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AIDS Denialism and Public Health Practice

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Abstract

In this paper, we respond to AIDS denialist arguments that HIV does not cause AIDS, that antiretroviral drugs are not useful, and that there is no evidence of large-scale deaths from AIDS, and discuss the key implications of the relationship between AIDS denialism and public health practice. We provide a brief history of how the cause of AIDS was investigated, of how HIV fulfills Koch’s postulates and Sir Bradford Hill’s criteria for causation, and of the inconsistencies in alternatives offered by denialists. We highlight clinical trials as the standard for assessing efficacy of drugs, rather than anecdotal cases or discussions of mechanism of action, and show the unanimous data demonstrating antiretroviral drug efficacy. We then show how statistics on mortality and indices such as crude death rate, life expectancy, child mortality, and population growth are consistent with the high mortality from AIDS, and expose the weakness of statistics from death notification, quoted by denialists. Last we emphasize that when denialism influences public health practice as in South Africa, the consequences are disastrous. We argue for accountability for the loss of hundreds of thousands of lives, the need to reform public health practice to include standards and accountability, and the particular need for honesty and peer review in situations that impact public health policy.

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Notes

  1. Science Guardian. Awards in Washington for Duesberg and Farber. Available at: <http://www.scienceguardian.com/blog/whistleblower-awards-in-washington-for-duesberg-and-farber.htm>. Accessed 2009 Sept 5.

  2. For a summary citing original studies, see [10].

  3. See http://duesberg.com/faq.html. Accessed 2009 Nov 25.

  4. See FDA’s Center for Drug Evaluation and Research. Available at:<http://www.fda.gov/Drugs/default.htm>. Accessed 08/06/2009.

  5. Example from ref. 3: Duesberg quotes a Lancet study (May MT et al. 2006;368:451–458) that ARVs have “not translated into a decrease in mortality” when the full statement reads “Virological response after starting HAART improved over calendar years, but such improvement has not translated into a decrease in mortality.” The authors are comparing 1998 mortality on HAART with 1995–1996 and 2002–2003 on HAART, not ARVs versus nothing.

  6. US Census Bureau International Database. Available at: <http://www.census.gov/ipc/www/idb/country.php>. Accessed 2009 Aug 9.

  7. http://www.avert.org/safricastats.htm. Accessed 2009 Aug 9.

  8. Joint United Nations Programme on HIV/AIDS (UNAIDS) Reference Group on Estimates, Modelling and Projections. Available at: <http://www.epidem.org/>. Accessed 2009 Aug 9.

  9. UNAIDS. Report on the Global HIV/AIDS Epidemic. Geneva: UNAIDS; 2000, 2002, 2004, 2006. In the 2006 report, UNAIDS suggests that its earlier modeling could have overestimated the prevalence of AIDS and death statistics. We used the estimates from the 2006 report for both 2005 and 2003 estimates, and the 2002 report for 2001 estimates.

  10. Health Systems Trust, South Africa. Available at: <http://www.hst.org.za/healthstats/178/data>. Accessed 2009 Aug 9.

  11. Health Systems Trust, South Africa. Available at: http://www.healthlink.org.za/healthstats/86/data>. Accessed 2009 Aug 9.

  12. Quoted by BBC News, 2008 Nov 7. Available at: <http://news.bbc.co.uk/2/hi/africa/7716128.stm>. Accessed 2009 Aug 7.

  13. Quoted in The Guardian, 2001 Jun 12. Available at: <http://www.guardian.co.uk/world/2001/jun/12/aids.chrismcgreal>. Accessed 2009 Aug 7.

  14. International Criminal Court. Available at:  <http://www.icc-cpi.int/about/Official_Journal.html>. Accessed 2007 Nov 20.

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Acknowledgments

We wish to acknowledge Professor George Seage who critiqued and helped refine the arguments on causation of AIDS in an earlier version of the argument.

Conflict of Interest

We declare that we have no conflict of interest.

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  1. Harvard School of Public Health AIDS Initiative and Department of Immunology and Infectious Diseases, Harvard School of Public Health, FXB 402, 651 Huntington Ave, Boston, MA, 02115, USA

    Pride Chigwedere & M. Essex

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  1. Pride Chigwedere
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  2. M. Essex
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Correspondence to M. Essex.

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Chigwedere, P., Essex, M. AIDS Denialism and Public Health Practice. AIDS Behav 14, 237–247 (2010). https://doi.org/10.1007/s10461-009-9654-7

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