BANGKOK AIDS CONFERENCE NOT LIVING UP TO ITS BILLING.

By Marcel Girodian

The XV International Aids Conference in Bangkok has the noble theme, "Access For All." According to the conference promoters, "we will ensure that all voices, all experiences and all concerns are represented." Unfortunately the truth falls short of the hype. All voices are not being represented, and access for all is not being granted, with regard to some very fundamental and critical issues.

Let's take the issue of HIV testing. In the US, most of Europe and Australia, a person is not considered HIV infected until a minimum of two criteria have been satisfied--testing positive first to a screening test, which is usually an ELISA test, and then to a confirmatory test, which is almost always the Western Blot. In the US, in fact, if the ELISA is positive, it is usually repeated, then if positive again the Western Blot is run. And if that's positive, the US Centers for Disease Control (CDC) recommends that the entire set of tests be run again, on a new blood sample, to reduce the chances that the tests could be reacting to one of the over 70 common conditions that are documented to cause false positives.

In Thailand, on the other hand, people are routinely pronounced HIV positive based on only two screening tests--two ELISAs or an ELISA and a GPA. The more specific Western Blot is used only if the two screening tests disagree. This has many problems. The ELISA and similar tests were developed to be super sensitive, as a means of screening blood donations. This means they are more likely to be falsely reactive to almost any condition that causes antibody proliferation in the blood. These conditions can be as common as the common cold, flu, herpes, pregnancy or past pregnancy, drug abuse, numerous viral and bacterial infections and many others. Moreover, according to Dr. Praphan Phanuphak, Aids specialist at Chulalongkorn University, in Thailand both tests are usually run on the same single blood sample, which means that if there is some condition causing a false positive, nobody is bothering to wait for the condition to clear and then get a second sample to be sure before declaring the unfortunate person positive.

The US CDC, in its role as Aids advisor to the Thai government (indeed, they have an office in the Thai Ministry of Health Building and offices in large cities throughout Thailand) is not raising its voice in objection to what is a dubious and very cavalier procedure for branding Thai people HIV positive--a procedure that would have a doctor called up for malpractice were it to be done in the US. A procedure that violates CDC's own recommendations for Americans. A simple question is--why? Why is there one HIV positivity standard for westerners, and a different, more lax one, for Thais?

The answer generally given is that the Western Blot test is too expensive for poorer countries. But, according to Dr. Phanuphak, the WB costs only about $30 US in Bangkok. So, while the AIDS establishment wants to ensure "access for all" to highly toxic AIDS drugs which, even in Thailand, cost hundreds to thousands of US dollars a year, per person, they are not willing to provide access for all to a $30 test that could acquit Thai people of being HIV positive in the first place.

How likely a possibility is that? In a study conducted in Russia, 30,000 people tested positive on the ELISA. Of these, only 66 could be confirmed by a positive Western Blot. (Voevodin, A. 1992) In a study published in the New England Journal of Medicine in 1988, 60 to 70% of twice-positive ELISAs were not confirmed by Western Blot (Burke, et al). In a study published in the Journal of the American Medical Association, 30 to 80% of twice-positive ELISAs were not positive on the Western Blot. (Sloand et al, 1991) The medical literature has many studies that have reached similar conclusions.

But what of those cases in Thailand where the Western Blot IS used? It is generally only used as a "tiebreaker" if the two screening tests disagree. But even then, the test is evaluated differently in Thailand than it is in the west. According to Dr. Wiwat Rojanapithayakorn of UN Aids, only two of the 10 bands (which are supposed to represent HIV proteins) on the Western Blot test must be reactive to the person's blood in Thailand in order to declare a person positive. In the US, generally three or more bands are needed. In France and Australia, usually four bands must react before a person is called positive.

Whether called positive based on two screening tests, or on a Western Blot, a HIV positive Thai person could conceivably emigrate to the West and become HIV negative. As a group of scientists from the University of Western Australia, Eleni Papadopulos-Eleopulos, Dr. Valendar Turner, Dr. David Causer and Dr. John M. Papadimitriou, concluded, "Many HIV positive Thais would not be HIV positive in the West."

No AIDS expert has ever provided any logical justification for these differing HIV positivity standards. Since the countries that pronounce people positive without a Western Blot (in Africa, even without any test at all) are generally developing countries, one suspects that "HIV" positivity is politically, not medically defined. As testing positive ruins a person's life, one must ask, who decided that Western lives are more valuable than those of Thais or Africans? Under whose influence have these dubious testing procedures been implemented, and why has nobody in a position of responsibility challenged them?

As anyone with a modicum of sensitivity should know, testing positive for HIV antibodies produces staggering psychological stress and turmoil in a person, which by itself is proven to suppress the immune system and make a person more likely to get ill. It is well documented that many people commit suicide shortly after being declared HIV positive. Nobody should be branded with the stigma "positive" and have their lives crushed on relaxed criteria that would not be allowed in richer countries.

Another way that the XV International Aids Conference is not providing "Access For All" is that they are not allowing alternative opinions about the nature and causation of AIDS to be heard. People in Thailand are not allowed to know that there are literally hundreds of fully credentialed doctors and scientists, including two Nobel Prize winners, who don't think that HIV is the cause of AIDS, don't think the tests are valid, and point out that the AIDS medicines are toxic and immune-suppressive and capable of causing AIDS all by themselves. You can see a list of these scientists and quotations from them at http://aras.ab.ca/articles/AIDSQuotes.htm

There are many bizarre anomalies about Aids in Thailand that have never been explained. Unlike in the west, where the disease is overwhelmingly restricted to male homosexuals and drug addicts, in Thailand the epidemic is said to be almost entirely heterosexual. Yet approximately 80% of the actual recorded "heterosexual" Aids cases in Thailand have been males. This is despite the fact that females, due to their much more receptive genital anatomy, have been found to be 8 times more likely than males to become infected from a single act of vaginal sex (Padian, et al, 1997). If HIV is the cause of AIDS, why aren't most of Thailand's AIDS cases female? Why are they overwhelmingly male, just as they are in the west?

The idea that the epidemic is caused by heterosexual sex in Thailand, and not by drug use or homosexual anal sex, as it is in the west, is largely based on interviews with people who test positive. But scientists conducting such studies routinely overlook the fact that people lie when self-reporting about stigmatized activities like homosexuality and drug use. We know that Thailand has an unusually large percentage of homosexual males, especially in the north. And, with Thailand's severe drug laws, a person would have to be crazy to admit to a government-connected researcher that he uses illegal drugs. Recreational drugs, whether injected or non-injected, can cause false positive HIV tests, and where are these drugs most available? Why in Northern Thailand, of course, adjacent to Burma and the golden triangle, and, "coincidentally," the epicentre of Thailand's Aids epidemic.

Since prostitution is declared to be a major vector for HIV transmission in Thailand, why are the prostitution centers--Bangkok and Pattaya--not the epicenters of this epidemic? Why is it the north, where there is much less prostitution? And how did a virus that is said to have originated in Africa get to Northern Thailand in such great numbers? Anyone who has spent time in Northern Thailand knows that Africans are about as common there as banana trees are in Sweden. In the west, prostitutes are almost never found to be HIV positive unless they are drug users. Why should this be different in Thailand? Can false positivity, caused mostly by drug abuse, explain the high level of HIV positive tests among brothel workers? It's a perfectly rational explanation that hasn't been pursued.

Thai studies have claimed HIV transmission rates as high as 1 in 18 sexual contacts. But most studies done in the west have concluded that HIV only transmits, at best, 1 in 1000 unprotected contacts, and as little as 1 in 8000 from females to males. Is there something different about Thai genital anatomy that accounts for the staggering difference? Previous suggestions that Thailand had a much more aggressive "subtype E" of HIV were disproven in 1996 by an expert commission at the Robert Koch Institute in Germany, which found no difference in infectivity. Is the discrepancy better explained by the high incidence in Thailand of conditions that cause false positives?

Dr. Christian Fiala, an Austrian physician who worked at Chulalongkorn University in the 1980s, has extensively researched Aids in Thailand. He notes that the definition of AIDS in Thailand differs from that in the West. "First, a fungal infection called Penicillium Marneffei has been added as Aids-qualifying disease. Thereby increasing the overall Aids figure by 8 percent, and even more in the so-called epicenter, the north of Thailand," he writes. PM sufferers would not be defined as having AIDS in the West. And fungal infections are notorious for causing false positive HIV tests. Nobody has researched whether PM does this.

Fiala also points out that, in Thailand, a so called "symptomatic HIV-infection" is also counted as an AIDS case. "Any HIV-positive patient, suffering from one of…11 mostly unspecific symptoms will get this diagnosis," he says. These people are added to the AIDS case numbers in Thailand, although they would not be considered AIDS cases in the rest of the world. "'Symptomatic HIV infections' represent more than 40% of the national figure and are highest in the north of Thailand, the so called epicenter of Aids,” says Fiala.

So not only would many HIV positive Thais not be HIV positive in the west, almost half of all Thais reported as "AIDS cases" would not be considered to have AIDS in the west.

Dr. Fiala also points out that HIV's rapid increase in Thailand in the 1990s happened at the same time that Thai sexually transmitted disease (STD) rates were declining sharply. Since HIV is 100 to 2000 times harder to transmit than other STDs, if other STDs decline, HIV should decline much more. Instead it skyrocketed as other STDs were crashing. This is impossible behavior for an allegedly sexually transmitted HIV.

Dr. Fiala also finds other baffling contradictions: "The highest prevalence of STDs is in Bangkok. But HIV and AIDS are both highest in the North. But STD prevalence is second lowest in the North. And even if one looks in more detail at the North one sees that there is absolutely no correlation between STDs and AIDS. With Phayao Province having the lowest STD prevalence and the highest number of AIDS cases in the North or on the other hand Lamphun Province with the highest STD prevalence and AIDS cases below average."

Because many Thai bar girls come from Issan, one would expect Issan to have a high rate of AIDS. Instead, Issan has one of the lowest AIDS rates of any region in Thailand. In short, the Thai AIDS data do not support the idea that AIDS is heterosexually transmitted. Fiala concludes, "Whatever might be the cause of HIV-positive tests in Thailand, it can not be heterosexually transmitted like the other STDs."

People in the US, Europe, Africa and India now have access to alternative opinions about Aids that are held by a growing number of medical specialists. Thai people, living in a culture that does not easily permit dissent, do not. They have little chance of finding out that all of the supposed "facts" about Hiv and Aids have been challenged by fully credentialed doctors and scientists. Considering that throughout medical history, the establishment view about all sorts of maladies has ultimately been proven false, by now we should have a more enlightened attitude. The right to hear alternative and dissenting opinions about medical matters should be a basic human right, especially to those people branded "HIV positive" under these very dubious circumstances.

But the XV International Aids Conference, sponsored and financed as it is by the drug companies, will recognize no such human rights except the right they claim everyone has to swallow (at public subsidy) toxic chemotherapy drugs which, though endlessly hyped as "life-saving," have never been demonstrated in any study to actually prolong life. Yes, these drugs often reduce a laboratory measure questionably called "viral load" and they seem to raise the white blood cell count, but there is little evidence that anyone who takes them actually lives longer. Indeed, two recent studies from Uganda (Morgan D et al, 2002 and Collaborative Group on AIDS Incubation and HIV Survival, 2000) found that unmedicated HIV + Ugandans lived as long after diagnosis as did HIV + westerners who were taking the Aids drugs. And these Ugandans had the disadvantage of being malnourished, while the westerners had plenty of food. (Malnutrition is the world's leading cause of immune deficiency.)

Though they haven't been proven to extend life, the AIDS drugs that XV International wants everyone to have access to have been proven to have many grotesque side effects such as heart failure, liver failure, kidney failure, pancreatitis, destruction of blood cells and bone marrow, nerve damage, psychiatric problems, anemia, diarrhea, blindness, cancer, redistribution of bodily fat from the face to the back (the so-called "Buffalo Hump"), and muscle wasting--side effects which are conveniently attributed to "HIV," although there are no known mechanisms by which "HIV" can be causing them.

XV International Aids Conference should either address these issues in a very public way, thereby ensuring "Access for All" to critical information that might allow Thai people to see Hiv positivity and Aids in a new light, or change their slogan to "Access For All To Our Unvalidated HIV Tests and Extremely Profitable Drugs," which perhaps sums up their philosophy more accurately.