In March, Harper’s magazine, ordinarily classy, bohemian, and reliably well written and reported, went ape. The venerable journal published an account of clinical drug trials that was more baleful (and more fantastic) than that painted by John le Carré in his 2000 novel The Constant Gardener, where pharmaceutical companies and governments murderously collude to hide the truth about an experimental drug.
The Harper’s story, “Out of Control,” by Celia Farber, is an extraordinary, overheated document. Farber is a polemicist, notorious for advancing the “Duesberg hypothesis”: the argument, proposed by University of California, Berkeley, virologist Peter Duesberg, that HIV does not cause AIDS. Instead, as Farber writes in Harper’s, “It could very well be the case that HIV is a harmless passenger virus that infects a small percentage of the population and is spread primarily from mother to child.” Like Duesberg, Farber believes that in the United States and Europe, AIDS sufferers have poisoned themselves: “many cases of AIDS are the consequence of heavy drug use, both recreational (poppers, cocaine, methamphetamines, etc.) and medical (AZT, etc.).” In Africa, she argues, AIDS is a kind of confidence game played by pharmaceutical companies and national governments: she uncritically offers up Duesberg’s position that “AIDS in Africa is best understood as an umbrella term for a number of old diseases, formerly known by other names, that…do not command high rates of international aid.” Duesberg (and, we presume, Farber) consequently believes that all anti-HIV medications are poisonous shams promoted by self-serving researchers, executives, and activists: “If toxic AIDS therapies were discontinued, [Duesberg] says, thousands of lives could be saved virtually overnight.”
Of course, the epidemiological evidence does not support the Duesberg hypothesis. Most virologists, and nearly all AIDS researchers, accept that HIV causes AIDS. Farber’s own views of HIV and AIDS drugs seem political, informed by an idiosyncratic set of dislikes: of AIDS activists, of big business, of pharmaceutical and recrea-tional drugs, and of something called “the scientific-medical complex.”
Farber’s assault on what she calls “the HIV theory of AIDS” is not new: she has been writing approvingly of Duesberg since the late 1980s. What is novel in “Out of Control” is her criticism of an HIV drug trial, called HIVNET 012, that took place in -Kampala, Uganda, in the late 1990s. Just how drug trials in the poor world should be managed is a real question, and a highly topical one. The same month that Harper’s unleashed Farber, Wired magazine published “A Nation of Guinea Pigs,” a story by Jennifer Kahn that addresses the outsourcing of drug trials to India. Portrayals of corrupt or dubious medical research have suddenly become a media genre, one that draws upon popular distrust of the motives and methods of pharmaceutical companies (a psychology that science writer Jon Cohen has dubbed “pharmanoia”).
HIVNET 012, funded by the National Institutes of Health, found that a brief, inexpensive regimen of a drug called nevirapine- – one shot for a mother at the beginning of labor and one for her infant shortly after birth – could dramatically reduce rates of mother-to-child transmission of the virus. But problems with HIVNET 012 have since come to light: audits and reviews have found that record keeping was sloppy, and adverse events were underreported by trial investigators. Farber believes that these failures suggest a conspiracy to promote drugs that are toxic.