Spectator make a spectacle of themselves – When pseudo-debate is worse than no debate at all…

In a democratic society, where compromise can be seen as tantamount to a civic duty, it is easy to assume that there are ‘two sides to every story’ – that, given any pair of opposing views, the truth will always be somewhere between them. The format of many TV, radio and newspaper reports tends to reinforce this mindset. A representative of one side will be invited to make a comment, and then an opposing view will be presented, with the reporter acting as a kind of referee. Even when a journalist isn’t explicitly reminding us that ‘the truth, as always, is somewhere in the middle’, the very fact that these two particular views have made it into the mainstream media automatically confers some degree of legitimacy on them both. And the fact that both are given equal airtime can add to the impression that they are both equally worthy of attention…

But if we take this principle too far, it can lead us into dangerous territory, and here the issue of ‘selection bias’ plays a vital role. The halfway point in a TV interview with a government minister on the issue of racism, for example, will look very different if the opposing view is from a human rights activist rather than  a member of Migration Watch or the BNP. Similarly, the halfway point in an interview with the Archbishop of Canterbury will be very different if the counterpoint is from an atheist like Richard Dawkins rather than a Muslim imam. Even where the journalist conducting the discussion takes a meticulously balanced approach, the very choice of interviewees will inevitably constrain the debate and lead the audience in a particular direction…

At worst, the ‘somewhere in the middle’ mindset can be strongly biased in favour of the status quo, pushing us towards a homogenised average of the views that manage to make their way into the media, however barmy, extreme or well-funded… (From Don’t Get Fooled Again)

Gimpy has been doing some excellent work on the Riverdance Film Festival’s endorsement of the AIDS denialist film “House of Numbers”. I really hope that the producers make it available for free on the internet soon so that I can watch it, as I’m keen to find out what the fuss is about.

In the meantime, I was intrigued to see that The Spectator was organising their own showing on October 28th (£35 a ticket, for anyone who’s interested – evidently the credit crunch hasn’t yet reached Savoy Place). This will be followed by a debate between ex-UK Minister of Health Norman Fowler,  Brent Leung (the film’s director) and Prof Beverly Griffin, Prof Charles Geschekter, and Dr Joe Sonnabend, who are described as “leading medical authorities”.

It seems to me that this is a really good illustration of two quite interesting nuances: Firstly, the way that a debate can be shaped and constrained from the outset, before a word has been spoken, simply through the selection of debate participants. Secondly, the way that the very existence of a debate can help to perpetuate a discredited ideology.

Beverly Griffin is an Emeritus (retired) Professor from London’s prestigious Imperial College, and a former director of the department of Virology at the Royal Postgraduate Medical School, Hammersmith Hospital. She has published widely on the Epstein-Barr virus and on Burkitt’s lymphoma, a cancer commonly associated with AIDS and believed to be caused, in part by Epstein-Barr. Griffin is quoted by the virusmyth website as suggesting, in 1991, that HIV might be “a necessary factor but not a sufficient explanation” of AIDS, or even that the virus might not cause the disease at all. The site also carries a broadly sympathetic 1989 book review by Griffin (originally published in Nature) of Jad Adams’ “AIDS; The HIV myth”.

Dr Joe Sonnabend is a New York physician (now also retired) who has been involved in treating AIDS patients since the early days of the outbreak, and was reportedly a pioneer of “community based research”, overseeing trials of new treatments for AIDS patients.  Until the late 1990s, Sonnabend was among those arguing that the link between HIV and AIDS was unproven. He has reportedly since come to a different view, believing that “The evidence now strongly supports a role for HIV”, in causing AIDS, while continuing to argue that other causal factors must also be involved – and that high doses of the AIDS drug AZT “killed thousands” during the 1980s.

Charles Geschekter is a retired Professor of History from the University of Chicago, whose specialist area is African history. Geschekter has denied that there is an AIDS epidemic in Africa – describing it as “The Plague That Isn’t” – and arguing that the belief in such an epidemic was partly the product of racism and “western sexual stereotypes”. Geshekter also served on South Africa’s notorious Presidency AIDS Advisory Panel during Thabo Mbeki’s Presidency in early 2000.

Looking at the track records of the three experts listed, a number of things seem quite striking. Firstly, only Dr Sonnabend appears to have been directly involved in AIDS research – and even this research seems limited to the trialling of treatments, rather than the basic question of the link between HIV and AIDS. Prof Griffin clearly has a credible and longstanding research record, but the only entry on the list that mentions HIV is a reference to her 1989 book review in Nature.  Prof Geshekter appears not to be a scientist at all, less still a “leading medical authority”.

What’s also striking is that all three ‘expert’ panelists have, at one time or another, adopted fringe views on HIV and AIDS, and been active in disputing the established scientific consensus. Of the five panel members chosen, only one, the former health minister Lord Fowler, appears unambiguously to share the view held by the overwhelming majority of scientists currently involved in AIDS research. Knowledgeable and eloquent though Norman Fowler doubtless is, he is not, himself, a clinician or researcher. It therefore seems doubtful that he will be able to represent the consensus view in a public debate as effectively as a fully qualified AIDS expert could have done – especially as he will be outnumbered four-to-one by people who take a minority view.

Perhaps one reason for this imbalance is that the real “leading medical authorities” on AIDS will generally refuse to share a platform with AIDS denialists, or engage in debate with them, largely for the same sorts of reasons that evolutionary biologists avoid Creationists, and established historians refuse to debate the Holocaust with the likes of David Irving. It’s possible for a person to be eloquent, reasonable-sounding and good at rhetorical point-scoring yet nonetheless wholly deluded and wrong. Science has arguably long passed the point where specialist questions could meaningfully be resolved through live oratory. The format of a face-to-face debate may make for good theatre, but it will usually be impossible for observers to go away and fact-check every technical claim being made. Where the scientific evidence is being distorted, mis-stated, or even made up completely on the spot, the lay audience will often be none the wiser.

But what is clear is that AIDS denialists such as Charles Geshekter and Brent Leung will benefit from being given such a high-profile platform for their views. The Spectator is, broadly speaking, a mainstream publication, and Savoy Place a prestigious central London venue. This event will, to paraphrase Richard Dawkins, look very good on their CV, and possibly open up further opportunities to spread the AIDS denial creed.

It seems to me unlikely that trying to persuade The Spectator, The Raindance Film Festival, or any other part of the establishment not to show “House of Numbers” is going to lead very far. We all know how much the pay-per-view media loves controversy – real or imagined – and the danger is that by trying to stop the film from being shown one just adds credence to the narrative about a Terrible Truth that the world is desperately trying to suppress. Personally I’d go the other way. If the makers of “House of Numbers” are right about AIDS, and the mainstream scientific community is wrong, then this is surely a message that as many people as possible need to hear. So why not make the film available for free online so that everyone can take a look, do their own fact-checking on the experts being quoted, and make up their own minds?

*Update* – BLBS comments:

It’s destined for youtube eventually anyway, no doubt. It’s cynical and manipulative but in such a dumbed-down way that you can see how some people might not get it if they’re not well informed. One example is Leung citing a Science Daily article with a headline saying something about studies suggesting that “sudden loss of T cells” doesn’t lead to AIDS. He goes right from there to say well, if sudden loss of T cells doesn’t lead to disease, then there “must” be co-factors or maybe HIV isn’t necessary at all.

He doesn’t mention that the studies are about transient CD4 T cell loss from the intestine of monkeys right after they’re infected with SIV. Specifically two monkey species, African green monkeys and sooty mangabeys, that are natural hosts of SIV and rarely develop disease. There is a recent theory that loss of intestinal CD4 T cells right after someone gets infected by HIV plays a key role in pathogenesis, and these studies do suggest that intestinal CD4 T cell depletion on its own is not be sufficient to precipitate disease progression. That’s what the Science Daily headline he’s quote-mining is trying to convey, albeit not very well.

But…the loss of CD4 T cells from the peripheral blood of human beings infected with HIV has been consistently associated with risk of disease and death in every study that’s looked the variables over the last 30 years. And unlike in SIV-infected African green monkeys and sooty mangabeys, loss of CD4 T cells from the intestine of people with HIV is not transient, but persistent.

So the studies do not in any way, shape or form suggest anything about co-factors, let alone that they “must” be required. In fact, these monkey models show the exact opposite, because when SIV from a natural host like the sooty mangabey is transferred across species into a rhesus macaque it causes progressive CD4 T cell loss, leading to opportunistic infections and death. No co-factors necessary. Same thing has happened because of the cross-species transfer of SIVcpz from chimps into humans, and there is of course ample precedent for disease resulting from cross-species transmission with many other pathogens.

Not surprisingly, out of all the people Leung interviews, he doesn’t interview the study authors or ask them about their work, because they’d have told him he’s out to lunch. It’s simply dishonest, and a typical denialist tactic.