Part 16: Questions for Those Who Still Have Questions

An excerpt from 100 Questions & Answers About HIV and AIDS, published by Jones and Bartlett Publishers, 2008. To purchase this book, click here. To read or listen to an interview with Dr. Gallant, click here.

• What about the theory that HIV doesn't cause AIDS?
• Isn't it true that drug companies are withholding the cure to make money?
• How do we know HIV wasn't created in a lab?

What about the theory that HIV doesn't cause AIDS?

In the early years of the AIDS epidemic, shortly after the discovery of HIV, a few scientists argued that AIDS was not caused by HIV infection. They proposed a number of alternative explanations, suggesting that AIDS was caused by drug abuse and zidovudine (in the developed world) and malnutrition (in the developing world). These scientists argued that Koch's postulates (the four criteria needed to prove that a microbe or organism is the cause of a disease [for an explanation of this term, click here]) had not been fulfilled and warned that antiretroviral therapy, rather than saving lives, was prematurely ending them.

If their hypothesis was far-fetched in the late-80s, it's complete lunacy today. Koch's postulates have been fulfilled many times over. We now have a solid and ever growing understanding of how HIV infects human cells, damages the immune system, and causes AIDS. The life-saving effects of antiretroviral therapy have now been well-established by countless clinical trials, large observational studies, and data from large populations. It was no accident that the death rate from AIDS declined by 50% in the year after HAART was introduced!

The so-called "scientists" who cling to their discredited hypotheses have forgotten one of the fundamental principles of science: You have to be able to admit that you're wrong. Their dwindling followers (most have either died prematurely or have come to their senses and started therapy) now treat "HIV denialism" more as a cult than as a scientific hypothesis. These wackos would be amusing if it weren't for their modest influence.They affected the policies of at least one government that was looking for a way to avoid paying for antiretroviral therapy and they have influenced gullible people not to get treated for a fatal disease. They have a lot to atone for!

Isn't it true that drug companies are withholding the cure to make money?

This is a popular point of view among conspiracy theorists and those with contempt for drug companies, but a little rational thought should put this myth to rest.

1. It's no surprise that we haven't yet eradicated HIV infection. The difficulty of finding a cure is discussed in Question 42.
2. People who develop therapies at drug companies are scientists. They're motivated by the things that motivate scientists everywhere else: publication in prestigious journals, the respect of their colleagues, Nobel Prizes, interviews on "Oprah," getting funding to do more research, and the knowledge that their work has made a difference to humankind. No scientist who discovers the cure for AIDS is going to keep quiet about it, even if ordered to do so by an evil, profit-hungry CEO!
3. Drug companies are competitive. If they're onto something big, they know their competitors can't be far behind. Being the second company to come up with The Cure won't be good enough. If a company had a cure, you'd have heard about it!
4. A cure for AIDS would be highly profitable. Sure, there's big profit in lifetime therapy, too, but it's shared among multiple competing drug companies and doesn't last forever. Drugs go off patent and get replaced by generics; they fall out of favor as they're replaced by newer and better agents. A cure is likely to be expensive and would result in an instant monopoly for the company that discovered it.
5. Most conspiracy theories are wrong.

How do we know HIV wasn't created in a lab?

This popular conspiracy theory gives far too much credit to the science of bygone generations. HIV first infected humans in the first half of the twentieth century (see Question 3). We have proof of human infection dating back to the '50s. The idea that such a complex virus could be created by scientists today is farfetched enough, but to think that it could have been invented over 65 years ago is preposterous.

Few of those who believe in this theory think it was just an innocent scientific experiment gone wrong. Instead, they believe it was part of a well-orchestrated plot to rid the country ... or the world ... of its "undesirable" elements: gay men, injection drug users, or minorities ... take your pick. But in the first half of the last century, we were too busy worrying about poverty (the '30s), the war ('40s), and communists (the '50s) to waste time trying to figure out how to wipe out gay men and drug users, who were barely on the radar screens of anyone except other gay men and drug users.

The fact that the HIV epidemic didn't originate in the developed world (where, as we know, all the evil scientists live) doesn't fit well with this theory either. Since the epidemic began in Africa, you'd have to propose that someone was trying to wipe out all Africans, a strategy that would not have been appreciated by the colonial powers who relied on them for labor and income.

Finally, it's inconceivable that the inventor of such a virus could also have planned an epidemic that would target specific groups of people. Its spread among gay men, drug users, and minorities was accidental, and in the end, it didn't stay confined to those groups anyway. Throughout history, there have been infamous examples of abuse of the human race by science and medicine, but the deliberate creation of the HIV epidemic is not one of them.

*Koch's postulates: The four criteria needed to prove that a microbe or organism is the cause of a disease. The postulates are: 1. the organism must be found in all animals suffering from the disease but should not be found in healthy animals; 2. The organism must be isolated from a diseased animal and grown in pure culture; 3. The cultured organism should cause disease when introduced into a healthy animal; and 4. The organism must be reisolated from the experimentally infected animal.