Anthony Brink: The trouble with nevirapine

Appendices

DEBATING AZT: MBEKI AND THE AIDS DRUG CONTROVERSY

Foreword by Martin Welz

 On 28 October 1999, after reading this debate, South African President Thabo Mbeki ordered an enquiry into the safety of the AIDS drug AZT. Now updated to reveal the President’s remarkable personal involvement in the subsequent controversy, Debating AZT also takes a critical look at the roles of rape survivor Charlene Smith, Supreme Court of Appeal Judge Edwin Cameron, AIDS Law Project director Mark Heywood, and Democratic Alliance leader Tony Leon.  Described by South Africa’s top investigative journalist, Martin Welz, as “extraordinary”, Debating AZT exposes the dereliction of the medical experts and journalists on whom the South African public has relied and provides the shocking facts.

JUST SAY YES, MR PRESIDENT: MBEKI AND AIDS

Foreword by xxxx xxxxx       

What’s President Mbeki on about? He claims that “scientists don't know what they are looking for when testing for HIV”, talks about AZT “triphosphorylation”, and suggests that AIDS activists see Africans as “promiscuous carriers of germs” and “human beings of a lower order.” Just say yes, Mr President explains. Relating momentous developments in the medical, political and legal arenas since the publication of Debating AZT at the close of 2000, it sets out the author’s contacts with government, exposes the prevarications of GlaxoSmithKline’s top officers, tells of the American Food and Drug Administration’s endorsement of Mbeki’s toxicity concerns, reports the considered responses of the ANC, critically evaluates media cover of the controversy – notably by the Mail and Guardian, rethinks the ‘Nkosi Johnson’ tragedy, has a close look at Zachie Achmat and his Treatment Action Campaign, and provides an extensive radical analysis of Supreme Court of Appeal Judge Edwin Cameron’s “AIDS movement” – with staggering conclusions. In doing so, it reveals the reasons for Mbeki’s wider doubts about the integrity of AIDS medicine generally, and lays bare its poisonous suppositions.

 Just say yes, Mr President includes two scoops: It tells the real story of how and why AZT was first synthesized in 1961 as related by its inventor to the author for the first time, explodes key claims about the pharmacology of AZT made by GlaxoSmithKline, and provides a lethal critique of the popular AIDS drug nevirapine – including the hitherto untold story of how the drug was forced through the Canadian Therapeutic Products Agency under political pressure after twice being rejected as unsafe and ineffective.

Reviews of Debating AZT: Mbeki and the AIDS drug controversy:

“…the ravings of a drivelling conspiracy-theorist crackpot loony fruitcake.”  David Beresford, columnist, the Mail and Guardian.

 “Very good. Convinced me completely.”  Paul Foot, investigative journalist, Private Eye and the Guardian, and author, Words as Weapons.

 “…you are justified in sounding a warning against the long-term therapeutic use of AZT, or its use in pregnant women, because of its demonstrated toxicity and side effects. … Your effort is a worthy one… I hope you succeed in convincing your government not to make AZT available...” Richard Beltz PhD, Professor of Biochemistry, Loma Linda University School of Medicine, California, inventor of AZT in the autumn of 1961.

 “Deserves serious treatment. More strength to your arm.”  Donald Woods, late former editor, Daily Despatch and author, Biko.

 “I agree with (the alas late) Donald Woods: it needs much more serious debate than big Pharma and the usual club of fringe beneficiaries are permitting. There is simply too big a case to answer, and it’s not being answered. Having said that, I suppose I look a bit of a fool because I’m one of the numberless well-intentioned people who has been championing cheapo antiretrovirals for the Third World’s afflicted etc. But the book worries me deeply, and, until the debate has been properly joined and fought, will continue to do so. … Well done and good luck…”  John le Carré, novelist, The Constant Gardener.

 “Absolutely amazing … a work of genius … he writes really well … I just love his one-liners.” Rian Malan, investigative journalist, Rolling Stone, and author, My Traitor’s Heart.

 “Anthony Brink is a man of many parts: magistrate or barrister by day, musician by night…, prose stylist. Above all, dedicated and fearless. …his book…is clear and crisp and his technical mastery most impressive.” Philip Johnson PhD, Professor of Law, University of California at Berkeley.

“…extremely courageous. ... I thought I was beyond shockability but [the book’s] revelations were stupefying. I think the marketing of AZT to pregnant women is an obscenity.”  James Hogan, science writer and science fiction novelist, The Legend that was Earth.

“Riveting… [The] style is very funny; it’s a shame the subject-matter is so serious… Perhaps, after all, Thabo Mbeki is a visionary, not the fiddling fool he’s made out to be… [If you are] wondering what all the fuss is about, you will not find a more forceful or persuasive explanation…than in this book. …meticulously referenced, Debating AZT rattles the not-so-dusty medical skeletons of Thalidomide, arsenic and mercury salts. It is a remorseless denunciation of the first and most widely used anti-HIV drug…”  Don Bayley, former science editor of the Sunday Independent and launch editor of the Independent Online.

 “Absolutely spectacular … superb ... the definitive refutation.”  Harvey Bialy PhD, editor at large, Nature Biotechnology,and scholar in residence, Institute for Biotechnology, University of Mexico.

“...excellent …the best, most comprehensive review on AZT currently available...”  Etienne de Harven MD, Emeritus Professor of Pathology, University of Toronto, Canada.

 “A hefty blow for free speech and against the strictures of dogma… Crisp. Logical. Sometimes over the top. Bristlingly intelligent. Exhausting. Acerbic. Sometimes vicious. For anyone who wants to know what Mbeki’s on about, it’s all here, in a nutshell.”  Yves Vanderhaeghen, deputy editor, the Natal Witness.

“…a rare combination of incisive insight, entertaining wit, profound perspicacity, all of which and a lot more being available through his racy, delicious pen. He exhibits the uncommon gift of a timely turn of phrase that truly adds spice to the intellectual content… Mr Brink’s book will have an Illichean impact likely to cure the increasingly sick HIV-AIDS establishment in particular and the medical and governmental establishments in general. His expose is both a diagnosis and a cure… [It] will remain a classic eye-opener to the misdeeds of modern medicine for decades to come. I am also sure that Mr Illich will give his imprimatur to Mr Brink at first reading.” Manu Kothari PhD, Professor of Anatomy, Seth Gordhandas Sunderdas Medical College, King Edward Memorial Hospital, Mumbai, India.

 “I started reading it the day it arrived, found it so fascinating that I…read it through to the end that evening. A case of not being able to put it down. Remarkable research and brilliant writing.”  Jaine Roberts MA, researcher, HIV and Economic Health Research Unit, University of Natal, Durban.

 “[AZT: A Medicine from Hell] is a well written, lucid article for anybody to read…  your arguments about prescribing this drug are excellent…  Perhaps when more people like yourself who are not scientists come out publicly to clarify the issue on this drug, pregnant women will be spared! Your article will now be additional prescribed reading for the students in my class.”  Shadrack Moephuli PhD (toxicology), senior lecturer, Department of Biochemistry, University of the Witwatersrand.

 “…very nice writing … you can’t really be a lawyer … I love the parallels with other past failed medical panaceas - calomel etc.” Denis Beckett, freelance journalist and filmmaker.

“What a good comprehensive review of the literature you performed! … During my research I noticed a lot of resistance from many different people to believe our data. In general there is resistance to the ‘bad news’.”  Ofelia Olivero PhD, staff scientist, US National Cancer Institute, USA.

 “Christ this is good… Beautifully written… Extremely accomplished… So much data. Makes the opposition’s platitudes look embarrassingly hollow… Eleni and I think it’s really great.”  Valendar Turner MD, consultant emergency physician, Department of Emergency Medicine, Royal Perth Hospital, Perth, Western Australia.

 “Anthony knows more about the science of this than all the other AIDS dissidents put together. … It’s the way you write, it’s the way you put it.”  Eleni Papadopulos-Eleopulos MSc, biophysicist, Department of Medical Physics, Royal Perth Hospital, Perth, Western Australia.

 “Mind-blowing.”  Richard Stretch, attorney, Pietermaritzburg.

 “A masterful piece.”  David Rasnick PhD, pharmaceutical biochemist and patent holder, visiting scientist, University of California at Berkeley, USA.

 “…outstanding...”  Hiram Caton PhD, Professor of Applied Ethics, Griffith University, Brisbane, Australia.

 “…wonderful … soldier on!”  George Kent PhD, Professor of Political Science, University of Hawaii, USA.

 “…great… very important…”  Stefan Lanka PhD, virologist, formerly of the University of Konstanz, Germany.

 “Enormously entertaining. …an outstanding piece of work ... expert, trenchant devastation of AZT apologists.”   Neville Hodgkinson, former medical correspondent, London Sunday Times, and author, AIDS: The Failure of Contemporary Science.

 “[AZT and Heavenly Remedies] is superb, extremely well researched, analyzed, written… I could not have done a better job… Are you a scientist or do you collaborate with one? How could you survey so many scientific publications as an attorney? …Could you publish your article or a variant of it in a medical/scientific journal? It would strengthen our case no end, if scientific papers of that quality would come from several sources, not only from Berkeley and Perth ... I still can’t believe he wrote that. He’s really a molecular biologist pretending to be a lawyer.”  Peter Duesberg PhD, Professor of Molecular Biology, University of California at Berkeley, USA.

 “Amazing.” Margarette Driscoll, senior features writer, London Sunday Times.

“Every South African should read it. ... I couldn’t put it down.”  Akash Bramdeo, television journalist, e-TV.

 “My man, … you write your ASS off. ... Great, great stuff.” Jon Rappoport, investigative journalist and author, AIDS Inc.

 “I laughed and I cried, I laughed and I cried.” Hector Gildemeister DPhil Oxon, molecular biologist, London.

 “I read it at work pinned between my desk and my knees and laughed until the tears rolled down my cheeks.”  Debbie-Ann Atkins, office machinery sales representative.

 “Humor kan soms ’n politieke daad van die ernstigste aard wees. Niks is gevaarliker as om onaantasbare persone en instansies belaglik te maak nie. … Wees gewaarsku – die boek het ’n vreemde uitwerking op die leser. Enersyds laai dit iets ondraaglik swaar – grotesk eintlik – op jou skouers, iets waarvan jy nie meer met integriteit kan afkom nie. Andersyds moet jy nie verbaas wees as daar na dese ’n glimlag aan jou lippe kom pluk elke keer as jy die woord ‘AIDS expert’ hoor nie. … Die kersie op die koek – wat van Debating AZT ’n meesterstuk maak – is die humor waarvan elke reël, asook die spasies tussenin, deurtrek is. … Brink se styl – die samespel van ligsinnige humor en dodelike erns – laat my byvoorbeeld onwillekeurig dink aan die profetiese literatuur in die Bybel. … Anthony Brink deins nie terug vir ‘lawsuits’ nie. Hy [skryf] in die styl van meeslepende fiksie. Die boek is ’n taboebreker – nie in die eerste plek omdat dit die taboe-gelaaide tema van VIGS in Suid-Afrika aanvat nie – maar ook en veral omdat dit alle genre-matige grense verontagsaam. Volgens die antropoloog Mary Douglas het taboe te make met verskynsels wat dreig om gevestigde klassifikasieskemas te ontwrig. Ook die outeur van hierdie boek is in dié sin ’n taboeverskynsel: ’n advokaat uit KwaZulu-Natal wat met innemende hubris die heilige teoretiese grond van die mediese wetenskap betree. … Ek kan nie Debating AZT sterk genoeg aanbeveel nie – of jy nou ’n literêre ervaring wil hê, boeiende geskiedenis wil lees, meer te wete wil kom oor die VIGS-polemiek, tot teologiese en filosofiese besinning gebring wil word, of sommer net lekker wil lag. As ek die pous was (of ’n leidende VIGS-navorser) sou ek die stempel van goedkeuring op hierdie boek aangebring het: nihil obstat. Dit staan geskrywe. Niemand sal ooit kan sê: ‘Ek het nie geweet nie ...’“  Gerrit Brand, PhD registrar, theologian, University of Utrecht, Netherlands.

Re: The Treatment Action Campaign

An extract from the preface to Just say yes, Mr President: Mbeki and AIDS

The people who were honoured in the Bible were the false prophets. It was the ones we call the prophets who were jailed and driven into the desert, and so on.

Propaganda is to democracies what violence is to dictatorships.

The duty of intellectuals is to tell the truth and expose lies.

Noam Chomsky

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Finally: South Africa faces particular perils posed by a hugely influential and successful organisation of professional AIDS-drug advocates, the Treatment Action Campaign. The effortless manner in which the TAC pushed Merck around over fluconazole, mobilised public opinion against the drug companies to shame them into abandoning their case against our government over the importation of generic drugs, and won a court order forcing the government to supply nevirapine to HIV-positive pregnant women, are all testimonies to its remarkable power and effectiveness. Led by a vanguard of salaried cadres working full-time, it comprises a wider cohort of volunteer activists and sympathisers in the public at large – 10 000 members, it claims. By positioning itself as a friend of the victimised and of the poor, it has won massive support across a range of constituencies, including the churches and the unions. Its networks into the newspapers and pull over the media rival anything we saw during apartheid, when politicians called the content of the eight o’ clock news with a phone call.

 As potent a coercive political force here as Jerry Falwell’s and Pat Buchanan’s mobs are in the US, the TAC has developed a bully pulpit from which it is calling the shots unchecked. On the most cursory analysis of its agenda and campaigns however, the TAC is hardly more than a lackey of the multinational pharmaceutical industry. Moving the merchandise being their common purpose. Apart from spats about how the industry’s largesse should be slushed about by way of grants in the ‘Fight against AIDS’, the TAC’s only significant quarrel with the pharmaceutical corporations concerns pricing. For the rest, their relationship is as cozy as a bourgeois marriage. It is symbiotic, and complimentary to perfection. TAC lobbyists are incomparably more valuable to the industry than conventional mercenaries hitting on politicians and journalists, because unlike hired agents, the TAC genuinely believes in the goods it sells for the industry by proxy, and consequently it evangelises about them with the zeal of reborn Southern Baptists. It does this because it believes all it’s been told. It really believes. The industry just adores the TAC’s street marches because they make for such potent propaganda. Free too. No amount of expensive advertising can reach into the public mind and reap returns in product support like even one TAC protest: ‘Gosh, Norma, those drugs sure must be something. Look at how those people are always carrying on about them.’

 The promises held by the drugs that the TAC promotes are all derived from what one might call official sources: the companies themselves spinning marketing propaganda, other industry-sponsored AIDS organisations, industry-sponsored treatment-information clearing-houses, industry-sponsored researchers, and industry-manipulated health bureaucracies such as the US Food and Drug Administration, the Centers for Disease Control and the National Institutes of Health. The history of how the said bodies have lurched drunkenly on licensing, indication and dosing policy in regard to AZT alone, just for a start, ought to generate scepticism among informed people concerning the reliability of everything and anything they officially advise. The TAC however, asks no questions about the integrity of the information it receives from its approved sources regarding the efficacy and safety of its favoured nostrums, and is hostile to any suggestion that it might be corrupt, wanting, or unsound – an pitiful display of worldly naivety to anyone with even a passing acquaintance of the way the pharmaceutical industry has historically prosecuted its business. We note here that in a critique he wrote for the New York Nation on 9 April 2001, John le Carré, in a breach of his usual measured English restraint, referred to the world’s pharmaceutical corporations as the “criminals of capitalism” – the burden of which soubriquet he’d elaborated in the London Spectator four months earlier. To the TAC on the other hand the pharmaceutical industry is not the most egregiously venal enterprise of the global economy (illustrations infra); it is Jesus handing out life-saving loaves of wonder, Father Christmas with a big bag full of beneficent goodies. Just a bit sharp on the costing.

 It’s not hard to understand why. On 10 February 2002 Rapport described TAC chief Zachie Achmat as the “meesterbrein” behind the TAC. So when we read this “mastermind” in the Saturday Star on 12 January 2002 referring to “Thabo Mbeki’s belief that antiretrovirals like AZT are toxic and destroy the immune system”, as if they aren’t and they don’t, then we’re in serious trouble. Because his organization wields tremendous power in our fledgling democracy – the most telling proof of which has been the substitution, by dint of a court order, of its own notions about an appropriate drug intervention in place of our democratically chosen government’s. Like the Third Reich however, we find that the TAC is led by a prodigiously energetic but ignorant buffoon, driven by an irrepressible sense of public purpose. To read the TAC’s press releases and its ‘TAC Pledge’ is to be taken by how startlingly puerile their choice of language, logical construction, syntax and tone all are. With such intellectual stock at the TAC’s leadership echelon, we can be certain that Achmat and fellow drug campaigners have never cast a critical eye over any published research reports concerning the vaunted benefits of their chemical darlings, much less gone behind their happy conclusions to enquire into the quality of their design, their conduct and execution, the quality of the data gathered, and their interpretation – and whether on a cooler, less interested analysis, the data gathered speak to anything like the same benefits reported.

 In campaigning for AZT and nevirapine, the TAC’s express charge is that in health policy, the African National Congress in government is a quisling to the poor, a betrayer of the black proletarian insurrection. We care, says TAC chief Zachie Achmat, not the party anymore: “…this is a government born from a party that always fought for human rights. Now black people must hear: Your lives are not worth anything.” To appearances then, the TAC is a militant left wing grassroots anti-establishment cell of urban guerrillas – like Zapistas, defenders of the underprivileged, pleading on their behalf to an uncaring government for a chance at life. ‘We represent you now, not those sell-outs. We’ve taken over.’ In reality, the TAC is right up the pharmaceutical industry’s arse. That the traditional left wing media, such as we have anymore, have missed this, is beyond contempt. In my book anyway. So the Mail and Guardian (“For people who think”) takes an especially severe flogging.

 It’s my opinion that as a potent corporate agency, dressed up in radical chic, the TAC has become a pernicious force in the life of our new democracy, and it needs taking down. Best by deflation, I reckon. So I mean to puncture it. With sharp facts garnished with ample lashings of scorn. If feelings get bruised, too bad. This is a serious matter. For many, of life and death. Death being a real possibility for anyone who believes the TAC’s claims. And proceeds to ingest the drugs it commends. As a colleague of mine discovered, killed by a single month’s course of AZT and 3TC. Reduced, like ‘Nkosi Johnson’, to a skeleton in nappies. Also completely incontinent, vomiting uncontrollably into a bucket. Also unable to talk, his facial muscles paralysed, the rest of his muscles wasted away. Unable able to pick himself off the floor when he fell. And so forth. (See What’s the Hayman case all about? in the appendices.) Judge Cameron ostentatiously conducts himself as the TAC’s cheerleader and political patron. His status on the Appeal Court bench imparts a credibility and legitimacy to the TAC agenda that other non-governmental organisations can only dream of. I think he has behaved deplorably irresponsibly. Turned to the light, his very own utterances in his drug campaign cut him to pieces, like a samurai pulling a hari kiri. As we’ll see. (A butcher’s apron is advised.)

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