Duesberg's Dismal Failure

(And why we should perhaps, just perhaps, be grateful for him!)

Introduction

Many ordinary people seem confused about AIDS. On the one hand, we have the vast majority of the scientific community apparently quite happy with statements such as "HIV causes AIDS"; on the other, "dissident scientists", among them several Nobel prizewinners, come up with statements such as that attributed to the famous Kary Mullis, featured prominently on the virusmyth.com website:
"If there is evidence that HIV causes AIDS, there should be scientific documents which either singly or collectively demonstrate that fact, at least with a high probability. There is no such document."

Things have become so confused, that the President of South Africa, Thabo Mbeki, has publicly supported the dissident viewpoint, and even spent over two million SA Rands (and over a year) encouraging the two sides to battle it out (with no conclusion in sight). Vituperative comments have proliferated, like the following (Also taken from the virusmyth website):

"The advertising drums are beaten hard all over the world today. The same doctors are calling for obedient candidates for their experiments and holding out the same promise of a cure who have poisoned countless AIDS patients by administering the DNA blocker AZT for the past ten years in an attempt to hunt down the phantom HI virus"
['Aids : Death by Prescription' - Kremer H. et al.]

Now it's easy to knock high-profile figures like Nobel prizewinners. One can point out that McLeod received a Nobel prize for lending someone his laboratory for the summer (Banting and Best discovered insulin, Banting and McLeod were awarded the Nobel prize). Nobel prizes have even been awarded for "discoveries" that turned out to be drivel. It's also easy to make assertions such as "Well he may be a Nobel prizewinner, but that doesn't mean he knows squat about virology". I think that this sort of assertion misses the point completely, and is probably highly inappropriate in the case of figures such as Mullis and Duesberg, who seem to be really bright people, at least formerly at the cutting edge of their disciplines.

I think the problem is one of a clash of philosophies , and that clash is highlighted by the statement of Mullis' quoted above! Let's say it up front:
In my opinion the "virusmyth" scientists are confused by an obsolete and outmoded philosophy!

"Hang on a second," you say, "what has proof of disease causation by a (putative) virus got to do with philosophy?" As it turns out, everything. The "HIV myth" problem has as much to do with philosophy, as the death of tens of millions of Russians and Chinese (under the despotic rule of Stalin and Mao respectively) had to do with the defective philosophy of Karl Marx. It's just that the problem that Duesberg & Co. are unsuccessfully grappling with goes back far further - to Francis Bacon, and probably further still. One could even speculate that inaction caused by the erroneous "virusmyth" philosophy may itself ultimately result in the death of millions!

A Problem of Philosophy

Consider Mullis' statement again:

"If there is evidence that HIV causes AIDS, there should be scientific documents which either singly or collectively demonstrate that fact, at least with a high probability. There is no such document."

This statement looks pretty damning, especially coming from someone with the authority of a Nobel prizewinner, himself a biochemist. The reason why Mullis was awarded the Nobel prize is certainly non-trivial. He invented the Polymerase Chain Reaction (PCR), arguably one of the most useful and widely applied biochemical techniques invented in the twentieth century! A convincing statement from a brilliant man, effectively saying that "There is no proof that HIV causes AIDS".

Let's look at his statement a bit more carefully. Implicit in his statement is the assumption that there is an something called "HIV", another recognisable problem "AIDS", and that there is "no proof that HIV causes AIDS". For the time being, we'll accept Mullis' assertion that there is an identifiable entity called "HIV", and indeed something called "AIDS" (We'll look at what his fellow dissidents say about these in more detail later). What we will now focus on is the requirement for proof that HIV causes AIDS .

It seems eminently reasonable to require proof. When we were back in high school, we all spent quite a lot of time proving mathematical theorems. In courts today, people are being found guilty based on evidence that "proves beyond reasonable doubt" that they are indeed guilty. Surely in science we must also have proof of our theories - an accumulated body of evidence that proves "beyond reasonable doubt" (or possibly, as Mullis has put it, "at least with a high probability"), that a scientific theory is true?

To answer this question, let's go back a bit in time, to the time of Sir Isaac Newton. Like Kary Mullis, Newton was a brilliant man. He came up with an absolutely stunning scientific theory, that explained gravity. Newton's theory explained the motion of the sun, planets, asteroids and moons of the solar system with extreme precision - it would seem, down to the last decimal place. One could have said that this magnificent theory was the last word in scientific theories, "proven beyond reasonable doubt". Newton's theory has been used to put spaceships into orbit, and men on the moon. It just happens to turn out that Newton's theory, although useful, is almost certainly wrong . Einstein came up with a theory that disagreed on certain small points, and this theory, general relativity, appears to be a better representation of how our solar system (and universe) really works. The orbit of mercury deviates (ever so slightly) and light from distant stars is bent by the sun, demonstrating that the eminent Sir Isaac Newton's theory is, in fact, wrong.

This sobering refutation of a brilliant theory (after it was accepted for hundreds of years as gospel) forces us to ask the question:

Can a scientific theory ever be proved true?

For the answer, we have to turn to a philosopher called Hume. In about 1740, David Hume came up against a problem now often called the "Problem of Induction". The basic idea behind the problem is this - Can we, knowing what has gone before, ever be sure in our knowledge of what is to come?. Unfortunately for us, it turns out that the answer is "no!". Here is a quote from Hume:

"Let men be once fully perswaded of these two principles, That there is nothing in any object, consider'd in itself, which can afford us a reason for drawing a conclusion beyond it; and, That even after the observation of the frequent or constant conjunction of objects, we have no reason to draw any inference concerning any object beyond those of which we have had experience;.." [1]

"But wait a bit" you cry! "Surely there are lots of things I can predict, knowing what has gone before! The sun set yesterday, and it's sure as shootin' going to set this evening as well."

Think about statements like the above "sun statement". Yes, the chances are extremely good that the sun will set for you this evening, but there are certain provisos! You might fly to the north pole in midsummer, and the sun might not set for an awfully long time. Now it's also always possible to "tighten up" your statement to exclude this sort of conjecture .. "The sun set yesterday, and it's going to set this evening, provided I don't fly to Greenland or the south pole, or take a spaceship into orbit, or get onto a very very fast plane indeed, and provided the sun doesn't go supernova, and provided the earth isn't struck by a gigantic rouge planet, and provided some highly improbable statistical quantum mechanical fluctuation doesn't transport the whole planet somewhere into deep space" and so on, but even with all these caveats, some of them vastly improbable, we can never be entirely sure of our assertion! Hume's problem of induction can never be resolved by just adding in more provided thats , as we cannot ever know whether we've left out a significant condition that could conceivably occur. You can't, just as Newton couldn't anticipate Einstein!

Even the "best" scientific theory may well be toppled tomorrow. No scientific theory, however "good" it looks, is immune from refutation. Anyone who says that their theory is irrefutable, is deluded. We can never prove a scientific theory. Can we then (along with Mullis) assert that we simply require "a high probability" of proof? And if this is the case, how do we go about demonstrating such a "high probabilty"?

Unfortunately, it turns out that this too is not possible! For a demonstration that we simply cannot rely on probability to show that a scientific theorem is likely to be true, we have to turn to another philosopher, Karl Popper. He showed this quite convincingly - as the information content of a scientific theorem increases, so its probability must decrease, for the probability of two assertions taken together must be less than the probability of each on its own, but clearly the information content of two assertions must together be greater than that of each alone (excluding the case where one or both of the assertions are tautologies). Quoting Popper:

".. if our aim is the advancement or growth of knowledge, then a high probability (in the sense of the calculus of probability) cannot possibly be our aim as well: these two aims are incompatible ." [2]

If his arguments don't convince you, or leave you confused, simply think of Sir Isaac again. Any scientist from say, the nineteenth century, asked whether Newton's theory was "true", would almost certainly have answered "yes". All the evidence was there, was it not? The motion of the planets was predicted to within a hairsbreadth by his theory. Observation upon observation upon observation upon observation affirmed the "truthfulness" of his theory.

Yet it turns out that venerable Sir Isaac was wrong! Where would our hypothetical nineteenth century scientist have erred? Simply in believing that multiple observations (however precise and wide-ranging) can confirm the validity of a theory. Hume tells us that, however many observations we make, we cannot be sure that we will in the future never make an observation that refutes our pet theory! And Popper shows us that, the more 'likely' a theory is to be true, the more trivial it is!

At this point, one might well despair. For we now know that we can never prove a scientific theory. And we can never even be reasonably happy that the theory is "probably true". Fortunately, there is no need to despair, or take refuge in mysticism (as some have done). For Karl Popper showed us the way out, and in so doing showed us the true meaning of science, something that appears to have escaped Duesbergs, Mullises, and many other scientists, both "dissidents" and "mainstream". What is science?

Science is the body of assertions that can be disproved!

Popper put it well, saying that "a system is to be considered scientific only if it makes assertions which may clash with observations; and a system is, in fact, tested by attempts to produce such clashes; that is to say, by attempts to refute it". [3]

The consequences of our simple statement above are quite disturbing. Not only does it force us to formulate all scientific assertions in a form that is refutable , but it also implies the need for a certain humility on the part of scientists, even an eagerness to see their pet theories overthrown by newer, better, and less probable theories, with greater information content!

Let's take one final look at Mullis' statement:

"If there is evidence that HIV causes AIDS, there should be scientific documents which either singly or collectively demonstrate that fact, at least with a high probability. There is no such document."

We can now see that, far from being a damning indictment of the "theory that HIV causes AIDS", Mullis' statement reveals his lack of knowledge of the scientific method (post Popper)!

The virusmyth.com website in more detail!

In the light of the above, it's now a good idea to read through some (perhaps even many or most) of the articles on the virusmyth.com website. It's vast, but the same themes are repeated again and again, almost ad nauseam. The major theme appears to be a vigorous and highly emotional attack on the "HIV/AIDS hypothesis". The attack is almost invariably based on "inadequacy of proof" rather than "falsification". Where criticisms are directed at the "HIV/AIDS hypothesis", "refutations" are commonly

  1. irrelevant;
  2. incorrect or illogical;
  3. Emotional statements with minimal or no scientific content.

It's perhaps worthwhile giving just a few examples (you will find many more):

  1. "about 5 percent of AIDS patients tested for HIV seroconversion never display signs of HIV infection"; "..less than 50 percent of all AIDS patients have been tested for seroconversion"; "..Koch's postulates have not been satisfied, nor have chimpanzees infected with HIV displayed any of the typical symptoms of AIDS" [BERNSTEIN 1990 in "rrbdowe.htm", our emphasis] - irrelevant to refutation of any reasonable hypothesis that I can think of!

  2. "The test can be wrong over 50 percent of the time" [DUESBERG 1993 in "bginterview.htm"] Duesberg appears to be disingenuous in this interview, especially as elsewhere on the site he says what we know to be inescapably true, that - "In a population with a low probability of infection, the false-positive rate is high" - ["pdbiotech93.htm"]

  3. ".. cancer is not a consequence of immune deficiency" [the same interview]. This is to the best of my knowledge incorrect. For example, transplant patients on long-term immunosuppression have an increased incidence of several tumours. Immunity seems rather important in the body's surveillance against tumours.

  4. "Almost all (94%) of the Americans who develop AIDS have been subject to abnormal health risks .. This indicates that specific health risks are necessary for AIDS" [ DUESBERG 1992 - Biomed & Pharmacother Vol.46, pp. 3-15, 1992 in "pdbiopharm.htm"; emphasis ours]. What about the 6%? Whatever the truth or falsity of the statement, the logic is appalling!

  5. " The observations that distinct AIDS risk groups have distinct AIDS diseases .. are also hard to reconcile with a common infectious cause" [DUESBERG 1992 Biomed & Pharmacother Vol.46, pp. 3-15, 1992 in "pdbiopharm.htm"] Immune suppression will surely be more likely to result in someone developing active tuberculosis (for example) if the bacillus is already present in the person's body. This I don't find "hard to reconcile". Likewise with other infections (either present already, or transmitted later).

  6. "In a deathly conspiracy of silence, the medical establishment is ignoring powerful evidence that HIV doesn't spread sexually, and it may in fact be harmless .. It is a demon, and we worship it with our terror.. HIV is present to that degree in salvia, breast milk , vaginal fluid - and those are not modes of transmission" ['Fatal Distraction' by C. Farber 1992; in "cffatal.htm", emphasis ours.]

  7. We are informed ["bginterview.htm"] that in the USA (as of 1992) there had been:

    Duesberg tries to use these figures to 'refute' the "HIV/AIDS" hypothesis. But looking at it another way, 1540 / (250 000 - 62 000) = 0.8%. In other words, according to Duesbergs' own figures, over 99% of USA people with AIDS who were tested for HIV were in fact HIV positive. Hardly convincing disproof!

Again, we encourage you to examine the virusmyth.com website in detail, looking for solid "refutation of mainstream hypotheses". I suspect that there may indeed be substantial attempts at refutation hidden somewhere on the site, but unfortunately couldn't find anything that I considered to be of substance. Perhaps it's hidden in among all the clamour for "proof", and the emotive allegations?

Being fair!

It's perhaps unfair to be too hard on the virusmyth "dissidents", before we get our own house in order! I suspect that all too often "mainstream" scientists have failed to provide clear, refutable hypotheses. It is just possible that some mainstream scientists too are "confused by an obsolete and outmoded philosophy"! The reaction of the dissidents may at least in part be attributable to such lack of clarity. Let us, for example, examine the statement "HIV causes AIDS". Is this refutable?

It would seem (at least to me) that the bald assertion "HIV causes AIDS" is not refutable as it stands. The statment can be read several ways, perhaps:

  1. "HIV always causes AIDS"; or
  2. "AIDS is always caused by HIV"; or
  3. "HIV sometimes causes AIDS".

The first statement appears nonsensical - there are several people who are walking around apparently healthy, fifteen or more years after they acquired HIV. The second is, to me, complete nonsense - just the other day I saw a woman in ICU who by any reasonable definition had "Acquired Immune Deficiency Syndrome" - she was critically ill with Pneumocystis carinii pneumonia and severe Candida infection, apparently as a consequence of immune suppressive medication for her renal transplant. Whether one accepts HIV as a cause of AIDS, or not, there are other causes of acquired immunodeficiency. The third statement is so vague as to be useless. For even if the virusmyth scientists could conclusively demonstrate in a group of AIDS patients that HIV was not the cause of the immune deficiency, we could always 'escape' by saying that there are other people out there with AIDS where HIV was indeed the cause. We need to reformulate our assertions about HIV and AIDS to make it easier for Drs Duesberg and Mullis to refute these assertions! In order to do this, we must first look at the problem. We will take an African point of view.

The Problem

One problem was defined over twenty years ago, when it was noticed that certain people were showing evidence of unusual infections (and neoplasms) that were previously considered rare. The question arose "What could tie together such seemingly disparate groups as haemophiliacs, homosexuals, and intravenous drug abusers, who now were all getting these strange infections, and rare tumours?" An immediate parallel is Hepatitis B - so a good first guess is that the cause is an infectious agent, carried in blood and perhaps semen. Repeatable methods now exist (including a Polymerase Chain Reaction based on the work of Mullis), pace Duesberg, for identifying 'HIV' - the Human Immunodeficiency Virus - that is associated with the strange disorders seen in the people mentioned above. We can even characterise different variants (or clades) of the virus, and we are beginning to unravel how the different genes we've identified within HIV work together to allow it to enter cells, promote its replication, and cause disease. We are beginning to understand how different mutations in the HIV genome confer resistance to 'anti-retroviral' agents.

In Africa too, we have a problem. The problem can be rather roughly and empirically characterised by standing in a busy medical intake ward, and looking around. Had you done this in, say, 1984 (when I was an intern), then you would certainly have seen a lot of sick people. Today, you will still see a lot of sick people - the difference is that many of these sick young people look as if they are going to die ! They are emaciated, and extremely ill, and if one follows them through the course of the next few weeks to months, many of them do die, in contrast to the very few who did so in 1984.

Of course, it's easy to say something like "You silly physician. The above is simply subjective nonsense! You can't really expect us to believe that there is a problem based on your notions, and vague memories of nearly twenty years ago." The above was not given as any sort of formal statement of the problem. But impressions also count. For a more formal look at the problem, we can consider the population growth statistics in the Kwa-Zulu Natal province of South Africa, where recently deaths outnumbered births! Or we can look at these gravely ill patients flooding into South African intake wards, and see that they are indeed grossly immune compromised, with oral fungal infections, Pneumocystis carinii pneumonia, Kaposi's sarcoma, and most common of all, infected with overwhelming tuberculosis.

Something has changed. I see a tidal wave of immunodeficiency sweeping across Southern Africa, carrying death and misery with it. This explosion of 'AIDS' seems to have been accepted by most people involved in health care, and indeed most Africans. (Some "dissident scientists" disagree with even this assertion).

How then can we create a "refutable hypothesis" based on the above? (Remember that we are not trying to prove that HIV causes AIDS without a shadow of doubt - for this is not the scientific method). Several possibilities spring to mind, but in view of the severity of the problem, the following assertions would seem to me to be most practical:

'Working Hypotheses'
AIDS can be defined as a syndrome of acquired immunodeficiency characterised by lowered CD4 counts and 'disseminated tuberculosis or unusual opportunistic infections or certain aggressive neoplasms'. (1) Most cases of African AIDS are associated with repeatable serological evidence of 'HIV infection'. (2) Prevention of transmission of 'HIV' (as indicated by repeated negative serology) prevents AIDS. (3) Continued suppression of 'HIV' replication (as indicated by lowered 'viral load' in the blood) constitutes an effective therapy, and is associated with improvement in immune function, and a lower incidence of opportunistic infections.

The statements we have generated are not only richly testable, but rather than simply making a bland assertion (e.g. "HIV causes AIDS"), the statements also contain possible solutions to the problem. This is what we need - not an argument about the ultimately unprovable problem of causation, but effective prevention and treatment of a scourge! Also take note that in our statements, we refer to 'serological evidence' - we leave the argument about the ultimate significance of the serology, and likewise the correlation of viral load with viral particles or whatever, to the nit-pickers. We are concerned with practical tests. We should be happy (within the context of our hypotheses) to look at, say, 'viral load' and not worry about the 'true meaning' of this quantity (provided it helps us in our management)!

Note that we must be careful in examining our hypotheses to:

  1. Not make unwarranted deductions or predictions. It would seem (for example) that several years ago 'scaremongers' from the scientific community predicted an explosion of heterosexual AIDS cases in the first world, based on widespread AIDS and HIV infection in the homosexual community - an unwarranted deduction. Wild and unwarranted predictions weaken the case for any hypothesis;

  2. Stand by logical consequences of a theory, and not attempt to "shore up" a flawed theory by introducing ad hoc hypotheses to explain away well-documented but embarrassing facts. (The temptation is always there)!

I would welcome comments from 'mainstream AIDS scientists' on the worth of the above "working hypotheses".

Testing our Hypotheses

Our "dissident scientists" may well at this point argue that we have "shifted the goalposts". We agree. We have shifted the goalpoasts from the crocodile-infested swamp of Hume's problem of induction, to the relatively solid ground of a Popperian attack on a very real problem. In so doing, we have made it easier for them to refute our hypotheses. If they wish to remain in the swamp, no problem. We'd rather get on with finding solutions to real problems.

How might the virusmyth scientists refute our assertions? Relatively easily. They might show (in properly designed and executed studies):

  1. ".. that a substantial proportion of African AIDS sufferers do not have 'evidence of HIV infection' ". Such refutation would be a severe blow to our hypothesis.

  2. ".. that prevention of 'transmission of HIV', for example perinatal prevention, does not prevents AIDS in children". By demonstrating this, our virusmyth scientists will have a convincing argument, not only against the importance of HIV, but also against perinatal use of anti-retrovirals!

  3. ".. that markers of immune suppression, evidence of opportunistic infections, and mortality rates are not changed in patients who are compliant with state-of-the-art anti-retroviral therapy and have evidence of substantial suppression of 'HIV replication' " (using, for example, Dr Mullis' PCR technology to document suppression of 'viral load' in blood). By demonstrating this, Duesberg et. al. would destroy the rationale for anti-retroviral therapy.

To the best of my knowledge, no such refutations exist. On the contrary, studies that have been done, through their failure to refute our hypotheses, appear to give substance to our "working hypotheses", although, of course, they can never prove them. (I am here tempted to launch into a long analysis of papers relevant to our 'working hypotheses' but feel that this would best be done on a separate web-page, in order not to make this document excessively long).

Alternative hypotheses

It should be clear from the above, that, should one or more of our "working hypotheses" prove to be invalid, we would have to seriously rethink our whole approach to the African AIDS epidemic. In the absence of refutation, we may provisionally accept our hypotheses (as with all science), but let's first have a look at the explanatory hypotheses provided by the virusmyth scientists. What do these competing hypotheses have to offer? Unfortunately, their website provides no one hypothesis - there is simply a vast amount of speculation. Even in the text of the recent Mbeki-sponsored conference, no one explanation is provided. Here are some of the hypotheses proposed:

We note that some of the dissidents seem prepared to accept the existence of HIV and AIDS, and that there is a substantial AIDS problem. Others even dispute these assertions. Those who accept that the 'AIDS epidemic' is a problem, seem to be asserting that the immune suppression is related to no one cause or agent, but a variety of causes, different for each individual or group of individuals. HIV, in the estimation of most (but not all) of those dissidents who believe it exists, is simply a harmless bystander. It must be very difficult for those arguing against the "dissidents", as it would seem impossible to find a consistent viewpoint to argue against! But there is one defining characteristic that I think I can identify, that unifies all of the dissident "explanations of the cause of AIDS". Not one of these explanations is formulated as a falsifiable hypothesis . As such, these so-called hypotheses must be rejected, for they have nothing to do with science!

Conclusion

Arguments against the "HIV theory of AIDS" seem to focus on the requirement for proof that "HIV causes AIDS". We have shown that such a request for 'proof' is an anachronism. The bulk of the virusmyth.com website seems to be devoted to such a futile quest for proof, but the "dissident scientists" have proposed several alternative theories that might "explain AIDS".

There is no one "dissident viewpoint" - there is a multiplicity of highly speculative hypotheses. Some deny that HIV exists, others deny that AIDS is a problem. The single unifying characteristic of all of the alternative explanations for AIDS (from those that believe it is a problem) is a lack of falsifiability . Consequently, these hypotheses have nothing to do with science, and can be, indeed must be ignored by serious scientists. (We cannot accept strange pseudo-hypotheses simply because the scientists who created them have Nobel prizes behind their names, or whatever).

In the absence of substantial alternative hypotheses, and with no refutation of falsifiable formulations of the "standard hypothesis", it would seem irresponsible not to accept and act on these falsifiable formulations. A final quote from Popper:

"Any empirical scientific statement can be presented (by describing experimental arrangements, etc.) in such a way that anyone who has learned the relevant technique can test it. If, as a result, he rejects the statement, then it will not satisfy us if he tells us all about his feelings of doubt or about his feelings of conviction as to his perceptions. What he must do is to formulate an assertion which contradicts our own, and give us his instructions for testing it. If he fails to do so, we can only ask him to take another and perhaps a more careful look at our experiment, and think again" [4]

We cannot simply make bland statements like "HIV causes AIDS". We must provide practical, relevant, and testable (falsifiable ) assertions that should allow "dissident scientists" to attack our standpoint using the scientific approach of falsification. Needless to say, we should welcome well-formulated attacks, for science can only proceed by the identification of problems, the creation and refinement of explanatory hypotheses, and the testing of these hypotheses for their ability to withstand the sharpest arrows we can shoot at them. In this sense, and this sense alone, we should welcome criticism from Professor Duesberg and his colleagues. We should perhaps be grateful to Prof. Duesberg for providing us with an opportunity to explore the nature of science, and see how badly one can go off the rails if one concentrates on "proof of causation" rather than "falsification".

References

  1. Popper Karl R. Objective Knowledge - An Evolutionary Approach p88. Ch 2 Section 26. Oxford University Press. First edition (1975 reprint, with corrections). ISBN 0 19 875024 2.

  2. Popper KR. Conjectures and Refutations - The Growth of Scientific Knowledge p 218. Ch 10 Section 1(III) Routledge & Kegan Paul. Fifth edition (revised) 1989. ISBN 0-415-04318-2.

  3. Popper KR. Conjectures and Refutations [Ibid] p 256. Ch 11 Section 2.

  4. Popper KR. The Logic of Scientific Discovery p 99. Ch V. Section 27. Unwin Hyman, 1990 (14th impression). ISBN 0 04 445934 3.