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February 23, 2009

Missing the forest for the trees

I’m still receiving emails and calls from AIDS denialists. One guy called me from Canada on my cellphone after midnight last Saturday, to tell me he was “disturbed” by some of the things I said about AIDS myths and conspiracy theories — and their devastating costs. I was more polite than he probably deserved and told him that if he wanted to discuss this, he should have the courtesy of calling during business hours. He called back at 8:45 Sunday morning. I think it’s probably the same guy who has sent me about a dozen links to wacky articles and posts denying the existence of AIDS. I’m hoping these people will forget about me, but I may have to reconsider having my contact details on this site. It’s never been a problem before and I hope I won’t have to resort to that as I think it’s important as a journalist to be accessible.

The whole situation has made me think more about how conspiracy theorists think and what makes them tick. All of the people who have contacted me are westerners, with little or no contact with Africa. I suppose it’s easier to deny the existence of the epidemic when you don’t see, on a daily basis, the overflowing hospitals and graveyards. Or the dramatic drops in death rates in places where ARVs have become available. Or the near-miraculous recovery of someone receiving ARV treatment.

Many of the people who have contacted me have extrapolated widely from their own experiences: they or someone they know and care for has responded badly to ARVs, so therefore they have decided that the treatment doesn’t work for anyone. As with all medical treatments, some people respond better to ARVs than others. There is a tragic desperation to many of the emails I’ve received — they’re grasping at straws, at the possibility that the disease itself doesn’t exist. The nature of HIV/AIDS makes this kind of self-delusion easier. Someone with AIDS can be seemingly healthy, even while their body’s defenses have been ravaged. But as I’ve seen too many times, all it takes is a single opportunistic infection to bring death swiftly.

The single unifying characteristic of the many people who have contacted me in recent weeks is their inability to see the forest for the trees. They focus on one mistake that was made in the scientific quest to understand AIDS (and certainly there were many) or one question we haven’t yet fully untangled. It’s as if we’re all looking at a giant jigsaw puzzle with some pieces still missing. We now know enough about AIDS to see the broader picture, but the conspiracy theorists are still focusing on the missing pieces. Despite the overwhelming evidence showing that HIV causes AIDS and that antiretroviral drugs are an effective therapy, they continue to insist that the epidemic doesn’t exist.

I remember when I was in college, a famous Yale mathematics profession named Serge Lange decided that AIDS was a statistical impossibility. He wasn’t an epidemiologist or a virologist or a doctor. To my knowledge, he’d never been to Africa. But from his office in New Haven, he decided that HIV couldn’t possibly cause AIDS or be transmitted sexually. He used to write long manifestos and leave copies of them outside our campus dining halls. But his theories ignored the very real evidence that a deadly epidemic was underway.

The funny thing is that that the video that prompted this backlash wasn’t really about the western AIDS denialists who have been flooding my inbox. I was speaking as much about the cost of denial and HIV/AIDS-related myths on the ground in Africa, among people who don’t know about retroviruses or t-cells: the rumors that AIDS is a bioweapon developed by America or the apartheid government, that condoms transmit AIDS, that people can protect or cure themselves with traditional medicine or by sleeping with a virgin.

There should be plenty of room for legitimate debate about HIV/AIDS. The early estimates about the number of infected, especially in Africa, were inflated, as even UNAIDS now admits. Western models for dealing with the epidemic were unthinkingly applied to Africa, even when they made no sense there. Our emphasis on privacy and consent, in particular, helped cast a veil of silence over the epidemic in Africa and fuel AIDS denial. But there’s a big difference between taking a critical examination of the epidemic and the willful refusal to accept the truth even in the face of overwhelming evidence. Okay, enough about AIDS denialists.

This is my last post on the issue. It’s a distraction from the real issues. 

2 Responses to “Missing the forest for the trees”

  1. David Crowe Says:

    Dear Nicole;

    Why will you not give me the courtesy of responding to my letter to you?

    Regards,
    David Crowe

  2. Gloria Says:

    I dont usually comment, but after reading through so much info I had to say thanks

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