OPINION
The Durban Declaration
By Roulette Wm. Smith
| Illustration: A. Canamucio |
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The 13th International AIDS Conference opened with a rousing call to "Break the Silence." Individuals, communities, and governments were implored to engage openly in dialogues on HIV and AIDS. Looming in the background was a hastily crafted Durban Declaration [DD] asserting, without proof, that HIV is the sole cause of AIDS.1 This factually is incorrect.2 Scientists, including an "AIDS-industrial complex," now are challenged to break all silence, end all blaming, and expose the ongoing denial of important scientific principles. Arrogance, smugness, and internecine acts must cease. Improved scholarship, especially regarding "slow virology," is essential. Truth and reconciliation are needed, along with moral leadership of the sort exhibited by Archbishop Desmond Tutu and President Nelson Mandela after apartheid ended in South Africa. Although challenging to implement, moral leadership must address costs to the infected, affected, and the infirm, and the consequences of the DD and "dissident" dogmas on public health, health delivery, and the sciences. It also must address roles that Nature and DD signers should play in decision-making that requires "peers."
Interestingly, Science Citation Index [SCI] reveals no DD signer or "dissident" having ever co-cited three seminal articles by Bjorn Sigurdsson3-5 that give rise to the concept of slow viruses, which include HIV. Co-cited together only 30 times between 1974 and 2000 (nine times since 1990), Sigurdsson's articles, together, reveal underlying AIDS-like disease in sheep--arguably the most important articles on slow viruses related to AIDS.6,7 Furthermore, few DD signers have publications on lentiviruses, other slow viruses, or challenges of causality. Can any DD signer be regarded as fair or impartial? Equally important, who best are arbiters of research in slow virology?
Regarding causality in AIDS, the Henle-Koch postulates cannot accommodate opportunistic pathogens.6 Subsequent evidence suggested that opportunistic pathogens are the elusive "cofactors," and account for the slowly progressive features of AIDS.2,7 These findings, clinical and epidemiological data, and Sigurdsson's three articles provide important clues to causes and cures of AIDS--to wit, roles for common versus uncommon "opportunistic" pathogens.2,6,7 Possible "cures" lie in multivalent (killed) vaccines against opportunistic pathogens. Neutralizing vaccines against HIV remain improbable due primarily to titer-dependent host- and virus-generated mutations in HIV. Thus, there is a scientific divide, with neither dissidents nor DD signers demonstrating full appreciation for underlying issues possibly through some missing information, naiveté, or ignorance.
The Durban Declaration as Dogma
The DD is among the most insidious and repugnant dogmas in the history of science. Regardless of one's perspectives, only dogmas associated with the DD and bovine spongiform encephalopathy (BSE) are costly in human lives. The DD clearly is aimed at discrediting a few dissidents1,8--akin to crushing pesky cockroaches--and chastising South Africa President Thabo Mbeki for providing dissidents a quasi-political forum to air their views. There is no evidence of any signer examining why dissident positions exist; to wit, confusion among dissidents and DD signers about fundamental distinctions in subclasses of retroviruses. Lentiviruses behave differently from oncoviruses and spumaviruses. Most opinions, on both sides of the scientific divide, are based on structure and function of oncoviruses and other non-lentiviruses. Neither group appreciates slow virus being a functional designation, with explications of slowness and progressiveness being central challenges.2,6,7 Few discern the relevance of molecular mechanisms of long-term memories7 or "recessive" functioning2 in slow virology.
Learning from the Durban Declaration
Six fundamental lessons can be derived from ongoing debates underlying the DD and dissident positions.
Axiomatic function: There is a need for core truths/axioms governing transmissible agents causing slowly progressive infections. To address this need, 11 "near-axioms" for slow virology were identified.2,7 They apply to HIV and expose inappropriate simplifying assumptions in a genre of genetic ancestry models. These near-axioms also contradict the central claim in the DD.2,7
Nomenclature: AIDS may be a misnomer as suggested by the eleven axioms and clinical and epidemiological data. HIV+ persons generally do not contract infections from common pathogens more frequently than do HIV- people. The immune system is intact for relatively common pathogens. The underlying syndrome involves "acquired abnormal tolerance" [AATS] for relatively uncommon pathogens.2,6,7 These findings point to roles for vaccines against relatively uncommon (opportunistic) pathogens as possible cures.2,4,6,7
Experimental design and control: When axiomatic results are combined with clinical, experimental, epidemiological, and theoretical findings, serious questions emerge regarding experimental designs and controls. For example, despite worldwide effort, no study has controls for improbabilities of vaccines against HIV revealed within the axiomatic framework.2,7 No studies explore the use of killed pathogens in multivalent vaccines against relatively uncommon opportunistic pathogens as an alternative having a reasonable probability for success.2,6,7 Such vaccines provide opportunities for novel clinico-experimental proofs, by denial, that HIV and other factors cause AIDS.7 Herpesviruses pose additional challenges for experimental designs and controls,9,10 as do autotoxicity, autovirulence, and context specificity.6 Furthermore, controls for common versus uncommon pathogens are necessitated by AATS.
History: Slow virus research is low-paying, under-
funded, contentious, and involves challenging (unconventional) scientific problems. Internecine behavior is the rule, not the exception. In marketplace economies, slow virology offers few incentives. The DD is a mere "replay" of past controversies and contentiousness.
Science without peers: Although peer review is deemed important in science, slow virology generally is without peers. Few have expertise beyond narrow domains within slow virology. This contributes to the underlying contentiousness. Few economic incentives and the protracted time course often required in slow virus research also limit numbers of peers.7,11 Significantly, SCI results reveal that neither DD signers nor dissidents meet meaningful criteria for being peers, adding support for moral leadership. Is the BSE Inquiry12 a possible model of moral leadership?
Science journalism and professionalism: With few peers, unconventional problems, and contentious behaviors characterizing slow virology, rigorous investigative science journalism is essential. Because controversy is an anathema for prestigious science publications7,8 those journals are unlikely to publish controversial, albeit important, results. Science news journals must expose important "cold,"3,5 obscure,2,6 unpublished,10 and controversial findings. Hot Papers13 and other frequency-based typologies14,15 have little relevance in slow virology.
Possible Remedies
Improvements in slow virus education and professionalism are desirable outcomes arising from the DD. The relative lack of peers and scientific divide suggest needs for truth and reconciliation to examine historical challenges and scrutinize broad ramifications, including potential harm and liability caused by inaction, poor scholarship, and consequences of scientific arrogance and smugness. Science news journals, in pursuing "good stories," should use their interdisciplinary resources and investigative skills for explicating controversy, elucidating challenging problems, and providing perspective and moral leadership for readers and peerless professionals. Ultimately, a slow virology review journal might accommodate the relative absence of peers and needs for improved scholarship. Nonanonymous reviews may stanch internecine behavior. Finally, rigorously controlled experiments aimed at demonstrating the
merits and pitfalls of multivalent vaccines against
pportunistic pathogens in AIDS are long overdue.
In summary, dogmas are restrictive and counterproductive. The DD undervalues slow virology and roles for multivalent vaccines against uncommon pathogens. These can save lives. Exemplary moral leadership--not governance--is essential.
Roulette Wm. Smith (Roulette@research.csudh.edu) is director of the Institute for Postgraduate Interdisciplinary Studies, Palo Alto, Calif., and Testing Officer at California State University, Dominguez Hills.
References
1. Commentary, "The Durban Declaration," Nature, 406:15-16, 2000.
2. R.W. Smith, "On mechanisms of slowness and progressiveness in slowly progressive processes," Annals of the New York Academy of Sciences 724:430-4, 1994.
3. B. Sigurdsson, "Mædi, a slow progressive pneumonia of sheep: An epizoological and a pathological study," British Veterinary Journal 110:254-70, 1954.
4. B. Sigurdsson, "Paratuberculosis (Johne's disease) of sheep in Iceland," British Veterinary Journal 110:307-22, 1954.
5. B. Sigurdsson, "Rida, a chronic encephalitis of sheep," British Veterinary Journal 110:341-54, 1954.
6. R.W. Smith, "AIDS and 'slow viruses'," Annals of the New York Academy of Sciences 437:576-607, 1984.
7. R.W. Smith, "[hiv-impact] Re: Cultural beliefs and customs," [HIV-impact] list server, www.edc.org/GLG/hiv-impact/hypermail/0202.html, June 16, 2000.
8. Group for Scientific Reappraisal of the HIV-AIDS Hypothesis, "Rethinking AIDS Website," www.virusmyth.com/aids/index.htm.
9. R.W. Smith, "HIV 'tat' gene is homologous with regions in HSV and EBV suggesting possible basis for synergism," In Abstract Book, 10th International Conference on AIDS (and International Conference on STD) [Yokohama, Japan] 1:141, 1994.
10. R.H. Rosadio, "In vitro characterization of herpesviruses isolated from goats and sheep," Master's thesis, Washington State University, Pullman, Wash., 1983.
11. D.F. Horrobin, "Peer review: is the good the enemy of the best?" Journal of Research Communication Studies 3(4):327-34, 1982.
12. Lord Phillips (Chairman), The BSE Inquiry, 62.189.42.105/report/contents.htm, Oct. 26, 2000.
13. E. Garfield, "The evolution of 'hot papers,'" The Scientist, 14[14]:4, 2000.
14. J.R. Cole, S. Cole, Social Stratification in Science, Chicago: University of Chicago Press, 1973.
15. G.J. Feist, "Distinguishing 'good' science from 'good enough' science," The Scientist, 14[14]:31, 2000.
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