In 1985, the FDA licensed the first commercial test to screen blood and blood products for HIV. In 1987, the FDA licensed the first anti-HIV drug called AZT (zidovudine). By 1989, 100,000 people in the United States were infected with the AIDS virus.
Since those initial reports, much has been learned about HIV. Researchers have determined that HIV reproduces itself and eventually kills immune cells called helper T cells, the most important immune cells in the body. Helper T cells help other immune cells make antibodies or kill virus-infected cells. In addition to paralyzing the immune system, HIV constantly mutates during a single infection. In essence, victims are infected with hundreds of different types of HIV, making it virtually impossible to neutralize the virus with antibodies or to make an effective vaccine. The good news is that as researchers better understood how HIV reproduces itself, they made highly active antiviral drugs. Although these drugs don’t cure AIDS, they at least have changed the disease from one that was invariably fatal to a chronic infection.
Enter Peter Duesberg.
In March 1987, Duesberg published an article in the journal Cancer Research, claiming that AIDS wasn’t caused by HIV—which he considered to be a harmless virus—but by long-term use of recreational drugs like heroin, cocaine, and amyl nitrate (poppers) by gay men. His hypothesis failed to consider babies or hemophiliacs who had received contaminated blood transfusions, homosexual men who didn’t use recreational drugs, or women who had acquired the disease from AIDS sufferers. Normally, the research community would have dismissed this kind of poorly reasoned article as coming from a crank who had ventured far from his field. But Peter Duesberg was no crank. And viruses were his field. Trained in Germany, Duesberg was a full professor in the Department of Cell and Molecular Biology at the University of California at Berkeley, receiving full tenure when he was only 36 years old. His meteoric rise was because, in 1970, he became the first scientist to identify a specific viral gene that caused cancer. For this remarkable achievement, in 1986, Peter Duesberg was elected to the National Academy of Sciences. That same year, he received an Outstanding Investigator Research Grant from NIH and was made a Fogarty Scholar in Residence.
In the 1990s, as more research continued to implicate HIV as the cause of AIDS, Duesberg modified his hypothesis. Now, he claimed that, in Africa, malnutrition caused AIDS; in wealthy Africans, anti-HIV drugs caused the disease; and in hemophiliacs, some as yet unidentified contaminant in transfused blood was the problem. The event that was probably the hardest for Duesberg to explain occurred when three laboratory workers were inadvertently infected with a highly purified clone of HIV. None of the workers were gay, used recreational drugs, were hemophiliacs, were malnourished, or lived in Africa; one developed a severe form of AIDS. Duesberg said that because the other two workers didn’t develop AIDS, HIV still hadn’t been proven to be the cause. (Duesberg wasn’t alone among famous scientists who had become AIDS deniers and conspiracy theorists. When evidence supporting the notion that HIV caused AIDS was clear, Nobel Prize–winning Kenyan ecologist Wangari Maathai said that scientists had created HIV in the laboratory for biological warfare. And Kary Mullis, who had won the Nobel Prize in chemistry for his discovery of the polymerase chain reaction [PCR], also stated that there was “no scientific proof” that HIV caused AIDS.)
Scientists eventually stopped listening to Peter Duesberg and his unsubstantiated rants. But Duesberg was not to be denied. In 2000, one year after taking over the presidency of South Africa from Nelson Mandela, Thabo Mbeki convened a Presidential AIDS Advisory Panel. He asked Peter Duesberg to head it. At the time, South Africa had more people living with HIV than any other country; 1 in 5 South African adults were infected with the virus. Mbeki, like Duesberg, believed that AIDS science was flawed and that anti-HIV drugs were poison, likening scientists to Nazi concentration camp doctors. Duesberg gave Mbeki the intellectual heft he needed to deny anti-HIV drugs to South Africans suffering from AIDS; as a consequence, more than 300,000 South Africans died needlessly from the disease.
Duesberg remains unrepentant. “I had all the students I wanted and I had all the lab space I needed,” he said. “I got all the grants awarded. I was elected to the National Academy [of Sciences]. I became California Scientist of the Year. All my papers were published. I could do no wrong…until I started questioning the claim that HIV [was] the cause of AIDS. Then everything changed.” But the problem with Peter Duesberg wasn’t that he questioned the contention that HIV caused AIDS; it was that he continued to deny a mountain of scientific evidence showing that it did. Like Linus Pauling before him, Duesberg simply refused to believe that he could ever be wrong.
Peter Duesberg didn’t limit his denial to HIV. He also didn’t believe that human papillomavirus (HPV) caused cervical cancer—an association that Harald zur Hausen proved and for which he won the Nobel Prize in 2008.
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RECENTLY, ANOTHER FORMER Nobel Prize winner has also swerved from science: Luc Montagnier, the French researcher who, along with Françoise Barré-Sinoussi, had won the Nobel Prize for his discovery that HIV caused AIDS. In 2010, two years after he won the Nobel Prize, Montagnier—like Linus Pauling and Peter Duesberg before him—made a series of embarrassing public declarations.
First, Montagnier said that DNA molecules could be teleported from one test tube to another (presumably, in a manner similar to the way people were teleported in the television series Star Trek).
Then, Montagnier claimed that homeopathy made sense. Homeopathy is based on the now disproved belief that if you dilute a substance to the point that not a single molecule remains, the water in which it was diluted will remember that the substance was there. “I can’t say homeopathy is right in everything,” said Montagnier. “What I can say now is that high dilutions are right. High dilutions of something are not nothing. They are water structures which mimic the original molecules.” (Given that there is a limited amount of water on Earth, you don’t want it to remember where it’s been.)
Finally, Montagnier joined the long list of those claiming a cure for autism. Montagnier said that when he took the blood of patients with autism—and diluted it to the point that not a single molecule of the original blood remained—he could detect electromagnetic waves indicating the presence of bacterial DNA. Autism, it appeared, was a bacterial infection. And it wasn’t just autism that was caused by bacteria. Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, rheumatoid arthritis, and chronic fatigue syndrome were bacterial infections, too.
In 2011, at the age of 78, Luc Montagnier left France to head a new division at the Jiao Tong University in Shanghai, China. Intent on proving that he was right, Montagnier studied a group of 200 children with autism, finding “spectacular” results in those who had received antibiotics. “[We] have observed that a long-term therapy consisting of successive antibiotic treatments with accompanying medications induced in 60 percent of cases a significant improvement, sometimes even a complete resolution of symptoms,” crowed Montagnier. “These children can now lead a normal school and family life!”
After Montagnier discovered what he believed was a cure for autism, he submitted a paper describing his findings to an obscure journal of which he was the senior editor; it was accepted for publication in three days. Then he traveled to Chicago to present his findings to a national festival of false promises known as Autism One. Taking the podium next to people who claimed that autism could be cured with hyperbaric oxygen treatments, bleach enemas, and chemical castration, Montagnier said that the only thing these children really needed was a prolonged course of antibiotics. Resistance from the mainstream medical community was, according to Montagnier, to be expected. Such is the life of a medical maverick. “In 1983, we were only a dozen or so people to believe that the virus we isolated was the cause of AIDS,” said Montagnier. “I’m just interested in helping these children.”
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WHAT HAPPENED TO LINUS PAULING, Peter Duesberg, and Luc Montagnier—all brillia
nt scientists who had clearly lost their way—all wedded to theories that were completely and utterly disproved by scientific studies?
One possible explanation is that these men had been so right for so long that even in the face of strong opposition, they could never imagine being wrong. Another possible explanation is that there is a fine line between genius and madness. Or maybe they just wanted to make the next big splash—something that would again thrust them into the limelight. Whatever the reason, all three men did an enormous amount of harm: Pauling, because he had convinced people to take large quantities of vitamins and supplements that have only increased their risks of cancer and heart disease; Duesberg, because he indirectly caused hundreds of thousands of South African deaths from AIDS; and Montagnier, because he took advantage of parents’ desperate desire to help their children by offering a medicine that could not possibly help and, therefore, could only hurt.
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THE LESSON IN THE LINUS PAULING STORY can be found in the movie The Wizard of Oz: Pay attention to the little man behind the curtain.
When first encountered, the Wizard of Oz was exactly as advertised: great and powerful. His voice was booming; his manner, intimidating; and his head, large, green, and oddly cerebral. But the Wizard wasn’t what he appeared to be. When Toto pulled back the curtain, the Wizard was just a rumpled old man with a high-pitched, irritatingly nasal voice. Exposed, the Wizard said, “Pay no attention to that little man behind the curtain.” But Toto’s revelation was impossible to ignore. Dorothy was appalled. “You’re a very bad man,” she said. “No, my dear,” replied the Wizard. “I’m a very good man. I’m just a very bad wizard.” In the end, the Wizard of Oz was successful because he was a good psychologist, not a good magician. The same applies to science: Don’t be blinded by reputation. Every claim, independent of a scientist’s reputation, should stand on a mountain of evidence. No one should get a free pass.
When Linus Pauling claimed that proteins folded in a certain manner or that sickle-cell hemoglobin had a different electrical charge, he had reams of biochemical data to prove it. But when he claimed that vitamins and supplements made you live longer, he had only the word of Irwin Stone, a man who had no scientific credentials, had never published a scientific paper in his life, and didn’t have a shred of evidence to back his contention.
Pauling counted on the “Wizard of Oz” effect to promote his belief that vitamins and supplements were miracle drugs. He hoped that people would ignore the little man behind the curtain (his lack of data) and pay attention only to the booming voice that came with having won two Nobel Prizes. Similarly, Rachel Carson was seductive because she was a dynamic storyteller: the most trusted science writer in America. Like Linus Pauling, Russell Portenoy’s claim that oxycodone could offer pain relief without addiction and Walter Freeman’s claim that lobotomies could cure psychiatric illnesses were persuasive because both men were respected members of the medical and scientific community. They were convincing because they wore the badge of academic success, not because they had reproducible data showing that they were right. Finally, Peter Duesberg’s claim that HIV wasn’t the cause of AIDS or Luc Montagnier’s claim that bacteria caused autism were granted full public hearings because both men were brilliant, highly acclaimed virologists. The point is that all scientists—no matter how accomplished or well known—should have unassailable data to support their claims, not just a compelling personality, an impressive shelf of awards, or a poetic writing style.
CHAPTER 8
LEARNING FROM THE PAST
Although it’s always easy in retrospect, several lessons have evolved from science’s darker past. Let’s see what happens when we apply these lessons to a variety of modern-day inventions like e-cigarettes, preservatives, chemical resins, autism cures, cancer-screening programs, and genetically modified organisms (GMOs).
1. It’s all about the data.
Truths emerge when studies performed by different scientists working in different environments using different methods find similar results. Ignoring these truths can have disastrous consequences.
On its surface, this lesson would appear to be easy to follow—just look at the data. The problem with data, however, is that there’s far too much of it. Every day about 4,000 papers are published in the world’s medical and scientific literature. As you would expect, the quality of these studies follows a bell-shaped curve: Some are excellent; some are awful; and most are more or less mediocre. So how is one supposed to separate good data from bad? One way would be to focus on the quality of the journals. But even that isn’t perfect. Excellent, peer-reviewed journals have published claims that excess coffee drinking causes pancreatic cancer; that the measles-mumps-rubella (MMR) vaccine causes autism; and that nuclear fusion—when two small nuclei combine to release energy—can occur at room temperature in a glass of water (cold fusion). All of these observations were later shown to be wrong by other investigators. (“The trouble with the world is not that people know too little,” wrote Mark Twain, “it’s that they know so many things that ain’t so.”)
So, if you cannot completely trust observations published in excellent scientific journals, what can you trust?
The answer is that science stands on two pillars: one more reliable than the other. The first pillar is peer review; before a paper is published, experts in the field review it. The process, unfortunately, is flawed. Not all experts are equal and sometimes bad data slip through. The second pillar saves the day: reproducibility. If researchers publish a paper claiming something fantastic (like the MMR vaccine causes autism), subsequent studies will prove it to be correct or not. For example, almost immediately after publication of the claim that MMR caused autism, hundreds of investigators working in Europe, Canada, and the United States tried to reproduce it. They couldn’t. Study after study involving hundreds of thousands of children and costing tens of millions of dollars found that those who had received the vaccine were at no greater risk of autism than those who hadn’t. Good science had won out.
2. Everything has a price; the only question is how big.
Even the most dramatic, lifesaving, groundbreaking, universally acclaimed scientific and medical breakthroughs—like antibiotics and sanitation programs—have come with a price. Nothing, as it turns out, is exempt.
The first antibiotic, sulfa, was invented in the mid-1930s. Next came penicillin, which was mass-produced during WWII. Antibiotics have saved our lives. Without them, we would continue to die routinely from pneumonia, meningitis, and a variety of other potentially fatal bacterial infections. In part because of antibiotics, we live 30 years longer than we did a hundred years ago. But aside from the problem of creating antibiotic-resistant bacteria, one consequence of antibiotic use was utterly unpredictable.
In the last decade or so, researchers have been studying something called the microbiome—the population of bacteria that line the surface of our skin, intestines, nose, and throat. Recently, researchers found a role for these bacteria that was surprising. The numbers and types of bacteria that cover our body in part determine whether we will develop diabetes, asthma, allergies, and obesity. More surprising, if we alter the bacteria of infants with antibiotics, we increase the risk of these disorders. The lesson is clear. Use antibiotics when you need them, but overuse them at your own risk.
Antibiotics aren’t the only dramatic scientific advance that has come with an unanticipated price. Even sanitation programs, which have decreased the incidence of food-borne and waterborne diseases like salmonella, shigella, E. coli, and hepatitis A, have unseen risks. Although the incidence of potentially fatal bacterial and viral infections has decreased in the developed world, the incidence of diseases like asthma and allergies has increased—a phenomenon that cannot be accounted for solely by industrialization. The reason for the unanticipated problem with sanitation can be found in an editorial in the New England Journal of Medicine titled “Eat Dirt.” Children in developing world countries are, from the moment of birth,
bombarded with germs; as a consequence, their intestines often contain parasites and toxin-producing bacteria that are rare in the developed world. Although these infections can cause malnutrition and even death, they make it far less likely that children in developing world countries will develop allergies and asthma. Researchers call this “the hygiene hypothesis.”
The point being that there’s always a price to pay. The challenge is figuring out whether a particular technology is worth the price. And we shouldn’t grandfather in certain technologies just because they’ve been around for decades, or even centuries. All technologies should be constantly evaluated. Perhaps the best example is general anesthesia. Although anesthetics have been around for more than 150 years, only recently has it become clear that they can cause problems with attention and memory that can last for years. “No particular anesthetic has been exonerated,” says Roderic G. Eckenhoff, a professor of anesthesiology at the University of Pennsylvania.
3. Beware the zeitgeist.
Three current technologies have been victims of the current culture: e-cigarettes, because no one likes the image of a teenager smoking, even if it’s not actually smoke; GMOs, because the technology smacks of hubris, our attempt to alter the natural order; and bisphenol A (BPA), because it is a chemical resin that can leach out of plastic baby bottles. All three technologies have been the victims of scientific studies purporting harm. And all three have suffered at the hands of the media. Negative press, however, shouldn’t blind us to the evidence.
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