Like many other speakers at the Royal Society conference on "The Origins of HIV and the AIDS Epidemic" (myself included) doctors Plotkin and Koprowski later revised their oral presentations for the published proceedings, which are about to appear as Philosophical Transactions of the Royal Society, London, B; 2001; Volume 356, pp. 778-977.
I shall be responding to their published articles (which contain many errors) in due course.
In the interim, I have decided to respond to the press statements released by the two doctors while at the conference.
On September 11, 2000, at the Royal Society conference on "The Origins of HIV and the AIDS Epidemic", Dr Stanley Plotkin released two documents for the press - a formal statement, and a backgrounder.
In these two documents, Dr Plotkin claimed that evidence from himself and others had disproved the oral polio vaccine (OPV) theory of origin, which proposes that the AIDS pandemic was sparked by the 1950s African trials of CHAT oral polio vaccine (developed by Dr Plotkin, Dr Hilary Koprowski and others at the Wistar Institute in Philadelphia).
However, both of Dr Plotkin's press releases were characterised by a high degree of inaccuracy and error, which has unfortunately been repeated in some of the subsequent reporting of the conference.
There were similar inaccuracies in Dr Hilary Koprowski's press release.
The following point-by-point analysis should help place these public statements in perspective.
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(A) "Press Conference Statement by Stanley Plotkin M.D."
DR PLOTKIN'S CLAIM: "We now know conclusively that the events postulated by Mr Hooper did not happen for three reasons".
RESPONSE: This key statement by Dr Plotkin is incorrect, because none of the "three reasons" he provides constitute anything approaching proof [see below].
PLOTKIN'S CLAIM: "Chimpanzee tissues were not used to make CHAT. Sixteen scientists with first hand knowledge say no, supported by documents of the time".
RESPONSE: This statement is doubly inaccurate. Firstly, the sixteen scientists in question signed forms stating that they "never saw/heard of chimpanzee cells" being used. They did not state that "chimpanzee tissues were not used to make CHAT", mainly because nobody (whether at the Wistar Institute, in Belgium or in Africa) could state such a thing with certainty. With regard to the Wistar, it is significant to note that the Institute did not have a monkey house. This means that for the last three years of the 1950s kidneys were arriving there already excised, and nobody has provided any physical or documentary evidence about their provenance. I am reliably informed (by a veterinary pathologist) that during the fifties it would have been impossible to distinguish between the kidneys of a macaque and those of a young chimpanzee. As for Africa, a former worker at the Bujumbura medical laboratory in the fifties has given detailed testimony about kidneys being removed from chimpanzees which were caged behind the lab, kidneys which were then sent both to Belgium, and to another lab in Butare, Rwanda. Although there is no evidence that they were used in Butare to produce CHAT vaccine, we know that other human vaccines were being prepared at the Butare lab at that very time, and that Dr Koprowski brought samples of CHAT and Fox (another of his OPVs) out to Bujumbura in February 1957.
The second assertion, that this claim is "supported by documents of the time" is quite simply incorrect, for not one single document from the 1950s (the period in question) has been produced which describes the species of cells in which CHAT vaccine was made. Furthermore, even those articles which Dr Plotkin cites from the 1960s are ambiguous on this issue.
PLOTKIN'S CLAIM: "The logistical problems of getting chimp tissues from the Congo to the US or Europe means that many people would have been involved, and it is inconceivable that no one would remember it."
RESPONSE: Even if this statement is correct (which is questionable), its overall implication is misleading. People do remember that chimp kidneys were being dispatched overseas, but they are not Dr Plotkin's witnesses. We know that many shipments of biomedical materials were made from the Congo to both the U.S. and Europe during the key 1956-1959 period, as acknowledged by several of the doctors involved, including some of the witnesses cited by Dr Plotkin. The question is what was in those shipments. In fact, two of these witnesses (the head of the Stanleyville veterinary lab from 1956 to 1959, and the widow of Tom Norton, the Wistar lab chief) have testified that as far as they know, some of these boxes contained chimp organs, including kidneys. Furthermore, Ghislain Courtois, who was in overall control of Lindi chimpanzee camp during this period, told a conference on the use of monkey cell cultures in December 1967 "More than ten years ago we sent kidneys from the Congo to Europe and they were quite satisfactory" (for making tissue culture). There is no record of any kidneys other than chimp kidneys being available to Courtois in 1956 or 1957. Another important detail came from the late Dr Gaston Ninane, who worked at the Stanleyville medical lab and at Lindi camp, who told me that on ten or twenty occasions blood samples from CHAT vaccinees, packed around with ice, were dispatched on planes that travelled back to Europe and North America stopping off at a US Air Force base in Libya. If (as seems likely) the shipments of chimpanzee kidneys were dispatched by the same route (and we have documentary proof that at least six shipments of chimp kidneys were sent from Stanleyville to Philadelphia), the "chain of custody" could have involved as few as three people (one at each end, and the courier), none of whom would necessarily still be alive today.
PLOTKIN'S CLAIM: "Even if chimp kidney had been used, the work of three laboratories tells us that HIV started spreading in about 1930, long before the CHAT vaccination in the Congo."
RESPONSE: Again, this statement is inaccurate, for it seeks to turn theory into fact. These three laboratories have hypothesised that "the most recent common ancestor" of HIV-1 existed in about 1930 (in other words, before the polio vaccine trials). This is theoretical work, based on certain assumptions. However, it is now becoming apparent that each of the three labs failed to properly allow for recombination, which is recognised as a major factor in retroviral evolution. In October 2000, shortly after the Royal Society meeting, two important papers were published which highlighted the fact that failing to take recombination into account can throw phylogenetic dating into disarray, and invalidate apparently convincing results. One of the authors has since proposed that if recombination occurs early on, when a new virus has just evolved, such an event is unlikely to be detectable through present-day genetic analysis. He further proposed that all it would require to produce the HIV-1 subtypes and variants seen today would be two chimpanzee SIVs which recombined (either in a person or in a tissue culture) in the distant past - the 1950s, for instance. This is exactly what the OPV theory proposes - that cells from two infected chimps were used to produce a culture in which CHAT vaccine was grown. There is a growing sense in genetics circles that the three labs quoted by Dr Plotkin may have over-stated their claims. Another geneticist studying this problem recently told me: "everything which has been done on dating [the AIDS epidemic] up to now is a dog's dinner".
PLOTKIN'S CLAIM: "As Dr Beale will show, even if SIV contaminated cells had been used, they would not have survived the preparation of polio vaccine".
RESPONSE: Again, Dr Plotkin refers to theoretical work as if it were fact. Nobody has yet carried out a proper experiment to simulate the making of 1950s polio vaccine in cells contaminated with chimpanzee SIV (the immediate ancestor to HIV-1). It is worth noting that in October 2000 a major article in the American Journal of Nephrology announced that the epithelial cells of the kidney (the same cells used to make polio vaccines in the 1950s) represent an unexpected and hitherto unrecognised site of HIV-1 infection.
PLOTKIN'S CLAIM: "Even if the vaccine had been contaminated with SIV, the first cases of AIDS are not associated with CHAT vaccination. ... [T]he epidemiology of AIDS is consistent with sexual transmission but does not agree with the polio hypothesis."
RESPONSE: This is quite simply untrue. According to my latest data, 70% of the earliest recorded cases of AIDS in Africa (30 cases identified retrospectively through 1980) come from the same towns and villages where CHAT vaccine was fed between 1957 and 1960. And nearly 85% of the earliest recorded instances of HIV-1 infection in Africa (again through 1980) come from the same towns and villages where CHAT vaccine was fed between 1957 and 1960. The sexual transmission of HIV-1 (which is not in doubt) completely fails to explain why the first cases of HIV-1 infection and AIDS occurred almost exclusively in areas where CHAT vaccine had been administered.
PLOTKIN'S CLAIM: "Mr Hooper made significant mistakes in reporting where CHAT vaccination was done."
RESPONSE: This, to say the least, is grievous exaggeration. I have spent months assembling information about where CHAT vaccination occurred in Africa - information which doctors Plotkin and Koprowski were largely unable or unwilling to provide. In one single instance, Dr Plotkin may be correct, in that I have been unable to confirm whether the proposed CHAT trial at Lubudi, in the south of the Congo, actually took place. (However, such a trial is mentioned as forthcoming in a newspaper report of a 1959 press conference attended by Dr Plotkin, and a key contemporary witness from the area has stated that it "probably" did occur.) Because it has not been confirmed, I have now removed the Lubudi trial from my analysis. However, Lubudi has no effect on the percentage associations between CHAT and AIDS, or between CHAT and HIV-1, reported above, which are based on analysis of 27 other CHAT trials in Africa. Dr Plotkin's references to "significant mistakes", and his claims that Lubudi is "key" to my argument (made elsewhere), are fundamentally inaccurate.
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(B) "Backgrounder for press from Stanley Plotkin M.D."
[Here, I shall address only those claims which have not been dealt with above.]
PLOTKIN'S CLAIM: "The virology laboratory at Kisangani [Stanleyville] was primitive and incapable of producing vaccine in any cell culture, let alone chimpanzee."
RESPONSE: The fact that Dr Paul Osterrieth states that he produced baboon kidney tissue culture at Kisangani in 1958 after training at the Wistar Institute in 1957 (a detail cited by Dr Plotkin) belies this claim, because any primate tissue culture is capable of producing "vaccine", if inoculated with a small sample of same (just as a small quantity of yogurt can be used to seed a new batch of yogurt in milk). Making polio vaccine was not an impossible, or even very difficult, process, even in Africa in the mid-fifties, as is indicated by the fact that from 1953 onwards, polioviruses were being grown in the kidneys of fifteen different African primates (including chimpanzees), and that live and killed polio vaccines were being produced in the cells of three of these species, at a small veterinary lab at Gabu, just 400 miles east of Stanleyville. In addition, human vaccines were also being produced during the fifties at two other labs in the Belgian colonies - those at Butare (Rwanda) and Lubumbashi. There are no records of polio vaccines having been produced at either lab, but both had the potential of doing so, in that they possessed the necessary technical staff, equipment and materials.
PLOTKIN'S CLAIM: "Even if chimps had been used [to make polio vaccine], those housed in the Kisangani colony [Lindi] were almost all young, and unlikely to carry SIV since they weren't yet sexually active."
RESPONSE: This statement is based on a number of incorrect assumptions, as shown by the following observations. (a) Juvenile chimps can be infected with SIV. In fact, all of the first four chimpanzees found to be SIV-positive were juveniles, aged five or less, when they became infected. (b) Most African primate species become infected with SIV not through sexual activity, but through bites and scratches, which can occur at any age. (c) Roughly 80 pygmy chimps (or bonobos) and 330 common chimps were present at Lindi between June 1956 and February 1958 (when only polio research was conducted at the camp). Not only were individual bonobos and common chimps routinely caged together, but there was one large cage where up to ten young chimps could play at a time. The spread of SIV from chimp to chimp at Lindi camp may therefore have been quite extensive.
PLOTKIN'S CLAIM: "Actual experiments carried out in several laboratories showed that even if kidney cells had been contaminated with SIV, the virus would not have survived vaccine preparation."
RESPONSE: This is a significant exaggeration. No experiment has yet been conducted that faithfully simulates the making of polio vaccine, using 1950s methods, in cells contaminated with chimpanzee SIV. It cannot, therefore be "shown" that the SIV would not have survived through to the vaccine. Further research is needed. As for Dr Beale's erudite and undoubtedly well-intentioned contribution to this debate, which concludes that the odds against SIV from kidneys surviving through to a final vaccine made therefrom would be several billion-to-one against, it has to be stressed that this is a theoretical calculation, based on how he believes any such vaccine would have been made.
PLOTKIN'S CLAIM: "Early cases of AIDS in the Congo were detected in cities, where sexual transmission was more likely, and where medical surveillance was better."
RESPONSE: This is a simplification. If we analyse the first 25 cases of AIDS in the Belgian colonies of Africa for which we can identify a place of domicile of the infectee, 16 came from cities, seven from small towns and two from rural areas.
PLOTKIN'S CLAIM: "Vaccination trials conducted in the United States and Europe with the same lots of vaccine did not result in AIDS."
RESPONSE: In interview, Doctor Plotkin admitted to me that the words "lot" and "pool" are not very precise terms with respect to vaccines. Koprowski's team was not alone in using both terms more or less interchangably. However, it is perhaps more relevant to speak in terms of "batches" of vaccine, each of which is produced at one place and at one time. There is documentary proof that a batch of CHAT pool (or lot) 13 was prepared at the Wistar for use in a small trial in Wyszkow, Poland. However, the large batch of CHAT pool 13 used in Leopoldville was, according to Henry Gelfand, the man who hand-carried it from Belgium to Africa, made at a lab just outside Brussels (probably the Rega Institute in Leuven). Similarly, different batches of CHAT pool 10A-11 (which was used in Africa on a large scale, and on a small scale in Europe and the U.S.) are known to have been made in different labs. It is therefore misleading to imply that because vaccine feedings conducted in Europe and the U.S. "did not result in AIDS", then the same must apply to the CHAT batches fed in Africa.
* Additional note: In a letter published in "Nature" on October 26, 2000, doctors Plotkin and Koprowski stated: "as presented at the [Royal Society] meeting, only two batches of vaccine were used in the mass vaccinations conducted in the Congo before 1959, the date of the first confirmed HIV infection in a human". This is not only inaccurate, but it further confuses the issue, for the two doctors are now confusing three different terms: "batch", "pool" and "lot". In his presentation at the Royal Society conference, Dr Plotkin asserted that three different CHAT vaccine pools (8 or 9, 10A-11 and 13) were fed in the Congo in 1957 and 1958. (Each of these three pools could have consisted of any number of batches.) In addition, he revealed that vaccine was in short supply in 1958, and implied that, because of that shortage, Dr Koprowski (and/or others) sent vaccine (CHAT pool 10A-11) out to the Ruzizi Valley on at least three different occasions in February and March of that year. This implies that at least five batches of (presumably American-made) CHAT were fed in Africa in 1957 and 1958. But others, such as Dr Ninane and Dr Gelfand, are convinced that Belgian-made batches of CHAT were used in the Ruzizi valley and Leopoldville in 1958. This would mean that a minimum of seven different batches of CHAT were fed in the Congo (and Ruanda-Urundi) in 1957-8. It may have been many more than this if, as I believe, different experimental batches of CHAT were administered in different places during the early African field trials - a proposition for which there is now some supporting evidence.
PLOTKIN'S CLAIM: "Several people quoted by Mr Hooper regarding transport of chimp kidneys deny they ever said what was attributed to them."
RESPONSE: In every instance of alleged inaccurate reporting cited by Dr Plotkin in his press statement or his speech (including, crucially, those involving doctors Bugyaki and Ninane), I have gone back to the original tapes and interview notes, and confirmed that what I have written in "The River" is correct. In other words, I have physical evidence to counter Dr Plotkin's claims. During two lengthy interviews in 1994 and 2000, Dr Louis Bugyaki, head of the Stanleyville veterinary laboratory during the fifties and a frequent visitor to Lindi chimpanzee camp, testified that chimp organs, including kidneys, had been sent to the USA at the request of Dr Koprowski, and that he had learnt this information from doctors Ninane and Osterrieth, both of whom worked both at Lindi and at the Stanleyville medical laboratory. On the second occasion he signed a written statement to this effect. However, at the conference we learnt from Dr Plotkin's speech that prior to the latter interview, Dr Bugyaki had already provided another written statement to members of the Plotkin team, which gave a different version of events, namely that he had no knowledge of chimp kidneys being sent to Belgium "or to other countries". These last four words were clearly in conflict with what he had twice told me. After the conference, therefore, one of my colleagues phoned Dr Bugyaki asking for clarification, and he reaffirmed that chimp kidneys had been sent from Lindi to the US in the fifties. This time, however, he added that he had heard about this not from doctors Ninane and Osterrieth, but from a sanitary agent, Jean Brakel, who had died in 1994. We are uncertain why Dr Bugyaki has recently modified his account of these events. As for the late doctor Ninane, one of his relatives told us that he was approached by three members of the Koprowski/Plotkin team during the final months of his life, when he was suffering from Parkinson's disease and Alzheimer's, and his denials that he ever made certain statements (which statements I have on tape) need to be viewed in that light. Another witness from the period who was approached repeatedly by members of Plotkin's team, and twice sent typed letters requiring only his signature, later told us that he could not sign statements which, as far as he knew, "were untrue". He described the approaches made to him as "a dishonourable proposition".
PLOTKIN'S CLAIM: "Although science can never prove a negative, I conclude from the above that the hypothesis of The River is highly improbable, and does not require further investigation."
RESPONSE: In the light of the above analysis of Dr Plotkin's press statements of September 11, 2000, I arrive at very different conclusions from him.
Dr Plotkin claims to be clarifying the issues raised in "The River", and showing that the OPV hypothesis has no basis in fact. In reality, many of his responses to "The River" are based on incorrect or misleading claims, or on misinterpretations of what I have written in the book. Far from clarifying the issues, he has confused them.
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(C) "Press Release by Hilary Koprowski, M.D."
DR KOPROWSKI'S CLAIM: "We have been left with the task of controlling damage done by 'The River', as a result of which people are questioning the vaccination of children; the Catholic church in Kenya has advised mothers not to take their children for polio vaccination as it was contaminated with HIV".
RESPONSE: When examined closely, this claim is revealed as highly questionable. The article in the Daily Nation of Kenya which Dr Koprowski cites in his speech is incorrectly referenced; no article about polio vaccines appeared on that date. However, a brief article was published one month earlier (in October 1999) which referred to "the Catholic church [in Nyeri district] calling for a boycott of the ongoing polio vaccination campaign", but which (in contrast to Koprowski's claim) gave no reason for the church's action. A search back through the Nation's archives for the previous four years reveals that there have been seven other articles concerning rumours about polio vaccines, some of which referred to claims that they were laced with either contraceptives or HIV. However, all seven were dated before the first publication of "The River" in September 1999. The truth is that there is a long-standing history of rumours about vaccines, and in particular polio vaccines, in Kenya and elsewhere in Africa, and these rumours are part and parcel of a religious/political debate that began long before my book was published, or indeed before the 1992 publication of Tom Curtis's article on the OPV theory. Meanwhile, I also am doing my best to ensure that people are getting the right message. Wherever possible (for instance in interviews on BBC World Service or Africa-based radio stations), I have encouraged people to have their children vaccinated against polio, and stressed the fact that whereas I am questioning the safety of an experimental vaccine made in the 1950s, the polio vaccines of today are, as far as is known, entirely safe.
KOPROWSKI'S CLAIM: "The author approached his task from an intuitive model rather than the kind of deductive process that every scientist uses in developing a hypothesis after observing a phenomenon."
RESPONSE: Not for the first time, Dr Koprowski is claiming that I have searched for facts to fit a theory, rather than vice versa. However, this claim is absolutely untrue, as anyone who has read the full text of "The River" should know. The reason I find the OPV hypothesis persuasive is that it is based on some very powerful scientific and historical evidence which has grown, step by step, over the years, and contrary to Dr Koprowski's claims, I have attempted to test (or disprove) the hypothesis at every juncture. Whenever a new piece of information or data emerges which seems to support the OPV hypothesis, my first response has been to adopt the stance of devil's advocate - and to see whether there is another possible interpretation. Also contrary to Koprowski's claims, I have been conscientious about including in the book as much relevant context as possible, including details which might run counter to the OPV theory. It is noticeable that much of the information which Dr Plotkin cites as evidence against the OPV theory is already documented in "The River", although Plotkin does not acknowledge this.
KOPROWSKI'S CLAIM: "Hooper conveniently overlooks the fact that Tom Norton and I were the first to take the vaccine ... "
RESPONSE: Dr Koprowski has frequently made claims along these lines, but the available records suggest that they may be incorrect. Although Dr Koprowski claimed to me in interview that he and Tom Norton had been the first to take his original oral polio vaccine, TN, the article about this trial in the American Journal of Hygiene states that the first vaccinee was in fact a six-year-old handicapped child, and that it was a year later that Tom Norton and Koprowski's then-boss, Herald Cox (not Koprowski himself) tested the vaccine on themselves. As for CHAT, the first human subjects to take this vaccine were, according to the literature, two infants born to female prisoners at Clinton State Farms, in New Jersey, U.S.A.
KOPROWSKI'S CLAIM: "The book is full of ad hominem attacks against me."
RESPONSE: In reality, the book contains a wide range of opinions and quotations, both positive and negative, from those who know Dr Koprowski from different walks of life.
KOPROWSKI'S CLAIM: "At the same time trials were conducted in the Congo, the vaccine was being given in New Jersey, Philadelphia, Switzerland and Poland. No one given that vaccine came down with HIV except for the Congolese. In other words, HIV was already present in Africa and ... had nothing to do with the polio trials."
RESPONSE: As detailed elsewhere, batches of CHAT intended for different trials were prepared in various laboratories, and in different substrates. The circumstantial evidence suggests that some experimental batches of CHAT may have been prepared in the kidneys of African primates, including chimpanzees. Whatever, there is no evidence that HIV-1 was present in Africa before February 1959 (when an HIV-1-infected blood sample was taken from Leopoldville, Congo). This is two years after CHAT vaccination began in that country.
KOPROWSKI'S CLAIM: "The publisher [of "The River"] received a letter asking for a chance to review the book for scientific accuracy ... [T]he publisher was, perhaps, more interested in sensationalism than truth, and refused our request."
RESPONSE: Dr Koprowski's conjecture about the interests of the publisher are without foundation. In fact, both the American and British publishers took extraordinary care to guarantee the scientific (and general) accuracy of the book - as did I myself - and Dr Koprowski was courteously informed, before publication, that the publisher was confident about the accuracy of the text. The fact that, despite his protestations, Dr Koprowski has not managed to demonstrate a single significant inaccuracy in some 1,100 pages of text would seem to suggest that the publishers were thorough.
KOPROWSKI'S CLAIM: "[T]he publication of this book, and the totally erroneous arguments on which it is based has caused near hysteria, with Koprowski being called 'the greatest murderer in history'."
RESPONSE: To my knowledge, there has been no "near hysteria" caused by the book. And, apart from one misguided reader on Amazon.com, to whom I responded immediately, nobody apart from Dr Koprowski himself has used the totally inappropriate phrase "the greatest murderer in history".
Edward Hooper. December 5, 2000. Slightly updated and revised on June 14, 2001.