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AIDS
IN AFRICA?
Eleni Papadopulos-Eleopulos & Valendar Turner
Rethinking AIDS Jan. 1995
According
to the World Health Organization, some 2.5 million Sub-Saharan
Africans have AIDS-Africa is apparently in the grip of an AIDS
pandemic. (In the USA 300,000 people have been listed as AIDS
cases.) AIDS in Africa is portrayed as providing two important
lessons for the West. The first is an example of the potential
devastation that AIDS can unleash; the second is that by heterosexual
spread, AIDS will eventually overtake the West. However, there
is no convincing evidence that millions of Africans are infected
with HIV, the putative cause of AIDS, or that African AIDS is
heterosexually spread.
The only evidence
that some Africans are "infected" with a virus called
HIV is indirect, being based on the random testing of Africans'
blood for the presence of antibodies that react with a collection
of so-called HIV proteins. If the "HIV proteins" (present
in the test kits) only reacted with HIV antibodies there would be
no problem. Unfortunately, this is not the case. Antibodies produced
in response to the presence of one foreign agent may also react
with another different foreign agent; and the more infectious agents
that a person has been exposed to, the greater is the likelihood
that such cross-reacting antibodies will be present. Ruling out
cross-reactions between "HIV proteins" and the plethora
of other antibodies present in individuals who are constantly exposed
to microbial agents, can only be achieved by determining how good
a match there is between the antibody reactions and the presence
or absence of pure HIV itself. In other words, an isolated viral
preparation of known purity must be used as a "gold standard"
for the antibody reactions. This has never been done, either in
Africa or in the West. Thus in Africa, no one knows whether the
antibody tests are specific for HIV, that is, whether a positive
test actually means HIV infection. Many experts on African AIDS
accepted this fact even at the beginning of the AIDS era. Earlier
this year, Myron Essex, a leading American researcher and his colleagues
from Harvard University, when discussing their experimental data
on HIV antibody testing in Africa, again warned that the HIV antibody
tests "may not be sufficient for HIV diagnosis in AIDS-endemic
areas of Central Africa where the prevalence of mycobacterial diseases
[leprosy and tuberculosis and others, whose antibodies cross-react]
is quite high". Thus, in Africa there is no certainty that
Africans are actually infected with a putative new agent, HIV. AIDS
experts also agree that acquired immune deficiency (the "AID"
in AIDS) is also long standing in Africa. Immune deficiency can
be caused by malnutrition, certain viral infections, and diseases
such as malaria and tuberculosis, all of which are known to exert
a major depressant action on the immune system.
Unlike the
West, AIDS in Africa is diagnosed without any laboratory tests.
Patients are classified as AIDS cases without laboratory proof that
they have either immunodeficiency or HIV infection. All that is
required is to have various clinical conditions. But the conditions
accepted as forming the "S"(syndrome) of "AIDS"
in Africa bear no relationship to AIDS in the West. In the West,
AIDS is diagnosed if a person has one or more of approximately 27
relatively rare diseases.
However in
Africa, AIDS is diagnosed according to the World Health Organization's
1986/87 Bangui" definitions that can best be described as a
collage of common non-specific symptoms, such as cough, fever, diarrhea,
tuberculosis (TB) and a cancer called Kaposi's sarcoma. Every one
of these diseases have been endemic in Africa for generations.
Kaposi's sarcoma,
for example, was described in the Ebers papyrus dating from 1600
BC. (In the West, Kaposi's sarcoma is restricted to gay men.) Of
the 661 million people in sub-Saharan Africa, 2-3 million have active
TB with an annual mortality of 790,000. Despite this and the fact
that in adults, "HIV infection" usually follows TB infection,
TB has now become an AIDS defining illness. In fact, 30-50% of African
"AIDS" deaths are from TB. In spite of all this, AIDS
experts expect that we should accept that something "new"
is afoot in Africa and that it is caused by a new agent, HIV. Suddenly,
a new disease, caused by a new agent has appeared. The old diseases
and their deleterious effects on the immune system are no longer
operative.
Many AIDS experts
also expect us to believe that unlike the story in the West, in
Africa AIDS is spread predominantly by heterosexual contact. Indeed,
since the number of heterosexual cases in the West is too small
to be statistically meaningful, the African "evidence"
is used to forecast the same predicament in the West. The claim
of heterosexual spread in Africa is based on absence of "evidence
of homosexual transmission or intravenous drugs" and the approximately
equal numbers of males and females who have AIDS as well as positive
antibody tests. The latter certainly does not prove that AIDS is
heterosexually spread-influenza and appendicitis also have an equal
sex distribution.
Given the fact
that positive HIV antibody tests may be due to the presence of antibodies
formed in response to malaria, tuberculosis, leprosy and many parasitic
diseases it is not surprising that an equal number of men and women
will be diagnosed as "AIDS" according to centuries-old
symptoms and have a positive antibody test.
In any case,
the theory that AIDS in Africa is transmitted heterosexually creates
more problems for the HIV theory of AIDS than it solves. A disease
is said to be caused by a sexually transmitted infectious agent
if one infected partner, say the active partner (man) transmits
the agent/disease to the passive partner (woman), who in turn transmits
the agent/disease to another man. That is, heterosexually transmitted
diseases are transmitted bidirectionally, from men to women to men.
In the West, the largest (thousands of cases) and most judiciously
conducted prospective epidemiological studies have proven beyond
all reasonable doubt that in both men and women the only sexual
act leading to the acquisition of "HIV antibodies"(women)
or "HIV antibodies" and eventual AIDS (gay men) is passive
(receptive) anal intercourse. In other words, in the West, "HIV
antibodies" and AIDS, like pregnancy, can only be acquired
by the passive partner. If, unlike pregnancy, the "HIV antibodies"
and AIDS are not caused by a non-infectious agent (sperm, semen)
but by HIV, then HIV will be the only unidirectionally sexually
transmitted infectious agent. The active partner will have to acquire
HIV by other means. This is strange enough: in the whole history
of Medicine there has never been a sexually transmitted agent/disease
which is spread unidirectionally in the West and bidirectionally
(heterosexually) in Africa.
The only other
alternative to this ludicrous scenario is to agree with African
physicians that positive HIV antibody tests in Africa do NOT mean
infection with HIV and that immunosuppression and certain symptoms
and diseases which constitute African AIDS have existed in Africa
since time immemorial. According to Professor P.A.K. Addy, Head
of Clinical Microbiology at the University of Science and Technology
in Kumasi, Ghana:
"Europeans
and Americans came to Africa with prejudiced minds, so they are
seeing what they wanted to see...I've known for a long time that
AIDS is not a crisis in Africa as the world is being made to understand.
But in Africa it is very difficult to stick your neck out and say
certain things. The West came out with those frightening statistics
on AIDS in Africa because it was unaware of certain social and clinical
conditions. In most of Africa, infectious diseases, particularly
parasitic infections, are common. And there are other conditions
that can easily compromise or affect one's immune system."
Dr. Konotey-Ahulu
from the Cromwell Hospital in London expresses a similar view: "Today,
because of AIDS, it seems that Africans are not allowed to die from
these conditions [from which they used to die before the AIDS era]
any longer. If tens of thousands are dying from AIDS (and Africans
do not cremate their dead) where are the graves?" According
to him, the uppermost question in the minds of intelligent Africans
and Europeans in that continent is: "Why do the world's media
appear to have conspired with some scientists to become so gratuitously
extravagant with the untruth?"
Eleni Papadopulos-Eleopulos
is a member of the Department of Medical Physics and Valendar F.
Turner, is in the Department of Emergency Medicine, at the Royal
Perth Hospital, Wellington Street, Perth 6000, Western Australia.
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