIDS in the late 1980s by a bold campaign initiated by gay activists and radical doctors and subsequently endorsed by the government and the mass media.

According to advocates of this view, we owe our low rates of HIV infection today largely to the success of initiatives such as the ‘Don’t Die of Ignorance’ leaflet distributed to 23 million households and the scary ‘Tombstones and Icebergs’ television and cinema adverts (though they are always quick to add that we must maintain vigilance and guard against complacency).

Now former AIDS industry insiders are challenging the imminent heterosexual plague story and many of the other scare stories of the international AIDS panic. James Chin, author of The AIDS Pandemic: The Collision of Epidemiology with Political Correctness, is a veteran public health epidemiologist who worked in the World Health Organisation’s Global Programme on AIDS in the late 1980s and early 1990s. Elizabeth Pisani, a journalist turned epidemiologist and author of The Wisdom of Whores: Bureaucrats, Brothels and the Business of AIDS, spent most of the past decade working under the auspices of UNAIDS, which took over the global crusade against HIV in 1996. Once prominent advocates of the familiar doomsday scenarios, both have now turned whistleblowers on their former colleagues in the AIDS bureaucracy, a ‘byzantine’ world, according to Pisani, in which ‘money eclipses truth’.

“Pisani reminds readers that ‘public health is inherently a somewhat fascist discipline’”

For Chin, the British AIDS story is an example of a ‘glorious myth’ – a tale that is ‘gloriously or nobly false’, but told ‘for a good cause’. He claims that government and international agencies, and AIDS advocacy organisations, ‘have distorted HIV epidemiology in order to perpetuate the myth of the great potential for HIV epidemics to spread into “general” populations’. In particular, he alleges, HIV/AIDS ‘estimates and projections are “cooked” or made up’. [Just like illegal abortion figures before Roe v. Wade.]

While Pisani disputes Chin’s claim that UNAIDS epidemiologists deliberately overestimated the epidemic, she admits to what she describes as ‘beating up’ the figures, insisting – unconvincingly – that there is a ‘huge difference’ between ‘making it up (plain old lying) and beating it up’. Pisani freely acknowledges her role in manipulating statistics to maximise their scare value, and breezily dismisses the ‘everyone-is-at-risk nonsense’ of the British ‘Don’t Die of Ignorance’ campaign.

Chin’s book offers a comprehensive exposure of the hollowness of the claims of the AIDS bureaucracy for the efficacy of their preventive campaigns. He provides numerous examples of how exaggerated claims for the scale of the HIV epidemic (and the risks of wider spread) in different countries and contexts enable authorities to claim the credit for subsequently lower figures, as they ‘ride to glory’ on curves showing declining incidence. As he argues, ‘HIV prevalence is low in most populations throughout the world and can be expected to remain low, not because of effective HIV prevention programmes, but because… the vast majority of the world’s populations do not have sufficient HIV risk behaviours to sustain epidemic HIV transmission’.

By the late 1980s, it was already clear that, given the very low prevalence of HIV, the difficulty of transmitting HIV through heterosexual sex and the stable character of sexual relationships (even those having multiple partners tend to favour serial monogamy), an explosive HIV epidemic in Britain, of the sort that occurred in relatively small networks of gay men and drug users, was highly improbable, as Don Milligan and I argued in 1987 (1).

As both Chin and Pisani indicate, high rates of heterosexually spread HIV infection remain the exceptional feature of sub-Saharan Africa (and parts of the Caribbean) where a particular pattern of concurrent networks of sexual partners together with high rates of other sexually transmitted infections facilitated an AIDS epidemic. Though this has had a devastating impact on many communities, Chin suggests that HIV prevalence in sub-Saharan Africa and the Caribbean has been overestimated by about 50 per cent. The good news is that, contrary to the doom-mongering of the AIDS bureaucracy, the rising annual global HIV incidence peaked in the late 1990s and the AIDS pandemic has now passed its peak.

“From AIDS to climate change, experts have been complicit in the prostitution of science to propaganda”

Most significantly, the sub-Saharan pattern has not been replicated in Europe or North America, or even in Asia or Latin America, though there have been localised epidemics associated with gay men, drug users and prostitution, most recently in South-East Asia and Eastern Europe.

Many commentators now acknowledge the gross exaggerations and scaremongering of the AIDS bureaucracy. It is clear that HIV has remained largely confined to people following recognised high-risk behaviours, rather than being, in the mantra of the AIDS bureaucracy, a condition of poverty, gender inequality and under-development. Yet they also accept the argument, characterised by Chin as ‘political correctness’, that it is better to try to terrify the entire population with the spectre of an AIDS epidemic than it is to risk stigmatising the gays and junkies, ladyboys and whores who feature prominently in Pisani’s colourful account.

For Chin and Pisani, the main problem of the mendacity of the AIDS bureaucracy is that it leads to misdirected, ineffective and wasteful campaigns to change the sexual behaviour of the entire population, while the real problems of HIV transmission through high-risk networks are neglected. To deal with these problems, both favour a return to traditional public health methods of containing sexually transmitted infections through aggressive testing, contact tracing and treatment of carriers of HIV. Whereas the gay activists who influenced the early approach of the AIDS bureaucracy favoured anonymous and voluntary testing, our whistleblowers now recommend a more coercive approach, in relation to both diagnosis and treatment.

Pisani reminds readers that ‘public health is inherently a somewhat fascist discipline’ (for example, quarantine restrictions have an inescapably authoritarian character) and enthusiastically endorses the AIDS policies of the Thai military authorities and the Chinese bureaucrats who are not restrained from targeting high-risk groups by democratic niceties. The problem is that, given the climate of fear generated by two decades of the ‘everyone-is-at-risk nonsense’, the policy now recommended by Chin and Pisani is likely to lead to more repressive interventions against stigmatised minorities (which will not help to deter the spread of HIV infection).

Chin confesses that he has found it difficult ‘to understand how, over the past decade, mainstream AIDS scientists, including most infectious disease epidemiologists, have virtually all uncritically accepted the many “glorious” myths and misconceptions UNAIDS and AIDS activists continue to perpetuate’. An explanation for this shocking betrayal of principle can be found in a 1996 commentary on the British AIDS campaign entitled ‘Icebergs and rocks of the “good lie”’. In this article, Guardian journalist Mark Lawson accepted that the public had been misled over the threat of AIDS, but argued that the end of promoting sexual restraint (especially among the young) justified the means (exaggerating the risk of HIV infection): as he put it, ‘the government has lied and I am glad’ (2).

This sort of opportunism is not confined to AIDS: in other areas where experts are broadly in sympathy with government policy – such as passive smoking, obesity and climate change – they have been similarly complicit in the prostitution of science to propaganda.

It is a pity that Chin and Pisani did not blow their whistles earlier and louder, but better late than never.

Dr Michael Fitzpatrick most recent books are MMR and Autism: What Parents Need to Know (buy this book from Amazon(UK)) and The Tyranny of Health: Doctors and the Regulation of Lifestyle (buy this book from Amazon(UK)).

The Wisdom of Whores, by Elisabeth Pisani, is published by Granta Books. (Buy this book from Amazon(UK).)

The AIDS Pandemic: The Collision of Epidemiology with Political Correctness, by James Chin, is published by Radcliffe Publishing Ltd. (Buy this book from Amazon(UK).)

(1) Michael Fitzpatrick and Don Milligan, The Truth About The Aids Panic, 1987

(2) Mark Lawson, ‘Icebergs and rocks of the “good” lie’, Guardian, 24 June 1996

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