An estimated 26.6 million in Sub-Saharan Africa are living with HIV/AIDS, according to official figures. But critics say these statistics are nothing more than hype shrouded in smoke and mirrors. Sam Burcher reports.
Being HIV positive is the usual requirement for an AIDS diagnosis, but testing for HIV is something of a misnomer in Africa where no HIV test is required to make an AIDS diagnosis. That is because, in October 1985, a conference of public health officials including representatives of the CDC (Centers for Disease Control) and WHO (World Health Organisation) met in Bangui, Central Africa to agree on a diagnostic definition of AIDS in Africa.
This would allow clinicians to identify an AIDS patient and also allow serious counting of such patients to begin. The Bangui definition is [1]: "prolonged fevers for a month or more, weight loss of over 10% and prolonged diarrhoea."
Agreeing this definition has meant that traditional African diseases linked to poverty, war, famine, tropical climate, open latrines and contaminated water are all neatly relabelled AIDS diseases. The consensus on Bangui is that "it has proved useful in areas where no testing in available." But as Charles Gilks of the BMJ (British Medical Journal) pointed out in 1991 [2], "persistent diarrhoea with weight loss can be associated with ordinary enteric parasites and bacteria." And, "in countries where the incidence of TB is high, substantial numbers of people reported as having AIDS may not in fact have AIDS."
Since 1993, endemic diseases such as TB have been included as AIDS defining illnesses, and in 2002, the WHO dropped TB down their world's greatest killer list and moved AIDS up as the leading cause of death. The Statistical Assessment Service (STATS) suggested that this is an attempt to "shift huge chunks of death around"[3]. Cervical cancer has recently been added to the list of AIDS defining diseases, which is easy to treat if detected quickly, but life threatening if not.
Professor Charles Gershetker, a frequent visitor to Africa as part of his research for the California State University, discovered that some pre-natal clinics were providing tests for HIV and collecting data. The problem with this is that pregnancy is one of the many conditions that can give a false positive result with the standard 'ELISA' test. Other known diseases to trigger an incorrect result are hepatitis, influenza, malaria, TB and recent vaccination.
So the yearly 'HIV positive' results returned from 4 000 pregnant women are extrapolated by the WHO's epidemiological computer to represent the entire populations' male, female young and old, burden of AIDS.
AIDS 'dissident' Professor Jens Jerndal from the Group For The Scientific Reappraisal Of The HIV Causes AIDS Hypothesis suggests that statistics are illusionist tricks to inflate the numbers of AIDS sufferers to inspire sufficient terror or panic in the general population, so as to enable the introduction of mandatory medical interventions, or constraints in freedom of movement or behaviour by those in power [4]. And for that, presenting the cumulative figure of those suffering from AIDS has more impact than reporting the number of new cases in a year, which would give a more accurate picture of the epidemic.
The practice of widening the definitions of diseases diagnosed as AIDS also concerns Prof Jerndal. At least twenty-nine different illnesses that existed before AIDS are considered as AIDS when they are accompanied by a HIV positive test. But there are more than sixty different conditions that can cause a positive result that bear no relation to HIV or AIDS. Jerndals' message is that the world has been sold the unproven HIV causes AIDS dogma along with a fatal drugs regime of conventional medicine that goes with it.
Misdiagnoses can have a devastating effect on the life of a patient and aside from inaccurate results a positive test for HIV is by no means predictive of the development of AIDS [5]. But, so far no real distinction is made between the two [6]. Worse still, in Africa, an AIDS diagnoses can mean existing treatment is withheld altogether because of the entirely unjustified fatal prognosis attached to the illness.
In whose interests would the creation of numbers of people suffering from a fatal disease in epic proportions? In the US in 2000, under President Clinton, AIDS in Africa, not in the US, was declared a matter of national security. It was suggested that while AIDS was confined to the homosexual community in the US, it was containable, but once heterosexual transmission had been established in Africa then everyone had a reason to panic and AIDS budgets soared [3].
All Africans are being unfairly labelled as insatiable, sexually promiscuous, reckless people while their key issue of poverty remains ignored. Statistics report HIV rates of infection as high as 25% in some African countries and more women than men are infected [7]. World Bank statistics for those living with AIDS in sub-Saharan African are at 29.4 million while in Cairo, Egypt, a short boat trip down the river, reveals 215 cases of HIV/AIDS in a population of 65 million [8].
UN anti-poverty strategies that promised to halve debts in sub-Saharan African by 2015 are now, according to UK Chancellor Gordon Brown, more likely to happen in 2147. Under the auspices of the World Bank and the International Monetary Fund $2.5 billion is transferred from sub-Saharan African banks into foreign banks and creditors accounts every year. A further blow is President Bush proposal to cut core funding to Africa. Gordon Brown and singer Bono are calling for a doubling in aid cash to Africa [9].
People are dying of diseases in Africa caused by inadequate living conditions and they deserve help now to improve quality of life primarily by access to clean water and good nutrition. Constructive help like sustainable agricultural plans would enable them to feed themselves [10]. And encouraging the use of affordable insecticide treated mosquito bed nets would combat the millions of annual infant malarial deaths. [11]
Assistance like this could replace the manipulative measures of foisting US tax credit goods on African states. While thousands starved, pharmaceutical companies made incongruous 'donations' of appetite stimulants to Sudan, and silicone implants to Malawi. These companies then claimed tax credit for their useless gifts and the recipient countries had to pay to dispose of them [12].
It is unlikely that attaching emerging and traditional diseases to an AIDS definition is useful for tackling the key problems of malnutrition and sanitation, but it would encourage the use of pharmaceutical drugs. Costs for conventional drugs are still prohibitive for many Africans and purchasing governments incur even greater debts to the World Bank. In order for any drug therapy to be truly successful it must be used in tandem with adequate nutrition and sanitary conditions.
One of the most recent combination therapy drugs is called Nevirapine; a non-nucleoside reverse transcriptase inhibitor (NNRTI), which reduces the viral load in HIV infection, is causing neuropsychiatric side effects in patients with HIV, but with no history of mental illness [13]. Three patients undergoing treatment developed psychotic reactions to the drugs. Two made impulsive suicide attempts after suffering command hallucinations while the third experienced persecutory delusions and depressive thoughts after starting nevirapine. Physical side effects include hepatotoxicity, gastrointestinal symptoms, and dermatological reactions.
Dr David Rasnick, a leading 'AIDS dissident' and designer of protease inhibitors (PI's), a drug used in the treatment of HIV infection, is confident that PI's can help reduce viral load, but is unconvinced that HIV causes AIDS. He said in an interview for the San Francisco Herald in October 2000 "In fact, I'm pretty sure right now there's no such thing as an AIDS epidemic in Africa, from my previous two trips last May and this July. The reason I say that in brief is that we've looked and looked and asked people, the government ministers, we asked the director of the medical research council in South Africa, the Centers for Disease Control in the US, everybody we could ask, "What are the numbers of AIDS cases in South Africa and how many AIDS deaths?" No answer at all. Zero. To this date we do not have an answer to that, and in fact, I don't think there is any such thing as AIDS going on in South Africa. It's just the same old things that Africans have been suffering and dying from for generations due to poverty, malnutrition, poor sanitation, bad water, that sort of thing. We're calling it AIDS now, instead of by the old-fashioned names that were more honest."
Professor P Addy, Head of Clinical Microbiology at the University of Science and Technology in Kumasi, Ghana, backs up the opinions of AIDS dissidents. He said: "I've known a long time that AIDS is not a crisis in Africa as the world is being made to understand. The West came out with those frightening statistics on AIDS in Africa because it is unaware of certain social and clinical conditions. In most of Africa infectious diseases, particularly parasitic infections are common. And these are the conditions that can easily compromise or affect one's immune systems. He concludes [14]: "The diagnosis itself, merely being told you have AIDS is enough to kill and is killing people."
Article first published 31/03/04
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