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VOL. 5 No. 1

By the end of their term in office the last British Conservative government had become the ‘government of sleaze’. To the public, ‘sleaze’ had come to be symbolized by brown paper envelopes filled with money for questions, given to MPs as payment for lobbying ministers.

In looking to pursue its marketing strategy for AZT inside the British parliament, Wellcome used two devices: first the science lobby and scientific institutions and secondly a small all-party parliamentary campaigning group, the All Party Parliamentary Group on AIDS (APGOA), which had until 1987 been more or less dormant.

In October 1988, just as Wellcome and the Medical Research Council were beginning the Concorde trials, the APGOA received sudden and quite substantial funding. This funding came in part from the Wellcome Foundation which in 1988 gave around £10,000. In later years, as well as the Wellcome donation, CRUSAID, a charity funded by Wellcome and responsible for distributing money to grass roots groups supporting people suffering from AIDS-associated illnesses, gave money to APGOA. Other contributors to APGOA were Roche and the London International Group, whose subsidiary, the London Rubber Company, produces condoms.

In November 1988, APGOA began regular publication of the Parliamentary AIDS Digest, a forty- or fifty-page journal published four or five times a year. The group funded two research workers who worked within parliament producing the Digest.

From the time that Wellcome began sponsoring the APGOA, doctors who wrote for the Digest and those who attended the all-party meetings were, in the main, doctors involved in the Concorde trials or another of Wellcome’s grant-receiving projects.

From 1989 onwards, Wellcome had an input to government which was even more influential than contact with MPs in the House. In July 1989, Sir Alfred Shepperd, who was at the time Chairman of Burroughs Wellcome and who had been Chairman of the Wellcome Foundation up to 1985, was a member of the Advisory Council on Science and Technology (ACST). This body advises the government and the civil service on matters of science. Its meetings are attended by the chief scientific adviser to the Cabinet Office and departmental chief scientists and scientific advisers. Also on this committee in the late 1980s was Professor Roy Anderson, who at that time headed the department of Pure and Applied Biology at London’s Imperial College of Science, Technology and Medicine. He was also a Wellcome Trustee. As a trustee he was one of a handful of powerful men who controlled the Wellcome funding empire. Throughout the time of his term of office with the ACST Professor Anderson was one of the most vociferous proselytizers for AZT.

In America it was the National Institutes of Health that controlled all the research around ‘HIV and AIDS’, ensuring that scientists kept to the beaten track. Research into ‘HIV’ was allowed but not into AIDS; research was allowed into anti-viral pharmaceuticals but not into natural health care for immune system disorders.

In Britain AIDS research funding and its direction were controlled by the Medical Research Council (MRC). The MRC was originally set up with a number of other Research Councils, so that government money could be equitably allocated to government-prioritized medical research projects.

Although scientific research had always had some identity of interest with industry, it was not until after the second world war that the dichotomy between the interests of citizens and those of industry began to be manifest. This dichotomy became evident in a number of different ways; with the advent of crop spraying with pesticides for example.

From its inception, the MRC was superficially independent of industry. In the nineteen fifties, the organization made various forays into such areas as the effects of chemicals on health. By the nineteen seventies, the MRC was constrained from any independent research by its links with industry. By the nineteen eighties, things had become much worse and as the government increasingly cut back on research funding their place was taken by industrial companies in partnership agreements, and the Wellcome Trust. By the late eighties and the era of AZT marketing, the MRC was the dog of an institution being wagged mercilessly by its pharmaceutical tail.

The results of many of these publicly supported projects were never published by the MRC. A clause in the research protocol ensured that Wellcome, or another company, had use of the research results before, or even instead of, the MRC.

In the Concorde Trial protocols, Wellcome managed to negotiate a clause of just this kind and consequently Wellcome were able to suspend the trial results while they organized damage limitation. During the waiting time, a number of Wellcome directors cashed in their own shares in the company. When the results were finally published they were written in ‘scientese’ which obscured their easy understanding.

A review of the MRC Committee on AIDS (MRCCoA), at the time when AZT was on the agenda, opens a window onto the intricate machinery of scientific vested interests that industry has created over the years. The individuals or their specific vested interests are not as important as the process which is involved; individuals and their interests change but the process continues.

In the mid eighties, MRCCoA consisted of a Chairman and eight members. The Chairman was Lord Jellicoe, who was also, at the time of Concorde, Chairman of the MRC itself. Lord Jellicoe was leader of the House of Lords from 1970-73 and during his time in the Lords he has been a member of the All Party Group for the Chemical Industry. At the time of Concorde he was also Vice Chairman of the All Party Parliamentary Group on AIDS. From 1978 to 1983 he was Chairman of the Board of Directors of Tate and Lyle, Britain’s biggest sugar company. In 1993, he was Chairman of Booker Tate, the confectionery conglomerate. From 1985 to 1990 he was on the Board of the Davy Corporation, a company which makes plant for the pharmaceutical and food processing industries. Lord Jellicoe is also involved with Rockefeller interests through a Directorship of Morgan Crucible.

Sir Austin Bide, a member of MRCCoA from 1987 to 1990, was the chief executive of the drug company Glaxo from 1973 to 1980 and then became the first Chairman of the Board and in 1985 their honorary President. Sir Austin has been Chairman of the anti-socialist Adam Smith Institute since 1986 and from 1974 to 1985 he was a member of the Council of the CBI.

An interest in the promotion of processed food is the one thing which stands out in the career of Sir David Crouch, a member of MRCCoA in the late eighties and Conservative MP for Canterbury from 1966 to 1987. He was a member of the Society of the Chemical Industry and Chairman of the All Party Group for the chemical industry for almost twenty years from 1970 to 1987. He was a director of the pharmaceutical company Pfizer from 1966 to 1987.

Sir David’s real interests, however, were in public relations; since 1964 he was chairman of David Crouch & Co, marketing and PR consultants, whose clients include Beechams. He was also a director of two other leading PR firms in the field of processed food marketing: Burson Marsteller Ltd, of which he was a director from 1972 to 1983, handle many of the large processed food and pharmaceutical accounts, including an account for Wellcome. In 1989, Sir David was a director of Kingsway Rowland the company which handled aspects of the PR account of AZT for Wellcome.

Of the scientists on the MRCCoA, Dr Joseph W.G. Smith is an interesting individual. Recently a Director of the Public Health Laboratory Service, in the 1970s he was head of bacteriology at the Wellcome research laboratories.

The most important of the MRC AIDS subcommittees throughout the time of Wellcome’s Concorde trials was the AIDS Therapeutic Trials Committee. This committee was responsible for selecting and overseeing all government and industry sponsored trials into AIDS and HIV at the time Wellcome received its license for AZT. At least five members of this committee, the only committee in the country which could, during the late eighties, have furthered competitive research and drug development, had received funding through the Wellcome Trust.

The monopolization and infiltration of ‘independent’ research facilities by commercial and industrial interests, represented, well before privatization, a considerable shift in the control of public money. As happened at the Ministry of Agriculture, Fisheries and Food, over the years the base of both research and regulation which had always been in the industry, began to manifest an everyday policy which was against the interests of consumers. How, for example, could the MRC ever be involved in independent research into health and chemicals, chemicals and food, chemicals and cancer, when its committees are dominated by chemical company interests?

Since the middle of the last century, first serving the new industrial bourgeoisie and later the working class as well, the general practitioner became the mainstay of the National Health Service. Until the 1960s, many general practitioners had a reputation for independence of mind. Over the last thirty years this independence has been eroded on the one hand by the drug marketing and the introduction of centralized high technology centres of scientific medical excellence and on the other hand by ongoing fiscal crisis.

From the beginning, Wellcome marketed AZT as a complex, high flying and very expensive drug. One of the advantages of this was that Wellcome did not have to depend upon general practitioners to dispense the drug. The ordinary doctor was, in fact, a serious problem for Wellcome as they entered the field of AIDS. What if general practitioners were to find other ways of treating HIV antibody positive patients?

Wellcome set out to educate general practitioners to the enormous dangers of HIV and AIDS, ensuring that most general practitioners were so afraid of the highly contagious nature of the ‘disease’, that they quickly passed patients on to the hospitals. To reinforce this and strike further discipline into doctors, the General Medical Council ruled that it would be a disciplinary offence for general doctors to treat AIDS patients.

In 1987, the year that AZT was licensed, the British Medical Association (BMA), the professional trade union for doctors and an organisation which had substantial links with Wellcome, set up the BMA Foundation for AIDS. In March 1988, Wellcome gave a covenant to the Foundation, a sum of £36,000 annually for four years, totaling £144,000. This meant that at the very heart of the British medical profession, Wellcome had control of the information flow on AIDS.

In 1988, Wellcome helped fund a £150,000 educational package for GPs about HIV and AIDS. The package contained three videos. It was expected that Wellcome representatives, together with reps from Calmic, one of Wellcome’s hygiene product companies, would show the videos and promote the free package in all 11,000 surgeries in Britain.

The Chairman of the BMA Foundation for AIDS was Dr John Marks who was also at that time Chairman of the Council of the BMA. Dr John Marks is the brother of Professor Vincent Marks, a leading member of a group which at that time was called the Campaign Against Health Fraud and later changed its name to HealthWatch. Professor Vincent Marks, with two of his colleagues at Surrey University, was also the recipient of a Medical Research Council grant of almost £120,000 to research ‘monoclonal antibodies to HIV’. Wellcome’s testing kits depended upon the efficient production of such monoclonal antibodies.

Another trustee of the BMA Foundation on AIDS was Dr Brian Gazzard, at that time, consultant physician at Westminster and St. Stephen’s Hospital. Dr Gazzard had appeared on Wellcome’s sales caravans and was also at the time one of the Concorde trial doctors. Dr Gazzard had also worked on research funded by the Wellcome Trust into so-called HIV, at the London School of Hygiene and Tropical Medicine.

The 1968 Medicines Act makes it a criminal offence to advertise medical treatments directly to patients (vulnerably ill people). However, the sale of AZT directly to individuals who had tested ‘HIV antibody’ positive – using a Wellcome-produced testing kit – was from the beginning the cornerstone of Wellcome’s marketing strategy.

Those who suffered AIDS-associated illnesses or who had been diagnosed ‘HIV antibody’ positive, mainly gay men, were an unknown factor. Pharmaceutical companies had no real experience of dealing with large, youthful, cultural identity groups.

The greatest potential for drug pushing was to be found in the plethora of self-help organizations which were springing up throughout the country. Here at these focal locations, not only gay men gathered but specifically those who had tested ‘HIV antibody’ positive.

Wellcome set out to buy up all the self-help groups which had contact with gay men who tested ‘HIV antibody’ positive in Britain and America. Where they were unable to fund them directly, they gave grants for journals, papers and magazines or for specific projects. There were no overt strings attached to such money but recipients had to adhere to the medical model of AIDS and act as conduits by which off-the-street gay men concerned about their health could be funneled into the charnel houses of chemotherapy.

The grant funding of self-help groups in the field of AIDS, by vested interest organizations, is perhaps one of the greatest scandals of AIDS medicine. By bombarding newly tested gay men with partial information about AZT and other so-called anti-viral drugs, Wellcome had found a way round the Medicines Act and the perfect way to construct a drugs market. Wellcome adopted a strategy which has been known within politics for hundreds of years. Wellcome didn’t need General Practitioners to sell AZT, they mounted their beach heads in the bourgeois sectors of the gay community and developed a colonial class which administered the medical model for them.

The use of self-help organizations was and still is a systematic marketing strategy, and while it is important to list the groups which received drug company money, it is more important to understand the strategy which Wellcome used. Sally joined an organization called Positive Life (PL) which had been set up by people who were HIV antibody positive. PL had been set up for five years by the time Sally joined in 1991.

Soon after starting work, Sally was asked to write a number of articles about AZT. Sally was nervous about writing the articles because she felt the need to be critical but responsible and she was worried she might upset people by suggesting AZT was toxic.

Not long after her first article came out she was contacted by the head of the Health Education Authority AIDS programme who suggested that her article might contain inaccuracies. She was insistent that Sally should have lunch with her. When Sally went to lunch she found that a media relations manager from Wellcome’s Public Relations Department was also there.

The conversation over lunch centred upon Wellcome’s relationship with voluntary sector organizations and the problems of marketing AZT. Not long after the lunch, the coordinator of PL received a phone call from a public relations company informing them that Wellcome wanted to fund their organization. PL did not accept the money.

Wellcome did not always have to make such direct advances to groups. From an early stage they managed to gain influence on the committees and boards of the major fund-dispensing bodies which acted as gate-keepers for voluntary sector funding. These strategically placed individuals, on the board, for example, of CRUSAID, an organization which in the early nineteen nineties was controlling in excess of £4 million in funding, made sure that funds were channeled only to organizations which believed in the use of antiviral drugs.

Much dissent especially in politics is based upon an intuitive and heart-felt sense of right and wrong; arguments take place around moral or ethical issues which are often impossible to prove. In AIDS, the principal orthodox proposition – that a Human Immunodeficiency Virus is the cause of AIDS – appeared to be based upon a scientific truth.

While it appears at first that only the idea of Gallo’s retrovirus and its transmission has shaped our perception of AIDS and its social relations, it is more complex than this. Gallo and Gallo’s idea are themselves a product of the social and commercial relations which exist inside science and the production of scientific knowledge.

Had Gallo presented his theory thirty years ago in a reputable scientific journal, rather than at a fin de sciècle press conference in Washington, his proposal would have been tested by his peers. A focused and centralized authority which had responsibility for evaluating scientific knowledge would have made a judgment, its clinical basis would have been replicated and a dialectical process would hopefully have forged the truth. As it was, there was no proving, no dialectical process, no clinical proof and no biological proof, no peer review, no open public critique. Gallo’s idea was passed down in tablets of stone and ‘HIV’ was found guilty without any kind of trial or search for the truth. Science by absolute decree of the idea. This is not how science has been practiced nor how truth has been arrived at over the last two centuries.

Karl Marx was the first important European philosopher to refute Hegal’s contention that ideas themselves shape material reality; rather Marx insisted, social attitude and concepts are created by material reality; especially the material reality of contemporary production. Marx went on to posit a whole system, in which ideas are tested against material reality, where a continual struggle, a dialectical process, takes place between man and the natural world. This is how the creation of the material world has been understood for the last hundred years and it is how we now understand the processes of human production, whether of ideology or of scientific knowledge.

Gallo, of course, did not personally create this whole condition of science, with its thousands of aspiring scientists, its universal commercial subsidy, its proliferation of research journals and its incestuous intimacy between government and laboratory. But come the hour, cometh the man and Gallo and his idea were the perfect product of the productive relations within twentieth century science. In the first instance, the condition of science in the developed world - the relationships within science, the authority of science and its institutions –ensured the passage of the Gallo’s idea into a material reality.

Duesberg (1996) analyses this position. At first, when he describes the evolution of the virology industry in the United States throughout the 1980s, it reads a little like sour grapes. But what he is in fact analyzing at the beginning of his book, are the conditions and relations, especially in the field of virology, which produce contemporary scientific knowledge. Given these relations and the structure of this kind of science, Duesberg points out that it was inevitable that the conclusion was reached that ‘AIDS’ was caused by a virus.

While Gallo’s ‘idea’ that a retrovirus is the cause of AIDS was a product of contemporary science, its reproduction and transmission in turn has been a consequence of the social, economic and political relations which exist today within both science and the medicine industry. For it was not simply the idea generated by Gallo, but a fluid series of material relations, which themselves have become an industry.

First there was the epidemiological approach, then the cell biology approach to research, the discounting of empirical qualitative research, then the pharmaceutical production of AZT. Then there was the long-standing relationship between the drug companies and doctors, between doctors and patients. Then there was the relationship between the drug companies and those who suffered from illnesses associated as AIDS. There was also the relationship between professional medicine and patients and the culture of the gay community itself. Between all these sets of relations, there developed relations, attitudes, views, which were initially based upon the production, distribution and exchange of drugs. These basic social relations around medical production were cemented together by the media, by fear of illness and a plethora of cultural and psychological networks.

The persistent clamour which surrounded the production of AZT and the very material reality of its production, left most people no alternative but to believe that the scientific community had first found the cause of AIDS and then with persistent logic and science found a cure for it. This construct was, however, a fantasy wish-fulfillment created by scientists who wanted to be seen able to respond effectively to what some of their number were already describing as a world plague.

The fact that people were ill with greater frequency and died more quickly when they took AZT, did not affect the public perception that users of AZT got better, or lived longer lives of better quality than people who unfortunately did not have access to the drug. From a very early stage, the great, mysterious and very male-oriented adventure of science began to depart from the real record of absolute clinical failure of so-called antiviral remedies. This total failure was in part disguised by the increasing under-standing of doctors, and their ability to treat the individual infections and other illnesses which made up the spectrum of AIDS.

Wellcome’s strategy of hegemony, brilliantly orchestrated, was highly successful. In 1992, five years after AZT was licensed, the 44.7 tonnes of AZT produced that year returned Wellcome over £250 million profit. The profits for the following year were even higher.

Over the last few years, AIDS science, which has as its only aim the production of magic-bullet drugs, has moved further and further away from the conditions of people’s living illnesses. The mad scramble of science to understand the intricacies of ‘HIV’ has given new meaning to the old axiom, ‘The operation was successful but the patient died’. AIDS scientists are now openly declaring that clinical end-points are no measure of the success of their work. To protect their authority, they have created an impenetrable wall around themselves, and within this wall its practitioners discuss mutual ideas which over the years have come to develop their own inner logic.

To people knowledgeable about AIDS but beyond the pale of orthodoxy, it appears as if AIDS scientists are slipping deeper into some kind of group psychosis. Apparently considered statements by scientists take on the meaning and form of mantras or cultish utterances which are nonsensical to those outside AIDS science. Such statements as: ‘If antivirals don’t work it’s because the virus is very intelligent and keeps mutating’; or ‘Non-infectious HIV is pathogenic’ or ‘Protease inhibitors mean AIDS is over’.

At some point early on in the bang of big AIDS science and its widening galaxy of abstract theorising it became impossible to readdress fundamental ideas. At issue in this reluctance was not only the plausibility of science and the authority of individual scientists but the continuing production and the profitability of anti-viral drugs. AZT was undoubtedly one of the factors which pushed the handcart of early AIDS speculation over the hill, and transformed it into the juggernaut of premature consensus.

If any doubt did begin to creep like cracks through the cultural hegemony created around AZT, at the end of the Concorde trials, these cracks were quickly filled by the culture of pharmaceutical influence which stood ready with the cocktail of combination therapy. The ‘combo’ approach which after all still had AZT as its central support, quickly came to be reflected upon with gothic disbelief but even then, science and medicine was saved at the last minute by protease inhibitors. These miracle drugs, despite the fact that they had been trialed for only two years will, it was said, give all those who are ‘HIV antibody’ positive, a happy and contented old age. The grim deception of that view is already apparent.

We are all in awe of science, especially medical science for it appears inarguable. What science does, is, and what science says can happen, scientists make happen. Like the stone masons and architects of the seventeenth century, scientists are constructing the everyday reality within which contemporary society lives.

When we look closely at the science of AIDS, and particularly at Gallo’s hypothesis, we realise quite quickly that we are not dealing with scientific truth in the normal sense of the expression. The idea that an HIV is the cause of AIDS-associated illnesses, is just that – an idea – there is, even now, no evidence but only supposition to support it.

This idea, however, has achieved a materiality of considerable proportion, and it has spurned an industry. An understanding of how this happened is important – important because in under-standing it, we understand not only how knowledge is reproduced in our society, but also how power is mediated. Without this information we can not know how to dissent. We have to have this intimate understanding of the way in which the power relations of orthodoxy shape the world in order that we can resist it.

We do not believe power resides in slogans and our dissent does not become real when we say ‘HIV is not the cause of AIDS’. Nor does our dissent become real if we simply argue the opposing scientific perspective. We have to dissent with who we are, with our acts; this is why the intimate knowledge of the orthodoxy’s power is important to us. To oppose them we must behave differently, resist their social and institutional relations and the way in which they produce and make material knowledge.

People have to empower themselves, in every area where industry and capitalist production have taken over the basic functions and interchanges of everyday life. People have to fight back by finding themselves and a better way of treating themselves.

MARTIN J. WALKER was born in 1947 and trained as a graphic designer. He has written books and articles while working as an investigator and researcher, including Dirty Medicine, his sixth book. His last book, With Extreme Prejudice: a study of police vigilantism in Manchester, was written following an investigation into the cases of two Manchester Students who were harassed by the Greater Manchester Police. His other books include: with Geoff Coggan, Frightened for my life; an account of deaths in British prisons, published by Fontana. With Jim Coulter and Susan Miller, State of Siege; politics and policing in the coalfields. The miners’ strike 1984, published by Canary Press. He was chairman of the Steering Committee on AZT Malpractice (SCAM) and the AZT on Trial conference, 1993.

BIBLIOGRAPHY (Parts I & II)

Burkett, E. (1995) The Gravest Show on Earth. Houghton Miflin, New York.

Duesberg, P. (1996) Inventing the AIDS Virus. Regnery, Washington.

Hodgkinson, N. (1996) AIDS: The Failure of Contemporary Science. Fourth Estate, London.

Kennedy, I. (1983) The Unmasking of Medicine. Sutton, Surrey: Paladin.

Schiff, M. (1996) The Memory of Water. Thorsons, London.

Lauritsen, J. (1993) The AIDS War. Asklepios, New York.

Lauritsen, J. & Young, I. (1997) The AIDS Cult : Essays on the Gay Health Crisis. Asklepios, Provincetown.

Marks, K. and Engls, F. (1942) The German Ideology. Laurence and Wishart edition, London.

Miller, J. (1994) The Passion of Michel Foucault. Flamingo, London.

Nussbaum, B. (1990) Good Intentions. Atlantic Monthly Press, New York.

Papadopulos-Eleopulos, E. (1993) Is a positive Western blot proof of HIV infection?

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Root-Bernstein, R. (1993) Rethinking AIDS. Free Press, New York.

Walker, M.J. (1993) Dirty Medicine: Science, Big Business and the Assault on Natural Health Care.

Slingshot, London.

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