AIDS - Where Medicine and Politics Intersect

Nobel peace laureate claims HIV deliberately created. 09/10/2004. ABC News Online

Wangari Maathai, Kenyan ecologist and Nobel peace prize winner, has reiterated her claim that AIDS was created in a laboratory. Scoffing at the idea that AIDS crossed from monkeys to humans, but only very recently despite millenia of close contact, as well as the idea that it is a curse from God, Maathai points to its disproportionate impact on black people to suggest a motive for the creation of AIDS.

A few years ago, South African president Thabo Mbeki was questioning whether AIDS was a disease caused by a retrovirus of the HIV group. (There are several sorts of both the HIV virus and their very similar SIV viruses which are found in monkeys.) Mbeki backed off when this view aroused much disfavor among NGOs and foreign governments supplying aid to South Africa.

The orthodox account runs something like this. Simian Immune-Deficiency Virus (SIV), which may be quite old in monkeys but does not appear to harm them, crossed to human populations in West Africa sometime in the 20th century giving rise to several types of Human Immune-Deficiency Virus (HIV) which causes the diseases collectively known as AIDS. The disease spread to Haiti and thence to the US, first being described in the medical literature based on an outbreak of rather rare cancers and pneumonia cases among homosexual men in New York about a quarter century ago. The disease has spread around the world, although Africa is particularly hard hit.

The monkey part of the story is a bit unsatifactory, but are there other problems with this explanation? Well, for one thing, it doesn't begin to account for the fact that Kaposi's sarcoma, one of those relatively rare conditions that started the search for the cause of AIDS, had been described in the medical literature as affecting the extremities, but in AIDS patients it had suddenly become a lung cancer.

What about the heterosexual spread of AIDS? It never seemed to take off in the US despite years of dire warnings. In fact, AIDS among women, except for prostitutes, has been relatively uncommon. But in Africa, AIDS is said to be spread primarily by heterosexual contact and women are more likely to be infected than men? Can this be the same disease in both places?

That's one of the key questions. When AIDS was first identified in the US, it was defined, as the name (Acquired Immune Deficiency Syndrome) suggests, by a constellation of discrete illneses. If a patient had enough of the marker conditions (Kaposi's sarcoma, pneumonia carinii, etc.) then the patient met the definition as having AIDS. Over time, adjustments have been made to the parameters of the syndrome and the parameters used in Africa today are not the same as when AIDS was first described in the US.

Later, after the connection to HIV was made, patients would be judged HIV infected or not based on blood tests. The fact that large numbers of persons were HIV positive but disease free was explained by the idea that in many persons the disease would require many years to produce disease. There remained a few problems, of course: HIV positive patients followed for years and never symptomatic, spontaneous seroconversions (patients becoming HIV negative without treatment), patients with the requisite constellation of diseases but remaining HIV negative. Unfortunately, most African nations are so poor that most AIDS work is based on the syndrome definition because facilities for blood tests are unavailable or too expensive for routine use.

Some critics believe that the syndrome parameters used in Africa overstate HIV infection rates - by including many cases of malaria, for example. There are strong financial incentives to maintain this error since AIDS attracts international donor interest much more so than mundane old malaria. Some authorities have even questioned whether HIV causes disease in humans any more that SIV does in monkeys. Most of them have backtracked when they realized that such a position could lead to career suicide. If this subject interests you, slog your way through Inventing The AIDS Virus before rejecting the critics out of hand.