The Aids road to hell: is it paved with good intentions?

Joseph Benarrous

It is not my intention in this study to comment on the staggering numbers of victims of the Aids pandemic, but rather to try and assess our knowledge to date as to what has caused the illness and the factors that have enabled it to spread so easily. This will also be an opportunity to bring to the fore once more, against the prevailing amnesia, the way in which the colonial powers have used Africa as a trial ground and Africans as experiment fodder, albeit under the guise of humanitarian aid. At the present time, when we are spending a lot of time holding forth on the physical impossibility of providing care in the poor countries, it is certainly difficult, but useful nonetheless, consider the question from an opposite standpoint.

It is vitally important that we determine the circumstances in which Aids has been able to develop and spread. Anglo-Saxon commentators, unlike their French counterparts, are beginning to appreciate the seriousness of this matter. The investigation published recently by a British journalist, Edward Hooper [1], brings us up to date over the question of the source of this pandemic which is ravaging the entire world and the continent of Africa in particular. Before this, Brian Martin, an Australian social science professor, allowed the most politically disturbing of hypotheses to be recognised as possible and even probable, presenting it to a wider and wider public, despite the attacks to which it was subject[2].

Today, two hypotheses are being disputed by the scientific community, after all the other more flimsy arguments have been swept away. The issues that are emerging behind the truth are so important that confrontations between the supporters of each theory are particularly strained.

The first hypothesis is that of natural transfer, while the second is iatrogenic, which means that medical science is entirely responsible. For those who support the origin of the illness by natural transfer, the accepted version is that the simian immunodeficiency virus (SIV) accidentally infected some men and women and, through mutation, created the two known versions of the human immunodeficiency viruses, HIV1 in central and eastern Africa and HIV2 in western Africa. Subsequently, so the theory goes, when a sufficient number of individuals were carriers of these deadly germs, the new viruses became widespread by one means or another, though the reasons for this spread are varied and ill-defined. We should note, however, that supporters of the natural transfer theory are tending more and more to incriminate the massive vaccine campaigns, because of the frequent use of poorly sterilised equipment and jet injectors which may have enabled large-scale propagation of the viruses to have taken place via the blood[3].

Those who support the iatrogenic hypothesis claim, for their part, that trials using certain oral polio vaccines are at the heart of the illness [4]. In the relentless race by scientists during the 1950s to find a new oral vaccine, large-scale trials were carried out in Africa, still under colonial rule, without adequate safety precautions being put in place and it is unfortunately possible that the vaccines used could have been contaminated with SIVs. Moreover, those who support the iatrogenic hypothesis do not reject the idea that several decades of massive vaccination campaigns could subsequently, but only subsequently, have greatly facilitated the spread of these new viruses.

It is obviously not feasible in this paper to question the use and the effectiveness of the new polio vaccines, since poliomyelitis is now on the point of being eradicated throughout the world. Nor should vaccine campaigns, when they are carried out with rigorous safeguards, be in any way criticised. What the iatrogenic hypothesis wants to condemn is the total lack of respect for the human condition and the casual attitude that prevailed during the trials of an experimental vaccine. What the natural transfer hypothesis invites us to denounce is the use of untried and untested material [5]. This is a suitable moment to recall that a new WHO directive recommends that in future only non-reusable syringes should be used for vaccinations and also that the jet injectors [6] used in the past should be replaced by equipment which does not give rise to any undesirable secondary aspiration of blood[7] into the body of the injectee.

For a long time, the guardians of the prevailing truth formed an impregnable barrier to the iatrogenic hypothesis, to the extent that access to specialist journals was hermetically sealed to those who defended it. It is true that this theory, if it does have any foundation, is absolutely horrific and challenges the entire edifice on which the medico-pharmaceutical dictatorship is established. The closed shop has here functioned perfectly in order to prevent the diffusion of theories considered to be iconoclastic.

E. Hooper’s achievement will have been to give credence to this theory and to see that it is recognised at least as plausible by a growing number of virologists, social science specialists and journalists, mainly Anglo-Saxon, of the written and spoken word. To write his book, containing more than 1000 pages and more than 2500 notes, he embarked on a very detailed investigation, speaking to many of the scientists involved in the problem and many surviving witnesses from the time when the doubtful vaccine trials were carried out.

All the cross-checking carried out during his investigation, and all the pitfalls encountered on the way, just as those who first held these hypotheses had encountered, confirmed the British journalist’s beliefs in his defence of the iatrogenic hypothesis. The solid basis of his reasoning and the very detailed demonstration he provides are constantly convincing more and more people, stunned at the notion that this disaster could have been caused by man himself. Everyone who has been affected in any way by Hooper's argument must hope that the terrible doubts surrounding the origin of this unprecedented viral epidemic will be clarified.

What is the basis for E. Hooper's reasoning? Firstly, a very troubling observation: the first cases of Aids appeared in those very same areas of the Congo, formerly Belgian territory, where large-scale trials of the incriminated vaccine were carried out, in particular, on very young children, between 1957 and 1959. Armed with this initial epidemiological data, the journalist looked at the manufacture of the vaccines in question, and noted that the polio virus cultures had been grown in cells from monkeys' kidneys. At that time, the techniques used to produce cell cultures were not governed by the very high standards in force today and it is not unreasonable to assume that unwanted viruses may have contaminated the cultures.

All this appears all the more incredible when we realise that a similar mishap occurred about the same time, when SV40 viruses from Rhesus monkeys of Asian origin unfortunately polluted millions of doses of polio vaccines, giving rise to a major panic among those that had been vaccinated. Moreover, manufacturing protocols had unhappily disappeared, as well as a considerable quantity of records from this period, and so an aura of incertitude, skilfully maintained, surrounded the origin and the species of the monkeys used. For several reasons, which he clearly demonstrates, Hooper was led to believe that these cultures were grown in cells from chimpanzee kidneys, primates which, although rarely infested, are carriers of an SIV with a very similar genetic pattern to HIV1.

One of the key elements that supports the hypothesis postulated by Hooper is that the first case of seropositivity established to be HIV1 dates back to 1959, and occurred in the very same region where the large-scale vaccine trials were carried out, which only goes to strengthen the journalist's disturbing revelation.

For those opposing the iatrogenic hypothesis, it is essential to prove that the virus was present in Africa before the date of these disastrous vaccinations. In order to support an argument capable of easing many consciences and sparing many vested interests, the defenders of the natural transfer theory have used enormous computers able to retrace the history of the virus and its mutations. These machines calculated[8] that the virus could, theoretically, have appeared well before the disputed trials took place and, with a great deal of media publicity, it was specified that this date could have been 1931, which would obviously complicate the defence of the iatrogenic hypothesis.

Some zealots even hastened to transform into certitude the conditionals used by the scientists in the presentation of their results, a process that was not only inelegant but, scientifically speaking, very irresponsible. For without challenging the personal integrity of the scientists who carried out the investigation with the computers, there is every reason to examine their results very closely, as there are so many possible routes through this kind of random calculation. Nevertheless, E. Hooper remains firm in his assertion that his theory will remain, and by a long way, the most pertinent, as long as no HIV positive blood is found in the blood banks dating from before the 1950s.

Alongside personalities from the world of science, journalists from the English-speaking press were also astonished by the accumulation of evidence gathered by E. Hooper. Finally, under growing pressure of public opinion, it was decided that analyses would be carried out on a small remaining sample of the vaccine used, in theory, [9] at the time, while it is to be hoped that its fifty years preservation will not have destroyed the possible proofs of accidental contamination.

The analyses were to be carried out by three independent laboratories, whose identities were to be kept secret. At first, the initial results were to be discussed at a meeting at the end of May 2000, at the Royal Society, London, between proponents of the competing hypotheses, with these results being published during the month of June. However, for reasons that were not made public, this confrontation was postponed to September 11 and 12. Will this finally enable us to throw some light on what could be the most dreadful consequence of an action imposed on a colonised country under the false pretext of a humanitarian campaign? 

Broad sections of public opinion seem to have too easily been willing to consider a series of theories of a racist nature, with the identification (even stigmatisation) of some scapegoats thus decreasing interest in the true sources of this humanitarian catastrophe. Generally speaking, Africa was diabolised [10] to such an extent that it was suggested that it was the African way of life and environment that were responsible for the viral pandemic that is shaking the planet. This notion of African guilt seems, over the years, to have become solidly encrusted in the public mindset. It is for this reason that, independently of the polemic opposing the specialists, it appears entirely indispensable to assess on a regular basis the problems raised, not only by the genesis of the pandemic, but also by the factors likely to have facilitated its propagation.

The discussion and publication of the analyses demanded by pressure of public opinion have thus been postponed for a few months; it is likely that there will be difficulties when a final, clear-cut biological verdict has be announced. It will doubtless be necessary not to set too much store by the consensus likely to prevail in the interpretation of the results, as the medical-scientific community has very specific rules for preserving its prestige and protecting its economic interests.

The more the competing hypotheses are in conflict, the more it appears that human responsibility on a large scale is involved, if we are not only to account for the genesis of the viral infection but also to determine the factors involved in its explosive distribution.

Two important elements must be highlighted. First, the suspect large-scale polio vaccination trials were carried out in a region of central Africa which had previously been colonised, whereas no industrialised State wanted to authorise experiments of this kind on its own territory. This, once again, highlights the non-respect, by the occupying power, of the dignity of those colonised. Moreover, if international concern is laudable in theory, especially when it relates to the prevention of contagious illnesses, public health programmes have not always been carried out with the necessary rigour.

Without waiting for a hypothetical scientific consensus, denouncing responsibilities that are already known has the advantage of calling on universal conscience as witness and to help in the establishment of new approaches, the better to master the infernal machine of this pandemic. All observers are in agreement in recognising that the appropriate medicines are far too costly for the populations of the developing countries to afford, Africa in particular, and that the pharmaceutical laboratories impose a dictatorship without concession for sales of their products. To the extent that human responsibility is recognised in the emergence and/or in the primary spread of the illness, the international community must have a moral obligation to take new measures to control the manufacture and distribution of treatments. It must also take responsibility for further research into new medicines. In order for such measures to be possible and practical, it would obviously be necessary to acknowledge not only the erring ways of science and medicine, but also and especially to admit explicitly that Aids is a consequence of the colonial situation.

Although an economic solution is not beyond the realms of possibility, the legal problems created by the setting up of international controls and the establishment of a "guardianship" over the medical laboratories would seem to be a much more difficult hurdle to overcome. The religion of liberalism must accept its limitations for the international community, when faced squarely with its responsibilities towards populations whose only crime is to be the object of its all-consuming care, will have to involve itself more in the search for a solution that is acceptable to all Aids sufferers.

A new ethic of the right to dignity should be defined. Hypocritical charitable donations and handouts made even in good faith would finally give way to a just reparation for the wrongs suffered. Moreover, recognising that the origin of the pandemic is directly attributable to foreign responsibilities, directly linked with the colonial situation, would mean that the negative representation of the physical and human environment in Africa could be reversed. However, would the pressure groups to whose advantage it is for this image of the continent to endure, allow this truth, which goes against their interests, to be released into the world?

The procrastination of those who support the so-called natural transfer theory suggests that everything will be done to postpone for as long as possible the expression of what is certainly a disturbing truth in many respects. The point is that, beyond the responsibility of those individuals who originated the tragedy, it is essential that from now on, new strategies be formulated for the future, committing the entire international community. Unfortunately the past is what a few individuals make it. It will be up to historians, to sociologists and to politicians to draw lessons from it.

At the present time, the unequivocal question that has to be put to the universal conscience is that of the present and the future. First and foremost, we must get those who are in charge today, Heads of State, UN, WHO, WTO, World Bank, pharmaceutical companies, to name but the most important, to acknowledge that the struggle towards progress is always marred by risks and in order to achieve the laudable aim of providing a health Utopia for all, mistakes with incalculable consequences have been made - and that those who have suffered the consequences are not the ones responsible.

It remains true, in fact, from a strictly epidemiological point of view, that the iatrogenic hypothesis would seem to be the most credible. Firstly, geographically, the areas where the first cases of the illness appeared coincide exactly with the areas where the suspect trials were carried out, and the maps back this up. Secondly, despite all the investigations and all the learned calculations carried out to try and prove that the HIV viruses had, theoretically, already contaminated man before these trials, it has so far been impossible to identify any blood that was HIV1 positive before 1959.

If the international community could openly admit that some individuals have failed in their responsibility, that their lack of vigilance and their lack of respect for the human condition have provoked this disaster, then perhaps it will be possible to set up initiatives and free the necessary budgets for an effective fight against Aids. It would then be much more difficult for the populations of the industrialised countries to believe themselves, wrongly, safe from a scourge whose ravages and responsibilities would then lose their ridiculous exotic gloss.

Footnotes

1. E. Hooper, The River. A Journey Back to the Source of HIV and AIDS, Harmondsworth, The Penguin Press, and Boston, Little & Brown, 1999. Republished in 2000 by Penguin with a new postscript.

2. See in particular the web page, http://www.uow.edu.au/arts/sts/bmartin/dissent/documents/AIDS/

3. On contamination via the blood, a topic that has been ignored for too long, see Jean-Paul Dozon, "D'un tombeau à l'autre", Cahiers d'études africaines, XXXI:1-2 (n° 121-122), 1991, pp. 135-157.

4. The pioneering title is the book by Julian Cribb, The White Death, Sydney, Angus & Robertson, 1996. See also Claude Chastel, Ces virus qui détruisent les hommes, Paris, Ramsay, 1996, which examines different possible theories and rejects most as being too far-fetched. Among the hypotheses retained, the iatrogenic hypothesis, he insists, merits more extensive analysis.

5. "The problem is sufficiently serious to threaten the future of vaccination programmes, but it has been largely ignored until now and has thus continued to increase". Vaccins et vaccination dans le monde, n°5, November 1997, p.2. In the same issue of this WHO journal, a pathetic appeal was launched, pp. 2-4: "We must act now and take advantage of the new mass vaccination campaigns that are soon to be launched, to improve injection safety. If we fail, we will not only have a catastrophe on our hands, but we will have missed a golden opportunity to resolve this problem". The problem of dangerous injections had already been raised at the Yamoussoukro meeting in 1994, which in turn followed those of Bamako in 1974, Dakar in 1981, Niamey in 1987. Cf. Marchés tropicaux, n°628, 1 April 1994, p.628.

6. Glaucus de Souza, "Multi Dose Jet Injectors and Safety Aspects in Brazil", CDC and WHO Meeting on jet injectors, Atlanta, 2-3 October 1996.

7. It has in fact been proved that these devices, which can contain several dozen doses of vaccine, draw up an amount of blood from the patient each time the precious vaccine is injected; this in turn is then injected into subsequent patients. It is this undesired diffusion of contaminated blood into healthy carriers which, given the steady increase in the number of infected cases, could be responsible for the large-scale propagation not only of Aids but also of other viral infections such as hepatitis B and C. There is a vast amount of scientific literature on this subject; note that for a very long time, hepatitis B was called the disease of the syringe.

8. David M.Hillis, "Origins of HIV", Science, vol. 288, 9 June 2000, pp.1757-1759.

9. In theory only, as the remaining sample has not been clearly identified.

10. Inevitable that we mention in this context a sadly famous tirade, which influenced future doctors heading for the colonies in Africa: "Over there, on the stinking coasts of the Atlantic, you will meet the redoubtable Sphinx of Malaria, pernicious Proteus, the frenzied phantom of Typhus, the livid, frozen spectre of Cholera, the yellow mask of the vomito negro. Beware of the earth and the waters that give off a poisoned breath." Quotation from Professor Mahé by C. Mathis in L'œuvre des Pastoriens en Afrique Noire, 1946, p.7.