Daily Archives: January 5, 2022

You are browsing the site archives by date.

Coronavirus (36): Denialism = Death

Back on March 14, 2020, I began a series on the Coronavirus, which continued through 35 installments (the most recent of which was posted on November 10, 2021).

This is not technically an installment of that series, but it addresses another kind of infection, which persists to this day among a certain brand of “libertarians”—who exhibited symptoms of it way back in the 1980s, when the HIV/AIDS crisis took hold in the United States. After seeing so many libertarians dismiss the COVID-19 “pandemic” (scare quotes intended) as non-lethal at best or an outright hoax at worst, I—a witness to hundreds of people in my hard-hit Brooklyn neighborhood being rushed to hospitals or off to funeral homes—was sickened, but not surprised by the denialism on display. On May 5, 2020, in the twenty-first installment of my Coronavirus series, “Lockdowns, Libertarians, and Liberation“, I wrote:

[T]here was something about the early response [of libertarians] to the coronavirus as a “hoax” or an “exaggeration” that was eerily familiar to me. Back in the 1980s, when HIV/AIDS was killing off a generation of gay men in the West (while ravaging a largely heterosexual population in Africa), some libertarians (including those influenced by Ayn Rand), ever fearful of those who proposed a growing governmental role in both medical research and in locking down bathhouses that were transmission belts for promiscuous, unsafe sex, grabbed onto the work of the molecular biologist Peter Duesberg, who played a major role in what became known as the AIDS denialism controversy. Duesberg was among those dissenting scientists who argued that there was no connection between HIV and AIDS, and that gay men were dying en masse because of recreational and pharmaceutical drug use, and then, later, by the use of AZT, an early antiviral treatment to combat those with symptoms of the disease.

If the scientific community had accepted Duesberg’s theories, hundreds of thousands of people would be dead today. The blood supply would never have been secured, since HIV screening of blood donors would never have become public policy, and countless thousands of people receiving blood transfusions would have been infected by HIV and would have subsequently died from opportunistic infections. …

So, while many libertarians have been at the forefront of rolling back the state’s interference in people’s personal lives, advocating the elimination of discriminatory anti-sodomy and marriage laws, there were some libertarians who, early on, in the AIDS epidemic, grabbed onto Duesberg’s theories as scientific proof that the whole HIV/AIDS thing was a pretext for the expansion of the state-science nexus.

While I do not dispute the dangers wrought by nearly a century of incestuous ties between government, science, and the medical, pharmaceutical, and health insurance industries, I do not believe that all the by-products of “state science” are “dangerous” to our health, as Edmond S. Bradley claimed back in 2006. Bradley, a doctor of music arts and composition, goes so far as to echo the Duesberg theory, which was dealt a serious blow by research developments in the late 1980s that bore fruit for effective treatments for HIV/AIDS by the mid-1990s.

Thinking that this 2006 Mises Institute article was an “outlier,” I was recently involved in a Facebook discussion where I was attacked by yet another “libertarian” for having proposed that there was something wrong with the Duesberg denialists. And then, on the site of the Property and Freedom Society, on January 5, 2022—only yesterday—a 2009 video of Duesberg was posted [YouTube link]. This resurrection of denialism is, of course, part of an overall pushback with regard to all things COVID. But it is not COVID that concerns me here.

The first cases of the “gay cancer” were reported in June 1981, but it was not until 1985, that HIV was first identified as “the causative agent of acquired immune deficiency syndrome (AIDS) and its complete genome was immediately available.” With nearly 48,000 people dead in the U.S. from AIDS by 1987, the formation of the group ACT UP (The AIDS Coalition to Unleash Power) was a turning point for bottom-up civil disobedience against the administrative bungling, political in-fighting and bureaucratic red-tape that made it virtually impossible for any drugs under development to be used in the fight against HIV/AIDS. AZT, the first drug approved for use in this fight, certainly had some of the horrific side effects that Duesberg highlighted, but back then, it was being administered in much higher doses, given the lack of alternative treatments.

The big breakthrough came with the discovery of HIV protease-inihibitors in the late 1980s. Protease inhibitors played a crucially important role in the creation of
highly active antiretroviral therapy (HAART). Proteases are

basically proteins that are used to break down other certain chemical structures of protein in your body—a process that can help with digestion or healing wounds. However, proteases are also necessary for certain conditions—including HIV—to thrive.  ‌Protease inhibitors, which figure among the key drugs used to treat HIV, work by binding to proteolytic enzymes (proteases). That blocks their ability to function. 

Protease inhibitors don’t cure HIV. But by blocking proteases, they can stop HIV from reproducing itself. As such, they lower the body’s viral load—a term that refers to the amount of HIV in the body—and slow the progression of HIV. 

It took about ten years for the first protease inhibitor to reach the market. Take a look at this table below—which will no doubt be dismissed by Duesberg denialists as CDC “fictions”:

The Duesberg denialists cannot explain what happened between 1993-1995 and 1996-2000. They cannot explain why the death rate from AIDS fell by nearly 50% in 1997 alone. I want an answer from these denialists as to why this happened. Did all those dirty, drug-addicted, gay men simply “straighten” up their act, and stop taking those recreational drugs that Duesberg saw as the cause of AIDS? Quite frankly, given that there were a reported 100,000 overdose deaths in 2021 alone—augmented by two years of a COVID crisis that has led to a significant rise in both mental health and substance abuse problems across the population regardless of sexual orientation or sexual practices—I’m wondering why, given Duesberg’s assumptions, we have not seen a corresponding rise in AIDS cases.

The Duesberg denialists have absolutely no explanation whatsoever for the remarkable turn of events from 1993-1995 to 1996-2000. It was with the introduction of “cocktail” drug therapies, which combined three or more antiretroviral drugs—chief among them those protease inhibitors that were able to prevent HIV from multiplying inside the body—that significantly reduced patients’ viral loads to undetectable levels, and that have curtailed the scourge of opportunistic infections that were killing people by the hundreds of thousands in the 1980s and early 1990s. Today, there are an estimated 1.2 million people living with AIDS in the United States—not dying from it.

This is personal. And I’ll even grant that it’s anecdoctal evidence. But in the 1980s, I was busy DJ’ing and dancing, though pharmaceuticals and unsafe sex were not part of the party. I knew scores of gay men, many of whom were very dear friends who died from AIDS. Only a handful of these friends could be characterized as recreational drug users.

One of my dearest friends in the world nearly died of AIDS in 1996, and if it were not for those miracle antiretroviral treatments, he would have been six feet under. Today, he is living and flourishing, without any detectable viral load, thanks to the medical breakthroughs from which he was able to benefit. Had he been diagnosed only two years before, I am convinced he would never have survived.

The Denialists have no answers. All they have is their stultifying ideological pseudoscience.

So I will declare this without an ounce of regret. To echo ACT-UP’s refrain that “Silence = Death“, I say “Denialism = Death.” And if you are among the denialists, then you have blood on your hands.

A H/T to my friend Ryan Neugebauer for some of the links in the above Notablog entry.

Postscript: Folks can check out the public discussion of this post on my Facebook Profile. For the benefit of readers, I reproduce several of my comments from that discussion here.

One commentator posted a link to this older 1996 piece, which was self-refuting, because it did not take into account the miraculous turnaround in AIDS-related deaths that occurred from 1997 to the present day. Then, the commentator posted a link to this dissenting voice to the scientific consensus, which focuses on the use of “poppers” (amyl nitrite) as a causal factor in HIV/AIDS. I wrote in reply:

It appears that Gary Stein (in the comments section of that link) had an effective response. I’ll reproduce it below for the benefit of readers. As the author himself notes, poppers are widely available over-the-counter and can be ordered online. Unless it can be demonstrated that there was a humongous decline in the use of amyl nitrite in 1996 leading to a 50% drop in AIDS deaths in 1997, I don’t see how any of this holds.

There are no drugs on the market that don’t come with potentially horrific side effects. Turn on TV or radio at any hour of the day or night, and all you will see are 50 disclaimers for every advertised drug imaginable: “This drug could cause anything from suicide to homicide, liver failure, heart failure, kidney failure” … and so forth. I have not said in my post that every drug is safe for every person in every context. I’ve simply asked a question: How can any of the Denialists explain the steep drop in AIDS deaths that occurred in the wake of the use of protease inhibitors? If there is no connection between HIV and AIDS as Duesberg claimed, then protease inhibitors should never have worked.

AIDS is not a pretty disease; even with the treatments available, it remains a brutal disease. The best thing is not to get it in the first place. But unlike the 1980s and the early 1990s, those who are HIV-infected today do not face an almost certain death sentence. I think the evidence is overwhelming that the drug cocktails have kept people alive. Here is how Gary Stein responded to the above author in the link you provided [I’ve edited the full reply for Notablog readers, but it is complete here]:

“There is no such evidence that poppers are in anyway associated with the development of AIDS. The study that the denialists like to claim as there own proof on this subject does not show any relationship between AIDS and Popper use. It does show a relationship to Popper use and KS [Karposi’s Sarcoma] but only if you read the report as carefully edited by the denialist so that they can make the claims they do about the reports results.

“Also relevant is the fact that immune problems haven’t been reported with the medical use of amyl nitrites or nitrates in nearly 150 years of use. There was also a huge exposure to people, tens of thousands of whom worked in industrial settings from the 1900’s to 1970’s, especially those working in the manufacture of nitroglycerin explosives and no immunity based problems were ever reported for those groups either. … [H]eavy drug-users were 1.56 times as likely to develop AIDS because they were 1.43 times as likely to be HIV-infected than light drug users. Further, it is of critical importance that HIV-positive individuals were equally likely to develop AIDS irrespective of their drug use pattern (51.4% AIDS among heavy-users versus 47.4% among non-users or light-users), which is hardly a robust affirmation of a drug-dose dependent hypothesis; this and the failure of even 1 of the 39 seronegative heavy drug users to get AIDS is inconsistent with Duesberg’s prediction that the incidence of AIDS should be drug-dose dependent and unrelated to serostatus.”

As my friend Ryan has pointed out, this link provides the most balanced discussion of the relationship of popper-use and HIV.

The same commentator then raised this article, which questions the HIV-AIDS relationship. I pointed out that the article had been formally retracted. I added:

Protease inhibitors target HIV specifically. They are not simply “antiviral” or “antibacterial”; they are commonly used as part of a cocktail of drugs that include antivirals. To cite a very clear explanation of how protease inhibitors work: “The main purpose of HIV is to copy itself as many times as it can. However, HIV lacks the machinery it needs to reproduce itself. Instead, it injects its genetic material into immune cells in the body called CD4 cells. It then uses these cells as a kind of HIV virus factory.”

“Protease is an enzyme in the body that’s important for HIV replication. Protease inhibitor drugs block the action of protease enzymes. This prevents protease enzymes from doing their part in allowing HIV to multiply, interrupting the HIV life cycle as a result. This can stop the virus from multiplying.”

Protease inhibitors are targeting HIV specifically, not the opportunistic infections. That was the game-changer. Not a cure. There are still major issues and drug side effects that require continued work in research and development. But stopping HIV replication in its tracks and reducing viral load to undetectable levels has been a key component to fighting AIDS. Since I do believe that there is a connection between HIV and AIDS, in contrast to the Duesberg Denialists, yes, I think that this is what drove death rates down dramatically.

The Duesberg Denialists have yet to explain what it was in 1996-97 that led to that dramatic drop—a drop that has continued till this day.

Another commentator remarked that Anthony Fauci was hated by gay activists, and I replied:

Ironically, Larry Kramer called Anthony Fauci a murderer and an incompetent idiot precisely because he saw him as part of an establishment that did not act to save the lives of people who were dying from AIDS. In 1988, he wrote:

“Your refusal to hear the screams of AIDS activists early in the crisis resulted in the deaths of thousands of Queers. Your present inaction is causing today’s increase in HIV infection outside of the Queer community.”

Their relationship changed dramatically overtime, however. See here.

There is a very fine documentary on the early years of the AIDS epidemic and the ACT UP response. It’s called “How to Survive a Plague“—and most of it highlights the kind of bottom-up pressure necessary to get “the FDA to approve drugs which could slow or even halt the AIDS virus, and demanded that drug trials (which would usually take 7–10 years) be shortened so potentially life-saving treatments could be made available. The film also documents the underground market for HIV drugs: many people relied on drugs imported from other countries, which were believed to potentially slow down the HIV virus despite not being FDA-approved.”

The film also highlights the strength of voluntary mutual aid among a community of marginalized people who were being told by the evangelical right that AIDS was God’s punishment for their sins and a government that indeed was a major obstacle to the development of life-saving treatments. But again, even these activists, staging “die-ins”, recognized that they had to deal with the conditions that existed, and in many instances, this meant dealing directly with Big Pharma companies to jump-start drug trials that the FDA was dragging its feet on.

Moreover, activists were attacking the government because of its inaction or obstacles to action. Reagan didn’t even mention AIDS until 1985. Some of this was, no doubt, politically motivated, since AIDS was seen as a “homosexual” disease—not something easily focused on by the administration’s evangelical supporters.

There is a bit of a debate about this, and it’s not inconsequential. But it has been said that Duesberg’s theories informed the policies of South African president Thabo Mbeki’s response to AIDS—which led to the deaths of 300,000 people in South Africa. See here and here.

Turning to the political and ideological issues underlying the problem of denialism, I made a number of comments that I bring together here:

In my experience with the libertarian movement for 40+ years, I’ve seen the pattern of deny or downplay over-and-over again when it concerns virtually any large-scale problems. The knee-jerk reaction seems to be to either deny that the problem exists or downplay its seriousness. And if anyone contradicts them, they dismiss the “evidence” (in scare quotes) with ridicule or an endless parade of “alternative facts” that don’t add up.The sad, but implicit premise behind this knee-jerk response is that they seem to be conceding that to merely address such problems, if they do, in fact, exist, one must also embrace full-scale “big government” solutions. That does not automatically follow, however. If the work of Elinor Ostrom has taught us anything, it’s that in the case of say, the ‘tragedy of the commons’, it is possible for communities, cooperatives, trusts, etc. to prevent resource depletion without widescale government intervention. But this still does not address the issue of how to handle large-scale catastrophes, be they pandemics, tsunamis, earthquakes, etc. Even Ayn Rand had more to say about the “ethics of emergencies” than most fundamentalist libertarians.

The problem here is that ideologues of any stripe often deal with the world as they wish it could be rather than the way it actually is. This is, dare I say it, a very undialectical way of handling real-world problems.

The only route to genuinely radical social change is to deal with the conditions that exist. We begin with the cultural and structural institutions that exist and respond with the tools at our disposal. If you’re a lover of liberty, you do your best to raise the flag of vigilance. You can scream, you can holler. But if you’re unwilling to even acknowledge that a problem exists because you think that the mere acknowledgment of the problem is a threat to your ideology—then it’s time to rethink the premises and implications of your ideology.

It is true that governments never met a crisis they didn’t like. This is the basis for everything from War Collectivism to erecting a Corporate State in response to a Great Depression. But there are certain “externalities” that have not been dealt with sufficiently in libertarian circles. I opened this post by freely admitting that the whole state science-medical-Big Pharma nexus is noxious. But this is what exists; we can hack at it by attacking oppressive licensure laws, IP regulations, health insurance oligopolies, and so forth.

But as someone whose policies disgusted me (D. Rumsfeld) once said: You go to war with the army you have, not with army you wish you had. If a “war” comes—a major public health emergency, a tsunami, a massive earthquake… what do you do? Not enough work has been done in libertarian circles on the response to catastrophes. I’ll note just two here (this and this), but they are woefully inadequate (even if they make legitimate points).

When people are so wedded to a limited perspective, it’s not necessarily the case that they are being intellectually dishonest. They just can’t entertain certain facts that don’t coalesce with their worldview. There may be very deep psychological reasons for this (and it must vary from person to person), but I suspect that the worldview somehow informs their sense of self, and if something threatens the worldview, it becomes a threat to that self. That skewed way of looking at the world, sadly, can become lethal—not only to those who hold onto it for dear life, but to everyone around them trying to survive a catastrophe and the catastrophe after that.

So when you engage such people in a critical discussion, they just keep throwing one ‘alternative fact’ after another at the wall, hoping one of them will ‘stick.’ And no matter what you say to people with those skewed perspectives, they’ll keep serving up another ‘fact’. And then, they hang out with people whose function is to serve as an echo chamber of the views they espouse, no matter how discredited those views are. And this is not just a problem within libertarianism; it’s a problem for any person involved in movements, left or right, or even religions, which provide “canned” answers to every issue they encounter.

The tragedy is that people who get caught up in this dynamic can’t allow themselves to think outside the square they’re imprisoned within. And yet, for people so imprisoned, being part of a group that is inside that same square with you also provides a sense of ‘community’… especially when you and those you associate with are the only ones with access to The Truth. It’s no wonder that folks like that more often than not find it difficult to have civil discussions with people outside their square. “Can’t you see The Truth!” they scream! And they’ll beat you over the head with their Truth no matter what you say to challenge them.

Of course, I didn’t pull any punches in this Notablog entry, which is why I said that folks who continue to engage in denialism (on the HIV-AIDS connection) have “blood on their hands”… quite literally, since governments, like that of South Africa, adopted the Duesberg thesis, and it’s estimated that 300,000+ people died without access to any of the effective treatments then available. Hence, the title: Denialism = Death.

I have no idea how to penetrate folks who are caught up in these kinds of mind-sets. Let it be known that I don’t have access to The Truth, myself, but I’m consciously wedded to—and practice—the very dialectical method I preach, which, in its origins, is founded on engagement, requiring one to keep shifting perspectives, vantage points, levels of generality, so as to get a better picture of the wider context. The method has, over the years, become a check against the entrenchment of self-imprisoning ideology in my own consciousness. It opens you up to intellectual and psychological evolution in a healthy way, which challenges you to “check your premises” (as Rand would say)—over and over again. Yes, I know, ironic coming from a woman whose acolytes created a cult of Truth Tellers. But the best of Rand is, as I’ve argued, highly dialectical. If only some of her followers had understood what they actually read. I suspect that ‘deprogramming’ oneself will vary from one person to the next, but clearly, engaging with the wider world is one step in the right direction.

I often joke about my half-Greek, half-Sicilian ancestry: the Greek side is ever-reasonable, seeking empathetic and compassionate engagement; the Sicilian side is more akin to the “Blood Bat” scene [YouTube link] from “The Untouchables.” I guess we all need some “Base-ball” to shake things up every so often.

For those of us who have had it “Up To Here” (using Sicilian hand gestures) with some people, the baseball bat is very useful! But the libertarian in me holds me back from using it against the folks I disagree with. Find a hard service and make sure to wear goggles so that no flecks blind you as you bang out your frustrations. This, accompanied by Sicilian curse-words tinged with a heavy Brooklyn accent, can be helpful, in a primal way. 🙂

Finally, in response to somebody who asked me what I thought of the “death” of New York City, I responded:

I don’t believe NYC is dead. Not by a long shot. This city has survived 9/11, Superstorm Sandy, and will survive all that has surrounded the COVID crisis. I’m a native New Yorker, have lived here all my life, and I remain a proud current resident of Brooklyn, New York. Don’t ever count this city out. But you know me well enough to know that I’d never feel any differently about this place—still the greatest city in the world.

Joel Schlosberg cites my thoughts about NYC in his essay, “A New Year One for Gotham.”

Postscript II: (18 January 2022): In light of the above, check out “COVID, AIDS, and Trying to Save Ourselves,” a poignant article by Jennifer Boulanger.