Charge of HIV Denialism Rejected
To the Editor:
Lawrence D. Mass [in “HIV Denialism and African Genocide” in the March-April 2011 issue]would like to have it both ways in his angry but misdirected attack on my 1996 book, Impure Science: AIDS, Activism, and the Politics of Knowledge (University of California Press), which he labels a “sophisticated apologia” for AIDS denialism. On the one hand, he acknowledges that my book appeared five years before South African President Thabo Mkebi shockingly justified his refusal to provide antiretroviral drugs to his citizens by citing the denialist claims of U.S. scientist Peter Duesberg. On the other hand, by the end of Mass’s diatribe, I am deemed complicit in Mbeki’s indifference to widespread death: “because of works like Epstein’s Impure Science … we must tiptoe all the more carefully around common sense and better judgment, even to the point of allowing many people to die.”
That’s a ridiculous reading of my book and its impact. Impure Science—which is mostly known for its lengthy analysis of how AIDS treatment activists changed medical research, and which does emphasize the potential virtues of questioning scientific orthodoxies—devoted two chapters to the controversy prompted by Duesberg and his followers. I argued that in 1987, when Duesberg first examined the claim that HIV causes AIDS, he raised legitimate questions about whether scientific certainty was running ahead of the documented evidence. I went on to show how Duesberg sought a following but became isolated over the next six years as new evidence accumulated from laboratory research and longitudinal cohort studies that left no meaningful doubt about the etiology of AIDS.
Mass apparently thinks that I was overly dispassionate in expressing that conclusion, and that if I cared about saving lives I should have been screaming it from the rooftops. Yet screaming is exactly what every famous AIDS authority had been doing for years, and by the time of the book’s publication, the denialists were a tiny fringe group with minimal credibility in the U.S. Does Mass really believe that if I had had the foresight to anticipate Mbeki and had pitched my arguments accordingly, then the tragedy in South Africa might have been averted? Alas, I don’t think that a foreign leader who failed to heed the global scientific consensus would have been swayed by my voice, whatever its amplitude or tone.
Steven Epstein, Professor of Sociology, Northwestern University, Chicago
To the Editor:
My first reaction to the simplistic and inaccurate attacks on Steven Epstein contained in Larry Mass’s essay, “HIV Denialism and African Genocide,” was surprise that someone as smart as Larry could so badly misread an academic study of the politics of science. Apparently, in his eyes a judicious study of competing paradigms immediately makes Epstein a “denialist,” when in fact a careful reading of Impure Science helps explain both the problems in the denialist position and why it attracted so much attention from a small group of loud-mouthed activists.
But on reflection, I was more shocked by the U.S.-centrism of Mass’s article, which totally ignores the considerable literature now available on Mbeki’s position and the politics that led to his denialism in terms of South African conditions. What happened in South Africa was undoubtedly a tragedy, but what led Mbeki to spend evenings searching for denialist literature was due to larger forces than the misrepresentations and ravings of a small group of New York activists. If the Review is going to publish a cover story on “African genocide”—itself a very loaded and I think inaccurate term—it should at the least be informed by some research of the literature on South Africa. You might have sought out a comment from one of the many South Africans who have built what is probably the most impressive activist AIDS network anywhere in the world, even if this meant less space devoted to such inconsequential figures as Ortleb and Lauritsen.
Dennis Altman, Professor of Politics,
LaTrobe University, Australia
Author’s Reply:
When I conclude that “because of works like Epstein’s Impure Science … we must tiptoe all the more carefully around common sense and better judgment, even to the point of allowing many people to die,” I wasn’t saying that Epstein’s analysis is in any way consciously complicit in what happened in South Africa. As Epstein also points out in his letter here, I did note that the AIDS denialism and mass deaths catastrophe in South Africa occurred years after the publication of Impure Science.
What I am saying is much more general: that because of freedom of speech and academic freedom and the principles of scientific inquiry and scrutiny that we all continue to value and abide by, we sometimes fail to speak out more boldy about cult phenomena such as AIDS denialism that seem troubled and dangerous. None of us could have foreseen what happened in South Africa. In the absence of much more outspoken concern from our leading activists and thinkers, however, we tolerated and indulged denialists and denialism more than we should have, until it was too late. I do not believe Epstein to be any kind of denialist, but I do believe that he, along with the rest of us, was too willing to be nonjudgmental in valuing the opinions and criticisms and impact of the denialist movement when we should all have been more alarmed about its dangers.
I share Altman’s concern that the published essay, which because of length had to be cut by half, did not cover a broader spectrum of what happened in South Africa. The original title, “Genocide By Sloth: AIDS Denialism, The Early Years and The Catastrophe in South Africa,” was likewise too bulky, but it called attention to the focus of the essay, which is about the origins of AIDS denialism during the early years of the epidemic, an important chapter in the history of AIDS that seems otherwise to have eluded historians. So while the writings and viewpoints of Charles Ortleb and John Lauritsen may seem inconsequential to the bigger picture of what emerged in South Africa, the writings and viewpoints of the denialists who most influenced them and whom they promoted, Peter Duesberg and Joseph Sonnabend, both of whom served on Mbeki’s panel of health advisors, were not.
Lawrence D. Mass, New York City
Correction
In the May-June 2011 issue, a review of the movie Undertow incorrectly identified one of the two protagonists as “Manuel.” The character’s name was actually Miguel.
