Reprinted from the Weekly Dig, June 4, 2003
Africa: Treating Poverty with Toxic Drugs
“What's the use of potentially deadly AIDS pharmaceuticals for people suffering from poverty-related diseases like chronic tuberculosis, or to pregnant mothers whose blood cross-reacts with the nonspecific HIV tests?”
According to the World Health Organization (WHO) and UNAIDS, 42 million people around the world are infected with HIV, and nearly 22 million people in Africa have died of AIDS. But AIDS isn't a single disease; it's a collection of diseases. When people are said to die of AIDS, they're known to die of a particular disease or condition, such as pneumonia, tuberculosis, malaria or basic malnutrition. AIDS researchers claim that HIV plays a role in the development of these illnesses, but in spite of this claim, 20 years of AIDS research has failed to prove causation between HIV infection and any so-called AIDS disease (as explored in “The AIDS Debate” parts one and two). So why do we call them AIDS deaths?
In the US, AIDS is defined as a collection of 29 previously-known conditions including yeast infections, hepatitis, the flu, pneumonia, tuberculosis and Kaposi's Sarcoma. These conditions are not known to be caused by HIV. Nevertheless, the one thing that classifies any one of these conditions as AIDS is a positive HIV-antibody test.
But even if HIV was found to cause these previously known conditions, a problem remains. The HIV-antibody tests do not diagnose actual HIV-infection. Instead, they look for non-specific antibody reactions in your blood to proteins in the HIV-test. The test manufacturers claim that the proteins stand in for HIV, but in reality, none of the test proteins have been proven to be specific to HIV. These tests are, in fact, so nonspecific that they cross-react with nearly 70 other documented conditions, including the flu, previous vaccinations, blood transfusions, arthritis, alcoholic hepatitis, drug use, yeast infections and even pregnancy, as well as conditions endemic in Africa: tuberculosis, parasitic infection, leprosy and malaria. Because no HIV test can actually find HIV, not a single HIV-test has been approved by the FDA for diagnosing HIV-infection.
In light of this nonspecific, cross-reacting test, how does the World Health Organization (WHO) diagnose AIDS in Africa?
Simple: they don't require any test at all. In 1985, the WHO created a new definition of AIDS for African nations and third world countries. The WHO's “Bangui Definition” allows Africans with common physical symptoms including diarrhea, fever, weight loss, itching and coughing to be automatically designated as AIDS patients, with no HIV test. But these very symptoms define life for the majority of Africans who lack essentials like sufficient food, safe drinking water, proper sanitation and basic medical care. These symptoms are also synonymous with the biggest killers on the continent: malaria, infectious diarrhea and tuberculosis.
Western AIDS organizations are working to get toxic AIDS drugs into the hands of African governments, but what's the use of potentially deadly AIDS pharmaceuticals to people suffering from poverty-related diseases like chronic tuberculosis and malaria infection, or to pregnant mothers whose blood cross-reacts with the nonspecific HIV tests?
To answer these questions, I spoke with AIDS researchers who've worked in Africa and studied the African AIDS epidemic.
Dr. Christian Fiala is a medical doctor and specialist in obstetrics and gynecology in Vienna. He's worked extensively in Uganda and Thailand researching AIDS.
Dr. Rodney Richards was one of the founding scientists for the biotech company Amgen where he helped develop some of the first HIV tests. Richards currently works full-time researching AIDS.
The interviews were conducted separately and integrated into a dialogue. Individual points-of-view belong to individual speakers.
How is AIDS diagnosed in Africa?
Christian Fiala: Your readers may be surprised to learn that AIDS in Africa is diagnosed completely differently than in Europe or the US. In Africa, an AIDS diagnosis can be made based on commonly occurring physical symptoms alone. This is ironic, because AIDS is a collection of diseases, and has no uniform symptoms. Even the co-founder of HIV theory, Luc Montagnier, admits that AIDS has no specific clinical symptoms.
How was this new AIDS definition devised?
Fiala: In 1985 the WHO held a meeting in Bangui, the capital of the Central African Republic. A WHO official, Joseph McCormick, wrote about it in his book Level 4: Virus Hunters of the CDC.
He wrote: “If I could get everyone at the WHO meeting in Bangui to agree on a single, simple definition of what an AIDS case was in Africa, then, imperfect as the definition might be, we could actually start counting the cases...”
This is what's known as the Bangui Definition.
How does the Bangui definition define AIDS?
Fiala: There are two categories of symptoms, major and minor. A patient is given an AIDS diagnosis when they have two major symptoms and one minor symptom. The major symptoms are weight loss, chronic diarrhea and chronic fever. The minor symptoms include coughing and generalized itching.
Let me clarify, based on the WHO's definition, if you have a fever, a cough and diarrhea in Africa, then you have AIDS?
Fiala: That's correct.
That seems absurd.
Fiala: It is. It's more absurd when you understand how common these symptoms are in resource-poor settings like sub-Saharan Africa. To begin with, less than 50 percent of Africans have access to safe drinking water. Over 60 percent have no sanitation. Most African villages don't have sewage systems. Human and animal excrements mix with the water supply. People drink this water and ingest infectious parasites and bacteria. As a result, dysentery is endemic.
When your intestines are full of infectious microbes, you'll likely develop a fever. Your body will try to purge itself by expelling the bacteria as quickly as possible. This is infectious diarrhea, and it's incredibly common in Africa.
Diarrhea drains liquid, salts, minerals and nutrients from the body. It weakens the immune system. When you have no safe water, you'll have diarrhea chronically. When you have chronic diarrhea, you can't help but to lose weight.
At this point, you've fulfilled the major symptom criteria in the African definition for AIDS. So you need one minor symptom, like generalized itching or coughing. In Uganda, a so-called “AIDS epicenter,” 80 percent of houses have floors made of packed soil or cow dung. An entire family lives on this floor. There are, on average, seven children per family, all living in this room. This is not what we in the US and Europe call proper housing, and it's easy to see how a problem like “generalized itching” might come up. At this point, an African suffering from itching, diarrhea and weight loss should be - according to the WHO - officially reported as an AIDS patient. The Bangui Definition simply relabels symptoms of poverty as AIDS.
The second problem with the Bangui Definition is Tuberculosis. TB is very widespread in Africa. It's a bacterial infection that infects the lungs. TB is spread by coughing, and it's highly infectious. The typical symptoms of Tuberculosis are fever, weight loss and coughing. This is exactly what is required for an AIDS diagnosis.
So if you have Tuberculosis in Africa, you can be diagnosed with AIDS?
Fiala: That's correct. According to the WHO, the typical symptoms of TB define AIDS in Africa.
Another problem with the Bangui Definition is malaria. Malaria is the most widespread disease in Africa and tropical countries. It's the leading cause of death in Uganda. It's spread by mosquitoes, so people are reinfected several times a year. A great many people die every year, while the rest develop a relative immunity, even though it's wearing away at them. The symptoms of malaria include fever, weight loss and fatigue. If you have a cough or itching, and you have malaria in Africa, you can be diagnosed with AIDS.
As if this wasn't problematic enough, in some African countries, such as Tanzania, health authorities have decided that a one-criteria diagnosis is all they need. A patient exhibiting just one of the major symptoms - diarrhea, fever or weight loss - can be given an AIDS diagnosis.
This is hardly scientific, and it's very different from what people are told about AIDS in Africa. The idea that there should be a different kind of AIDS for Africans or Europeans or Americans defies the scientific definition of viral infection. A single virus doesn't cause different diseases in different people or in different countries. A viral infection doesn't vary so wildly so as to create pelvic cancer in women, Kaposi's sarcoma in gay men, and tuberculosis in Africans. But this is what we're asked to believe about HIV.
What's the treatment for TB and Malaria?
Fiala: The best treatment is prevention. The most effective way to reduce all of these infectious diseases is to improve the standard of living and hygiene for local residents - to provide safe, clean water; plentiful, healthy food; proper housing and basic medical care. This is exactly how the incidence of TB and other infectious diseases was dramatically reduced in the US and Europe.
The treatment for malaria is well known and simple: treated mosquito nets that protect villages; clean, safe, non-stagnant water; and the inexpensive, highly efficient drugs that effectively fight the disease.
Why don't African Countries have clean water systems?
Fiala: You could've asked that question 100 years ago in the US and Europe. Sewage and water systems rely on economic development. We have these things in the West because we know they're absolutely essential, so we've invested money and energy in them.
Many African nations don't have the money to develop this infrastructure and modernize the villages. The money they have is being re-routed into AIDS. These countries are being pressured by international AIDS organizations to take money out of rural development and put it into AIDS education, condom distribution, abstinence campaigns and toxic AIDS pharmaceuticals.
We're told that there are nearly 30 million African AIDS patients. This is an enormous number of people. How are these cases counted?
Fiala: The United Nations AIDS organization (UNAIDS) and the WHO use various computer modeling programs to come up with their numbers.
Rodney Richards: When you read about the millions of HIV-infected in Africa, you may notice that the word “estimated” precedes the number in the official publications.
What does “estimated” mean?
Richards: All WHO/UNAIDS reports of HIV-infection in Africa are "estimates" based on HIV tests performed on blood samples taken at pregnancy clinics. These global reports are created jointly by the WHO and UNAIDS.
Why is blood taken from pregnancy clinics?
Richards: In countries with little infrastructure, medical care is very limited, and is generally reserved for the most vulnerable segment of the population, such as infants and pregnant women. Even in the poorest countries, there are pregnancy clinics serving expectant mothers and women who've just given birth.
Pregnant women regularly line up at these clinics for a check-up that includes a blood screening for syphilis. Syphilis infection is common in many African countries, and must be treated before a baby's birth, or the child could die or be severely damaged.
Once a year, UNAIDS researchers collect leftover blood samples from these clinics, and test them with a single HIV-antibody test called the Elisa. The resulting number of HIV-positive results is fed into an epidemiological computer modeling program (Epi-model) at the WHO headquarters in Geneva. The Epi-model program then extrapolates the HIV-positive test results onto the entire population - young and old; men, women and children. When we hear about the number of people infected with HIV, it's this number that's being reported.
How do reported numbers of HIV-infection correspond to actual number of people tested?
Richards: The WHO/UNAIDS tells us that there are currently 30 million HIV-positive Africans, yet less than one in a thousand of these people have ever been tested. In South Africa, the WHO/UNAIDS reports 5 million people are infected with HIV, but this number is based on only 4,000 actual HIV-positive test results from pregnant women.
But even these positive test results are hardly indicative of HIV-infection. The HIV-antibody tests used in these surveys are known to come up positive based on cross-reactions with antibodies produced from malaria, TB and parasitic infection - all common conditions in Africa. The test manufacturers themselves warn that pregnancy is a known cause of false positives.
Fiala: Testing pregnant women for HIV-infection is a self-fulfilling prophecy, but pregnant women are the only people regularly tested for HIV-infection in sub-Saharan Africa.
We're told that 28 million people worldwide and 22 million Africans have died of AIDS. How are AIDS deaths counted in Africa?
Richards: AIDS deaths are also estimates. The number of deaths is projected from the Epi-model estimate of HIV-infections. It is assumed that if a certain number of people are HIV-infected, then a certain number will die of AIDS. This assumption is based on what researchers know historically about disease progression in AIDS patients, primarily from studies done on HIV-positive IV drug abusers and male homosexuals in the US and Europe.
Are these numbers accurate?
Richards: No, the numbers have been greatly inflated. For example, the WHO/UNAIDS says that there has been 2.2 million AIDS deaths in Uganda so far, but the Ugandan Ministry of Health records a cumulative total of only 56,000 AIDS deaths since the beginning of the epidemic. The WHO's report is 33 times higher than the actual number of recorded, verified deaths.
As of the end of 2001, official government bodies in the developing world have managed to account for only 7 percent of the cumulative AIDS deaths that the WHO/UNAIDS claim have occurred. The Russian Federation can only account for only 3 percent of the UNAIDS estimate of AIDS deaths. India has 2 percent of the UNAIDS estimate. China has only 1 percent.
If I understand correctly, the number of people we're told have HIV and AIDS in Africa is actually an inaccurate computer extrapolation based on test results from non-specific, cross-reacting antibody tests given to pregnant women?
Fiala: That's correct.
And the number of AIDS deaths in Africa is a projection based on the previous estimation, and is also greatly inflated?
Richards: That is also correct.
What does an AIDS diagnosis mean for an African with TB or malaria?
Fiala: In many African clinics, basic medical supplies like antibiotics are extremely limited. A clinic may only have 10 bottles of antibiotics. AIDS patients are frequently refused antibiotic treatment, because it's assumed that they'll die, no matter what. Western doctors have made it clear that AIDS is a fatal disease. Helping them is considered a waste of scarce resources.
What's the main AIDS organization in Uganda?
Fiala: TASO - The AIDS Support Organisation. They claim to be independent, but they're heavily funded by the pharmaceutical industry. They're currently constructing buildings to prepare the ground for massive HIV testing, with this non-specific, cross-reacting test, and to distribute toxic AIDS drugs.
In Africa, 50 percent of the population has no access to clean drinking water and the vast majority lack even basic medical care. And the response from multimillion dollar AIDS organization is to promote HIV testing, give out condoms and to implement treatment with deadly AIDS drugs. These drugs are similar or identical to chemotherapy drugs used in cancer treatment. They work by stopping cell growth. They kill your body from the inside out.
Which AIDS drugs are being used in Africa?
Fiala: Boehringer, a pharmaceutical company, has been doing studies in Uganda with a drug called Nevirapine. The FDA refused approval of Nevirapine in the US for so-called mother to child transmission because it's ineffective and has deadly side effects, but this is exactly how the drug is being used in Africa - on pregnant women and unborn children.
In one drug trial, 17 percent of patients taking Nevirapine developed liver problems. A US health care worker taking Nevirapine had to have a liver transplant to save his life as a result of drug toxicity. Five women in South Africa died and dozens developed severe liver problems in a combination AIDS drug trial that included Nevirapine.
The manufacturer's warning label for Nevirapine itself states that patients taking the drug have experienced: “Severe, life-threatening and in some cases fatal hepatotoxicity [liver damage],” and “severe, life-threatening skin reactions, including fatal cases.”
These are the most toxic drugs known to medicine, and they're being applied to the most vulnerable part of the population - pregnant mothers, unborn children and newborns - all based on a faulty test, or no test at all, while their actual food, shelter and water needs continue to be ignored.
What would actually help Africans is infrastructure development: proper sanitation, safe water, basic medical care and plentiful, nutritive food. This is simple, clear and logical. What's astounding is that the UN is recommending just the opposite.
In 1999 the UNAIDS commission gave its official recommendations to a meeting of finance ministers representing various African countries. The UN's exact recommendations to African nations: to redirect billions of dollars from health, infrastructure and rural development into AIDS - condoms, safe sex lectures and deadly pharmaceuticals. This is not what these already suffering people need to be healthy and successful. This is exactly how to propagate death, disease and poverty.
If the AIDS story in Africa feels like a parody of a bureaucratic blunder, take note: In April of this year, the US Centers for Disease Control (CDC) announced a new HIV testing strategy for the United States. Rather than relying on voluntary HIV-testing, federal officials are urging the testing of all pregnant women in the US, and are implementing measures to make HIV-testing a routine part of hospital visits. The CDC is promoting a rapid HIV-test for use in all federally funded clinics, as well as homeless shelters, prisons and substance abuse treatment centers.
The HIV-antibody tests are known to cross-react with antibodies produced during pregnancy, drug abuse and nearly 70 other common conditions, and no HIV test is FDA approved to diagnose HIV infection. The standard medical treatment for HIV infection is a combination of the most toxic drugs ever manufactured.
“The AIDS Debate” series has explored the scientific and sociological process that formed HIV theory, and the ramifications of a speculative theory enforced upon a trusting, uninformed public.
We must ask ourselves, are we doing the best we can for sick people? Is the best we can offer impoverished Africans AZT and Nevirapine? Is the best we can do for drug-addicted mothers is force more drugs into their system? And what about people unlucky enough to register HIV positive on these scientifically unvalidated tests. Do they deserve to be told that they have a fatal illness?
“As to diseases, make a habit of two things-to help, or at least to do no harm."
As for human beings, one thing's for sure. We can always do better.