From the Archives

Drugs, Lies, and Statistics

(Blocked from publication in Rethinking AIDS, 1993)

by Bryan Ellison

[Editor’s note, 2005: This article is being published for the very first time now, on ATTAC Report. It was censored in 1993 on the objection of Dr. Harvey Bialy, an advisor at the time to the publication Rethinking AIDS. He, and apparently other advisors, could not find anything inaccurate about this article, but they did not want to offend the scientific establishment with such a bold exposé. Professor Phillip Johnson was also likely involved in suppressing this article; his role in sabotaging the scientific protest against the War on AIDS is told in another article now available on ATTAC Report.]
 

Where Donald Francis leads, people follow. A longtime retrovirologist with the Centers for Disease Control (CDC), Francis is the individual who first insisted that a retrovirus must cause AIDS, and who recruited Robert Gallo to find one. Widely known for his aggressive style in pushing the War on AIDS, he brazenly illustrated the CDC’s reckless public health attitudes in a January, 1992 speech that was excerpted the following September in the Journal of the American Medical Association:

Following a more enlightened model for drug treatment, including prescribing heroin, would have dramatic effects on HIV and could eliminate many of the dangerous illegal activities surrounding drugs. In addition to treatment, safe injection must be stressed both for those in treatment programs and those out of treatment. [emphasis added]

This belief, that drugs at any concentration are safe but a dormant virus will kill you, permeates the thinking at the major medical journals. Nature, for example, published last March [1993] a Commentary by Michael Ascher et al. claiming to find no effect whatsoever of drugs on development of AIDS, versus a whopping effect of antibodies against HIV.1 The piece was based on an epidemiological study of over 1,000 men living in the center of San Francisco. Unlike a formal scientific paper, the Commentary contained no methods section describing its data-gathering or statistical techniques, nor did it completely represent its own data. Instead it presented sweeping conclusions and an attractive graph (on a blue background, no less!) to a naive audience.

Peter Duesberg attempted to respond, pointing out several profound flaws of logic in the Commentary. His letter was rejected from publication. But in the May 13 issue of Nature, its editor, John Maddox, somehow felt compelled to comment on the unpublished letter. “Has Duesberg a right of reply?”, asked Maddox in the title. His answer required over 1,000 words of self-justification — a most emphatic ‘No.’ What then Duesberg? “He should stop,” demanded Maddox.

But the Commentary’s own presentation did contain several obvious and fatal flaws. Months before its publication, the authors, who are based in Berkeley, California, presented the data in an earlier form to Duesberg. We noticed the defects, and I specifically mentioned them to three of the four Commentary authors. When I suggested to Warren Winkelstein, the epidemiologist and senior author, that he should address these problems before publishing, he turned to me blankly and declared, “The evidence for HIV is overwhelming.” A statistician present at the conversation challenged Winkelstein immediately, asking if he was avoiding my criticisms because it would require too much work.

The Commentary that finally appeared had not addressed a single concern, and had even used my comments to hide the flaws more cleverly:

  • Ascher et al. used the CDC’s circular definition of AIDS, which diagnoses the syndrome on the basis of defining diseases only if the patient has antibodies against HIV, or under the presumption of hidden infection. Thus purely by artificial definition, AIDS can only occur in the presence of HIV. The Commentary reported a perfectly clean “zero” AIDS cases among men uninfected by HIV. But to wiggle out of the charge of circularity, the authors claimed that “AIDS cases were diagnosed by the clinical criteria defined by the Centers for Disease Control (CDC), which are irrespective of HIV infection status.” As we have since verified, this is not true.
  • The Commentary not only listed all AIDS cases as occurring among the HIV positives, but also showed that group as losing its T cells over an eight-year period. The uninfected men, in contrast, maintained steady levels of T cells. When I previously asked Ascher whether the infected men might have used more drugs, he readily admitted they must have, which is the reason they caught HIV in the first place. Recreational drug use is, unsurprisingly, associated with needle sharing and promiscuous sexual activity. But Ascher et al. not only failed to describe the difference in drug use between HIV positives and negatives, they even disguised it. Heterosexuals, all but one who were uninfected, supposedly used drugs (except nitrites) as often as did the homosexuals, half of whom had HIV. The authors barely mentioned they had only looked at four drugs, and only at entry into the study.
  • The drug-AIDS hypothesis is analogous to the cigarette-lung cancer hypothesis or the alcohol-liver cirrhosis hypothesis. That is, the risk of disease increases with the total lifetime exposure to the substance in question; in each case, statistical effects can only be seen after years or even decades of drug consumption. Yet all throughout the Commentary, Ascher et al. classify the men in the study into high-, low-, and zero-drug groups only according to the men’s self-reported use of four drugs immediately before the study began. The authors try to imply otherwise, stating that “We examined the cohort at 6-monthly intervals for 96 months, and obtained drug-use data and determined HIV serostatus at each examination.” All true. But other than the data on marijuana, nitrites, cocaine, and amphetamines for the two years preceding the beginning of the study, no other drug data was used in the Ascher et al. analysis. They even avoided using their own data on heroin, ethyl chloride, hallucinogens, and other drugs. Moreover, the Commentary never commented on the problem of unverified answers regarding use of psychoactive and illicit substances.

If Ascher et al. do not want to check their database to answer these criticisms, someone else should. Allen Downey (a UC Berkeley graduate student in Computer Science) and I are currently submitting a paper to Nature that does exactly that. Our analysis, which cannot be released until official publication, uncovers some startling results from the same database of the San Francisco Men’s Health Study. We are invoking Maddox’s recent editorial promise that “When he [Duesberg] offers a text for publication that can be authenticated, it will if possible be published — not least in the hope and expectation that his next offering will be an admission of error.” We will, however, have to disappoint Maddox in his “hope and expectation.”

Let us hope Maddox is finally willing to permit honest and open debate with our offering of original data for publication.
 

[Editor’s note, 2005: Our scientific study that re-examined the Ascher et al. study discovered (1) at least 45 cases of uninfected, HIV-negative men with AIDS diseases; (2) heavy drug use among those men identified in the Ascher et al. study as having “no drug use”; (3) heavier drug use among HIV-positive men than amongst HIV-negative ones, showing that the HIV virus was not associated with AIDS; and (4) serious gaps in the study’s database, making it useless for any other conclusions. In short, our new study devastatingly refuted the Ascher et al. study.

John Maddox, editor of Nature, was clearly caught off guard by our paper, and he ultimately rejected it from publication — without explanation and in direct violation of his earlier promise. Our study was later published in the prestigious scientific journal Genetica in January of 1995.2 To our knowledge, no answer has ever been made against our paper in the years since then.]

References

1. Ascher, MS, Sheppard, HW, Winkelstein, J, & Vittinghoff, E, “Does drug use cause AIDS?,” Nature 362:103-4 (March 1993).

2. Ellison, BJ, Downey, AB, & Duesberg, PH, “HIV as a surrogate marker for drug use: a re-analysis of the San Francisco Men’s Health Study,” Genetica 95:165-171 (Jan. 1995).