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Africa AIDS testing problems/Bangui
By the way, there is interesting work in the infectability of
HIV.
At every turn, it is proven that transmission from female to
male
is much more difficult than transmission from male to female.
This puts some serious doubts on the possibility of a
heterosexual
epidemic which needs free, 50/50, equal opportunity of men
and women. Which is why there has never been a heterosexual
epidemic in Europe or America, and why it is highly doubtful
there is a heterosexual epidemic in Africa.
A researcher who still believes in the reliability of the
tests,
but who seriously doubts the heterosexual mode of
transmission, is dr. David Gisselquist ( david_gisselquist@yahoo.com
).
He has succeeded in having his theory heard (and crassly
dismissed)
by the WHO/UNAIDS and he could tell you something about the
lack
of openness to new ideas in that institution.
http://www.who.int/mediacentre/statements/2003/statement5/en/
There is also a lot of interesting material published on the
subject of infectivity by dr. Nancy Padian:
Padian, N. and Pickering, J., "Female-to-male
transmission of
AIDS: a re-examination of the African sex ratio of
cases",
JAMA 256:590
Padian, N.S., Shiboski, S.C., Glass, S.O., Vittinghoff, E.
(1997), "Heterosexual transmission of human
immunodeficiency virus
(HIV) in northern California: Results from a ten-year
study", Am. J.
Epidemiol. 146:350-357.
Another person, who is a non-believer in the entire HIV/AIDS
paradigm, is Christine Maggiore.
She was "diagnosed" hiv positive 12 years ago, but
has ignored
her classification and went on to have two children and is
still
alive and apparently healthy today.
Her website is at: http://www.aliveandwell.org/
She has an
e-mail list as well.
Cheers and a happy new year,
Alex
From her e-mail list:
From: "Christine Maggiore" <christine@aliveandwell.org>
Subject: AIDS in Africa: Apocalpse When?
Date: maandag 15 december 2003 22:12
What the Media Missed on World AIDS Day
Out of South Africa comes another stunning report from
journalist Rian
Malan, author of the ground-breaking Rolling Stone article
"AIDS in Africa:
A Search for Truth."
Malan meticulously dismantles the apocalyptic predictions for
AIDS on the
continent, presenting widely ignored facts that offer a
striking contrast to
just about everything we heard on World AIDS Day.
A brilliant work brimming with integrity and courage, I
encourage you to
share this widely.
With best wishes for the holidays,
Christine
PS Look for local event news coming next...
===
The Spectator (London)
December 14, 2003
http://www.spectator.co.uk/article.php3?table=old
<http://www.spectator.co.uk/article.php3?table=old§ion=current&issue=200
3-12-13&id=3830>
§ion=current&issue=2003-12-13&id=3830
COVER STORY
Africa Isn¹t Dying of Aids
The headline figures are horrible: almost 30 million Africans
have
HIV/Aids. But, says Rian Malan, the figures are
computer-generated
estimates and they appear grotesquely exaggerated when set
against
population statistics
Cape Town
It was the eve of Aids Day here. Rock stars like Bono and Bob
Geldof
were jetting in for a fundraising concert with Nelson Mandela,
and the
airwaves were full of dark talk about megadeath and the armies
of feral
orphans who would surely ransack South Africa¹s cities in
2017 unless
funds were made available to take care of them. My neighbour
came up
the garden path with a press cutting. ŒRead this,¹ said
Capt. David
Price, ex-Royal Air Force flyboy. ŒBloody awful.¹
It was an article from The Spectator describing the bizarre
sex
practices that contribute to HIV¹s rampage across the
continent. ŒOne
in five of us here in Zambia is HIV positive,¹ said the
report. ŒIn
1993 our neighbour Botswana had an estimated population of 1.4
million.
Today that figure is under a million and heading downwards.
Doom
merchants predict that Botswana may soon become the first
nation in
modern times literally to die out. This is Aids in Africa.¹
Really? Botswana has just concluded a census that shows
population
growing at about 2.7 per cent a year, in spite of what is
usually
described as the worst Aids problem on the planet. Total
population has
risen to 1.7 million in just a decade. If anything, Botswana
is
experiencing a minor population explosion.
There is similar bad news for the doomsayers in Tanzania¹s
new census,
which shows population growing at 2.9 per cent a year.
Professional
pessimists will be particularly discomforted by developments
in the
swamplands west of Lake Victoria, where HIV first emerged, and
where
the depopulated villages of popular mythology are supposedly
located.
Here, in the district of Kagera, population grew at 2.7 per
cent a year
before 1988, only to accelerate to 3.1 per cent even as the
Aids
epidemic was supposedly peaking. Uganda¹s latest census tells
a broadly
similar story, as does South Africa¹s.
Some might think it good news that the impact of Aids is less
devastating than most laymen imagine, but they are wrong. In
Africa,
the only good news about Aids is bad news, and anyone who
tells you
otherwise is branded a moral leper, bent on sowing confusion
and
derailing 100,000 worthy fundraising drives. I know this,
because
several years ago I acquired what was generally regarded as a
leprous
obsession with the dumbfounding Aids numbers in my daily
papers. They
told me that Aids had claimed 250,000 South African lives in
1999, and
I kept saying, this can¹t possibly be true. What followed was
very ugly
‹ ruined dinner parties, broken friendships, ridicule from
those who
knew better, bitter fights with my wife. After a year or so,
she put
her foot down. Choose, she said. Aids or me. So I dropped the
subject,
put my papers in the garage, and kept my mouth shut.
As I write, madam is standing behind me with hands on hips,
hugely
irked by this reversion to bad habits. But looking around, it
seems to
me that Aids fever is nearing the danger level, and that some
calming
thoughts are called for. Bear with me while I explain.
We all know, thanks to Mark Twain, that statistics are often
the lowest
form of lie, but when it comes to HIV/Aids, we suspend all
scepticism.
Why? Aids is the most political disease ever. We have been
fighting
about it since the day it was identified. The key battleground
is
public perception, and the most deadly weapon is the estimate.
When the
virus first emerged, I was living in America, where HIV
incidence was
estimated to be doubling every year or so. Every time I turned
on the
TV, Madonna popped up to warn me that ŒAids is an
equal-opportunity
killer¹, poised to break out of the drug and gay subcultures
and
slaughter heterosexuals. In 1985, a science journal estimated
that 1.7
million Americans were already infected, with Œthree to five
million¹
soon likely to follow suit. Oprah Winfrey told the nation that
by 1990
Œone in five heterosexuals will be dead of Aids¹.
We now know that these estimates were vastly and indeed
deliberately
exaggerated, but they achieved the desired end: Aids was
catapulted to
the top of the West¹s spending agenda, and the estimators
turned their
attention elsewhere. India¹s epidemic was likened to Œa
volcano waiting
to explode¹. Africa faced Œa tidal wave of death¹. By 1992
they were
estimating that ŒAids could clear the whole planet¹.
Who were they, these estimators? For the most part, they
worked in
Geneva for WHO or UNAIDS, using a computer simulator called
Epimodel.
Every year, all over Africa, blood would be taken from a small
sample
of pregnant women and screened for signs of HIV infection. The
results
would be programmed into Epimodel, which transmuted them into
estimates. If so many women were infected, it followed that a
similar
proportion of their husbands and lovers must be infected, too.
These
numbers would be extrapolated out into the general population,
enabling
the computer modellers to arrive at seemingly precise tallies
of the
doomed, the dying and the orphans left behind.
Because Africa is disorganised and, in some parts, unknowable,
we had
little choice other than to accept these projections. (ŒWe¹
always
expect the worst of Africa anyway.) Reporting on Aids in
Africa became
a quest for anecdotes to support Geneva¹s estimates, and the
estimates
grew ever more terrible: 9.6 million cumulative Aids deaths by
1997,
rising to 17 million three years later.
Or so we were told. When I visited the worst affected parts of
Tanzania
and Uganda in 2001, I was overwhelmed with stories about the
horrors of
what locals called ŒSlims¹, but statistical corroboration
was hard to
come by. According to government census bureaux, death rates
in these
areas had been in decline since the second world war. Aids-era
mortality studies yielded some of the lowest overall death
rates ever
measured. Populations seemed to have exploded even as the
epidemic was
peaking.
Ask Aids experts about this, and they say, this is Africa,
chaos
reigns, the historical data is too uncertain to make valid
comparisons.
But these same experts will tell you that South Africa is
vastly
different: ŒThe only country in sub-Saharan Africa where
sufficient
deaths are routinely registered to attempt to produce national
estimates of mortality,¹ says Professor Ian Timaeus of the
London
School of Hygiene and Tropical Medicine. According to Timaeus,
upwards
of 80 per cent of deaths are registered here, which makes us
unique:
the only corner of Africa where it is possible to judge
computer-generated Aids estimates against objective reality.
In the year 2000, Timaeus joined a team of South African
researchers
bent on eliminating all doubts about the magnitude of Aids¹
impact on
South African mortality. Sponsored by the Medical Research
Council, the
team¹s mission was to validate (for the first time ever) the
output of
Aids computer models against actual death registration in an
African
setting. Towards this end, the MRC team was granted privileged
access
to death reports as they streamed into Pretoria. The first
results
became available in 2001, and they ran thus: 339,000 adult
deaths in
1998, 375,000 in 1999 and 410,000 in 2000.
This was grimly consistent with predictions of rising
mortality, but
the scale was problematic. Epimodel estimated 250,000 Aids
deaths in
1999, but there were only 375,000 adult deaths in total that
year ‹ far
too few to accommodate the UN¹s claims on behalf of the HIV
virus. In
short, Epimodel had failed its reality check. It was quietly
shelved in
favour of a more sophisticated local model, ASSA 600, which
yielded a
Œmore realistic¹ death toll from Aids of 143,000 for the
calendar year
1999.
At this level, Aids deaths were about 40 per cent of the total
‹ still
a bit high, considering there were only 232,000 deaths left to
distribute among all other causes. The MRC team solved the
problem by
stating that deaths from ordinary disease had declined at the
cumulatively massive rate of nearly 3 per cent per annum since
1985.
This seemed very odd. How could deaths decrease in the face of
new
cholera and malaria epidemics, mounting poverty, the
widespread
emergence of drug-resistant killer microbes, and a state
health system
reported to be in Œterminal decline¹?
But anyway, these researchers were experts, and their
tinkering
achieved the desired end: modelled Aids deaths and real deaths
were
reconciled, the books balanced, truth revealed. The fruit of
the MRC¹s
ground-breaking labour was published in June 2001, and my hash
appeared
to have been settled. To be sure, I carped about curious
adjustments
and overall magnitude, but fell silent in the face of graphs
showing
huge changes in the pattern of death, with more and more
people dying
at sexually active ages. ŒHow can you argue with this?¹
cried my wife,
eyes flashing angrily. I couldn¹t. I put my Aids papers in
the garage
and ate my hat.
But I couldn¹t help sneaking the odd look at science websites
to see
how the drama was developing. Towards the end of 2001, the
vaunted ASSA
600 model was replaced by ASSA 2000, which produced estimates
even
lower than its predecessor: for the calendar year 1999, only
92,000
Aids deaths in total. This was just more than a third of the
original
UN figure, but no matter; the boffins claimed ASSA 2000 was so
accurate
that further reference to actual death reports Œwill be of
limited
usefulness¹. A bit eerie, I thought, being told that virtual
reality
was about to render the real thing superfluous, but if these
experts
said the new model was infallible, it surely was infallible.
Only it wasn¹t. Last December ASSA 2000 was retired, too. A
note on the
MRC website explained that modelling was an inexact science,
and that
Œthe number of people dying of Aids has only now started to
increase¹.
Furthermore, said the MRC, there was a new model in the works,
one that
would Œprobably¹ produce estimates Œabout 10 per cent lower¹
than those
presently on the table. The exercise was not strictly valid,
but I
persuaded my scientist pal Rodney Richards to run the revised
data on
his own simulator and see what he came up with for 1999. The
answer,
very crudely, was an Aids death toll somewhere around 65,000
‹ a far
cry indeed from the 250,000 initially put forth by UNAIDS.
The wife has just read this, and she is not impressed. ŒIt¹s
obscene,¹
she says. ŒYou¹re treating this as if it¹s just a computer
game. People
are dying out there.¹
Well, yes. I concede that. People are dying, but this doesn¹t
spare us
from the fact that Aids in Africa is indeed something of a
computer
game. When you read that 29.4 million Africans are Œliving
with
HIV/Aids¹, it doesn¹t mean that millions of living people
have been
tested. It means that modellers assume that 29.4 million
Africans are
linked via enormously complicated mathematical and sexual
networks to
one of those women who tested HIV positive in those annual
pregnancy-clinic surveys. Modellers are the first to admit
that this
exercise is subject to uncertainties and large margins of
error. Larger
than expected, in some cases.
A year or so back, modellers produced estimates that portrayed
South
African universities as crucibles of rampant HIV infection,
with one in
four undergraduates doomed to die within ten years. Prevalence
shifted
according to racial composition and region, with Kwazulu-Natal
institutions worst affected and Rand Afrikaans University
(still 70 per
cent white) coming in at 9.5 per cent. Real-life tests on a
random
sample of 1,188 RAU students rendered a startlingly different
conclusion: on-campus prevalence was 1.1 per cent, barely a
ninth of
the modelled figure. ŒDoubt is cast on present estimates,¹
said the RAU
report, Œand further research is strongly advocated.¹
A similar anomaly emerged when South Africa¹s major banks ran
HIV tests
on 29,000 staff earlier this year. A modelling exercise put
HIV
prevalence as high as 12 per cent; real-life tests produced a
figure
closer to 3 per cent. Elsewhere, actuaries are scratching
their heads
over a puzzling lack of interest in programs set up by
medical-insurance companies to handle an anticipated flood of
middle-class HIV cases. Old Mutual, the insurance giant,
estimates that
as many as 570,000 people are eligible, but only 22,500 have
thus far
signed up.
In Grahamstown, district surgeon Dr Stuart Dyer is
contemplating an
equally perplexing dearth of HIV cases in the local jail. ŒSexually
transmitted diseases are common in the prison where I work,¹
he wrote
to the Lancet, Œand all prisoners who have any such disease
are tested
for HIV. Prisoners with any other illnesses that do not
resolve rapidly
(within one to two weeks) are also tested for HIV. As a
result, a large
number of HIV tests are done every week. This prison, which
holds 550
inmates and is always full or overfull, has an HIV infection
rate of 2
to 4 per cent and has had only two deaths from Aids in the
seven years
I have been working there.¹ Dyer goes on to express a dim
view of
statistics that give the impression that Œthe whole of South
Africa
will be depopulated within 24 months¹, and concludes by
stating, ŒHIV
infection in SA prisons is currently 2.3 per cent.¹ According
to the
newspapers, it should be closer to 60 per cent.
On the face of it, these developments suggest that miracles
are
happening in South Africa, unreported by anyone save a brave
little
magazine called Noseweek. If the anomalies described above are
typical,
computer models are seriously overstating HIV prevalence. A
similar
picture emerges on the national level, where our estimated
annual Aids
death toll has halved since we eased UNAIDS out of the
picture, with
further reductions likely when the new MRC model appears.
Could the
same thing be happening in the rest of Africa?
Most estimates for countries north of the Limpopo are issued
by UNAIDS,
using methods similar to those discredited here in South
Africa.
According to Paul Bennell, a health- policy analyst associated
with
Sussex University¹s Institute for Development Studies, there
is an
Œextraordinary¹ lack of evidence from other sources. ŒMost
countries do
not even collect data on deaths,¹ he writes. ŒThere is
virtually no
population-based survey data in most high-prevalence
countries.¹
Bennell was able, however, to gather information about Africa¹s
schoolteachers, usually described as a high-risk HIV group on
account
of their steady income, which enables them to drink and party
more than
others. Last year the World Bank claimed that Aids was killing
Africa¹s
teachers Œfaster than they can be replaced¹. The BBC
reported that Œone
in seven¹ Malawian teachers would die in 2002 alone.
Bennell looked at the available evidence and found actual
teacher
mortality to be Œmuch lower than expected¹. In Malawi, for
instance,
the all-causes death rate among schoolteachers was under 3 per
cent,
not over 14 per cent. In Botswana, it was about three times
lower than
computer-generated estimates. In Zimbabwe, it was four times
lower.
Bennell believes that Aids continues to present a serious
threat to
educators, but concludes that Œoverall impact will not be as
catastrophic as suggested¹. What¹s more, teacher deaths
appear to be
declining in six of the eight countries he has studied
closely. ŒThis
is quite unexpected,¹ he remarks, Œand suggests that, in
terms of
teacher deaths, the worst may be over.¹
In the past year or so, similar mutterings have been heard
throughout
southern Africa ‹ the epidemic is levelling off or even
declining in
the worst-affected countries. UNAIDS has been at great pains
to rebut
such ideas, describing them as Œdangerous myths¹, even
though the data
on UNAIDS¹ own website shows they are nothing of the sort. ŒThe
epidemic is not growing in most countries,¹ insists Bennell.
ŒHIV
prevalence is not increasing as is usually stated or implied.¹
Bennell raises an interesting point here. Why would UNAIDS and
its
massive alliance of pharmaceutical companies, NGOs, scientists
and
charities insist that the epidemic is worsening if it isn¹t?
A possible
explanation comes from New York physician Joe Sonnabend, one
of the
pioneers of Aids research. Sonnabend was working in a New York
clap
clinic when the syndrome first appeared, and went on to found
the
American Foundation for Aids Research, only to quit in protest
when
colleagues started exaggerating the threat of a generalised
pandemic
with a view to increasing Aids¹ visibility and adding urgency
to their
grant applications. The Aids establishment, says Sonnabend, is
extremely skilled at Œthe manipulation of fear for
advancement in terms
of money and power¹.
With such thoughts in the back of my mind, South Africa¹s
Aids Day
Œcelebrations¹ cast me into a deeply leprous mood. Please
don¹t get me
wrong here. I believe that Aids is a real problem in Africa.
Governments and sober medical professionals should be heeded
when they
express deep concerns about it. But there are breeds of Aids
activist
and Aids journalist who sound hysterical to me. On Aids Day,
they came
forth like loonies drawn by a full moon, chanting that Aids
was getting
worse and worse, Œspinning out of control¹, crippling
economies,
causing famines, killing millions, contributing to the
oppression of
women, and Œundermining democracy¹ by sapping the will of
the poor to
resist dictators.
To hear them talk, Aids is the only problem in Africa, and the
only
solution is to continue the agitprop until free access to Aids
drugs is
defined as a Œbasic human right¹ for everyone. They are
saying, in
effect, that because Mr Mhlangu of rural Zambia has a disease
they find
more compelling than any other, someone must spend upwards of
$400 a
year to provide Mr Mhlangu with life-extending Aids medication
‹ a
noble idea, on its face, but completely demented when you
consider that
Mr Mhlangu¹s neighbours are likely to be dying in much larger
numbers
of diseases that could be cured for a few cents if medicines
were only
available. About 350 million Africans ‹ nearly half the
population ‹
get malaria every year, but malaria medication is not a basic
human
right. Two million get TB, but last time I checked, spending
on Aids
research exceeded spending on TB by a crushing factor of 90 to
one. As
for pneumonia, cancer, dysentery or diabetes, let them take
aspirin, or
grub in the bush for medicinal herbs.
I think it is time to start questioning some of the claims
made by the
Aids lobby. Their certainties are so fanatical, the powers
they claim
so far-reaching. Their authority is ultimately derived from
computer-generated estimates, which they wield like weapons,
overwhelming any resistance with dumbfounding atom bombs of
hypothetical human misery. Give them their head, and they will
commandeer all resources to fight just one disease. Who knows,
they may
defeat Aids, but what if we wake up five years hence to
discover that
the problem has been blown up out of all proportion by unsound
estimates, causing upwards of $20 billion to be wasted?
--
Christine Maggiore, Founder/Director
Alive & Well AIDS Alternatives
<http://www.aliveandwell.org>
http://www.aliveandwell.org
11684 Ventura Boulevard Studio City, CA 91604 USA
Tel 818/780-1875 National Toll-free 877/411-AIDS Fax
818/780-7093
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