Medical journal under attack as dissenters seize AIDS platform

The BMJ (British Medical Journal) is under fire from AIDS researchers over a series of publications on its website. The postings in question make up a steady stream of unreviewed articles from people who deny that HIV causes AIDS.

The dispute crystallizes the conflict between a journal's desire to experiment with open, unmoderated electronic debate and its fundamental obligation to readers to provide them with authentic information, researchers say.

If you search the BMJ's website for 'AIDS' in all articles published over the past two years, the results are surprising. One in six of the top 300 returns are written by AIDS 'revisionists'. Add in responses to these missives, and more than one-third of the returned articles centre on that debate.

The disproportionate prominence of this discussion compared with other AIDS issues is angering some researchers. They point out that almost all of the articles concerned are unreviewed 'Rapid Responses' — electronic letters to the editor that are published within 24 hours, and are screened only to exclude libel or breaches of patient confidentiality.

David Rasnick, a leading AIDS sceptic, accounts for 46 Rapid Responses published since January 2002. Rasnick, a chemist who is a visiting scholar at the University of California, Berkeley, gives his affiliation as “a member of the Presidential AIDS Advisory Panel of South Africa”. Another sceptic, Eleni Papadopulos-Eleopulos, a biophysicist at Royal Perth Hospital in Australia, has made 33 postings.

Researchers complain that the credibility conferred on Rapid Responses by the BMJ label may mislead policy-makers and members of the public over the debate. “It looks to the unsuspecting that this is solid stuff,” says Simon Wain-Hobson, who studies AIDS at the Pasteur Institute in Paris. Wain-Hobson is one of several AIDS researchers who argue that unfettered debate on the BMJ website offers revisionists an opportunity to punch well above their weight in a renowned journal.

Brian Foley, an AIDS researcher at the Los Alamos National Laboratory in New Mexico, is one of the scientists most active in responding to the revisionists' BMJ postings. He criticizes the BMJ for allowing what he describes as the misuse of a respectable scientific journal to contribute to the dissemination of disinformation. “I do not think responding to BMJ posts is a worthwhile use of my time,” he says.

Many scientists argue that not responding is the best policy. John Moore, an AIDS researcher at Cornell University in New York, is an example. He says that revisionists are best ignored: “It's an unwinnable debate based on faith not fact.”

Richard Smith, editor of the BMJ, admits that a problem of unmoderated forums is that one side of an argument can “lose by attrition” to a more vocal minority. But Smith also cherishes the principle of Rapid Responses, which have solicited more than 20,000 submissions since being introduced five years ago. Its philosophy, says Smith, is based on free speech.

But such aspirations cut little ice with Moore. “The BMJ is wrong to grant the revisionists space in what should be considered a prestigious journal,” he says. The quality threshold for publishing Rapid Responses is “obviously very low”, says Smith, who admits that some people abuse the system by “pursuing vendettas or obsessions, by writing every day, or at excessive length”.

But Smith feels that this is the price to pay for the benefits of free debate. “Freedom of speech means you end up with lots of abuses,” he says. “I continue to think it is the right thing to do.” But whereas the BMJ's editorial board has unanimously endorsed this general principle, he says that as a result of researchers' criticisms, he may raise the specific issue of AIDS revisionism with both this body and the journal's ethics committee.

Rasnick says that he “applauds the BMJ for having the courage and integrity to allow debate” and questions why mainstream AIDS researchers complain so much “if their position is so secure”. He says that he wants to know why “over 100,000 scientists and doctors, the 140,000 papers, and the $118 billion spent all combined have not come up with the proof that AIDS is contagious; that AIDS is sexually transmitted; that HIV causes AIDS; that anti-HIV drugs do more good than harm; or that AIDS is devastating and depopulating Africa or anywhere else.” Most AIDS researchers strongly dispute these assertions.

Smith adds that in the immediate future the BMJ may add a visible health warning to its Rapid Responses to indicate their unreviewed nature, or may change the BMJ's default online search option — currently set to include 'Articles and Rapid Responses' — to 'Articles only'.

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Butler, D. Medical journal under attack as dissenters seize AIDS platform. Nature 426, 215 (2003). https://doi.org/10.1038/426215a

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