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DEBATING AZT MBEKI
AND THE AIDS DRUG CONTROVERSY Anthony
Brink Foreword
by Martin Welz On 28 October
1999, South African President Thabo Mbeki ordered an enquiry into the safety of
the AIDS drug AZT. He did so after reading this debate. Debating AZT has now been updated to reveal the President’s
remarkable personal involvement in the subsequent controversy. It also takes a
critical look at the roles of rape survivor Charlene Smith, acting
Constitutional Court Justice Edwin Cameron, and AIDS Law Project director Mark
Heywood, and it exposes the dereliction of the medical experts and journalists
on whom the South African public has relied. Described by South Africa’s top
investigative journalist, Martin Welz, as “extraordinary”, Debating AZT tells the inside story and provides the shocking
facts. During
times of universal deceit, telling the truth becomes a revolutionary act. “Absolutely spectacular … superb ... the definitive refutation.” Harvey Bialy Phd, editor at
large of Nature Biotechnology;
scholar in residence, Institute for Biotechnology, University of Mexico. “...excellent … the best, most comprehensive review on AZT currently available...” Etienne de Harven MD, Emeritus
Professor of Pathology, University of Toronto, Canada. …a rare combination of incisive insight, entertaining wit, profound perspicacity, all of which and a lot more being available through his racy, delicious pen. He exhibits the uncommon gift of a timely turn of phrase that truly adds spice to the intellectual content… Mr Brink’s book will have an Illichean impact likely to cure the increasingly sick HIV-AIDS establishment in particular and the medical and governmental establishments in general. His expose is both a diagnosis and a cure… [It] will remain a classic eye-opener to the misdeeds of modern medicine for decades to come. I am also sure that Mr Illich will give his imprimatur to Mr Brink at first reading. Manu Kothari Phd, Professor of
Anatomy, Seth Gordhandas Sunderdas Medical College, King Edward Memorial
Hospital, Mumbai, India.
Don Bayley, former science editor of the Sunday Independent and launch editor of the Independent Online, South Africa. “[AZT: A Medicine from Hell] is a well written, lucid article for anybody to read… your arguments about prescribing this drug are excellent… Perhaps when more people like yourself who are not scientists come out publicly to clarify the issue on this drug, pregnant women will be spared! Your article will now be additional prescribed reading for the students in my class.” Shadrack Moephuli Phd (toxicology), senior lecturer, Department of
Biochemistry, University of the Witwatersrand, South Africa. …very nice writing … you can’t really be a lawyer… I love the parallels with other past failed medical panaceas - calomel etc. Denis Beckett, freelance journalist and filmmaker, South Africa. “What a good comprehensive review of the literature you performed! … During my research I noticed a lot of resistance from many different people to believe our data. In general there is resistance to the ‘bad news’.” Ofelia Olivero Phd, staff
scientist, U S National Cancer Institute, USA. “…impressive detail. Your researches have been extensive and your comments useful. …keep up the good work.” Dr Costa Gazi, Secretary for Health, Pan African Congress, South
Africa. “Christ this is good… Beautifully written… Extremely accomplished… So much data. Makes the opposition’s platitudes look embarrassingly hollow… Eleni and I think it’s really great.” Valendar Turner MD, consultant emergency physician, Department of
Emergency Medicine, Royal Perth Hospital, Perth, Western Australia. “Anthony knows more about the science of this than all the
other AIDS dissidents put together.” “No, no; you don’t, you don’t [merely reflect the medical
literature]. It’s the way you write, it’s the way you put it.” Eleni Papadopulos-Eleopulos MSc, biophysicist, Department of Medical
Physics, Royal Perth Hospital, Perth, Western Australia. “I started reading it the day it arrived, found it so
fascinating that I abandoned my thesis and read it through to the end that
evening. A case of not being able to put it down. Remarkable research and
brilliant writing. I really enjoyed your style.” Jaine Roberts MA, researcher, HIV and Economic Health Research Unit,
University of Natal, Durban, South Africa. “Mind-blowing.” Richard Stretch, attorney, Pietermaritzburg, South Africa. “A masterful piece.” David Rasnick Phd, pharmaceutical biochemist and patent holder,
visiting scientist, University of California at Berkeley, USA. “…outstanding...” Hiram Caton Phd, Professor of
Applied Ethics, Griffith University, Brisbane, Australia. “…wonderful … soldier on!” George Kent Phd, Professor of
Political Science, University of Hawaii, USA. “…great… very important…” Stefan Lanka Phd,
virologist, formerly of the University of Konstanz, Germany. “[AZT and Heavenly Remedies] is superb, extremely well
researched, analyzed, written… I could not have done a better job… Are you a
scientist or do you collaborate with one? How could you survey so many
scientific publications as an attorney? …Could you publish your article or a
variant of it in a medical/scientific journal? It would strengthen our case no
end, if scientific papers of that quality would come from several sources, not
only from Berkeley and Perth...” “I still can’t believe he wrote that. He’s really a
molecular biologist pretending to be a lawyer.” Peter
Duesberg Phd, Professor of Molecular Biology, University of California at
Berkeley, USA. Adv Anthony Brink of the Pietermaritzburg Bar discusses AZT with Dr Desmond Martin, president of the Southern African HIV-AIDS Clinicians Society. Dr Martin serves as virology consultant on the editorial board of the AIDS journal AIDS Bulletin, published by the South African Medical Research Council, and was co-chairman of the Scientific Programme (Basic Sciences) for the 13th International AIDS Conference held in Durban in July 2000. He was formerly deputy director of the National Institute for Virology in Johannesburg, and director of its AIDS Unit. Doctors and lawyers are alike in that they both rob you; the difference
is that doctors kill you too. Anton Chekov Who in the rainbow can draw the line where the violet tint ends and the
orange tint begins? Distinctly we see the difference of the colors, but where
exactly does the one first blendingly enter into the other? So with sanity and
insanity. In pronounced cases there is no question about them. But in some
supposed cases, in various degrees supposedly less pronounced, to draw the
exact line of demarcation few will undertake tho’ for a fee some professional
experts will. There is nothing namable but that some men will undertake to do
it for pay. …an evil nature, not engendered by vicious training or corrupting books
or licentious living, but born with him and innate, in short “a depravity
according to nature.” By the way, can it be the phenomenon, disowned or at least concealed,
that in some criminal cases puzzles the courts? For this cause have our juries
at times not only to endure the prolonged contentions of lawyers with their
fees, but also the yet more perplexing strife of the medical experts with
theirs? But why leave it to them? Why not subpoena as well the clerical
proficients? Their vocation bringing them into peculiar contact with so many
human beings, and sometimes in their least guarded hour, in interviews very
much more confidential than those of physician and patient; this would seem to
qualify them to know something about those intricacies involved in the question
of moral responsibility; whether in a given case, say, the crime proceeded from
mania in the brain or rabies of the heart. As to any differences among
themselves these clerical proficients might develop on the stand, these could
hardly be greater than the direct contradictions exchanged between the
remunerated medical experts. Dark sayings are these, some will say. But why? Is it because they
somewhat savor of Holy Writ in its phrase "mysteries of iniquity"? If
they do, such savor was far from being intended, for little will it commend
these pages to many a reader of today. Herman Melville Billy Budd CONTENTS DEDICATIONS
AND ACKNOWLEDGEMENTS AZT: A
MEDICINE FROM HEAVEN (Dr D J
Martin) WHY THE ‘AIDS
TEST’ IS USELESS HOW COULD THEY
ALL BE WRONG? DOCTORS AND AIDS Foreword The
upside of democracy is that every citizen has the right of access to
information, the right to express, exchange and debate different points of view
and, finally, to a vote. The downside, of course, is that each citizen is
burdened with the responsibility of having to think for himself. That, in a
nutshell, is what the investigative magazine noseweek is about, and why, prompted by the author of this book
nearly two years ago, noseweek
published a series of articles titled Rethinking
AIDS. For
the first time South Africans were exposed to a critical re-evaluation of HIV
and AZT undertaken by a number of very eminent scientists. Clearly,
many South Africans, reared in a society where for half a century they were
forbidden to think for themselves, now find it too onerous a responsibility.
They long for the quick fix. If AIDS is a problem, there must be a pill for it
- which the government must pay for. Anyone, be it politician or pharmaceutical
company, who is prepared to offer them that assurance, no matter how
recklessly, is eagerly assumed to be right - because that lets us off the hook
and instantly makes us feel good. The fact that it may not make the AIDS
sufferers feel any better is, apparently, of no consequence. Conversely,
anyone who raises questions about AIDS exposes our vulnerability, and clearly
makes many people, including the president of the South African Medical
Research Council and the editor of the Mail
and Guardian, very, very angry. Some abandon any attempt at thought - such
as Sunday Times writer Laurice Taitz,
who, in reporting the AZT controversy, gaily took it upon herself to declare to
her readers: “the truth is the drug is not toxic.” Read this book and you will
know why I say the Sunday Times
clearly does not take AIDS seriously when it assigns a writer of Ms Taitz’s
intellectual ability to the subject. And that when Dr William Makgoba,
president of the Medical Research Council, declares he has read nothing
critical about the effects of AZT on infants, this is a reflection not of the
state of science on the matter, but of his own arrogant indolence. Anthony
Brink is a citizen who takes his rights and his responsibilities seriously. He
has written a book for every intelligent citizen to read. If you are not a
member of those professions, do not be intimidated by the medical and
pharmacological terminology. Simply stick with the argument. It is
devastatingly clear. Reading
this debate about AZT between Brink, a Pietermaritzburg advocate, and Dr Des
Martin, president of the Southern African HIV-AIDS Clinicians Society, leads
one to reflect on the question: “What is an expert?” Dr Martin may have the
credentials of expertise, but Brink has the intelligence, investigative zeal
and adherence to the principles of scientific enquiry that make for authority
on this subject. He has tracked and digested every important reference to AZT
in contemporary medical literature. The result is a comprehensive and alarming
review of the findings of medical researchers on the clinical use of the drug. AZT
was originally prescribed in high doses on its own as a therapy for people who
tested HIV-positive. Other journalists have reported the fraudulent nature of
the clinical trials on which this usage was based. When independent, much
larger trials eventually showed that when HIV-positive individuals who showed
no sign of illness used AZT, it significantly increased, rather than decreased, their chances of developing AIDS
- and of dying - this regimen was quietly dropped. That this has not yet become
a major medical scandal is testament to the power and resources of
pharmaceutical giant GlaxoWellcome, and, by extension, the industry as a whole.
Now
there are new, even more dangerous claims made for AZT, supported by
well-funded lobbies. Anthony Brink demonstrates the sort of ability and
dedication needed to properly scrutinise those claims. If you have any better
information and arguments, let me know. Martin
Welz Editor,
noseweek Cape Town. Dedications and
acknowledgements To Thabo Mbeki, President of the Republic of South
Africa, for his sterling moral and political leadership in the AZT controversy
in South Africa; to Dr Manto Tshabalala-Msimang, National Minister of Health in
South Africa, for equal integrity and political courage; to Dr Ian Roberts,
former special advisor to the Minister of Health, for passing this debate on;
to my family for enduring a completely preoccupied and distracted husband and
father during the hundreds of hours stolen from them to research and write this
work; to my late father Robin Brink, whose enthusiasm for his medical
negligence law practice seems to have infected me with a similar interest in
medical malfeasance; to Arthur Wilke, my late grandfather by marriage, who
developed my fascination for microbiology as a boy; to journalists Martin
Williams, Martin Welz, Martin du Plessis, Vivienne Vermaak and Albertus van Wyk
for their commitment to ventilating the little-known facts about AZT in South
Africa; to John Lauritsen, Michael Ellner, Celia Farber and Joan Shenton for
pioneering exposes of the drug; to Dr Manu Kothari, Professor of Anatomy at
Seth Gordhandas Sunderdas Medical College, King Edward Memorial Hospital,
Mumbai, India, for the deepest spiritual and intellectual inspiration; to my friend
in politics, Lluis Botinas of Barcelona, Spain, executive director of
Plural-21, for amour-piercing discussions about the ideological and
metaphysical substrates of modern medicine that made the AZT disaster not
merely possible but its logical consummation; to Ivan Illich for Medical Nemesis: The Expropriation of Health, perhaps the most incendiary book I
have ever read; to Dr Peter Duesberg, Professor of Molecular Biology at the
University of California at Berkeley, for kind encouragement - fundamental
disagreements about ‘HIV’ notwithstanding; to Dr Val Turner, consultant
emergency physician at the Royal Perth Hospital, for invaluable friendly advice
and guidance throughout this project; to Dr Todd Miller, molecular
pharmacologist at the University of Miami, for similar help; to Eleni Papadopulos-Eleopulos,
biophysicist at the Department of Medical Physics, Royal Perth Hospital,
everything. Finally, to my very many unnamed friends in this subject world-wide
for your personal support and assistance, and for all that you have done, and
in many cases sacrificed, to bring the terror to an end. PREFACE In the David Lynch movie Blue Velvet, Geoffrey Beaumont returns to visit his friendly
middle-American hometown Lumberville. Dawdling around in a field he comes
across a severed human ear. He finds himself drawn into investigating a surreal
criminal netherworld, and is propelled towards dreadful discoveries. For me,
stumbling on to AZT has been a bit like that, and my enquiry into the history
and pharmacology of AZT has been a Carrollian tour through a chamber of
horrors. It’s not the first time that medicine has gone mad, but I think that
in time the entry of AZT into the apothecary will be judged the gravest
pharmaceutical disaster since the days of strychnine, arsenicals, and mercurous
chloride. Having interested South Africa’s leading
investigative journalist Martin Welz in AZT and other problems with the
HIV-AIDS paradigm, I was commissioned in October 1998 to write an article for
his whistleblowing journal noseweek.
After I had done so, Welz decided to publish a general introductory article
featuring AIDS sceptic Nobel laureate Kary Mullis first, and to go to press
about AZT in a later issue (see January 2000 edition). At this time an intense
public controversy was raging about the economics and morality of the South
African government’s decision not to provide AZT to rape victims and
HIV-positive pregnant women. The angry condemnation that the government drew
for this decision from AIDS activists, journalists, opposition politicians,
doctors, health workers and others was premised on the conviction that AZT was
a life-rescuing miracle drug. The look of it was that desperate supplicants
were being denied the sacrament. As the ensuing debate did not concern the
drug’s safety or efficacy, I thought publication of my critique shouldn’t be
delayed so I sent it to several South African newspapers. Martin Williams at
the helm of the Citizen took the lead
and published AZT: A Medicine from Hell
on 17 March 1999. South
Africa’s leading AIDS treatment authority, Dr Desmond Martin, rose to the piece
and mounted a rebuttal two weeks later, entitled AZT: A Medicine from Heaven. My rejoinder AZT and Heavenly Remedies was printed
the following day. I thereafter revised and extended it substantially to
incorporate discussion of important papers in the medical press excluded by the
newspaper’s space constraints, as well as a torrent of research papers
published subsequent to our newspaper debate. Dr Martin’s contentions about the
‘AIDS epidemic’ are treated separately in Appendix I to my reply. After
reading this debate, South African President Thabo Mbeki caused a local and
international furore when on 28 October 1999 he ordered an enquiry into the
safety of AZT. The following month, Dr Helen Rees and Dr Precious Matsoso,
respectively the president and director general of the South African Medicines
Control Council, received copies of both this debate and of the seminally
important examination of the molecular pharmacology of AZT by
Papadopulos-Eleopulos et al,
published in a special supplement to the journal Current Medical Research and Opinion in mid-1999. This paper is
discussed at the end of my reply to Dr Martin in my literature review AZT and Heavenly Remedies. Neither the toxicity data discussed in
this debate nor the Perth group’s explosive review seemed to have made any
impression on these ladies. On 11 May 2000, Dr Rees responded to a warning
issued by the European Medicines Evaluation Authority concerning “life-threatening
skin and liver reactions” and other “potentially lethal side effects” of
Nevirapine (Viramune), currently being marketed aggressively in South Africa.
After the deaths of several black women on antiretroviral trials (including
Nevirapine), she remarked nonchalantly that “many AIDS medications could cause
liver and other problems. ‘But the combination therapy can make a huge
difference to people’s lives’.” One wonders how the Medicines Control Council
would have reacted had the victims been white. To her great credit, when she
learned of the deaths, South African Minister of Health Dr Manto
Tshabalala-Msimang intervened directly and terminated the trials. Incredibly,
“an uproar in South African medical circles” was reported in response to her move
to prevent the deaths of more women. (On Sunday 13 August 2000 she announced
that she had declined to make Nevirapine available to HIV-positive pregnant
women, and directed that it should not be used outside approved research
environments.) Dr Tshabalala-Msimang has
rejected two reports on AZT by the MCC on the grounds that they deal
inadequately with the drug’s toxicity. On 15 March 2000, in the course of a
radio interview, she expressed her dissatisfaction with the failure of a third
report to address the issue of AZT’s long term risks, and said that she had
commissioned further investigation. But from the minister’s forthright negative
public statements on AZT and the even stronger sentiments emanating from
Mbeki’s office, it would seem to be ‘game over’ for those calling on the
government to buy and supply it to pregnant women and rape victims.
In preparing the manuscript I decided to retain its
original case-answer-reply debate format for two reasons. First, AZT: A Medicine from Hell serves as an
easy introduction to the subject and a handy summary of the case against the
drug, which I elaborate in my detailed reply to Dr Martin under the title AZT and Heavenly Remedies. Second, AZT: A Medicine from Heaven stands as an
authoritative statement of the case for AZT by South Africa’s leading AIDS
doctor and academic AIDS expert. This lends balance to my treatment of the
subject, and better equips readers to form their own conclusions. The research
papers discussed in AZT and Heavenly
Remedies are cited in an informal manner for the lay readership I had in
mind, but they are sufficiently identified to enable any interested reader to
locate them. Excerpts from the literature are precisely quoted however, and I
have retained American spelling and journal house-styles regarding the use of
upper and lower case in the titles of papers. Concerning my polemical style and sardonic tone, I
should explain that I wrote with politicking in mind. (It’s a trick I picked up
from Galileo. Unable to sell his discovery of the moons of Jupiter to his
peers, he took to pamphleteering to the lay public instead.) This is because,
after some dismal early encounters, I realised the futility of engaging with
‘the experts’, and decided to bring this appallingly dangerous drug to the
attention of our political leaders and investigative journalists instead. My
apprehensions were confirmed by the responses of ‘the experts’ to Mbeki’s
extraordinary initiative in directing an enquiry into the safety of AZT. On
their own showing they hadn’t examined the important recent medical literature
on AZT with which the President was au
fait and which founded his concerns, and they condemned him ignorant of it.
Among them are Dr William Makgoba, president of the Medical Research Council,
and South Africa’s most eminent pharmacologist, Professor Peter Folb of the
University of Cape Town. Consulted by Nature
correspondent Michael Cherry to comment on the Perth group paper after Mbeki
sent it to Cherry and asked him whether he’d read it, Folb contributed a
disgracefully glib, uninformed, unreferenced, and tendentious opinion. Mbeki
fittingly rejected it. How South Africa’s leading medical experts failed to
meet their responsibilities to President Mbeki and to the South African public
in the AZT controversy is a tale told in the latter part of AZT and Heavenly Remedies. We’ll also
have a look at the performance of some prominent journalists, AIDS activists,
church leaders, the leader of the official opposition in parliament, and a
constitutional court justice. And finally, Mbeki’s remarkable knowledge of
AZT’s pharmacology and his insights into the inarticulate dynamics of the
controversy are revealed in his own words, in letters and interviews quoted in
full. He also gives the world an exemplary lesson in democracy in practice –
the importance of independent enquiry, and the dangers posed by unthinking
deference to ‘the experts’ in any institution or profession, especially the
buffoons who run the medical show here. No thanks from me to South Africa’s AIDS activists
and Human Rights lawyers, all of whom have looked away - one of whom said that
she could not afford to examine the issues raised by me or she would be out of
a job, and another who opined that I was a public menace and should be killed. I’m frequently asked why this subject seized my
interest. At heart I’m a science geek. I had a provisional patent when I was
ten, and was keenly interested in chemistry and microscopy as a boy. From
impressive experiments with high-explosives to triple-stained microscopic
slides and photomicrographs of blood, assorted microbes and cross-sections of
my grandmother’s appendix, I drifted into audio electronics and equipped a
recording studio and concert sound rig with most of the gear home-made. On my
father’s ill advice, I took Latin at school but biology has long been my
fascination. Part of it has been that the more I read and the more I reflect on
it, the more textbook biology drifts from fact and begins to resemble the holy
doctrines of the Roman Catholic Church, supporting aggressively defended
commercial and professional empires. I’m also one of those annoying inquisitive
types with little respect for ‘authority.’ Being interested in cancer, the
immune system and all that, I closely followed the drama of HIV-AIDS from the
very beginning. Having accepted everything I read about it hook, line and
sinker for years, I was inspired to examine the scientific foundations of the
infectious AIDS paradigm afresh when I discovered in late 1996 that two of the
most accomplished biologists in our time, Nobel laureates Walter Gilbert and
Kary Mullis (discussed in my piece The
AIDS Apostates) did not subscribe to it. That led me on to AZT. An
irresistible imperative then possessed me. I couldn’t just carry on with my
picnic while a child was drowning, so I jumped in. Or to mix metaphors, it was
like finding a grave in my garden, and then more the deeper I dug. Or watching
good neighbours carted off by secret police, never to be seen again. Not the
kind of thing one can walk away from. Not me anyway. After the conclusion of my brief newspaper debate
with Dr Martin, I was moved to amplify my reply to him by the publication of a
sudden flood of papers during the rest of 1999 and in 2000 - all with serious
implications for the continued medical use of AZT, but none of which were
surfacing in the public discourse about the drug. The death of a legal
colleague after a single month’s course of AZT in combination with a similar
drug 3TC was an added impetus. That’s how this book grew, its thread ripped
undone and a new patch sewn in every time another paper on AZT came out in the
medical press. And with every development in the controversy on the home front.
It’s updated to September 2000. Because I amplified AZT and Heavenly Remedies considerably after it was printed in its
original form, I thought it proper to afford Dr Martin an opportunity to
respond. I wondered what he would make of the Olivero papers on the
transplacental carcinogenicity of AZT, the Ha, Blanche and De Martino papers on
AZT’s foetal toxicity (and many more have since come in), and the vast survey
of the literature on AZT and analysis of its pharmacology by
Papadopulos-Eleopulos et al, which
decisively debunks its manufacturer’s claims. Dr Martin’s colleague, fellow
virologist Dr John Sim, intercepted the invitation, declined it, and proffered
a sympathetic psychiatric diagnosis that I suffer mental perturbation. For an
amusing exercise in Foucaultian deconstruction, Dr Sim’s response is a
priceless little treasure, and I have put it up as Appendix II. On 28 June 2000, Cape Town architect Richard Hepner,
the editor of the Health Independent,
asked Dr Martin again whether he would like to refute or comment on my extended
reply, AZT and Heavenly Remedies -
specifically the kernel of it, an excerpt I had prepared entitled Is AZT safe for babies? He declined the
offer and said he stood by his piece AZT:
A Medicine from Heaven, and suggested that Hepner simply publish it again.
Offered the same opportunity, fellow AZT advocate Professor Gary Maartens at
Groote Schuur Hospital in Cape Town asked Hepner, “What’s in it for me?” and
likewise declined it. The value of this work, I hope, has been to
systematise a large body of clinical and research data on AZT, render it in prose
transparent to non-experts and to launch it into the popular domain. I daresay
the ‘AIDS experts’ could learn a thing or two from it too, but for reasons
you’ll see, I’m not optimistic. For locating the papers I’ve cited, all credit
to David Crowe, Peter Duesberg, Bryan Ellison, Celia Farber, Billi Goldberg,
Neville Hodgkinson, Matt Irwin, James Jerome, Heinrich Kremer, John Lauritsen,
Todd Miller, Eleni Papadopulos-Eleopulos, David Rasnick, Val Turner, and Penn
Xarwalyczha. ANTHONY BRINK
South Africa September
2000. ILLUSTRATIONS |
