City Paper is not for tourists
When a coalition of 12 black and Hispanic AIDS organizations announced its intent last week to wrestle a $2 million District government AIDS grant away from the Whitman-Walker Clinic, the story made news in both the Washington Post and Washington Times. The pioneering health clinic had been receiving District money to provide counseling and care for the disease for a decade, and with the contract to provide AIDS services going up for a competitive bid for the first time this year, it stood to reason that Whitman-Walker would be challenged for the grant.
The new alliance, dubbed the Sankofa Community Coalition of HIV/AIDS Services, included the minority health groups SALUD, the Inner City AIDS Network, and Lifelink Inc. But at the coalition’s center was the Abundant Life Clinic (ALC), the health clinic headed by Dr. Abdul Alim Muhammad, the Nation of Islam’s (NOI) health director.
That Minister Louis Farrakhan’s top doc would jockey for a District government contract was predictable, given his recent history. Muhammad’s ALC has already collected a $211,000 grant for AIDS treatment in Washington, and, in July, he was instrumental in the firing of District AIDS czar Caitlin Ryan, whom the ALC accused of illegal interference with their bid for additional public money. (Although the NOI and the ALC bill themselves as separate entities, the distinction is only nominal: The leadership and the relevant views of the two groups are virtually identical.)
From his Mayfair/Parkside neighborhood clinic, Muhammad has for almost two years propounded conspiracy theories about the origin of the disease and prescribed an unorthodox treatment regimen described by most medical authorities as useless. Yet neither Muhammad’s AIDS ideology nor Farrakhan’s demonstrated bigotry earned a mention in the Post and Times stories on Sankofa’s plans to win a government contract, a startling omission seeing how, under the terms of the Sankofa proposal, Muhammad’s ALC would be designated the District’s main provider of medical care.
The Post and Times further failed to report that Muhammad and the NOI endorse and market an AIDS miracle drug they call ImmuViron, which they sell at a huge mark-up, thus earning remarkable profits. The drug, whose generic name is alpha interferon, is similar in structure to the proteins produced naturally by the human body in response to viral infections. Injections of pharmaceutical alpha interferon have proven effective in treating certain cancers including a rare form of leukemia and Kaposi’s sarcoma (a common opportunistic cancer in AIDS patients). But the Food and Drug Administration (FDA) has never certified any alpha interferon product as an efficacious AIDS medicine.
Alpha interferon in low doses taken orally (in a form known by the trade names of Kemron and Immunex) was first tested as an AIDS medicine in 1990 at the Kenyan Medical Research Institute (KEMRI) by Dr. Davy Koech. Koech gave the drug to his patients, and his early trials looked so promising that the president of Kenya, Daniel arap Moi, proclaimed the drug the cure for AIDS. KEMRI claimed that nearly all patients on Kemron experienced a total reversal of AIDS symptoms and a dramatic rise in the number of HIV-fighting CD-4 cells. In a few KEMRI cases, test results indicated that HIV had been obliterated.
The drug was subsequently investigated by others in the scientific community, but they could not reproduce KEMRI’s astounding results. A National Institutes of Health (NIH) committee reviewed data from 12 clinical trials in Canada, Germany, Thailand, Zambia, and elsewhere. It concluded in April 1992 that Koech’s original claims were wrong and recommended that the NIH pursue no further exploration of Kemron. It also urged AIDS patients who were taking the drug to think about switching to other therapies. A large World Health Organization study in Uganda, released at this year’s international AIDS conference in Berlin, further bolstered the NIH committee’s finding by concluding that Kemron had no effect on patients’ life expectancy, CD-4 counts, rates of opportunistic infection, or severity of symptoms.
Most AIDS professionals now regard KEMRI’s early reports of a breakthrough as either fraudulent or the results of a flawed study design. But some reputable doctors still consider alpha interferon’s efficacy an open question. The National Medical Association, an organization of black physicians, has urged additional study of the drug, and Dr. Wilbert Jordan of the King Drew Medical Center in Los Angeles still regards it as a potentially exciting therapy. These doctors, however, hold the minority opinion. Dr. Mark Smith, a prominent black AIDS clinician who served on Hillary Clinton’s health-care task force, expressed the view of the vast majority of the medical establishment when he told me, “There is zero or close to zero reason to think [ImmuViron] works.”
Despite the scientific findings, alpha interferon’s appeal did not die, thanks to the prominence it was accorded by some in the African-American media. Harlem physician Barbara Justice visited KEMRI and extolled Kemron on her weekly radio health show on WLIB-AM, a New York station with a black nationalist orientation. New York’s Amsterdam News and the Washington Afro-American regularly criticized the NIH for ignoring the KEMRI results, and helped spread the theory that a racist conspiracy by white researchers was suppressing the discovery.
“If [the drug] had come out of Sweden or somewhere else, it would have been on Page 1 everywhere,” Amsterdam News Editor Wilbert Tatum told the New York Times.
The NOI was an early alpha interferon advocate, but it did not actively champion the drug until the fall of 1991, when Muhammad visited Kenya on NOI’s behalf. The Oct. 7 issue of the Final Call, the NOI’s national weekly, hyped the drug with the headline “AIDS Treatment Found in Africa,” devoted six articles to Kemron, and ran an editorial by Muhammad thanking Louis Farrakhan for dispatching him and Barbara Justice to Nairobi. Then, in March 1992, Farrakhan announced that NOI intended to sell the drug in the United States under the trade name Immunex (NOI later renamed its alpha-interferon product ImmuViron) and appointed Muhammad to oversee its distribution.
With profit as a new incentive, NOI mobilized to promote its drug, expounding the most extreme versions of the conspiracy theories week after week in the Final Call. An August 1992 editorial in the newspaper alleged that the white cabal that was intentionally depriving blacks of life-sustaining ImmuViron as part of a plot to exterminate them might have originally manufactured the AIDS virus as part of a genocidal scheme.
“Be it far from the Final Call to suggest that a “conspiracy of silence’ has existed in the white media about the positive effects of low-dose oral alpha interferons,” the editorial read. “Also be it far from us to suggest that the AIDS virus is not a naturally occurring virus but is one that is man made and was introduced into Black populations in Africa….A high ranking official in the military in 1969 testified that the AIDS virus was in the making.”
Matching those fantastic accusations were advertising claims made for ImmuViron in the Final Call, such as this one from March 23, 1992: “AIDS TREATMENT SUCCESSFUL: Reverses all clinical signs and symptoms in the majority of cases.” Inquiries were directed to Muhammad’s Abundant Life Clinic.
Meanwhile, the news pages of the Final Call (Dec. 14, 1992) were describing the FDA-approved treatments AZT, DDI, and DDC as poisonous components of the white conspiracy to kill blacks. While AZT does possess an undesirable level of toxicity, calling it a poison ignores its overall therapeutic value. The Nov. 12, 1992, edition of ABC’s PrimeTime Live covertly filmed Dr. Justice telling a patient that AZT was poison.
The medical demagoguery of Farrakhan and company deliberately exploits the mistrust many blacks hold for the government that sanctioned the infamous Tuskegee Project. In the ’30s, the U.S. Public Health Service participated in a study of the long-term effects of syphilis. A group of black Alabamans with advanced, untreated cases of the disease was given free medical care for other ailments, but denied penicillin in the ’40s when the drug was proven an effective syphilis treatment. This horrific experiment lasted into the ’60s, with project researchers autopsying the remains in the name of science.
Given Tuskegee, it’s perhaps no wonder that 30 percent of American blacks polled in 1992 accepted the possibility that HIV might have been designed in a laboratory to infect blacks. But it’s positively absurd to dole out taxpayer dollars to an organization that promotes this belief and has implicated all of traditional medicine—the major hospitals, universities, research institutes, and doctors—in a conscious plot to withhold information about ImmuViron, the compound the NOI says is the only drug that works.
If the Abundant Life Clinic were a big pharmaceutical company instead of the health adjunct to the Nation of Islam, ACT UP radicals would be staging “die-ins” at its front door in protest of rampant profiteering.
A six-month regimen of ImmuViron from the ALC advertised in the Final Call carries a price tag of $1,930; compare that to the $700 charged for an identical alpha interferon product called Immulin and distributed until recently by various “buyers’ clubs” in the U.S. (Buyers’ clubs dispense unapproved drugs in personal-use quantities for AIDS patients.)
Both Immulin and ImmuViron are manufactured by Encarich, a British company. Encarich President Roger Wyatt told PrimeTime Live that the two compounds are indistinguishable. “That’s two trade names for the same product,” he said. An independ ent lab verified Wyatt’s claim at the behest of PrimeTime Live.
Ron Mealy of the Carl Vogel Foundation, a Washington buyers’ club, acknowledges that “the drug has shown little to no therapeutic value in clinical trials,” but says his organization sells the alpha interferon product trade named Viroterm anyway, because it is not harmful and his group is committed to patients’ right to choose treatments.
The federal government has tiptoed around the legal aspects of alpha interferon sales. The FDA, which polices the pharmaceutical industry, has tolerated the sales of such experimental drugs for terminal illnesses like AIDS, even though it is, strictly speaking, illegal. The FDA’s one enforcement proviso is that it won’t abide by the “commercialization or promotion” of experimental drugs. While profiteering has not typically been a problem at the buyers’ clubs, the Abundant Life Clinic’s aggressive merchandising clearly violates FDA guidelines. Besides advertising ImmuViron at a huge markup in the Final Call, the clinic offers misleading propaganda: Individuals requesting information on the drug from the ALC are sent a packet entitled, “Winning the War on AIDS,” that calls ImmuViron “miraculously successful” and claims that the concoction has restored “97 percent of…patients to normal, healthy lives.”
Yet the FDA has not reprimanded the ALC.
“The fact that we have not taken action in a given instance,” says Randy Wykoff, director of AIDS coordination at the FDA, “should not indicate that it is legal or that we are comfortable with it or that we will not take action in the future. But we have to prioritize our enforcement to the most egregious threats to the public health.”
The NOI publicity campaign drove many AIDS patients away from the approved AIDS therapies. Dr. John Killen, currently the acting director of the Division of AIDS at the NIH, reported that “large numbers of individuals are opting to take low-dose interferon and declining to take therapy that, from our perspective, has proved beneficial in good, sound, clinical trials.” Many inner-city doctors, including Dr. Lawrence Brown of Brooklyn’s Addiction Research and Treatment Corporation, argued that commissioning an authoritative federal study on ImmuViron would help stem the tide of fleeing patients.
The NIH researchers were caught in a dilemma: If they refused to pursue the clinical trial, they might produce a public-health emergency; if they ordered the trial, they would appear to be endorsing an operation they were definitely ambivalent about.
“Anytime any [unapproved] therapy reaches widespread use, it may well be the ethical thing…to test that therapy to come to the aid of those people who are confused,” says Dr. Daniel Hoth, former director of the Division of AIDS.
In September 1992, the NIH announced that it would sponsor another trial of oral alpha interferon, and Drs. Muhammad and Justice were invited to assist in the trial’s design and implementation. “We had to do something,” is the succinct way another former NIH official describes the NIH’s move. “Minority patients were being driven away from the therapies that are known to have benefits, however modest.”
The new study was not without precedent: In the early ’80s, the NIH sponsored a clinical trial that debunked the contention that laetrile cured cancer. While debunking ImmuViron may quash the confusion over its efficacy, the new trial also carries a significant health cost, notes Dr. Smith.
“There are [many] drugs and not enough money to research them all,” Smith says. “If you spend money on this, what new drug aren’t you spending money on?” The trial’s price tag hasn’t been calculated, but will surely run into the millions.
The ALC backpedaled from their more exaggerated ImmuViron claims when they met with the NIH in 1992 to discuss a new trial of the drug. Instead of calling the drug a cure or describing dramatic reversals of symptoms, ALC officials claimed only that ImmuViron made their patients feel better. Meanwhile, the Final Call remained insistent as ever that ImmuViron was a major breakthrough.
The NOI’s duplicity angered Smith. “At NIH they give seemingly scientific statements, and then they turn around and yell, “Cure!’ ” he says. “It does not augur well for reasoned debate.”
But the ALC isn’t much interested in reasoned debate, as the quackery behind the group’s ImmuViron pronouncements prove. The NIH’s sponsorship of a new alpha interferon trial and the FDA’s refusal to rein in the profiteering ALC indicate a timidity on the part of the federal government, paralyzed by a genuine moral dilemma.
Locally, however, Muhammad’s success in garnering District grants for the ALC and orchestrating Caitlin Ryan’s ouster reflects simple civic spinelessness. The free and open inquiry of science seems to take a back seat to the expediency of politics. How else to explain the fact that Mayor Sharon Pratt Kelly awarded Muhammad an August 1992 proclamation honoring him for his AIDS work?
Art accompanying story in the printed newspaper is not available in this archive: Photograph by John Anderson.