A Controversy Takes Public Shape
Most scientific publications, sociologists of science have pointed out, are destined to die a lonely death. Given the tremendous number of publications that appear each year, it is inevitable that the average paper is ignored by the vast majority of scientists. Only a minority of papers are cited by many others; fewer still become the object of direct debate. As a general rule, one need not invoke a complicated explanatory apparatus to account for the fact that a scientific paper may sink beneath the surface of professional attention without causing much of a splash.[11]
Duesberg's paper might have been particularly inclined in that direction because many of the points he was making were not especially new. Such questions as how the virus could cause the near-elimination of T-cells when only a few seemed to be infected had been raised before; this particular anomaly had made it into the National Academy of Sciences' Confronting AIDS and had even been discussed in the gay press. But arguably Duesberg's essay was different, and it might have been expected to generate a livelier response. It was written by an eminent scientist whose articles typically had been cited by dozens of other scientists each year. It was published in a respected journal. It had enormous implications if correct in its arguments. And it constituted nothing short of a declaration of war on some of the most prominent virologists in the world. Yet had it not been for the pressure exerted by outsiders who wrote about Duesberg in the alternative and mainstream press, the scientific community might never have addressed Duesberg's claims. Indeed, throughout the latter part of 1987 and early 1988, it was precisely the "AIDS establishment's" apparent avoidance that most incensed the HIV dissenters—and that provided them with their best ammunition.
The first apparent published mention of Duesberg's article came in a cover story by John Lauritsen in the June 1, 1987, issue of the New York Native . As the issue's cover advertised, the focus of the article was to encourage people with AIDS not to take the medication AZT.[12] Recently approved for AIDS patients, AZT was believed to inhibit replication of the virus in infected cells by interfering with the process of reverse transcription. AZT, in other words, made sense as a treatment for AIDS only if AIDS was caused by HIV. This is precisely what Lauritsen disputed, and much of the article was devoted to the proposition that "HIV Is Not the Cause of AIDS."[13]
With the discovery of the virus, "dogma rapidly came to prevail"; "all other research efforts were shunted aside, ostracized, under-funded," Lauritsen complained. Against this dogmatism, it was—until now—impossible for dissenters to make their voices heard: "Since 1984, there have been a few of us who stated in print that epidemiological evidence, together with the failure of HIV to fulfill any of Koch's postulates, made it most unlikely that HIV could be the sole cause of AIDS. … We were isolated. Some AIDS researchers did not believe in the 'AIDS virus' ideology, but, in the interests of self-preservation, they remained silent." But now that a prominent scientist had entered the fray, "all this has changed"; and the HIV dissenters could emerge from their isolation. As Latour has noted, "the power of [scientific] rhetoric is to make the dissenter feel lonely"; this is precisely what happens to the "average person" who tries to challenge highly technical scientific texts.[14] The most obvious solution is to recruit credible allies who can provide rescue from isolation. Lauritsen had found just such an ally.
"Unless HIV's champions can do some very fancy explaining," Lauritsen concluded, "Duesberg's article has unambiguously relegated the 'AIDS virus' etiology to medical history's trash heap of falsified hypotheses." Insisting that "Gallo and the other 'AIDS virus' ideologues" must respond to Duesberg's article "fully and in detail," Lauritsen did his best to up the ante in the controversy: "If the Public Health Service and the media remain silent about Duesberg's article, and persist in expounding the discredited HIV mythology, then gay men will have cause to be gravely concerned. This would mean that the government and their confederates in the medical establishment are not acting in good faith, that nothing they say can be trusted, that their interests are hostile to ours. Their silence would raise the possibility of a horrible hidden agenda."[15]
Soon after this article appeared, Lauritsen went to interview Duesberg at the NCI, where Duesberg was working while on sabbatical from the University of California. The interview was published both in the Native and, sometime later, in its more literary offshoot, Christopher Street; the Native ran photos of Gallo and Duesberg on its cover, with the headline "Which Man Is Right?" The interview recorded a fascinating duet between Duesberg and Lauritsen, with Duesberg voicing his support for Lauritsen's claim that AZT is poisonous ("It is a poison. It is cytotoxic.")[16] and Lauritsen feeding Duesberg suggestions about what might cause AIDS. When Duesberg
shrugged off a direct question on causation ("Well, that's a difficult one. … I really wonder what it could be"), Lauritsen put forward the idea advanced earlier by various proponents of a multifactorial etiology that AIDS might have different causes in different groups. Duesberg chimed in: "Absolutely. And in Africa I don't think anybody knows what kind of AIDS exists, or whether AIDS exists. In the case of the drug users, I could well see that an infection of toxins—and the drugs are impure; no one knows where they come from—is hell for the immune system. And also medical injections—streptomycin or penicillin—are also not good on a regular basis. They are immunosuppressive themselves. Perhaps it is a simple question of lifestyle."[17]
While assuring Duesberg that it was not incumbent on him to come up with an alternative hypothesis—"It's quite enough to have falsified theirs"—Lauritsen nonetheless pushed Duesberg's speculations further. He described for Duesberg what he called the "profile" of the average AIDS patient—a profile whose characteristics supposedly included long-term drug abuse, promiscuity, and repeated cases of sexually transmitted disease:
[Lauritsen: ] Looking at that profile … I think it would be surprising if such people did not become seriously sick from their lifestyle.
[Duesberg: ] I would be surprised, too. The number of contacts, the number of things they inject. You wonder how they could do it.[18]
By the end of the interview, Duesberg appeared to be sliding out of his formal position of agnosticism and toward an endorsement of a lifestyle model similar to the immune overload hypothesis that had been so popular in the first years of the epidemic—indeed, a particularly judgmental version of that hypothesis.
According to James Kinsella's study of AIDS and the media, the Native's publisher, Chuck Ortleb, quickly took it upon himself to conduct a "phone-calling campaign" to promote Duesberg's arguments.[19] But the Native —a paper whose fascination for unorthodox and speculative theories had left it with tarnished credibility even among its intended readership of gay men, let alone elsewhere—had only minimal power to spread the word about Duesberg or to evoke much alarm about a "horrible hidden agenda." Duesberg's claims did begin to circulate in gay communities; they were picked up, for example, by Charles Shively, writing about various alternative AIDS theories in Gay Community News .[20] But only with Katie Leishman's September
1987 article in the popular magazine Atlantic Monthly did Peter Duesberg begin to hit the mainstream. Dubious of official pronouncements about the epidemic, Leishman's article ranged widely, exploring the possibilities of insect transmission and presenting a sympathetic portrait of Jane Teas's unappreciated efforts to push the African swine fever hypothesis. Near the end of the article, however, she also turned to Duesberg and Koch's postulates, noting that Duesberg "is so certain of his claim that he has offered to be inoculated with HIV."[21]
Soon afterward, Duesberg made his first of what would prove to be several appearances in a British television documentary series called Dispatches . In an episode entitled "AIDS—The Unheard Voices," produced by a group called Meditel and broadcast on November 13, the narrators cited Duesberg to suggest that discrimination against anti-body positive people, however deplorable on its own terms, was particularly irrational if HIV were not even the true cause of AIDS.[22] Though controversial in Britain, the show attracted little notice in the United States. Meanwhile, Harvey Bialy, the editor of a journal called Bio/Technology , had become interested in Duesberg's arguments, and Bialy invited Duesberg to write a summary of his Cancer Research article. Adopting a journalistic style, Duesberg complained that "the 'deadly AIDS virus' has been sold to the public as the cause of AIDS with the confidence and authority that is usually derived from absolute scientific proof."[23]
In the immediate aftermath of the Leishman piece and Duesberg's own article in Bio/Technology , Duesberg began to be recognized in U.S. media circles as a credible and "quoteworthy" dissenter on the subject of AIDS.[24] By the end of 1987, gay newspapers such as Gay Community News and San Francisco's Bay Area Reporter were publishing articles specifically about Duesberg—and about the failure of his colleagues to respond to him. "How come researchers continue to study HIV but have not refuted Duesberg's theory?" asked the subhead to the GCN article. "I've asked questions they apparently can't answer," Duesberg was quoted as saying.[25]
Before long the story had acquired its own momentum. In January, Celia Farber, a journalist with the pop music magazine Spin , featured Duesberg in a long interview in her column called "AIDS: Words from the Front."[26] In the interview, Duesberg suggested that researchers such as Gallo found themselves simply unable to retreat from their original claims because the "stakes are too high now": "Every progress report from their laboratories is discussed by Dan Rather and
Barbara Walters, Newsweek , and Time magazine. … To say that now, maybe, the antibody wasn't worth committing suicide for or burning houses for, would be very embarrassing."[27] Even more provocatively, Duesberg delivered a stinging critique of the political economy of contemporary biomedical research, questioning the motives of AIDS researchers: "Scientists researching AIDS are much less inclined to ask scrutinizing questions about the etiology … of AIDS when they have invested huge sums of money on companies that make money on the hypothesis that HIV is the AIDS virus. … Gallo stands to make a lot of money from patent rights on this virus. His entire reputation depends on this virus. If HIV is not the cause of AIDS, there's nothing left for Gallo. If it's not a retrovirus, Gallo would become irrelevant."[28]
As a reporter for the journal Science would later put it: "In the world of biomedical research, where ties to industry are pervasive but mentioning the fact is not, these are fighting words."[29]