What Really Caused The AIDS Epidemic?

In 1885 Ulysses S Grant died from an oral cancer widely believed to have resulted from his long term heavy consumption of cigars.  However, despite continually mounting scientific evidence for the link between tobacco and many diseases, the public notion that smoking was safe, or even healthy, persisted for another 100 years.

Benjamin Franklin discovered that hot lead in printer’s type was dangerous to his health, yet 200 years later we were still putting lead into gasoline and house paint.

In 1881 President James Garfield was hit by an assassin’s bullet.  The wound was serious, but should not have been fatal. Garfield died 11 weeks later from infections caused by doctors repeatedly searching for the bullet with unwashed fingers inserted into the wound.  Scientific studies by the Hungarian physician Ignaz Semmelweis had shown more than 30 years earlier that hand washing reduced the death rate from puerperal fever of mothers giving birth in clinics, but Semmelweis’s evidence was not widely accepted.  The United States had much evidence of wound treatment and survival rates from the Civil War, but the evidence was largely unexamined and unanalyzed.  In France Louis Pasteur had developed the germ theory of disease, but the theory was still rudimentary, viruses had not been discovered, and the link between infectious substances and specific bacteria was not established. In the US doctors retained a practical certainty that the inconvenience of hand washing was unnecessary.

These are examples of discord between scientific evidence and practical opinion.  In the first examples the evidence is one sided, but the popular view was conflicted.  There were anti-smoking campaigns, as well as pro-smoking advertising and product placement by the tobacco industry that maintained public uncertainty about the health effects of smoking.  The effects of tobacco and lead don’t show up immediately, so the public was uncertain.

In the hand washing example, the evidence was as yet uncertain, lacking an accepted theoretical basis, but doctors were certain (the wrong way) and took risks that they could (and should) have avoided.

The first kind of discord is the more easily identified and studied.  Climate science and evolution are examples of firm scientific evidence being disputed by an uncertain public.  Evidence that conflicts with economic, political, or religious interests or ideological beliefs tends to be ignored by the interested parties.

The second kind of discord is a little harder to identify and analyze, but it is perhaps even more common and its effects can be even more costly.  There is a natural tendency to seek certainty and resolution and to seize upon answers to questions even when those answers are tentative and the science, the evidence, and the analysis behind them are still open to scientific dispute.

This second discord occurs when scientific issues are uncertain or unresolved, but the public holds and acts upon beliefs that are not backed by science, especially when those false certainties are supported by institutional interests.

Not so long ago blood-letting was widely accepted as the preferred medical treatment for numerous conditions.  George Washington died from it.  Benjamin Franklin accepted it.  We recently avoided eggs, then butter, then salt.  Now, instead, sugar is the concern.  We used to remove children’s tonsils, now we leave them in except in extreme cases.  We banned marijuana as dangerous, now we prescribe it.  There is a wide gap between what is believed at a particular time and what is actually known.  Faith is said to be pretending to know things you don’t know.  When people say they have faith in science, they are pretending to know things they don’t know about science.  Science is not something to be taken on faith.

Science is a method of inquiry, not a set of certainties.

Science is a method of inquiry, not a set of certainties.  Science applies to things we are uncertain about.  Science aids decision-making by providing evidence.  Most decisions can’t wait for certainty.

Science also enriches life apart from immediate practicality.  We are consumers of information.  There is a problem, though.  Much of our information, many of the things we think we know, especially things we unthinkingly accept without question, are going to turn out to be false.

Desire for certainty makes us gullible.  We want the truth, but what we have is information, evidence, and theories.  We live in a reality that includes powerful institutions that have a strong interest in what we accept as true.  Private corporations and other business entities make their profits by selling products, and by avoiding government constraints, and they spend large sums on advertising and lobbying and the creation or manipulation of public opinion.  Political parties and government itself are powerful institutions that have interests in public information and the formation of public opinion.  Nonprofit institutions can be just as strong as business institutions, and have similar interests.  Religious institutions have obvious interests in the formation of beliefs.  Public opinion relating to economics, politics or religion are hot topics where strongly held opinions often lead to conflict.

Our lives are constrained by institutions that saturate world society, and the institutions in turn are constrained and interact with public opinion.  Public opinion based on facts and evidence, rather than institutional interests, is necessary for wise and beneficial relationships among the public and the institutions we rely on.  Science should contribute facts and evidence.  Science might be presumed to be an neutral arbitrator, until it is realized that science, too, is a matter of institutions.  The method of science is available to all of us individually, but the practice of science is complex, interpersonal (or inter-institutional), and expensive.

Discussing all this in the abstract has limited appeal.  A case study on how science, institutions, and public opinion interact can shed more light on the situation than a purely theoretical discussion.

The case study presented here takes on a topic that is less personal and possibly less inflammatory than one directly involving politics, economics or religion, but which has the same kind of powerful institutional influence in the background.  The case study is about the origins of the HIV/AIDS epidemic, a subject of interest in itself, and which could have important consequences for the fight against the epidemic in Africa and other places where inadequate funding has been a constraint.

To read the full case study go to: http://www.greenmedinfo.com/blog/what-really-caused-aids-epidemic


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