By Christine Maggiore
Q: Dear Christine,
I noticed your column hasn’t appeared in the last few issues. Are you still “alive and well?”
A reader in Newport
A: Dear Reader,
Yes! Thanks for noticing my absence. I took a few months off to have and spend time with my new baby, an extraordinarily beautiful and healthy little girl.
Since managing the responsibilities of full-time motherhood (of two
children) and full-time work at Alive & Well makes it more of a
challenge to produce this column, I hope you and other readers will
enjoy the following article while I get myself organized for a comeback
in the next issue.
New Study Shows
AIDS Drugs Equally
As Effective As
Poverty & Malnutrition
by Rodney Richards, PhD; edited by Christine Maggiore
If antiretroviral drugs are responsible for dramatic improvements in survival among HIV positives taking the treatments, we should expect to see dramatically reduced survival among HIV positives with no access to the wonder drugs. Surprisingly, this is not the case. In the March 8, 2002 issue of the medical journal AIDS, scientist from the Medical Research Council and the Uganda Virus Research Institute in Uganda (MRC/UVRI) report that untreated “HIV infected” Ugandans are surviving “considerably longer than has been expected.”(1)
In fact, this is an understatement. The untreated Ugandans in the above study are actually surviving just as long as their medicated HIV-positive counterparts in the developed world, according to data published in the April 1, 2000 issue of The Lancet. (2) This latter study was conducted by the Collaborative Group on AIDS Incubation and HIV Survival Group (Collaborative Group) which analyzed data from 13,030 individuals with known dates of seroconversion from Europe, North America, and Australia to estimate time from seroconversion to AIDS and death.
Specifically, “median time from seroconversion to death was 9.8 years”(1) in the Ugandan study, as compared to 10.1 years for aged matched individuals in the Collaborative Group study; and median time from sero-conversion to AIDS was 9.4 and 9.3 years for the two studies, respectively (see note 1).
Even more miraculously, for individuals infected at ages15-24 in these studies, 10-year survival was substantially better in antiretroviral-free Ugandans than it was in their medicated counterparts living in Europe, North America, and Australia (78% vs 66%, see note 2).
Could it be that these particular rural Ugandans are living in abundance with good nutrition and the necessary resources to provide for an environment conducive to fending off the opportunistic infections waiting to take advantage of their failing immune systems?
The authors give us the answer in a separate report, which was published two months earlier in the British Medical Journal (BMJ). “Most of the population” in their study area “lives in poverty; food is often in limited supply, there is no electricity, and there is poor access to any, let alone clean, water. Malaria is endemic, and infections other than HIV, especially bacterial infections, are common.”(3)
Interestingly, the BMJ publication doesn’t even talk about time to AIDS or death. Rather it focuses on symptoms in these “HIV-infected” individuals and paradoxically concludes that “disease progression associated with infection with HIV-1 seems to be rapid in rural Uganda.” Only in the world of HIV/AIDS can “rapid” disease progression be correlated with “considerably longer” survival. The apparently schizophrenic conclusions in these two publications, which are derived from the same patient population, are discussed further in note 3.
Rather than comment on the contradictory nature of observable facts, the authors of the Ugandan study attempt to divert attention from the extraordinary survival rates observed in their subjects by emphasizing these rates are “comparable to survival times in industrialized countries prior to the widespread use of antiretroviral therapy.” Technically true, but only because survival times have not changed since the widespread use of antiretroviral therapy in industrialized countries!
The Collaborative Group study analyzed data for 13,030 individuals who seroconverted in the pre-HIV-era (before 1983), the prophylaxis-era (1983-1987), the AZT-era (1987-1990), the mono-therapy-era (1990-1993), and the combination therapy-era (1993-1996). Contrary to all expectations, the authors inform us that they “found no evidence of a difference in survival or time to the diagnosis of AIDS for individuals who seroconverted in 1983-96.”(2)
No difference in survival time or progression to an AIDS diagnosis for people who became HIV positive from 1983-1996, despite all the dramatic improvements in therapies during these years? How can this be?
Prior to AZT treatment, we were told that prophylaxis against PCP (pneumocystis carinii pneumonia) and MAC (mycobacterium avium complex) dramatically slows progression to AIDS and death, after the release of AZT in 1987 we were told AZT dramatically slows progression to AIDS and death further still. Then in 1993, we were told combination therapy dramatically slows progression to AIDS and death even further!
In fact, and in stark contrast to all that we’ve been told about the drug therapies, the only group in the Collaborative Group study that actually did enjoy significantly better survival were those individuals who seroconverted to HIV positive before 1983, before there were any AIDS treatments or prophylaxis in use!
So is it fair to say that AIDS prophylaxis, AZT, and combinations of AIDS drugs did nothing for those receiving treatment? Technically, it is not fair to say prophylaxis, mono-therapy, and combination therapy did nothing, since those who seroconverted in years when these drugs were immediately available actually did significantly worse! The authors offer a nonsensical rationalization to account for this glaring anomaly: “The apparently better survival for individuals seroconverting before 1983 may be an artefact, because these individuals seroconverted before the discovery of HIV-1 as the causative agent for AIDS.”
Rather than focusing on 13,030 examples demonstrating a complete lack of benefit to any of the anti-retrovirals used alone or in combination up to 1996, the authors instead present this data as a summary of survival “before the widespread use of HAART,” apparently putting forth the implication that with HAART, survival rates are most certainly improved. Yet the authors offer no data of their own or even a reference to a single publication showing us how patients who sero-converted in the HAART-era are actually doing with regard to survival rates.
Today, nearly two years after the Lancet article on the Collaborative Group study, the PubMed data base still does not list any published comments on the results of the Collaborative Group study, and I am still unaware of any publication that reports data for survival or time to AIDS in persons with known dates of seroconversion after 1996, in the era of ostensibly better HAART therapy.
Even if such data were to become available, and even if the data were favorable to HAART, the fact remains that the 513,486 AIDS patients reported to the CDC(4) prior to 1996 needlessly consumed billions of dollars worth of useless antiretrovirals that seriously compromised the quality, and perhaps even the quantity, of their lives.
Do these half-million individuals, their families and loved ones deserve to know that the promised benefits of these drugs aggressively promoted by the pharmaceutical industry, our public health institutions, and uncritical journalists, were nothing more than illusions? That the only thing real that resulted from their dedicated compliance to consuming these chemicals were compromised quality of life and debilitating side-effects? Or do we continue to divert attention from their senseless pain and suffering by shining the light of hope on the new unproven toxic drugs of the HAART-era?
While the results of the Collaborative Group study tell us why untreated HIV-positive Ugandans are surviving just as long as their treated counterparts in the developed world (the drugs are demonstrably worthless, at best), they don’t reveal why HIV-positive Americans and Europeans who have full access to food, water and health care do not fare better than their impoverished Ugandan counterparts. Is there anything that can explain the remaining part of this paradox?
The Ugandans enrolled in the above studies did have access to regular check-ups, diagnostic testing, and free medication for routine health-care, which might have contributed to survival. However, when the researchers studied matched HIV positives outside of the study cohort who did not have access to these amenities, survival times were no different. The authors characterize this fact as a “disappointing” finding for which “we do not have a good explanation.”(1) It would seem from this that access to health-care and medicine is of little use to malnourished people with no access to food or clean water.
Could it be then that the HIV-positive Ugandans in these studies are not surviving surprisingly long, but rather, that the HIV-positive subjects in developed countries on antiretrovirals are actually dying surprisingly fast? Perhaps the anti-retrovirals are not worthless but are actually as harmful as poverty and malnutrition.
To check this hypothesis, I propose a study that would give some of the Ugandans in the above studies access to food and clean water and then assess their survival rates. If such a study were under taken, I predict we would see the median survival among untreated HIV-positive Ugandans significantly surpass that of their medicated counterparts in the developed world. Can such a study be conducted? It’s not unethical to give Africans food, is it?
Summary: Median time from seroconversion to AIDS and death in poor, starving rural Africans (without access to health care, purified water or electricity) living in the Masaka District of Uganda (where malaria, dysentery and measles are endemic) is no different than that observed in Europeans, North Americans, or Australians who have full access to proper nutrition, health-care, “life-prolonging” anti-retrovirals, and prophylaxis against opportunistic infections.
Conclusion: These observations are consistent with the hypothesis that anti-retrovirals are killing people as effectively as poverty and malnutrition.
Christine Maggiore tested HIV positive in 1992 and was given five to seven years to live. More than ten years later, she enjoys natural good health and is the mother of two exceptionally bright and healthy children. Her book, “What If Everything You Thought You Knew About AIDS Was Wrong?” has been translated into five languages and is endorsed by Nobel prize-winning scientist, Dr. Kary Mullis, and best-selling authors, John Robbins, Tony Robbins, and Gavin de Becker. Christine's personal story and alternative AIDS work have inspired feature segments on ABC News’ 20/20, NBC Evening News, and CNN and have been re-counted in a variety of publications including Newsweek, SPIN, GQ, Mothering, and LA Weekly as well as in many international news journals. Christine is the founder and director of Alive & Well AIDS Alternatives, a non-profit education, support and research net-work. To find out more visit www.aliveandwell.org
Return to the July/August Index page