Matt White
12-01-2005, 05:49 PM
I've watched "The Origins of AIDS" on Sundance a couple of times now. This should have been on NATIONAL TELEVISION. Very distrubing......
From 1981, when the condition was first recognized in American gays, to the present, the origin of the epidemic, the pandemic, has always intrigued people. From molecular biologist to taxi driver, everyone has an opinion. As the millennium approaches, 50 million people around the world have been infected with HIV, of whom 15 million have developed AIDS. Most of the latter have already died. As of this year, it is the world's biggest killer infectious disease.
But one thing which, even back in the early eighties, was overwhelmingly clear both to the gay communities of New York and Los Angeles, and to the villagers of southern Uganda who witnessed the first epidemic outbreak in the general population, was that this syndrome, this collection of diseases, was something entirely new.
Many, including many of those dedicated and overworked AIDS physicians, would ask whom the question of origin benefits: what purpose does it serve to try to answer the unanswerable? The battle is raging already, they would argue; we need to treat the wounded, not apportion blame.
A fair point, on one level. But doctors, of all people, should know that very often diseases can be cured, or treated, only after we have a proper understanding of their aetiology. (The classic example is the cholera outbreak of 1854, which killed 500 Londoners before an epidemiologist, John Snow, deduced the crucial role of the water supply, and stopped the epidemic by removing the handle of the Broad Street pump.) Furthermore, if the genesis of AIDS has involved avoidable events or human error, then perhaps we can learn useful lessons, and thus avoid similar disasters in the future.
So this is not just an academic question. It is one to which, as a species, we need answers.
QUESTION OF TIMING
My own quest into the origin of AIDS began in the summer of 1990 in Covent Garden, at one of those wobbly tables out on the cobblestones, where waitresses bring cafetieres and expensive sugary pastries. By that stage I had been working on AIDS for four years, and my first book, Slim, about the epidemic in East Africa, had just been published (Hooper, 1990). During the round of interviews and discussions that followed, I was once again struck by the sheer volume and range of explanations for the advent of the syndrome, which ranged from the carefully-reasoned, via the paranoid, to the seriously wacky.
Thinking that a book on the subject might take a couple of years to research and write, I decided to investigate further, and my first step was to interview a haematologist called Alan Fleming, who had written a series of articles (mostly for a fairly obscure German journal) in which he documented the earliest traces of HIV infection in Africa, stretching back as far as 1959. By this stage, the proposition that AIDS had emerged from Africa was still viewed as controversial, although the scrupulous epidemiological evidence assembled by Professor Fleming left little doubt.
As I scribbled notes among the pastry-plates, Fleming made three very powerful points. The first was that the immediate ancestors of the HIVs, the simian immunodeficiency viruses or SIVs, were found naturally only in African primates. (In these animals, the SIVs caused no disease, which -- together with the large number of African primate species which had already been identified as SIV carriers -- suggested that these were ancient infections.) At that juncture, two variants of HIV (HIV-1 and HIV-2) had been identified. However (and this was his second point), in that huge -- albeit unintended -- biological experiment called the Slave Trade, over ten million people from central and west Africa had been transported to Brazil, the Caribbean and the south-eastern United States. Other viruses, including two other human retroviruses, had been transported with them. But the two HIVs had not, even though central and west Africa are nowadays widely considered as the "hearths", or original homes, of HIV-1 and HIV-2. It therefore seemed likely that both the HIVs had emerged in man after the 1860s. Fleming's third point was that when transferred to other primates, such as Asian monkeys and humans, the SIVs caused immunodeficiency and death. This was yet another indicator of the recency of the HIVs, in that they appeared to be SIVs which had not yet had time to adapt to a state of benign co-existence with their new (human) hosts.
Professor Fleming summed up his position about origin by posing a simple question: why now?
He suggested that if I seriously wanted to follow up on these issues, I should start off in a decent medical library. I packed up tape recorder and notebook (to this day, the relevant pages have a tendency to stick together), and that same afternoon began what turned out to be many months of burrowing through the stacks. First, I tried to unearth ancient AIDS cases hidden in the medical literature, cases which involved unexplained immunodeficiency in otherwise healthy adults, but which had been diagnosed at the time as diseases like Pneumocystis carinii pneumonia (PCP) or cryptococcal meningitis, which are two of the most characteristic opportunistic infections of AIDS.
During the next couple of years, I followed up eight of the most clinically plausible cases on the ground. The patients in question had died between 1945 and 1969 in Britain, America, Canada and Sweden. I interviewed pathologists, hospital consultants, GPs, friends, family and colleagues, and -- with permission from the next-of-kin -- examined the medical records. In each instance, there eventually turned out to be a far more plausible explanation than HIV disease. The charts of some patients revealed that they had received extensive radiotherapy or heavy treatment with steroids during their hospital stays. Some had been exposed to toxic substances or radiation in the course of their work, or as a result of where they lived. Others seemed likely to have been infected by a quite different retrovirus, HTLV-1. All these were factors which, in themselves, could have compromised the immune responses. So even if my search was, in the end, unproductive, it provided useful perspective on the true nature of AIDS.
Check it out...or the book...THE RIVER.........
From 1981, when the condition was first recognized in American gays, to the present, the origin of the epidemic, the pandemic, has always intrigued people. From molecular biologist to taxi driver, everyone has an opinion. As the millennium approaches, 50 million people around the world have been infected with HIV, of whom 15 million have developed AIDS. Most of the latter have already died. As of this year, it is the world's biggest killer infectious disease.
But one thing which, even back in the early eighties, was overwhelmingly clear both to the gay communities of New York and Los Angeles, and to the villagers of southern Uganda who witnessed the first epidemic outbreak in the general population, was that this syndrome, this collection of diseases, was something entirely new.
Many, including many of those dedicated and overworked AIDS physicians, would ask whom the question of origin benefits: what purpose does it serve to try to answer the unanswerable? The battle is raging already, they would argue; we need to treat the wounded, not apportion blame.
A fair point, on one level. But doctors, of all people, should know that very often diseases can be cured, or treated, only after we have a proper understanding of their aetiology. (The classic example is the cholera outbreak of 1854, which killed 500 Londoners before an epidemiologist, John Snow, deduced the crucial role of the water supply, and stopped the epidemic by removing the handle of the Broad Street pump.) Furthermore, if the genesis of AIDS has involved avoidable events or human error, then perhaps we can learn useful lessons, and thus avoid similar disasters in the future.
So this is not just an academic question. It is one to which, as a species, we need answers.
QUESTION OF TIMING
My own quest into the origin of AIDS began in the summer of 1990 in Covent Garden, at one of those wobbly tables out on the cobblestones, where waitresses bring cafetieres and expensive sugary pastries. By that stage I had been working on AIDS for four years, and my first book, Slim, about the epidemic in East Africa, had just been published (Hooper, 1990). During the round of interviews and discussions that followed, I was once again struck by the sheer volume and range of explanations for the advent of the syndrome, which ranged from the carefully-reasoned, via the paranoid, to the seriously wacky.
Thinking that a book on the subject might take a couple of years to research and write, I decided to investigate further, and my first step was to interview a haematologist called Alan Fleming, who had written a series of articles (mostly for a fairly obscure German journal) in which he documented the earliest traces of HIV infection in Africa, stretching back as far as 1959. By this stage, the proposition that AIDS had emerged from Africa was still viewed as controversial, although the scrupulous epidemiological evidence assembled by Professor Fleming left little doubt.
As I scribbled notes among the pastry-plates, Fleming made three very powerful points. The first was that the immediate ancestors of the HIVs, the simian immunodeficiency viruses or SIVs, were found naturally only in African primates. (In these animals, the SIVs caused no disease, which -- together with the large number of African primate species which had already been identified as SIV carriers -- suggested that these were ancient infections.) At that juncture, two variants of HIV (HIV-1 and HIV-2) had been identified. However (and this was his second point), in that huge -- albeit unintended -- biological experiment called the Slave Trade, over ten million people from central and west Africa had been transported to Brazil, the Caribbean and the south-eastern United States. Other viruses, including two other human retroviruses, had been transported with them. But the two HIVs had not, even though central and west Africa are nowadays widely considered as the "hearths", or original homes, of HIV-1 and HIV-2. It therefore seemed likely that both the HIVs had emerged in man after the 1860s. Fleming's third point was that when transferred to other primates, such as Asian monkeys and humans, the SIVs caused immunodeficiency and death. This was yet another indicator of the recency of the HIVs, in that they appeared to be SIVs which had not yet had time to adapt to a state of benign co-existence with their new (human) hosts.
Professor Fleming summed up his position about origin by posing a simple question: why now?
He suggested that if I seriously wanted to follow up on these issues, I should start off in a decent medical library. I packed up tape recorder and notebook (to this day, the relevant pages have a tendency to stick together), and that same afternoon began what turned out to be many months of burrowing through the stacks. First, I tried to unearth ancient AIDS cases hidden in the medical literature, cases which involved unexplained immunodeficiency in otherwise healthy adults, but which had been diagnosed at the time as diseases like Pneumocystis carinii pneumonia (PCP) or cryptococcal meningitis, which are two of the most characteristic opportunistic infections of AIDS.
During the next couple of years, I followed up eight of the most clinically plausible cases on the ground. The patients in question had died between 1945 and 1969 in Britain, America, Canada and Sweden. I interviewed pathologists, hospital consultants, GPs, friends, family and colleagues, and -- with permission from the next-of-kin -- examined the medical records. In each instance, there eventually turned out to be a far more plausible explanation than HIV disease. The charts of some patients revealed that they had received extensive radiotherapy or heavy treatment with steroids during their hospital stays. Some had been exposed to toxic substances or radiation in the course of their work, or as a result of where they lived. Others seemed likely to have been infected by a quite different retrovirus, HTLV-1. All these were factors which, in themselves, could have compromised the immune responses. So even if my search was, in the end, unproductive, it provided useful perspective on the true nature of AIDS.
Check it out...or the book...THE RIVER.........