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November 11, 2002

LEFTIES, PHARMAS AND AIDS

Arguments About Toxicity And Lack Of Drug Efficacy Do Not Seem To Appeal To Those On The Left When It Comes To AIDS. What’s Going On Here?

By David Crowe

One of the strangest moments of my life occurred when I confronted Ralph Nader at a public talk on medicine in my home town on the subject of AZT and was accused, by him, of being a conspiracy theorist. It was particularly ironic because I have been a Green Party activist for several years and, in just about every other way, admire him for his integrity and cogent analyses of all that is wrong with society today.

Ralph Nader genuinely believes that, if the rich get AZT, then so should the poor. Arguments about toxicity and ineffectiveness do not appeal to him. Nader likely gets his information on AZT and other AIDS drugs from people like Dr. Sidney Wolfe, the director of the Public Citizen Health Research Group, which Nader helped to establish. Wolfe called the drug a ‘proved treatment’ for HIV-positive pregnant women in a letter to the British Medical Journal in 1998. This, despite researchers at the National Cancer Institute calling the drug "a genotoxic transplacental carcinogen in animal models" in the title of a 1997 article in the Journal of AIDS.

Nader is far from alone among people on the left, in unquestioningly accepting the need for AIDS drugs, and focusing on economic barriers to AIDS drug access, rather than focusing on the squandering of resources on treatments that may be useless or even dangerous.

There is not much that radicals and multinational companies agree on, but the desperate need for drugs for those suffering from AIDS is an exception. Left-wing radicals may argue that drugs should be made available without cost to victims, or that patents should be waived to allow production by generic manufacturers, but by and large, they strongly support the ‘drugs into bodies’ philosophy.

This attitude probably stems from a legitimate desire to extend medical care to everyone, resulting in a fear of criticizing a system that would potentially do so. Ironically, even in Canada, which has one of the strictest socialized medicine systems in the world, doctors are essentially capitalists, billing the state instead of their patients. Doctors who value money above their medical standards can still run an assembly-line practice, accept gifts from pharmaceutical companies, while not having the overhead of multiple insurance companies and bad debt to threaten their cash flow.

Radicals seem to fear that AIDS dissidents are a clique of far-right fanatics hoping to sow fear among the disadvantaged groups who are most likely to get AIDS — gay men, IV drug addicts and Africans. The aim, presumably, is to get them off drugs, and into graves.

Chris Talbot, a Marxist, participating in a debate on the World Socialist website in 2001, seemed to be more concerned about the right-wing connections of Bryan Ellison, a one-time graduate student and co-writer of Peter Dues berg (who has challenged the HIV theory of AIDS), than of his ideas. Ellison’s fanaticism was apparently revealed by his suggestion that instead of spending billions on AIDS, it would be better to focus treatment efforts on the 30 individual diseases that are said to be associated with AIDS.

Another ironic twist is that Stephen Lewis, once Canada’s cuddliest socialist, is now Koffi Annan’s Special Envoy for HIV/AIDS in Africa. Interviewed on CBC radio shortly after his appointment in 2001, Lewis gushed about the benefits of a new pill that was merely a combination of two existing AIDS drugs, as if the only problem with AIDS drugs was the number of pills to be taken in a day. Words like ‘side effects’ and ‘toxicity’ apparently never touch his lips. Lewis is a dream salesman, because of his anti-capitalist credentials, charm and integrity. There is nothing more convincing than a salesman who truly believes in his product, and Lewis has obviously been impeccably briefed. As icing on the cake, drug companies do not even have to pay his salary, nor a commission on the sales he will generate!

Those on the left apparently cannot conceive that they may be unwitting pawns in a huge game; that HIV/AIDS theories, tests and drugs are based on questionable science and fostered by the intense greed that directs the higher echelons of medicine. Battling pharmaceutical companies for quicker or cheaper access to drugs is just a diversion from the real issues of drug effectiveness and toxicity. Drug companies can reduce prices and still make a profit. They cannot significantly improve the effectiveness and safety of an approved drug nearly as easily.

AIDS treatment activists from ACT-UP or similar groups are a staple of major AIDS conferences. They trash drug company booths, splash fake blood and paint slogans demanding more drugs, more quickly. Ironically, these groups are often funded by drug companies. Rarely do they go to jail. Yet, when an avowedly non-violent AIDS dissident like Christine Maggiore of Alive & Well applies for a booth in a corner of a hall in the basement of one of these conferences, the request will not be welcomed.

The reason for this apparent contradiction is that the noisy treatment activists are guaranteed newsmakers, providing free publicity that builds billions of dollars of demand for ‘life-saving’ AIDS drugs, far outweighing the cost of repairing company booths. To keep the deliberately created clamor for drugs under control, drug companies can announce a price reduction, a new pill (often merely a different combination or dosage of existing drugs) or a new research initiative as part of the play fight with activists.

AIDS dissidents are a much more serious threat by suggesting that people testing positive on an HIV test might be better off without the products of the drug company (or even without getting tested in the first place). They will not be satisfied until AIDS drug factories are shut down and this means that they must be silenced at any cost.

What Is This Stuff Called AZT?

AZT was the first AIDS drug approved (1987), and still one of the most widely prescribed. A failed cancer drug, it was designed to mimic one of the four DNA building nucleosides (Thymidine). Yet, unlike the beads that form a chain of DNA, AZT can only join the chain at one end. Each molecule of AZT has the capacity to terminate the growth of one strand of DNA.

The theory is that this prevents HIV from being reverse-transcribed into the DNA. However, analysis of AZT research by Duesberg and by the "Perth Group" of scientists, indicates that the triphosphorylation of AZT, necessary for incorporation into growing DNA chains, simply does not occur to any significant extent. This means that AZT cannot have any beneficial effect, but it may still have detrimental effects, particularly on mitochondria, the energy management organelles of all living cells.

It would now be considered malpractice to give a high dose AZT (as was done in the late 1980s). Yet AZT, with all its published carcinogenic, mutagenic and teratogenic potential, is still the major drug prescribed to pregnant women to prevent HIV transmission to their infants.

AZT has a long list of published side effects, including anemia and destruction of bone marrow (critical components of the immune system). This is the panacea that drug companies and radical activists alike are trying to bring to poverty stricken, malnourished mothers in the Third World, many of whom are already anemic due to malnutrition or parasitic infections, such as hookworm. Where are these mothers going to go when they need a blood transfusion, or worse yet, become transfusion dependent? Where do they go for their Procrit (a blood booster that is advertised in just about every AIDS journal "for AZT-treated, HIV-infected patients with anemia")?

An up and coming drug, and the only other one recommended for use in pregnant women is Nevirapine. This one has fewer published side effects than AZT, largely because much less research has been done. Yet, in 2001 the CDC had to warn against its use after needle stick injuries because of the risk of liver failure and other nasty events. The drug company (Boehringer-Ingelheim) withdrew its application for use in pregnant women in the United States, but is still pushing hard for its use elsewhere in the world. The reason given for the withdrawal was a disagreement over the definition of an adverse reaction in the only study to have been performed on pregnant women with this drug in Uganda. This study compared Nevirapine against AZT, rather than a placebo, so nobody knows if the shockingly high rate of adverse effects (over 50%) in the mothers and babies (including a 15% death rate in the babies) is due to the drugs, or to HIV.

There certainly is room for argument over AZT and Nevirapine. If the theory that HIV causes AIDS is accepted, the severe toxic effects of these drugs might be acceptable for a greater gain. But there is no room to completely dismiss concerns about their use.

A Final Word

Perhaps if I had not grown up influenced so much by a socialist mother, I would not feel so bad about this. Accepting that the role of the state is to try to ensure that everyone has a minimally acceptable standard of living and equal opportunities to advance should not mean that we can blindly throw money at a problem and necessarily get a positive response.

I can respect the opinions of people who study both sides of HIV/AIDS and conclude that AIDS drugs, while far from perfect, are the lesser evil. But too many left- wing radicals appear in knee-jerk fashion to see access to all medicines as a critical factor for the development of socialized medicine, and completely close their eyes to the limitations of the drug-centric approach to AIDS.

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