Sunday 25 October 2009

Why has the Spectator become Mbeki's unlikely ally on HIV-AIDS?

Spectator editor Fraser Nelson thinks it is time to question the Aids consensus, as The Spectator this week hosts a screening and panel debate on a controversial US documentary 'House of Numbers which seeks to open up a debate about whether HIV causes AIDS at all.

Nelson blogs:

Is it legitimate to discuss the strength of the link between HIV and Aids? It’s one of these hugely emotive subjects, with a fairly strong and vociferous lobby saying that any open discussion is deplorable and tantamount to Aids denialism. Whenever any debate hits this level, I get deeply suspicious.

The New Statesman's Mehdi Hasan spots an emerging pattern of Spectator denialism;

Ben Goldacre at the Guardian is scathing about the bad science of the film, about which he had written before.

Graeme Archer on centre-right thinks the piece captures a broader rise of denialism and a pernicious misunderstanding of scientific evidence.

But my first thought was how much this all simply felt like 'deja vu all over again'.

It is a decade and a half since Andrew Neil's Sunday Times put a great deal of energy into a long-running campaign challenging the HIV/AIDS link, leading to several very public spats with the science journal Nature and many others.

(With Andrew Neil chairing The Spectator's publishing group, one would not have to be a conspiracy theorist to at least wonder whether there could possibly be any other dots to join up here; I am not aware of Neil making any recent statement about what he now thinks of the AIDS issue, and the controversial Sunday Times coverage of 1993-4).

But the scientific and public policy debate in this area also had an enormously high political and media profile over the last decade particularly because of former South African President Thabo Mbeki's stance on questioning the HIV/AIDS link.

Mbeki made significant efforts to give a platform and profile to those who sought to challenge the mainstream scientific consensus. And South Africa adopted an AIDS strategy very much at odds with mainstream policy and scientific opinion, notably in anti-retroviral drugs to AIDS patients, and or to prevent the infection of newborn babies.

A peer-reviewed Harvard study published last year suggested that, had South Africa followed similar policies to Botswana and Nambia, then around 365,000 premature deaths might have been prevented. (This estimate was described by other leading epidimologists to the New York Times as 'reasonable' and based on 'truly conservative assumptions').

Mbeki's departure from office saw his controversial health minister replaced by veteran ANC activist Barbara Hogan, who responded to the study by saying:

“I feel ashamed that we have to own up to what Harvard is saying. The era of denialism is over completely in South Africa.”

Throughout all of this, there was never much international support for Mbeki's position (except for former Sunday Times science correspondent Neville Hodgkinson, who had left the paper when a new editor did not wish to continue to push the AIDS issue).

Yet Mbeki does seem to have, belatedly, discovered an unlikely ally, as The Spectator this week seeks to bring AIDS scepticism back into mainstream debate here in Britain.

Fraser Nelson blogs that he just wants to ask questions - almost as if all of this debate hasn't taken place.

While the challenge to the HIV/AIDS link was strongly rebuffed in 1993, perhaps some weight might have been given to the point that the existence of the disease was itself fairly new, so that more evidence might emerge. There was academic evidence of the impact of HIV on Aids in Africa fifteen years ago, but the weight of evidence since then has struck most informed observers as overwhelming.

It is far from clear that there is much, if anything, new in this recurring controversy. All of the individuals and arguments reported sound extremely familiar from these long-running debates.

Ben Goldacre had written about the film a month ago, and wrote at new year about the death of the anti-AIDS drugs activist featured in the film, following that of her three year old daughter from AIDS, after she had refused anti-retroviral drugs in pregnancy. (Anecdotes and data are different things, but the film's failure to mention this, except in small print at the end of the credits, does rather fatally undermine the idea that its motivation was to "just ask questions"). See also the interesting account from New Humanist editor Caspar Melville, who writes that he found out about the film's links to the AIDS-denial movement after chairing a Cambridge film festival panel about the film.

It looks to me as though the more interesting questions here are about journalism, rather than AIDS science.

So what is The Spectator up to?

Clearly, the Speccy is seeking to be provocative - but it may be hard to get a handle on the mix of two different possible motivations, one journalistic and the other political.

Weekly magazines have to be attention-seeking, polemical and controversial. Breaking taboos can be one easy and sometimes powerful way to try to do that. Yet there can be diminishing returns if it becomes a predictable, one-note approach. Choose one issue, and marshall good evidence, to challenge the scientific estabishment and "the debate" might matter. Do it on every single issue and many people are going to think it is either crankery or trolling.

Our weekly political magazines have also, traditionally, taken pride in their authority and reputation for critical intelligence too. Indeed that is foundational to any ability to undertake controversialist taboo-breaking in a way that is worthy of notice. Putting that reputation behind a heretical case is a good idea if (and only if) you genuinely believe that the heretics have something important to bring to the table.

If The Spectator wants to be sceptical about MMR, global warming and HIV/AIDS, then you get to the point where the big, newsworthy surprise would be a cover story declaring for David Cameron on climate change.

Challenging the scientific establishment not on one issue, but on almost every issue, may make this as much an ideological agenda as a journalistic one. The argument then becomes primarily about the nature of scientific expertise itself, or indeed all evidence or expertise in public debate.

And that is reminiscient of the emerging schism on the US right - between what might be called the rationalist and the irrationalist wings of the US conservative movement. Bush speechwriter David Frum worries about the Palinisation of the US right risks rejecting "a functional and serious conservative movement" for "a Poujadist mob of cynical know-nothings"

On this occasion, my guess is the Spectator is engaged more in mischevious stirring, rather than any deeply held interest in the HIV/AIDS issue itself.

If this were mostly controversy for controversy's sake, then the subject chosen might be thought to be in questionable taste. But that might not be particularly consequential. However much magazines aspire to 'thought leadership', its interventions are of course of an entirely different magnitude to those of Mbeki, or even of the Sunday Times in the 1990s. The impact of this Spectator debate on UK scientific, policy or public debate on this question is almost certain to be negligible.

But a more interesting question may be where The Spectator might want to take its scepticism about science next. Were the editor to seriously hold the view that, the more strongly held a scientific 'consensus' view, the more worthwhile it would be to challenge it, then there is really only one place that should end up.

Forget AIDS. Forget climate change even. There is surely one yet bigger question where the science seems entirely settled - yet is ideologically contested - and where those attempts to question the consensus then generate a vociferous scientific backlash.

"Whenever any debate hits this level, I get deeply suspicious", writes the editor.

So how long, I wonder, before we might now expect The Spectator to ask another question:

Is the theory of evolution really all it is cracked up to be?


James Graham (Quaequam Blog!) said...

Never mind evolution: if you are looking for a subject where there is scientific consensus what about the Copernican model or the spherical Earth theory?

threepenguins said...

I "denialism" another word for "heresey"? (There might even be an etymological link between them). I like the New Atheists because they bark at the Catholics. The Creative Designers keep the New Atheists on the hop. All these obsessed groups would be dangerous to civil society if they did not keep each other in check. So, please, leave "consensus" and "denialists" to the heresy hunters and be glad there are still folk out there willing to stir the pot.

Tony said...

think the speccy's film has now been pulled