Controversial AIDS Doc Leads to Stormy Confrontation

A panel discussion about a controversial AIDS documentary, House of Numbers, descended into a screaming match April 21 at the Boston International Film Festival, with both the film's director, Brent Leung, and other members of the audience shouting down and attempting to drown out the remarks of Dr. Daniel Kuritzkes, an HIV expert and Harvard Medical School professor who was interviewed in the film.

Many of the audience members who attempted to silence Kuritzkes were supporters of a fringe movement known as AIDS denialism, which consists of people who argue that the HIV virus either is not the cause or not the sole cause of AIDS. While AIDS denialism has been roundly rejected as bogus science by the mainstream scientific and medical community, House of Numbers suggests that there is still a robust debate about the cause of AIDS, the existence of HIV, and the validity of HIV testing. Kuritzkes used his remarks to try to debunk the denialist movement, and he is one of more than a dozen scientists interviewed in the film who have signed onto a statement rejecting AIDS denialism and claiming that they were misled about Leung's intentions in making the film.

Leung and the denialists in the audience at the AMC Loews Boston Common theater vocally objected to the format of the panel discussion even before it got underway. The panel, organized by Amit Dixit -- a board member of Massachusetts Area South Asian Lambda Association (MASALA) -- in conjunction with Fenway Community Health and the festival organizers, included Kuritzkes and Fenway president and CEO Dr. Stephen Boswell. Kevin Cranston, head of the Massachusetts Department of Public Health's Bureau of Infectious Disease, served as moderator, and Cranston invited Leung to participate as a panelist, although Leung elected to remain in the audience.

As Kuritzkes began reading from a prepared statement two members of the audience who appeared in the film walked down to the front of the theater, sat beside Boswell and Kuritzkes at the panelists' table and refused to leave. Those audience members, Christian Fiala, an Austrian gynecologist, and Liam Scheff, identified in the film as a freelance journalist, both claimed that they were forcibly joining the panel to provide balance. In the middle of Kuritzkes's speech Leung and several other audience members shouted over him, "This is not a panel!" and, "Where's the panel?" The shouting reached a fever pitch when Kuritzkes began reading a list of names of AIDS denialists who allegedly died of complications from AIDS.

"This is an exercise in free speech," said Cranston, attempting to quiet the crowd. "Dr. Kuritzkes is speaking. After he has completed speaking we will open up for free dialogue. We can only do this if one person speaks at a time. Shouting people down is not dialogue."

Several audience members continued shouting over Kuritzkes's remarks despite Cranston's admonition. Cranston warned audience members that anyone who continued to interrupt the program would be asked to leave. A police officer was present inside the theater, but he did not directly intervene, and Fiala and Scheff remained seated at the panelists' table for the rest of the program.

Fair and balanced?

Leung's film followed his personal journey to London, Germany, South Africa and the United States (Leung is Canadian) talking to a mix of scientists and health officials as well as AIDS denialist activists like Fiala, Scheff, and freelance journalist Celia Farber, who wrote a controversial 2006 article in Harper's Magazine that was widely accused of promoting the denialist cause. The film included an interview with Peter Duesberg, a University of California-Berkeley molecular biology professor and arguably the most famous AIDS denialist. Leung also interviewed Christine Maggiore, founder of the denialist group Alive and Well. Maggiore was HIV-positive but denied the link between HIV and AIDS; she died last December. Maggiore's supporters claim that her death was unrelated to AIDS, but a copy of her death certificate posted on AIDStruth.org, a site aimed at opposing the AIDS denialist movement, lists the cause of death as disseminated herpes viral infection and bilateral bronchial pneumonia, AIDS-related opportunistic infections. An L.A. Times obituary of Maggiore reports that her three-year-old daughter died in 2005 of AIDS-related pneumonia.

The film also included interviews with luminaries in the field of HIV/AIDS research, including Robert Gallo and Luc Montagnier, credited as co-discoverers of the HIV virus, Peter Piot, former executive director of UNAIDS, and Anthony Fauci, director of the National Institutes of Allergy and Infectious Diseases at the National Institutes of Health (NIH).

In his narration of the film Leung claims that his goal is to present an unbiased view of the state of HIV research, but his film suggests that certain key facts about HIV/AIDS that have been long settled in mainstream scientific circles are still in dispute. During a segment about the beginnings of the AIDS crisis among gay men in the United States Kary Mullis, a leading AIDS denialist and a Nobel Prize-winning chemist, blamed many early AIDS cases on poppers, saying, "What exactly caused Kaposi's sarcoma? We know that now. It was amyl nitrite."

Former Sunday Times health reporter Neville Hodgkinson, who wrote several articles questioning the link between HIV and AIDS, says in the film, "The lifestyle explanation proved politically unacceptable, but the virus explanation proved very, very acceptable to many different parties."

In another section Duesberg claims that many of the symptoms of AIDS were in fact caused by the drugs used to treat the syndrome. Several people interviewed in the film question the effectiveness of HIV tests. Ostensibly to provide balance the film also includes interviews with people rebutting the AIDS denialists' arguments, but there is minimal discussion of the reasons why mainstream scientists have largely written off the denialists' claims as junk science. During one interview Duesberg says, "They're all prostitutes, most of them, my colleagues."

At the film's end Leung suggests that the cause of the global AIDS epidemic is poverty, not the HIV virus.

"At journey's end I find myself perplexed, bewildered at times with an overall feeling of dismay and sadness. I found a research community in disarray over the most fundamental understanding of HIV, all the while presenting a monolithic public posture of authority and certainty. Bluntly stated, we have tests that prove nothing, remedies that kill, and statistics manipulated to the point of absurdity," Leung says. "Ninety percent of global HIV corresponds to areas of great poverty and squalor. Ironically, while we may have been pursuing a phantom killer, a shape-shifting assassin, perhaps the real enemy has been hiding in plain view, clear as day and as old as time."

During a post-film question-and-answer session held before the panel Leung claimed that his film took a neutral stance on the question of what causes AIDS. He declined to say which side he represents.

"The purpose of the film is to present a broad range of ideas, and those ideas are for you, the audience, and for scientists to take and to create a catalyst for more discussion," said Leung.

One audience member asked Leung who funded the film, noting that Leung seemed to have a large budget for travel. Leung declined to name the sources but described them as a group of "funders from all over the world." When Bay Windows later asked him if most of his funders supported the viewpoint of AIDS denialists, Leung claimed that they did not.

Filmmaker versus subject

Once the panel discussion got underway and Cranston succeeded in getting the audience under control, Elizabeth Ely, an audience member affiliated with the denialist group Rethinking AIDS, asked Kuritzkes what remarks in the film had been taken out of context. Kuritzkes said his own remarks in the film had been presented in a misleading light. During the film there is a brief clip of Kuritzkes saying that in the early days of the epidemic the standard dosage of the AIDS drug AZT was likely too high. The clip follows comments by Duesberg blaming AZT for many of the symptoms of AIDS.

"I can give you an example of my own quotation where I was quoted very briefly in talking about how early doses of AZT were toxic and that was the end of the statement, but in a broader discussion about anti-retroviral therapy, as I recall, the issue is really that the drugs have improved over time, the drugs have become less toxic, and the treatments today are highly effective, which is why we've seen an 80 percent reduction in mortality from HIV," said Kuritzkes.

Leung jumped in and told the crowd, "I would like to add that was not taken out of context. Antiretrovirals are a separate part of the film. AZT is one part of the film."

Kuritzkes replied, "AZT is an antiretroviral, unfortunately."

Kuritzkes is one of several scientists featured in the film who have since come forward and argued that they were interviewed for the film under false pretenses and that they believe House of Numbers promotes an AIDS denialist agenda. John Moore, a professor at Weill Medical College of Cornell University, drafted a statement signed by himself and 15 others interviewed for the film, including Kuritzkes, Gallo and Piot, alleging that the film "presents the AIDS denialist agenda as being a legitimate scientific perspective on HIV/AIDS, when it is no such thing. [Leung's] film perpetuates pseudo-science and myths."

Moore, who was not present at the screening, told Bay Windows he and several other scientists interviewed for the film first came in contact with Leung through Martin Delany, the pioneering AIDS activist and executive director of Project Inform who passed away in January. Delany was interviewed for the film, and Moore said Delany vouched for Leung as a legitimate filmmaker. Moore said Leung interviewed him on two successive occasions, once in 2006 and again a year later, and said Leung told him the goal of his film was to document the history of AIDS research and to expose the lies behind the denialist movement. Several weeks ago Moore said Leung e-mailed him and other film participants a link to the film trailer, and Moore was shocked to find that the film seemed to present a sympathetic portrait of denialists.

"I didn't know he lied until I saw the trailer," said Moore, who said watching the trailer prompted him to draft his statement and contact the other film participants to ask them to sign it. He has not seen the film, which debuted at the Nashville Film Festival April 19 and has only screened in Nashville and Boston, but he said based on the trailer and conversations he has had with people who have attended the screenings he believes the film falls squarely in the denialist camp.

Leung told Bay Windows that he was up front with Moore about the subject of his film. He said he told Moore that the film was a documentary on public awareness about HIV and AIDS, about AIDS education and testing and other issues relating to the epidemic. He also said that since Moore had authored a 2006 New York Times op-ed opposing the denialist movement entitled "Deadly Quackery," he wanted "to address whether HIV is the cause of immune deficiency. And that was the extent that I told him it was about." He said he believes some of the scientists who signed Moore's statement were upset because the film allegedly shows them making contradictory statements about the nature of HIV and AIDS.

What's at stake

During the panel discussion Boswell told the denialists in the crowd, "It's important to know there's a lot at stake. If you're wrong and HIV does cause [AIDS] you're doing a profound disservice to our race."

Ely responded from the audience, saying, "And if you're wrong you're doing a profound disservice. That's our point."

Boswell replied, "Science has a way, a system for testing new ideas, and if you have an idea that's different then you can present those ideas, you can test them in a scientific way, present your findings in a peer-reviewed journal, have another laboratory verify what you say happened. I haven't seen any of that happen in any of this work. All I know is that we test for HIV in the blood supply and over a period of three years transfusion-transmissible AIDS virtually disappeared in the United States. We start testing women for the HIV virus who are pregnant, and we virtually eliminate AIDS in children. In 1995 I give a cocktail of medications to patients who are within weeks of dying, and those patients a few weeks later have gained 10, 20 pounds, and some of them are alive today."

Following the panel Leung told Bay Windows that he nearly pulled the film from the festival 15 minutes before the screening. He said festival organizers had promised him that there would be a "two-sided" panel discussion, and he objected to the selection of Cranston as moderator, calling him "obviously biased to one side" because of his work on HIV/AIDS in the public health sector.

Asked if his film was designed to spread the message of the AIDS denialist movement Leung said, "I don't feel strongly about getting their message out. I feel strongly about freedom of speech. As I've gone around the world interviewing these world scientists who set the foundation for everything we know about HIV and AIDS and continue to set the foundation in policies, I found that there's a lot of disconnect between what they say, there's a lot of contradiction, there's a lot of confusion, and people are dying. So it doesn't matter who says what, what arguments come from each side. We have to have an open dialogue. We need to know why people are dying."

The film festival released a statement saying that the goal of the post-film panel was to create a venue for members of the community to respond to the film.

"The Boston International Film Festival never intended to host a formal debate about the film; we intended to provide a forum in which members of the community could engage with, and respond to, the film. It was a difficult decision to screen 'House of Numbers,' and we are very pleased that the director, Brent Leung, attended the screening and answered questions about his film," read the statement in part.

The statement goes on to say that there was some miscommunication between festival organizers and the filmmaker about the format of the panel discussion but that the festival decided to go forward with the panel "to create an opportunity for healthy social discourse."

The statement also says the festival requested the presence of a police officer at the screening in response to concerns about security.

"In anticipation of the event, we were concerned about security and we believed it was very important to have a visible police presence at the screening; Security issues were also considered in how the situations were handled. ...We are issuing this statement so that other festivals can be aware of the potential for escalated actions, and that the other festivals can be extremely diligent in their planning so that future screenings can be executed in a safe and constructive manner."

Chloe McFeters, public relations manager for the festival, declined to elaborate on what prompted concerns about security. Dixit, who worked with the festival organizers to organize the panel discussion, said the festival requested a police officer because an AIDS denialist with a past history of violent actions and run-ins with the law had posted on the Internet that he would attend the Nashville screening, and the Boston festival organizers were concerned he would attend the Boston screening as well.

Dixit said that he believes the film presents a biased perspective in favor of the AIDS denialists, and the goal in selecting Boswell and Kuritzkes as the panelists was to bring in respected members of the local scientific community to present their response to the claims laid out in the film.

"I said [to the filmmakers during the planning process] you have 87 minutes, and then the director Q&A, but for me to put these people on the same panel [the night of the screening] who barged up, who have no credentials, it's an absolute insult to the people we know, it's an insult to Boswell and Dan who have been doing this for years. ... Fenway, myself, we were about creating a scientific dialogue, that was what the whole premise was," said Dixit.

He said he was frustrated that the denialists in the audience seemed intent on drowning out the panelists.

"For me I was very disappointed in not being able to hear the experts. Dan spoke eloquently and he answered the questions right on. I was very proud to have our heroes onstage," said Dixit. "But I was very disappointed. What we tried to do was create a scientific dialogue. It was interrupted by denialists in the audience who were very aggressive, and they couldn't engage in a civil manner to our experts."