from Fear of the Invisible
AIDS is to be diagnosed with different symptoms in Africa
It is common knowledge that AIDS in Africa is rampant, that it affects men and women alike, and is destroying the population and economic prospects of Sub-Saharan Africa. Everyone also thinks, as I have for most of my life, that AIDS in the West and Africa has the same diagnostic definition and symptoms; that they are clinically the same. This is only surely sensible - the same virus must cause the same illness?
But, when I investigated, I found the truth was utterly otherwise. AIDS is diagnosed entirely differently in Africa. Officially in Africa a person only has to have a few symptoms common to many diseases that ultimately are caused by great poverty, poor water supplies and lack of sanitation. Again there is no requirement to test positive for HIV for an AIDS diagnosis. This was strangely easy to discover. I only needed to go to the official WHO website and look it up. This tells me that our media has not been doing its homework when reporting AIDS in Africa.
This unique African definition of AIDS, and its special diagnostic rules, was created in the early days of AIDS research. In 1983 Robert Gallo had speculated the AIDS virus was from Africa, saying that this was because he had detected a trace of one of his suspect cancer retroviruses, HTLV-I (not HIV), in a case among blacks on Haiti. When in 1985 Gallo tested blood sera from children in Uganda and discovered that 67% had ‘HIV' antibodies, he deduced from this that these children had no chance of survival, and that Uganda would come to a quick and disastrous end.
Although this was horrific, the discovery that males and females tested HIV positive equally in Africa must also have been something of a relief for him. It was essential to his virus theory that both genders be equally infected.
But this relief did not last long. It was soon discovered that the Africans testing positive were rarely falling ill with the AIDS indicating diseases of the West, with PCP, Thrush and Kaposi Sarcoma. This surely meant that they were not getting AIDS! This seriously threatened his HIV theory. If this virus caused these illnesses in the West, why wasn't it doing so in Africa?
But in 1984-5 a close colleague of Gallo's, Professor Myron Essex of Harvard, recommended that the HIV test be not relied on in Africa. He had just discovered that mycobacteria test falsely positive in the HIV test. It seemed the HIV antibody is also against mycobacteria. He concluded, since mycobacteria are very common in Africa, the test was unreliable in that continent. (This also could explain why so many Ugandans tested positive.)
Essex stated: ‘our observations ... suggest that HIV-1 Elisa and Western Blot results be interpreted with caution ... [they] may not be sufficient for HIV diagnosis in AIDS-epidemic areas of Central Africa where the prevalence of mycobacterial infections is quite high.' His finding has since been confirmed by a host of other studies. This is a mayor reason why WHO has since not relied on HIV tests in Africa.
In late 1985 a solution to this embarrassing enigma was worked out at a meeting of international health experts and representatives of Central African governments held in the West African city of Bangui between October 22nd- 25th 1985, under the auspices of the World Health Organisation.
At this there were protests from African government representatives who held that the West was grossly exaggerating the AIDS problem in Africa since few Africans were falling ill with the classic AIDS symptoms. But the international agencies run roughshod over these objections and it was agreed that in future black Africa should have its own unique definition of AIDS, one that did not rely on the HIV test, nor on the presence of the main AIDS-indicating illnesses as then defined - and one that would definitely ensure that in future Africa had a gigantic AIDS epidemic.
The new rules laid down that Africans in future should be diagnosed with AIDS if they scored a total of 12 points from a new list of general symptoms of illness. These official African AIDS diagnostic rules are still current, and are called the ‘Bangui Clinical Definition of AIDS.' This is from the WHO website:
BANGUI CLINICAL DIAGNOSIS OF AIDS
Exclusion criteria (If these are present then it is not AIDS)
1. Pronounced malnutrition
2. Cancer (excluding Kaposi Sarcoma)
3. Immunosuppressive treatment
Inclusion criteria with the corresponding scores
Weight loss exceeding 10% of body weight 4 points
Protracted asthenia (defined as ‘weakness or debility' ) 4 points
Very frequent signs
Continuous or repeated attacks of fever for
more than a month 3 points
Diarrhoea lasting for more than a month 3 points
Cough 2 points
Pneumopathy (Any disease of the lungs) 4 points
Oropharyngeal candidiasis (Thrush in mouth or throat) 4 points
Chronic or relapsing cutaneous herpes (severe rash,) 4 points
Generalized pruritic dermatosis (severe itching) 4 points
Herpes zoster (relapsing) (a painful infectious skin rash) 4 points
Generalized adenopathy (enlargement of lymph modes.) 2 points
Neurological signs (signs pertaining to nervous system) 2 points
Generalized Kaposi's sarcoma (a skin cancer) 12 points
It finally stated that 'THE DIAGNOSIS OF AIDS IS ESTABLISHED WHEN THE SCORE IS 12 OR MORE.'
In 1994 this was modified slightly. The WHO ‘Expanded Case Definition' of that year ignores Essex's 1985 advice and recommends that the HIV test be done as well - but also says, if this were not available, then the original Bangui Definition should be adhered to unchanged. Thus African states have practically identical AIDS reporting forms, with the Bangui definition on them.
Thus, most astonishingly, for an African to be told they are cursed with AIDS, it more than suffices to have an intermittent fever, protracted weakness, diarrhoea and 10% weight loss - all symptoms that can result from living in unsanitary conditions. With these symptoms, the African AIDS epidemic could be sharply diminished by funding sewage works, clean water supplies, and better nourishment. These are the very same measures that ended the epidemics that ravaged the British poor in the 19th century.
But by adopting this definition and calling this AIDS, the international experts had done the contrary. They had created by fiat a massive African AIDS epidemic reportedly caused by promiscuous sex, with death only delayed by powerful chemotherapy type drugs. This has also led to preachers advocating sexual abstinence and to bishops blaming African bigamy. The result is that in Africa some call AIDS the ‘American Initiative to Destroy Sex.'
To make matters worse, individual African countries have exasperated these errors. Tanzania has said just finding one of the above symptoms is all that is required for an AIDS diagnosis and Uganda for a period allowed TB by itself to be defined as AIDS. As a result, their AIDS diagnoses soared.
In South Africa however a positive HIV test is now required and, despite the Bangui Definition, TB itself is acknowledged to be the greatest killer in South Africa, particularly among younger adults. This is verified by the 2005 official South African statistics based on death certificate reports. They tell us that TB kills 4 times more people than AIDS, in South Africa and that ‘flu, pneumonia, heart diseases and diabetes all kill more than AIDS. (AIDS is today credited with 2.7% of deaths in South Africa,)
However, according to these same South African statistics, diseases of poverty are increasing, with malnutrition growing as a major cause of death for children aged under four. As severe malnutrition produces AIDS-like symptoms, these cases could be misdiagnosed as AIDS in future.
Certain AIDS scientists have contested these official figures on the basis that deaths from TB are really deaths from AIDS. However TB has been around for far longer than AIDS - and has long been a major killer. The same is true of Malaria. According to the World Health Organisation, there are more cases of TB and Malaria every year in Africa than the total number of African AIDS cases reported since 1982. (However HIV test manufacturers warn that both malaria and TB bacteria can falsely test positive for HIV.)
Dr Christian Fiala, a researcher of AIDS in East Africa, has reported; ‘TB is very widespread in Africa. It's a bacterial infection that infects the lungs. TB is spread by coughing, and is highly infectious. The typical symptoms of Tuberculosis are fever, weight loss and coughing. This is exactly what is required for an [African] AIDS diagnosis.' The tragedy, he added, is that less than one hundredth of the money spent on chasing the AIDS virus is currently spent on fighting TB or malaria. (Not all TB cases are in the lungs - sometimes the bacteria multiply in other parts of the body.)
In South Africa, WHO calculates its AIDS epidemic statistics, not from a survey of the whole population, or from overall population statistics, but from the presence of ‘HIV antibodies' in blood tests done on a few thousand pregnant women attending clinics - despite research findings that show healthy human placentas often contain retroviruses (seen by Electron Microscope) that falsely test as if HIV.
On top of this the WHO computer team in Geneva has vastly increased their statistical allowance for ‘error factors' when working out their estimates for the numbers AIDS inflicted in Africa. While their field reports list around 70,000 a year of Africans as testing HIV positive; their annual estimate for AIDS in Africa is calculated by multiplying these reported cases by an ever increasing error factor to account for ‘under-reporting.' In 1996, WHO thus justified multiplying the number of registered AIDS cases by 12 times to get their estimate, but in 1997 put this up to multiplying by 17 - thus statistically producing a horrendous estimate.
Dr James Chin should know what the correct figures are. He reported in his recent book ‘The AIDS Pandemic: the Collision of Epidemiology with Political Correctness' that he ‘was responsible from 1987 to 1992 for receiving and tabulating national reports of AIDS cases submitted to WHO in Geneva.' He reported that there is ‘gross overestimation of most national HIV prevalence estimates in SSA' (Southern Africa). As for the Philippines, he tells how initially ‘the minister of health multiplied the 50 detected HIV/AIDS cases by 1000 to derive an estimate of 50,000!' He concluded: ‘If you knew how most HIV/AIDS numbers are generally "cooked," you would surely use them with extreme caution!' It is ‘very clear that reported AIDS cases in most developing countries are totally unreliable and thus unusable as any meaningful measure.'
What then of all the ‘AIDS' orphans in Africa? A World Health Organisation report, marked for ‘restricted' distribution, explained ‘there is confusion as to what is meant [in Africa] by the term "orphan." It can mean the absence of one parent, temporary or permanent (as Madonna found when she was introduced to her orphaned child's father). It is also presumed that most African orphans are so because of AIDS. However, a WHO report on AIDS in Uganda noted, ‘no distinction made as to the cause of orphanhood, which in some areas included the effects of war.' Uganda between 1966 and 1986 had an estimated million people killed in war. Many other wars have recently devastated Central Africa with over a million also killed in Zaire.
But, with a very large proportion of the medical funds available in Africa earmarked for fighting AIDS, doctors must be greatly tempted to use the lax standards of the Bangui Definition to declare most of their patients have AIDS, as this could be the only way for them to get the funds they desperately need. Likewise for patients, most will easily qualify under this definition, so they too may benefit from asking for help as an AIDS victim.
The practical consequence of blaming so many common illnesses on HIV, despite each having its particular cause, is that African governments are today under enormous pressure to re-allot their scant health funds away from the diseases of poverty to pay for expensive antiretroviral medicines. Today, if any African government shows reluctance to spend most of its health budget on antiretrovirals, Western interests accuse it of malgovernance. If any local doctor needs funds, he also knows what he must say.
Finally and more optimistically, it should be noted that, that, despite the widespread malnutrition, poverty and disease, the African population is far from shrinking. The US Bureau of the Census, in its International Database 2001, reports that between 1980 and 2000, during reportedly the worse years of the African AIDS epidemic, the population of Sub-Saharan Africa went up from 378 million to 652 million.
Gallo to Director of NCI, 4th August 1983.
Saxinger WC, Levine PH, Dean AG, et al. Evidence for exposure to HTLV-III in Uganda before 1973. Science 1985;227:1036-1038.
His views are in a paper he and colleagues published in 1985.
Myron ‘Max' Essex, Head of Harvard AIDS Institute. In a 1994 study he warned that ‘existing antibody tests ‘may not be sufficient for HIV diagnosis' in settings where TB and related diseases are commonplace.'
Another such study found ‘ELISA and WB may not be sufficient for HIV diagnosis in AIDS-endemic areas of Central Africa where the prevalence of mycobacterial diseases is quite high' Kashala, O. Marlink, R. Ilunga, M. Diese, M. Gormus, B. Xu, K. Mukeba, P. Kasongo, K. & Essex, M. 1994 Infection with human immunodeficiency virus type 1 (HIV-1) and human T cell lymphotropic viruses among leprosy patients and contacts: correlation between HIV-1 cross-reactivity and antibodies to lipoarabinomannan. Journal of Infectious Diseases 169, 296-304.
ChicagoTribune November 24, 1985
Papadopulos-Eleopulus et al. AIDS in Africa: distinguishing fact and fiction World Journal of Microbiology and Biotechnology 1995, 11. 135-143
‘While an increasing number of deaths are associated with lifestyle diseases (such as heart disease and diabetes) as the underlying cause, the dominant contributors to the growth in mortality are deaths associated with tuberculosis, and influenza and pneumonia. Malnutrition was among the ten leading causes of death among children aged under 4. Although there was fluctuation during the three years in the percentages of deaths linked to malnutrition, the numbers of deaths increased steadily.' South African Health Statistics. Published March 2005.
Panem, S. 1979. C Type Virus Expression in the Placenta. Curr. Top. Pathol. 66:175-189 - quoted in Eleni Papadopulos-Eleopulos, Valendar F. Turner and John M. Papadimitriou Is a Positive Western Blot Proof of HIV Infection? BIO/TECHNOLOGY VOL.11 JUNE 1993. This can be found on www.theperthgroup.com The retroviral protein p30 common to many retroviruses was also identified in human placentas by antiblot testing in Proc. Natl. Acad. Sci. USA Vol. 81, pp. 6501-6505, October 1984 Medical Sciences Detection and immunochemical characterization of a primate type C retrovirus-related p30 protein in normal human placentas (retroviral core protein/two-dimensional electrophoresis/immunoblot analysis) Lois B. JERABEK, ROBERT C. MELLORS*, KEITH B. ELKON, AND JANE W. MELLORS Research Division, The Hospital for Special Surgery, Affiliated with the New York Hospital-Cornell University Medical College
Peter Duesberg, Evidence to South African Presidential Commission on AIDS, 2000.
From Dr Christian Fiala, an Africa based AIDS specialist.