UPDATE: Patrick Holford has been in touch to clarify his position - emphasising that nutritional approaches to HIV/AIDS should be used “alongside medication”, and stating that he has “never advised anyone to stop taking, or not to take ARVs”. Obviously, this is extremely welcome - I’ve e-mailed Holford to ask for some further details, but I’m very glad to see him clarifying his position on this.
I’ve received an e-mail arguing that it’s unfair for me to attack Jerome Burne by noting that he was apparently videoed at a Matthias Rath rally, applauding. As I say in the original post, I wasn’t entirely comfortable with taking this line: it could easily seem like an unfair personal attack on Burne and Holford. That’s why I’m going to review this issue here - and it would be great if readers could let me know what they think of my position on this.
With this in mind, I think the first thing I ought to do is to provide a link to the video so that readers can watch it, and see Burne’s response to Rath’s speech - that way, you can judge for yourself whether or not Burne’s reaction is acceptable. So, you can watch Rath’s latest London speech here (for some reason I can’t get the video to embed in the blog; blogging’s great like that - the future’s here, but it’s broken).
I don’t apologise for the fact that Matthias Rath makes me very angry. Rath has claimed that the proprietary vitamin pills he sells can treat a startling range of illnesses - from cancer to heart disease. However, I’m going to focus (as did in the London speech) on HIV/AIDS.
While estimates as to numbers of deaths in South Africa vary, it is apparent that - at ‘best’ - several hundred thousand South Africans have died of AIDS-related illnesses in the past couple of years. The people dying of AIDS tend, disproportionately, to be relatively young (there is a particularly high increase in the death rate among 25 to 49-year-olds). While such deaths are always tragic, this is compounded by the fact that AIDS is a relatively nasty way to go. Those dying of AIDS are often survived by their children: there are currently over one million AIDS orphans in South Africa.
The reason that I am so angry with Rath is that he has been using his - considerable - to intervene in South African politics. The Guardian observes that Rath has taken out adverts in South Africa (and elsewhere in the world) claiming that “Aids drugs are toxic and potentially deadly“. For The Guardian, this has increased the widespread public uncertainty [in South Africa] around whether these drugs are safe to use and are beneficial.In the video above, Rath claims - misleadingly - that people on antiretroviral drugs have a 4-6 times higher chance of dying of AIDS than those who are not taking these drugs.
Antiretroviral drugs do have unpleasant side-effects - to state the obvious, one should do everything possible to avoid contracting HIV in the first place - but, for those who have contracted HIV/AIDS, these drugs save lives. To misquote Woody Allen (talking about aging) - the effects of antiretroviral drugs can be really nasty, but they sure beat the alternative. One can first note the dramatic fall in AIDS-related deaths in the US, after the introduction of these drugs (at the same time as the number of people living with HIV/AIDS has been going up):
Some have argued that it is not helpful to focus on the benefits of these drugs in the US: it has been claimed that, in poorer communities, other problems like malnutrition will mean that people do not benefit from antiretrovirals. However, the evidence is that antiretrovirals are still useful to these communities. For example, a study of the efficacy of these drugs in a Jo’burg township shows that they are effective (and cost effective).
This doesn’t mean that vitamin supplementation is pointless. For example, there is some evidence for supplementation with vitamin A, C, and a multivitamin in HIV/AIDS patients (although the evidence is not conclusive, and there are potential risks - speak to your Dr or dietician if you’re considering this type of supplementation, as this isn’t an area where one should rely on online advice from a blogger). Clearly, it is also a good idea for those with HIV/AIDS to eat a healthy diet (food poverty in South Africa has, sadly, been an issue for some time - and needs to be addressed ASAP). However, a healthy diet and vitamin supplements can be a helpful complement to antiretroviral drugs. Sadly, though, those who use these as an alternative to antiretrovirals are very likely to die unnecessarily early.
Moreover, the Treatment Action Campaign argues that Rath’s marketing techniques, and experiments, have been linked to specific unnecessary deaths in South Africa. Treatment Action Campaign offer five case studies of South Africans who died while on a Rath trial; they argue that, “for three of these patients Rath is at a minimum responsible for contributing to their deaths“. In his speech in London, Rath talked about this trial. The video above appears to show Burne applauding.
Hopefully, it will now be clear to you why this makes me angry with both Rath and Burne. I could give plenty of additional examples of reasons to be angry about Rath, but this post is getting a bit long already. There’s lots more detail on Treatment Action Campaign’s site.
So - is it fair for me to write about Burne’s behaviour on the video, and criticise Burne for this? I can understand why people might be unhappy if I seem to be condemning Burne by his association with Rath. Had Burne just being in the audience at the talk, that would have been understandable - after all, Burne is a health journalist. However, applauding Rath is a different matter.
Burne is the co-author (with Holford) of a book titled Food is Better Medicine than Drugs. I therefore think that Burne’s behaviour at a Rath speech is worth noting. Rath is a famous advocate of vitamins (what Burne and Holford would probably call ‘food’) as an alternative to antiretroviral drugs. Burne appears to have responded very positively to Rath’s position, despite the fact that people have died and are dying in South Africa (and elsewhere) because they are choosing to rely on ‘food’ instead of effective antiretroviral drugs. I do think that it is quite acceptable to discuss this on a blog.
A second question is whether it is acceptable for me to write about this on a blog about Patrick Holford - am I trying to somehow condemn him just because of his association with Burne and therefore with Rath? Holford has not made his position on antiretroviral drugs and HIV particularly clear. Given that his previous statements on HIV and vitamin C have been criticised - and that Holford was recently on a speaking tour in South Africa, where this was a hot media issue - I think it is perfectly reasonable to ask Holford to clarify his position. Again, I would note that Holford co-authored Food is Better Medicine than Drugs with Burne: I’d like to know whether Holford acknowledges that, in the case of HIV/AIDS, drugs are a necessary part of the best treatment approaches.
If Holford is aware that antiretroviral drugs are the best available treatment for HIV/AIDS, he should quite explicitly say so: people are currently dying unnecessarily because of misconceptions about antiretroviral drugs. Given that his co-author has apparently been caught on video responding so positively to Rath, I think it is also reasonable to ask that Holford makes explicit his opinion of Rath: is Rath wrong to advocate vitamin pills as an alternative to antiretroviral drugs?
This is all a messy business, though - looking at how well the character of Burne and Holford stands up, instead of analysing Holford’s science. Hovever, given the fact that, even as I write this post, South Africans are dying unnecessarily because they do not have access to, or choose not to take, effective HIV/AIDS medications, this may not be an appropriate time for moral niceties. I think it’s reasonable for me to ask about Burne and Holford’s views on HIV/AIDS, antiretroviral drugs and Rath. If an influential nutritionist like Patrick Holford were to publicly and unambiguously back proven treatments for HIV/AIDS - while condemning the sale and promotion of ineffective ‘alternative’ treatments - this could have a positive effect: Holford could help save lives. It’s worth noting that Holford has previously lectured in South Africa, and gives his name to a line of vitamin pills sold there: it’s not as if he’s unknown in South Africa, or unfamiliar with the situation there.
So, do you agree with me? Is this important information to get out, or am I being unfairly harsh on Burne/Holford/Rath? Let me know what you think.
