13 Jul 2009

Aids denialist’s mystery death

In 1992, Christine Maggiore, a successful businesswoman, tested positive for HIV. The diagnosis sent her life spiralling in new directions that would see her embracing denialist views on HIV/Aids, burying her HIV-positive daughter after refusing to allow her Aids medicines, and meeting with former president Thabo Mbeki.

With Maggiore's death on 27 December, 2008, a chapter in the history of Aids denial came to an end. We do not know for certain what she died of, but we do know she had been suffering from pneumonia for at least six months prior to her death. Experts agree that the most likely explanation is that the pneumonia was Aids-related. This has not been confirmed by a coroner's report.

Those who had supported Maggiore in her rejection of established HIV science find it hard to contemplate that her death might have been Aids-related. They ‘blame’ a radical detoxification cleanse that Maggiore had taken shortly before her death. But, as Dr David H Gorski points out on the respected blog site Science-Based Medicine, ‘If Christine Maggiore was in fact so healthy, why did she think she needed to undergo such a radical detoxification regimen? Healthier people, a.k.a. the “worried well” who are most drawn to “alternative” medicine, tend to opt for much less radical detoxification regimens.’

A daughter's death
Whereas doubt clouds Maggiore's own death, a coroner’s report unequivocally found that the death of her 3-year-old daughter Eliza Jane Scovill in 2005 was caused by Aids-related pneumonia.

Maggiore had refused to take antiretroviral drugs during her pregnancy and insisted on breast-feeding Eliza Jane despite the risk of transmission.

Yet, soon after Eliza Jane's death, the LA Times quoted Maggiore as saying, ‘I have been brought to my emotional knees, but not in regard to the science of this topic. I am a devastated, broken, grieving mother, but I am not second-guessing or questioning my understanding of the issue.’

Anti-scientific views
‘Christine Maggiore died because of her anti-scientific view that HIV does not cause Aids,’ says Nathan Geffen, former Director of Research and Communications at the Treatment Action Campaign. ‘People are entitled to make their choices even if they are not in their own best interests, but in Maggiore's case she also convinced many other people not to take antiretrovirals and she refused to take them to prevent her own child from contracting HIV. Her child and many others died because of her. That is unforgivable.’

After becoming acquainted with the denialist views of Peter Duesberg (who would later serve on President Mbeki's Presidential Advisory Panel on Aids) in the mid-90s, Maggiore came to doubt that HIV causes Aids and founded the group Alive and Well Aids Alternatives – which encouraged HIV-positive pregnant woman to avoid taking Aids medicines. She also wrote a book called What If Everything You Thought You Knew about Aids Was Wrong, which sold over 50 000 copies, and made a number of TV and radio appearances.

She was also invited to the 13th International Aids Conference held in Durban in 2000 and met with then president Thabo Mbeki.

She formed part of the group of people who helped influence Mbeki and former health minister Manto Tshabalala-Msimang's policies on HIV/Aids, and she certainly gained apparent credibility for herself by this association.

’By courting the Aids denialists, Mbeki has increased their stature in the United States,’ wrote Nicoli Nattrass, director of the Aids and Society Research Unit at the University of Cape Town, and Professor John Moore from Cornell University, in the International Herald Tribune. ‘He lent credibility to Christine Maggiore, a Californian who campaigns against using antiretrovirals to prevent transmission of HIV from mothers to children, when he was photographed meeting her.’

Indeed, Alive and Well (the organization founded by Maggiore) is still actively promoting the view that HIV does not cause Aids, and has received support from high-profile celebrities, including the American rock band The Foo Fighters.

Though the case made by Alive and Well may have the sheen of science, that is superficial: it is in fact selective and misleading. Denialist concerns about HIV/Aids have been answered many times over. For an excellent analysis of denialist myths, see the following two articles: The evidence that HIV causes Aids (from the US National Institute for Allergy and Infectious Diseases) and Debunking denialist myths (on AidsTruth.org).

The cost of denial
Like Maggiore, denialists often claim they are exercising freedom of speech and that mainstream medicine is silencing dissent – Maggiore herself at times claimed only to be presenting an alternative – there is clear evidence of the impact that pseudoscience and Aids denial has had on the health of South Africans. Last year Harvard researchers said it was a conservative estimate that more than 330 000 lives had been lost to HIV/Aids in South Africa between 2000 and 2005 simply because the government failed to implement a feasible and timely antiretroviral treatment programme.

In addition, an estimated 35 000 babies were born with HIV during that same period because of government's reluctance to introduce a mother-to-child transmission prophylaxis programme using nevirapine (an anti-Aids drug).

Not implementing such programmes is of course exactly what Maggiore was campaigning for.

An end to denial?
According to Geffen, Aids denialism is declining, partly because Mbeki and Tshabalala-Msimang are no longer controlling South Africa's health system. New Health Minister Barbara Hogan was quick to go on record stating that "we know that HIV causes Aids."

Nevertheless, Geffen points out, there are still thousands of fake Aids cures being sold in South Africa, and getting rid of this kind of quackery will not be easy. For example, Peggy Nkonyeni, Kwazulu-Natal MEC for Health, has been reported to have close ties with a number of people selling untested cures. She also made headlines for suspending a doctor who had provided antiretroviral drugs to HIV-positive pregnant women attending an antenatal clinic in the province.

Geffen says we have our own Maggiores here ‘and they are far more deadly than her’. ‘Her (Maggiore's) book was featured on Criselda Kananda's radio show (on MetroFM). Kananda, like Maggiore, continues to try to convince people to take medical decisions that will likely result in their avoidable death,’ said Geffen.

Kananda, who has tested HIV positive herself, told the Citizen newspaper she will never take antiretrovirals because ‘they are a deadly and easy way out’. Like Maggiore she insists HIV does not cause Aids, and that Aids is instead the result of a compromised immune system, of living an unhealthy lifestyle and being attacked by infectious diseases.

(Marcus Low, Health24, Updated July 2009)