Suppressed Inventions and Other Discoveries (14 page)

PASCAL'S STUDIES

If the medical research establishment was reluctant to investigate the theory, others were not. One of them was Louis Pascal, an independent scholar in New York City. In 1987, he heard a radio talk show with guest Eva Lee Snead who proposed that polio vaccine contaminated with SV40 was responsible for AIDS. Pascal knew enough biology to realize that SV40 couldn't be the cause, but what about the SIVs? He decided to investigate.

By reading medical journals from the 1950s and 1960s and making comparisons with recent reports about the development of AIDS, Pascal soon had a powerful set of arguments suggesting that polio vaccination campaigns in Africa may have led to AIDS. He focused on a particular batch of vaccine used by Hilary Koprowski, a pioneer in polio eradication but less well known than Jonas Salk and Albert Sabin. Koprowski's CHAT Type 1 polio vaccine was given to some 325,000 men, women and children in central and west Africa from 1957 to 1960, plus a few thousand people elsewhere, such as Poland. Pascal found a remarkable geographical coincidence. The main use of CHAT was in central Africa, not far from the area of Africa with one of the highest incidences of AIDS in the world today. Significant doses of CHAT were also administered in the city of Leopoldville; today that city, now called Kinshasa, has an extremely high incidence of AIDS. Sabin later found this batch of vaccine to be contaminated by an unidentified virus.

Koprowski's vaccine was administered orally, by spraying a mist of vaccine into a person's mouth. This seems to raise an immediate objection: HIV, some later critics said, has not been shown to be transmitted orally, so it is unli kel y that SIV could be transmitted to humans this way. Pascal has two responses. First, HIV can be transmitted orally, most clearly from breast-feeding mothers to their children. All that is required is that the mucus [membranes] in a recipient's mouth have reduced immune response. Second, it is quite possible that some of the recipients of the vaccine had ulcers or cuts in their mouths, allowing SIV to enter the bloodstream.

Pascal's main interest was to track the origin of HIV-1. He attributes it to an undiscovered SIV that infected a small number of people in central Africa via Koprowski's CHAT vaccine, followed by the spread of HIV-1 elsewhere via person-to-person contact.

Pascal had one further argument. He notes that the immune system normally resists alien cells, or indeed any biological material with an unfamiliar genetic sequence. This of course is why it is necessary to suppress the immune system when transplanting organs. Pascal asks rhetorically, how better to spread a virus from one species to another than by giving it to large numbers of individuals, some of whom are likely to have impaired immune systems? He then points out that Koprowski's vaccine was given to large numbers of children, some of whom were less than 30 days old. Not only are young children's immune systems undeveloped; the youngest children were given 15 times the adult dosage of polio vaccine.

Pascal found much else in his search through the medical literature, enough to convince him that this theory was worth testing because of its serious implications. One immediate implication is that vaccines should not be cultured on monkey kidneys. There are a number of different SIVs and new ones continue to be discovered. Pascal speculated that a new SIV might be entering the human species every few years, potentially leading to a new type of HIV and causing the death of a million or more additional people. Because different HIVs have different rates of exponential spread, one or two types will usually dominate infection statistics. Nevertheless, the human consequences of a single further new HIV are considerable. Therefore, Pascal thought his theory deserved urgent consideration. After all, a delay of a few years might conceivably lead to the deaths of millions of people.

Another implication of Pascal's theory is the need for an urgent assessment of other possible methods for spreading disease from one species to another. One example is the recently carried-out transplantation of a baboon liver into a human. This provides an ideal opportunity for the spread of any virus in the baboon to the human, given the mixing of cells and blood and the use of drugs to suppress the recipient's immune system. Another example is some of the experiments with genetic engineering.

Pascal had a theory and had good reason to believe it deserved urgent consideration. If the theory could be proved wrong, then there was nothing to worry about; but if it proved correct (or possibly correct) then its implications should be dealt with immediately. He assumed that since the theory seemed so obvious, there would be others who would come up with it independently. But, just in case, he did what he could to make sure it received critical examination.

Pascal believed that if he wrote up his findings and sent them to scientists and to scientific journals, then—taking into account the important potential social implications of the theory—scientists would either refute his ideas or accept them. In other words, he expected his ideas to be considered objectively, irrespective of who he was or how he wrote up his material. Proceeding on this assumption, Pascal wrote an account of his theory, including plenty of references and logical argumentation so that others could check his facts and inferences. He sent his paper to a number of prominent scientists for their examination and also submitted it to a number of leading scientific journals.

From the prominent scientists, Pascal received only one cursory acknowledgment. From the scientific journals—Nature, Lancet, and New Scientist—he received the brushoff, either a rejection with little or no explanation, or year-long failures to answer.

Pascal thought that scientists and scientific journals would give his ideas a fair hearing. Unfortunately, the standard view that science is objective and open to new ideas—a view that is taught to science students in high school and university and to the general public through many popular treatments—is flawed. The reality is that being taken seriously by the scientific research establishment depends sensitively on who the writer is, what their institutional affiliation is, how they write their paper and, not least, what they have to say. To be taken seriously, it is a great advantage to be an eminent scientist, to write from a prestigious address, to write precisely in the standard journal style, and to say something that is just marginally original and not threatening to any powerful interest group. Pascal, by being an "independent scholar" with no institutional affiliation, by writing in a style that deviated somewhat from the standard passionless prose and not citing prominent scientists in quite the appropriate respectful way, and by presenting a highly threatening proposal, was never taken seriously.

Defenders of the system would say that Pascal should have couched his ideas in the standard format. If he wanted to be taken seriously, he had to play the game of scientific publication by the rules. From Pascal's point of view, this sort of attitude misses the point. It was he who was raising a serious issue for science and public health. He felt it was the responsibility of editors to deal with his concerns promptly and effectively. If he was wrong, nothing was lost; if he was right, many might suffer. Therefore the "scientific reception system," namely the system by which potential contributions to scientific knowledge are considered, certified, and published, was responsible for making sure his ideas received proper consideration, even if he didn't couch them precisely in orthodox form.

Cynically speaking, the system works reasonably well to serve the interests of career scientists, who have a strong incentive to play the game by the rules, since that is the way they obtain publication and thereby obtain jobs, grants, and promotions. But Pascal was not seeking a career in science, nor did he particularly care about having his name in print. He was primarily concerned about scientific ideas and the social implications of science. This lack of career motive and personal ambition can seem strange to professional scientists. Likewise the operation of the scientific reception system seems strange, indeed immoral, to someone like Pascal with different motivations and goals.

One of his correspondents, a philosopher, sent Pascal's paper to the Journal of Medical Ethics, whose editor then invited Pascal to submit a paper on the ethical issues associated with his case. After much labor, Pascal prepared a new paper, but it was rejected ... for being too long.

In 1990 I began corresponding with Pascal and was quite impressed by his ideas, his grasp of the issues, and his thoroughness. After his paper was rejected by the Journal of Medical Ethics, I arranged for it to be published in a working paper series at my university.
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As soon as it began to be circulated, it generated considerable interest among scientists and others. One of the responses was by the editor of the Journal of Medical Ethics, who wrote an editorial explaining why they had rejected it, making known its availability and commenting that Pascal's thesis "is an important and thoroughly argued one and ought to be taken seriously by workers in the AIDS field."
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OTHER INVESTIGATORS

Pascal had long said that he would not be surprised if others independently developed the same theory, since it was so obvious. As indicated by the quote from the AIDS researchers, it had indeed been considered, but apparently not investigated further because of reservations about the possible implications. Most of the scientific community remained ignorant of the theory, aided by unreceptive journals.

One exception was two South African scientists, Professors Gerasimos Lecatsas and Jennifer J. Alexander. Independently of Pascal, they wrote several letters and short pieces to scientific journals raising the possibility of AIDS arising from polio vaccines. Most of their early submissions were rejected, but not all.
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However, this airing of the idea in a medical journal did not stimulate others to investigate more deeply. Instead, they were personally attacked in a reply to their letter in the South African Medical Journal.

Blaine Elswood, an AIDS activist and employee of the University of California at San Francisco, also developed the same theory independently of Pascal. Elswood worked with medical researcher Raphael Stricker and they prepared a carefully written scientific paper. It was rejected by the British Medical Journal. They next tried Research in Virology. After being given strong encouragement by Luc Montagnier, months passed. Then, in an apparent reversal, they were asked to shorten the paper, delete most of a section on SV40, and resubmit their material as a letter to the editor. Many more months passed before their letter was finally published.
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It was followed by a rebuttal from the editorial board of the journal.

Clearly the mainstream scientific journals were not eager to give the theory much visibility. Elswood had anticipated this, and he had encouraged Tom Curtis, a free-lance journalist based in Houston, to investigate. Curtis was enthusiastic. Starting with materials obtained from Elswood, he delved further into the literature and also did interviews with many scientists, including Sabin, Salk, and Koprowski. He wrote a series of important stories in the Houston Post and a major piece published in Rolling Stone.
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Whereas the scientific journals had stalled on the story for years, Curtis' Rolling Stone story broke through the usual barriers. It became a news item not only in the press, radio and television, but also a story in the news columns of scientific journals.
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Koprowski wrote a response in the form of a letter to the editor of Science.
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Curtis wrote a reply, but Science refused to publish it.
The Wistar Institute, headed by Koprowski until 1991, holds seed stocks of polio vaccines. Koprowski had earlier been asked by medical researcher Robert Bohannon to release its vaccines for testing. If vaccines from the 1950s African campaigns were found to be contaminated by SIVs, this would provide support for the But Koprowski failed at first to even Bohannon also had little success with similar requests to the Food and Drug Administration.
Curtis' story in Rolling Stone made it harder for Wistar to refuse to cooperate. The Institute set up an independent advisory committee to advise it concerning the implications of the theory. The committee provided a brief 8-page typed report which concluded that the chance that AIDS had originated from polio vaccination campaigns was "extremely low."
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Unfortunately the committee never consulted Pascal, Elswood or Curtis in preparing its report. Even if, a priori, the chance of causing AIDS from polio vaccines was quite low, we know now that AIDS did develop somepolio vaccine-AIDS theory. answer Bohannon's letters. how. Therefore, the key issue is not the absolute probability of AIDS developing from a particular sequence of events, but the relative probability, namely the probability compared to other ways that AIDS might have developed (cut hunters, monkey bites, and so forth). But the Wistar committee made no such comparisons.
The only bit of real evidence that the committee used to criticize the theory was the case of a Manchester seaman who died in 1959, in retrospect apparently having contracted AIDS. HIV was detected postmortem. Koprowski, in the letter to Science, also made a big issue of the Manchester seaman. Yet there are several possible explanations for this case which reduce its power as an objection to the theory.
First, the test for HIV in the seaman's remains may have been a false positive. In other words, the seaman may not have had AIDS at all, but instead the tests that showed HIV may have been contaminated. Aptly, the first four pages of Pascal's paper deal with how easy it is for cell lines to be contaminated, drawing on the famous case of HeLa.
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(See the inset "The HeLa Affair" on page 81.) Pascal uses the example to show how easy it is for scientists to slip up and how eager they are to avoid acknowledging their mistakes.
Second, the seaman might have been infected by HIV during a trip to Africa or by contact with other seamen, and then have developed AIDS much more rapidly than usual, especially considering that he was given immune-suppressive drugs.
Third, the seaman might have contracted AIDS via some earlier vaccine experiments from the 1920s to the 1950s, at least one of which involved the injection of live monkey cells into thousands of people.'
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Pascal points out that there is evidence of experiments involving grafts of monkey or chimpanzee organs at least as early as 1916.
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It is possible that monkey viruses could have been transmitted to humans on one or more of these earlier occasions, leading to anomalous cases of disease. This is compatible with polio vaccination campaigns in Africa being the cause of the AIDS pandemic.
It is now the conventional wisdom in the history and sociology of science that a single piece of evidence is not sufficient to reject a theory. Within any general picture, such as a scientific paradigm, there are always some anomalies. These anomalies are either explained away or ignored so long as there are compensating advantages or insights to be gained from the wider picture. This is not to say that anomalies should be dismissed as trivial. Quite the contrary. But they are not alone sufficient basis to reject a theory.
The importance placed on the Manchester seaman example by opponents of the polio vaccine-AIDS theory, and their lack of examination of alternative explanations, suggests the eagerness with which they have