25 million dead people can't be wrong. Or can they?
Twenty years ago, Andre Chad Parenzee, then 15, arrived in Australia from Cape Town, South Africa. He grew up, became a chef and settled in Port Pirie, South Australia's fourth-largest city, known more for its lead smelters and industrial plants than its fine dining. The future looked good — until 1998, when he had a blood test.
He was told he carried the human immunodeficiency virus — HIV.
He told his fiancee he had cancer, and she believed him. They married. He often had sex with her, unprotected sex, knowing he had been diagnosed with the virus. Then he had sex with two other women.
Of course, he had a reason for not telling, which was good enough for him: "It was just the fact that I didn't know how she would react to me telling her. I thought she would leave me like everyone else."
She did eventually leave him because Parenzee's secret stayed a secret no more. It was revealed after one of the three women had a blood test and found, to her horror, she also showed signs of the virus. In came the Director of Public Prosecutions. In came the Supreme Court. In came the jury's verdict: "Guilty, guilty, guilty!" to three counts of endangering lives. Fifteen years, said the judge.
That was last year. This year, Parenzee is arguing for leave to appeal on the grounds that AIDS doesn't exist, and neither does HIV. If it doesn't exist, he should be free to walk and continue to have sex — without warning his partners.
Parenzee sits impassively in the dock, staring into the middle distance, stroking his goatee. If the chef understands the scientific arguments raging around him — and because of him — about retroviruses, blots, mathematical deviations and statistics, his face doesn't show it.
This is believed to be the first case in any jurisdiction, in any court, in any country, where AIDS itself is on trial.
That's why the eyes of the world are now on the handsome sandstone Court of Criminal Appeal in central Adelaide, where judge John Sulan is deciding whether there is enough scientific controversy about the existence of HIV and AIDS to give Parenzee another shot at freedom.
It may seem that 25 million dead are some sort of proof. That's how many people are alleged to have died of AIDS-related causes in the past 25 years. And the toll keeps rising. It's now 3 million a year, victims of what could be the greatest mass epidemic of all time. Could all these corpses really be lying?
Yes, say experts. Not all experts, of course, but enough to occupy the witness box at the District Court for a week. That's right — experts arguing in a court of law that unprotected vaginal intercourse with a suspected HIV carrier is safe. In fact, the climax of last Tuesday's testimony was an exchange between prosecutor Sandi McDonald and defence witness Eleni Papadopoulos-Eleopoulos. "Would you have unprotected vaginal sex with a HIV-positive man?" McDonald asked. "Any time," Papadopoulos-Eleopoulos replied.
Papadopoulos-Eleopoulos, a slight, middle-aged bachelor of science and a medical physicist at Royal Perth Hospital, knows the importance of her evidence. Another witness for the defence is emergency doctor Val Turner, from the same hospital.
Seldom did Parenzee look at Papadopoulos-Eleopoulos as she was giving the evidence he hopes will save him.
He continued to stare at the opposite wall and slowly stroke his beard.
The first the world knew of HIV was when a virologist at the world-renowned Pasteur Institute in Paris was trying to find the cause of a new disease then sweeping the Western world. No one knew what the disease actually did and, at that stage, it did not even have a name. But its name was death. It was AIDS, a syndrome rather than a specific disease.
US doctors noticed it among gay men around the San Francisco area, and even then it seemed to be a collection of other diseases and infections. Healthy people have a healthy immune system, so when a virus or bacteria invades, the body throws its formidable defences at the intruder. But with AIDS, the body's natural defences seem terminally, hopelessly damaged. People with AIDS can die of any number of diseases that most people would shake off. Many, in fact, die of candida, which everyone knows as the common fungal irritant thrush.
So what caused AIDS? No one knew, but one Parisian researcher, Dr Willy Rozenbaum, thought it might be caused by a virus. He asked virologist Luc Montagnier for help. In 1983, Montagnier announced he had discovered the signature of a new virus. He said it was the AIDS culprit.
Viruses, like humans, have protein in their DNA. Tests for HIV look not for the virus itself but for evidence of its proteins, or the human body's cellular reaction to it. It's like identifying a tiger by its footprint or a dog by its fleas. But how to test if someone has "full-blown AIDS"? Well, HIV is thought to attack the body's T-cells — the ones that fight infection. The test for AIDS essentially counts your T-cells.
Papadopoulos-Eleopoulos says that's not good enough.
"I am a scientist, I look for science — I do not look for consensus," she said in evidence.
In that, she is right — the number of people who believe something is no indication of its truth. After all, there was a time when most people believed the world was flat. So why isn't her minority scientific opinion more widely debated? Papadopoulos-Eleopoulos and her colleagues believe it's partly because of money.
US researcher Robert Gallo also claimed to have found evidence of the virus around the same time as the French team. The dispute about who "discovered" it was eventually settled at a meeting between, of all people, US president Ronald Reagan and French prime minister Jacques Chirac. At stake was not just honour. It was hundreds of billions of dollars.
The fight against HIV and AIDS is wallowing in money, brimming with it. Researchers might still be labouring in the scientific salt mines were it not for AIDS money. Some are now fabulously rich and famously famous. The money available in the field is unimaginable. Australia shares some of the $1.4 billion that Bill Gates gave away for AIDS research. And that's just one donation. After the historic Reagan-Chirac handshake, the US and France shared patent rights to mass-marketed blood-screening tests for HIV, tests worth billions. Royalties fund the world's richest private research centres. Then there are the drug companies. Plus reputations, personally the most valuable thing of all.
Which is why it's not just the ordinary public in the gallery at the District Court in Adelaide. State, federal and international government health authorities as well as tens of thousands of medical researchers are poring over the transcripts. For the defence is Kevin Borick, one of South Australia's best-known and most expensive QCs (working pro bono on the appeal application). On the other side of the table is experienced Adelaide-educated prosecutor Sandi McDonald.
Now the big guns have been brought in to fire for the Crown — among them the director of the Australian National Centre for HIV, Professor David Cooper AO, his deputy, Professor John Kaldor, Emeritus Professor Peter McDonald from Flinders University, Dominic Dwyer, the eminent medical virologist and infectious diseases physician at Westmead Hospital, and next week the biggest gun of all, the man partly credited for finding the virus, Robert Gallo himself. The prosecution says it's unprecedented.
People are in jails the world over because their fingerprints have been found at the scene of the crime. Courts regard fingerprints as incontrovertible proof. They are no longer in debate. As long as Parenzee's witnesses convince the court that there is legitimate scientific debate about the existence of HIV, he may be back on the streets.
There is still no cure for HIV, no magic inoculation as there is for polio or smallpox. There is still no way of giving the body back its ability to fight common infections, which most people shake off with a few days in bed but which are fatal to AIDS sufferers.
But if AIDS doesn't exist, what's killing them?
Papadopoulos-Eleopoulos says AIDS is a disease caused by the inside of the body becoming oxidised following repeated exposure to semen through passive anal intercourse. It cannot be transmitted from one person to another during vaginal sex.
Yet thousands of people have shown signs of the virus after receiving contaminated blood. So are the HIV doubters visionaries like Galileo or lunatics like the Flat Earthers?
Doubters of HIV and AIDS are despised by their opponents. Experts called by the Crown were emphatic — HIV is a specific virus, and vaginal sex passes it on. From the public gallery, though, Parenzee's supporters — his mother has reportedly spent $250,000 on the defence — saw even professors make some concessions under Borick's penetrating cross-examination.
At least a few scientists are in the anti-HIV camp.
"If there is evidence that HIV causes AIDS, there should be scientific documents which either singly or collectively demonstrate that fact, at least with a high probability," Nobel prize-winning chemist Dr Kary Mullis said in 1993. "There is no such document."
Even University of California's Dr Harry Rubin, professor of molecular and cell biology, has expressed doubts. "It is not proven that AIDS is caused by HIV infection, nor is it proven that it plays no role whatever in the syndrome," he said in 1994.
The judge can decide this case only on the evidence before him. The court cannot call on William of Ockham, the 14th century philosopher who said that in any question, the simplest answer which relies on the least supposition is probably the correct one.
That principle is now known as Ockham's Razor, and in this case it suggests HIV will lead to AIDS.
Malaria was once thought to be caused by bad air. Leeches were once the preferred treatment for a dozen ailments — in the 1800s, French and English hospitals used 13 million a year. Ulcers were believed even a few years ago to have been caused by stress or spicy foods.
Will a virus-caused immune deficiency go the same way?
Or will Ockham's razor slice through the dissenters?
The case continues.