Robert Gallo praises PEPFAR, dismisses Duesberg

I attended a conference at Princeton this week in which eminent scientists discussed the state of efforts to develop a vaccine for the virus that causes AIDS as well as other treatment and prevention technologies like new anti-retrovirals, microbicides and male circumcision. It was a very interesting workshop, giving me a greater appreciation of the difficulties scientists have had in being able to come up with a vaccine. As I understand it, the AIDS virus is a particularly difficult kind of virus because it inserts its own genetic material into the host organism and then replicates inside the cells of that individual. Stopping that process is no easy endeavor.

The scientist Robert Gallo, who was one of the scientists who ultimately proved that HIV causes AIDS, made for a most entertaining speaker. For me, as a political scientist, his comments on PEPFAR were among the most interesting. He was effusive in his praise for the Bush Administration, suggesting that the administration had done more than any of its predecessors. He was talking mostly about treatment. I’m not sure if his enthusiasm went beyond that to prevention programs. Another prominent scientist, Emilio Emini, also supported Gallo’s comments on PEPFAR and noted that the Europeans are not doing nearly as much. I’m probing this in a new paper I’m working on for an upcoming workshop at Princeton that my blog collaborators and I have organized for May 5th on the “Politics and Policy of HIV/AIDS“.

Gallo also said some very interesting things about the infamous HIV/AIDS “denialist” Peter Duesberg whose work got some unprecedent and probably unnecessary exposure in a recent Harper’s (see Ben’s post on this.) Gallo will soon have his own reply in Harper’s Duesberg (here is a reply), but he was pretty clear that Duesberg, whom he regarded as a former friend, was promulgating disinformation and bad science in his quest to debunk the links between HIV and AIDS. Gallo described Duesberg’s stuff as off-the-wall-insane, bordering between crap and insanity, that was fueled by malignant narcissism that ought to be regarded as below the zero of knowledge. Merely mentioning Duesberg gives him more credit than he deserves. Gallo cites a 2003 New England Journal of Medicine piece in which he tries to put to bed some of the “denialist” claims. Here are some excerpts:

The year 1984 was a time of both intense excitement and harsh discussions between members of our two groups. Identifying the cause of AIDS presented a unique challenge, because unlike other viral diseases responsible for past epidemics (or, more recently, the severe acute respiratory syndrome), AIDS was characterized by clinical signs that developed years after the infection had occurred, and by then, patients usually had numerous other infections. Thus, an exceptional linkage of agent to disease had to be established. This linkage was made (particularly in Bethesda) through the repeated isolation of HIV from patients with AIDS and, more important, through the development of a readily reproducible blood test. The growth of the putative virus in T-cell lines was an enormous step, facilitating the development of a blood test for HIV, which became available in blood-transfusion centers in 1985 and produced convincing evidence of the association between HIV infection and AIDS. The blood test also helped in the cloning and molecular characterization of the genetic material of the virus at the end of 1984, which clearly proved that the new virus belonged to the subfamily of lentiretroviruses; this finding, in turn, opened the way for the design of specific drugs and vaccines.

Other indirect evidence that HIV was the cause of AIDS came from the demonstration, in 1984, of its high degree of tropism for the subgroup of CD4+ T cells, its consistent isolation from patients of different origins who had AIDS, and the isolation of similar viruses that cause AIDS in nonhuman primates (specifically, macaques). Thus, the causative relation between HIV and AIDS was accepted by the scientific and medical community in 1984 and was further verified through the later isolation of HIV type 2 in West African patients with AIDS. The relation was also supported by the clinical efficacy of drugs that specifically inhibit HIV enzymes and the demonstration that mutations in one of the co-receptors for HIV (CCR5) make some persons highly resistant to HIV infection and AIDS.

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2 Responses to “Robert Gallo praises PEPFAR, dismisses Duesberg”

  1. Hmm. My impression was that all viruses worked this way. HIV is different in being a retrovirus, so it’s composed of RNA, rather than DNA. Or do I have that wrong too?

  2. Not sure if all viruses work that way. I don’t think so based on Gallo’s comments. We should inquire with Ben or other public health, medical professionals.