Introduction

In 1932 the American Government promised 400 men - all residents of Macon County, Alabama, all poor, all African American - free treatment for Bad Blood, a euphemism for syphilis which was epidemic in the county. Treatment for syphilis was never given to the men and was in fact withheld. The men became unwitting subjects for a government sanctioned medical investigation, The Tuskegee Study of Untreated Syphilis in the Negro Male. The Tuskegee Study, which lasted for 4 decades, until 1972, had nothing to do with treatment. No new drugs were tested; neither was any effort made to establish the efficacy of old forms of treatment. It was a non therapeutic experiment, aimed at compiling data on the effects of the spontaneous evolution of syphilis on black males. What has become clear since the story was broken by Jean Heller in 1972 was that the Public Health Service (PHS) was interested in using Macon County and its black inhabitants as a laboratory for studying the long term effects of untreated syphilis, not in treating this deadly disease.

The Tuskegee Study symbolizes the medical misconduct and blatant disregard for human rights that takes place in the name of science. The studies principal investigators were not mad scientists, they were government physicians, respected men of science, who published reports on the study in the leading medical journals. The subjects of the study bear witness to the premise that the burden of medical experimentation has historically been borne by those least able to protect themselves. The government doctors who participated in the study failed to obtain informed consent from the subjects in a study of disease with a known risk to human life. Instead, the PHS offered the men incentives to participate: free physical examinations, free rides to and from the clinics, hot meals on examination days, free treatment for minor ailments, and a guarantee that a burial stipend would be paid to their survivors. This modest stipend of $50.00 represented the only form of burial insurance that many of the men had. By failing to obtain informed consent and offering incentives for participation, the PHS doctors were performing unethical and immoral experiments on human subjects. From the moment the experiment begun, the immorality of the experiment was blatantly apparent.
For forty years between 1932 and 1972, the U.S. Public Health Service (PHS) conducted an experiment on 399 black men in the late stages of syphilis. These men, for the most part illiterate sharecroppers from one of the poorest counties in Alabama, were never told what disease they were suffering from or of its seriousness. Informed that they were being treated for "bad blood," their doctors had no intention of curing them of syphilis at all. The data for the experiment was to be collected from autopsies of the men, and they were thus deliberately left to degenerate under the ravages of tertiary syphilis, which can include tumors, heart disease, paralysis, blindness, insanity, and death. "As I see it," one of the doctors involved explained, "we have no further interest in these patients until they die."


Using Human Beings as Laboratory Animals

The true nature of the experiment had to be kept from the subjects to ensure their cooperation. The sharecroppers' grossly disadvantaged lot in life made them easy to manipulate. Pleased at the prospect of free medical care, almost none of them had ever seen a doctor before, these unsophisticated and trusting men became the pawns in what James Jones, author of the excellent history on the subject, Bad Blood, identified as "the longest non therapeutic experiment on human beings in medical history." The study was meant to discover how syphilis affected blacks as opposed to whites, the theory being that whites experienced more neurological complications from syphilis whereas blacks were more susceptible to cardiovascular damage. How this knowledge would have changed clinical treatment of syphilis is uncertain. Although the PHS touted the study as one of great scientific merit, from the outset its actual benefits were hazy. It took almost forty years before someone involved in the study took a hard and honest look at the end results, reporting that "nothing learned will prevent, find, or cure a single case of infectious syphilis or bring us closer to our basic mission of controlling venereal disease in the United States." When the experiment was brought to the attention of the media in 1972, news anchor Harry Reasoner described it as an experiment that "used human beings as laboratory animals in a long and inefficient study of how long it takes syphilis to kill someone."


A Heavy Price in the Name of Bad Science

By the end of the experiment, 28 of the men had died directly of syphilis, 100 were dead of related complications, 40 of their wives had been infected, and 19 of their children had been born with congenital syphilis. How had these men been induced to endure a fatal disease in the name of science? To persuade the community to support the experiment, one of the original doctors admitted it "was necessary to carry on this study under the guise of a demonstration and provide treatment." At first, the men were prescribed the syphilis remedies of the day, bismuth, neoarsphenamine, and mercury, but in such small amounts that only 3 percent showed any improvement. These token doses of medicine were good public relations and did not interfere with the true aims of the study. Eventually, all syphilis treatment was replaced with "pink medicine" aspirin. To ensure that the men would show up for a painful and potentially dangerous spinal tap, the PHS doctors misled them with a letter full of promotional hype: "Last Chance for Special Free Treatment." The fact that autopsies would eventually be required was also concealed. As a doctor explained, "If the colored population becomes aware that accepting free hospital care means a post-mortem, every darky will leave Macon County . . ." Even the Surgeon General of the United States participated in enticing the men to remain in the experiment, sending them certificates of appreciation after 25 years in the study.


Following Doctors' Orders

It takes little imagination to ascribe racist attitudes to the white government officials who ran the experiment, but what can one make of the numerous African Americans who collaborated with them? The experiment's name comes from the Tuskegee Institute, the black university founded by Booker T. Washington. Its affiliated hospital lent the PHS its medical facilities for the study, and other predominantly black institutions as well as local black doctors also participated. A black nurse, Eunice Rivers, was a central figure in the experiment for most of its forty years. The promise of recognition by a prestigious government agency may have obscured the troubling aspects of the study for some. A Tuskegee doctor, for example, praised "the educational advantages offered our interns and nurses as well as the added standing it will give the hospital." Nurse Rivers explained her role as one of passive obedience: "we were taught that we never diagnosed, we never prescribed; we followed the doctor's instructions!" It is clear that the men in the experiment trusted her and that she sincerely cared about their well being, but her unquestioning submission to authority eclipsed her moral judgment. Even after the experiment was exposed to public scrutiny, she genuinely felt nothing ethical had been amiss. *SEE HER LINK BELOW*

Many critics of The Tuskegee Study draw comparisons to the similar degradation of human indignity in inhumane medical experiments on humans living under the Third Reich. How could such callousness happen outside Nazi Germany? To deny that race played a role in The Tuskegee Study is naive. All 600 subjects (399 experimental and 201 controls) were black the PHS directors and most of the doctors who studied them were white. Was The Tuskegee Study government sanctioned, premeditated genocide? In July 1972, Jean Heller broke the story. Under examination by the press, the PHS was not able to provide a formal protocol for the experiment, in fact, one never existed. While it was obvious to the American public as a whole, PHS officials maintained that they did nothing wrong. By the time the story broke, over 100 of the infected men had died, others suffered from serious syphilis related conditions that may have contributed to their later deaths even though penicillin, an effective treatment against syphilis, was in widespread use by 1946.

On July 23, 1973, Fred Gray, a prominent civil rights lawyer, brought a $1.8 billion class action civil suit against many of those institutions and individuals involved in the study. Gray demanded $ 3 million in damages for each living participant and the heirs of the deceased. The case never came to trial. In December, 1974, the government agreed to a $10 million out of court settlement. The living participants each received $ 37,500 in damages, the heirs of the deceased, $15,000. Gray received nearly $ 1 million in legal fees. Had the subjects of The Tuskegee Study been taken advantage of ? Although the survivors and the families of the deceased received compensation, no PHS officer who had been directly involved in the study felt contrition. No apologies were ever tendered; no one ever admitted any wrong doing. On the contrary, the PHS officers made it clear that they felt they were acting in good conscience. They felt betrayed by the government's failure to defend the study they commissioned. But as one survivor said "...I don't know what they used us for. I ain't never understood the study." In 1990, a survey found that 10 percent of African Americans believed that the U.S. government created AIDS as a plot to exterminate blacks, and another 20 percent could not rule out the possibility that this might be true. As preposterous and paranoid as this may sound, at one time the Tuskegee experiment must have seemed equally farfetched. Who could imagine the government, all the way up to the Surgeon General of the United States, deliberately allowing a group of its citizens to die from a terrible disease for the sake of an ill conceived experiment? In light of this and many other shameful episodes in our history, African Americans widespread mistrust of the government and white society in general should not be a surprise to anyone.

THEORIES THAT AIDS IS A GOVERNMENT CONSPIRACY TO DESTROY UNDESIRABLE POPULATIONS MAY MAKE POLITICAL SENSE, BUT ARE THEY SUPPORTED BY FACTS?:


AIDS has an uncanny knack for attacking people the dominant society considers "undesirables": gays, injection drug users (IDUs), prisoners, and people of color. The commonly cited US statistic that African Americans have twice the AIDS rate as white Americans understates the problem because it is based on the total number of cases since 1981. While white gay men constituted the large majority of cases in the early days, by the early 1990s the rate of new cases among Latinos was 2.5 times higher than among whites, and the black/ white ratio was even starker at 5-1 for men and 15-1 for women. By 1993, AIDS had become the leading cause of death among African Americans between the ages of 25 and 44. Internationally, the racial disparity is even worse: About 80 percent of the world's 9 million AIDS deaths through 1995 have occurred in Africa, where 2 million children have already been orphaned.

AN ALMOST PERFECT FIT

The correlation between AIDS and social and economic oppression is clear and powerful. What is more, the pattern meshes neatly with an extensive history of chemical and biological warfare (CBW) and medical experiments which have targeted people of color, Third World populations, prisoners, and other unsuspecting individuals. In the first North American example of CBW, early European settlers used smallpox infected blankets as a weapon of genocide against Native Americans. A few centuries later, the US Army conducted hundreds of tests that released "harmless" bacteria, viruses, and other agents in populated areas; one was to determine how a fungal agent thought mainly to affect black people would spread. Washington also subsidized the pre marketing tests of birth control pills before a safe dosage was determined on Puerto Rican and Haitian women who were not warned of the potentially severe side effects. Since the 1940s, the US has conducted 154 tests on 9,000 people, soldiers, mental patients, prisoners many of whom had no idea of the risks involved. On another level, the drug plague in the ghettos and barrios whether by intent or not has the effect of chemical warfare against these communities.


The most apposite example is the four decade long Tuskegee syphilis study. Starting in 1932, under US Public Health Service auspices, about 400 black men in rural Alabama were subjects in an experiment on the effects of untreated syphilis. They were never told the nature of their condition or that they could infect their wives and children. Although penicillin, which became available in the 1940s, was the standard of treatment for syphilis by 1951, researchers not only withheld treatment but forbade the men from seeking help elsewhere. This shameful "experiment" was stopped in 1972, only after a federal health worker who was involved blew the whistle. Nor is experimentation on people of color a thing of the past. Beginning in 1989, 1,500 children in West and East Los Angeles and Inglewood were given an experimental measles vaccine as part of a government sponsored trial. Most of the subjects were Latino or African American. The parents of these children were never told that they were part of an experiment with an unlicensed drug, and thus had a less than adequate basis for giving their consent. The Edmonston-Zagreb, or E-Z vaccine was also tested in Senegal and Guinea-Bissau and Haiti, Guinea, and more than a dozen other Third World countries. Trials in Los Angeles conducted with the cooperation of Kaiser Permanente, the Centers for Disease Control (CDC) and John Hopkins University, were stopped two years later after questions were raised about the vaccine's relationship to an increased death rate among female infants. When use of the experimental drug came to light, CDC Director Dr. David Satcher noted, "A mistake was made. It shocked me. ... But things sometimes fall through the cracks." Dr. Stephen Hadler, director of the epidemiology and surveillance division of the CDC's national immunization program, said that although researchers have not confirmed a causal association between the more potent dose of E-Z vaccine and the deaths, "it was enough to make the World Health Organization say that "high doses of the vaccine should no longer be considered for use in kids." It should be emphasized, he told the Los Angeles Times, that the deaths occurred among children living in poor countries, many of whom were malnourished and did not have access to adequate health care. Hadler did not, however, emphasize that those same conditions are all too common in the US. In light of this gruesome pattern and pervasive evidence in every corner of society that the lives of blacks are less valued, there are good reasons why so many prisoners as well as a significant portion of the African American community believe that government scientists deliberately created AIDS as a tool of genocide.


Dangerous To Your Health

There is only one problem with this almost perfect fit: It is not true. The theories on how HIV the virus that causes AIDS was purposely spliced together in a lab wilt under scientific scrutiny. Moreover, these conspiracy theories divert energy from the work that must be done in the trenches if marginalized communities are to survive this epidemic: grassroots education, mobilizations for AIDS prevention, and better care for people living with HIV. They distract from the urgent need to focus a spotlight on the life-and-death issue of AIDS prevention and on the crucial struggle against a racist and profit driven public health system that is responsible for tens of thousands of unnecessary deaths. After more than nine years doing AIDS education in prison, I have found these conspiracy myths to be the main internal obstacle in terms of prisoners' consciousness to implementing risk reduction strategies. A recent study at the University of North Carolina, Chapel Hill, confirmed that African Americans who believe in the conspiracy theories are significantly less likely to use condoms or to be tested for HIV. Put bluntly: The false conspiracy theories are themselves a contributing factor to the terrible toll of unnecessary AIDS deaths. What's the use, believers ask, of making all the hard choices to avoid spreading or contracting the disease if the government is going to find a way to infect people anyway? And what's the point of all the hassles of safer sex, or all the inconvenience of not sharing needles if HIV can be spread, as many conspiracy theorists claim, by casual contact such as sneezing or handling dishes? The core of the mind-set that undermines prevention efforts is "denial." People whose activities have put them at risk of HIV are often petrified and turn to conspiracy theories as a hip and seemingly militant rationale for not confronting their own dangerous practices. At the same time, such theories provide an apparently simple and satisfying alternative to the complex challenge of dealing with the myriad of social, behavioral, and medical factors that propel the epidemic. While convinced that humans did not design HIV, my main concern here is not to disprove the conspiracy theories. Neither do I attempt to solve the problem of the origins of AIDS or even review the many different theories and approaches to that question. The origin of this disease, as of many others, is likely to remain unsolved for years to come. Rather, the article examines the validity of one set of theories being widely propagated to prisoners and to African American communities: that HIV was deliberately spliced together in a lab as a weapon of genocide. What follows is a look at the major flaws in, and political agenda of, the major conspiracy theories. Readers uninterested in this detailed critique may skip to the section beginning with "The Real Genocide," which discusses the system that made these theories so plausible and that abets as part of its routine functioning the spread of AIDS to "undesirable" communities.


SCIENTIFIC UNRAVELING

An early version of the AIDS-as-biowarfare theory was based on the work of two East German scientists, Jakob and Lilli Segal, published by the Soviet news agency Tass on March 30, 1987. The Segals claimed that HIV could not have evolved naturally, being in fact an artificial splice between visna virus (a retrovirus that infects the nervous system of sheep) and HTLV-1 (the first retrovirus known to infect humans). This splice, they asserted, was created at the notorious CBW lab at Fort Detrick, Maryland, and then tested on prisoners in the area. Finding the article politically credible, I sent it to Janet Stavnezer, a friend and long-time supporter of the civil rights and anti-war movements, who is a professor of molecular genetics and microbiology specializing in immunology. Her response was unequivocal: The Segals' splice theory is scientifically impossible. A few years later, as perestroika spread, the Soviet Union withdrew these charges whether out of good science or good diplomacy is unknown. In any case, by then, even non-scientists had noted flaws. For example, there was an obvious error of US geography. The Segals had speculated that the Maryland prisoners, once released congregated in New York City, which then became the seedbed of the epidemic. But most Maryland prisoners would have returned to Baltimore, or Washington, DC neither of which was an early center of AIDS. Since the Segals, there have been a number of related theories that HIV was artificially created by splicing two existing viruses. One, set at Fort Detrick, puts the date back to 1967; another implicates the World Health Organization (WHO), starting in 1972. Stavnezer and Mulder debunk these theories by showing that none of the viruses posited in the various splice theories has nearly enough genetic similarity (homology) with HIV to be one of its parents. Investigative journalist Bob Lederer conducted a separate inquiry into AIDS conspiracy theories for Covert Action Information Bulletin in 1987. One of his prime sources, Dr. David Dubnau, a long- time activist against CBW, was emphatic: The HIV splice theorists "are simply wrong," he said, and offered the same explanation as Stavnezer and Mulder. Lederer had written in the 1987 article that the various non splice theories of dissemination were plausible. Recently, in light of current knowledge, he has revised his conclusion and determined that "None of the AIDS as CBW theories [including the non splice theories] really holds up." Needing a vehicle for the deliberate dissemination of the allegedly spliced virus, the conspiracy theorists also characterize vaccination programs (against smallpox in Africa, hepatitis-B among gay men in the US, and polio in various places) as examples of a CBW campaign. While vaccination programs with inadequate controls for contamination may have contributed to the spread of the infection, they could not have been a prime cause: The geography of the vaccination campaigns does not correspond with the locations of early centers of AIDS. Meanwhile such unsubstantiated rumors can dangerously discourage people here and in the Third World from getting the same protection for their children that have done so much to stop diseases for more privileged whites.

There is another telling problem with the theories: timing. HIV almost certainly arose well before scientists had any reason to consider retroviruses as possible CBW agents to destroy the human immune system. The first human retrovirus (HTLV-1) was not discovered until 1977, and could not immediately be linked to any disease. Through the end of the 1970s the search for human retroviruses was propelled by speculation that they might cause cancer, not that they would target the immune system. Since the epidemiological evidence shows AIDS in several countries in 1978, HIV (a virus with a long incubation period), had to exist at least a few years before that. And it is probably considerably older. Retrospective tests on 1,129 blood samples taken in 1971-72 from US injection drug users found that 14 were HIV positive. There are also cases of patients who died of AIDS defining illnesses decades ago: a teenager in St. Louis in 1968, a sailor in England in 1959, and a Norwegian sailor, his wife and child in the late 1960s. Preserved tissue and blood samples from all of these cases later tested positive for HIV antibodies, although the more difficult direct tests failed to find the virus itself. Medical case histories going back to the 1930s the earliest period in which accurate records were kept show isolated cases with all the earmarks of AIDS. Various analyses of the DNA sequences a technique used for broad assessment of a specie's age have provided estimates for the age of HIV that range from 30-900 years. In brief, the lack of knowledge of any human retroviruses before the late 1970s and the compelling evidence for the earlier genesis of HIV virtually eliminate the possibility that scientists deliberately designed such a germ to destroy the human immune system. More specifically, and decisively, Stavnezer and Dubnau independently confirm that all the alleged splices are in fact impossible because HIV does not have nearly enough genetic similarity to any of the proposed parent viruses.


SHYSTER SCIENCE

The most common source of the conspiracy theories circulating in New York State prisons is William Campbell Douglass, M.D.15 His article "WHO Murdered Africa, "(referring to the World Health Organization), and his book AIDS: The End of Civilization, are prime sources for many black community militants and prisoners who embrace the conspiracy theory out of a sincere desire to fight genocide. But Douglass, who is white, expresses little concern for black lives. He instead states his purpose as being the defense of Western civilization, and describes his politics as "conservative" which turns out to be quite an understatement for his ultra right wing political agenda. Douglas taps into the font of mistrust created by the arrogance and glibness of establishment science. Quick acceptance of the still unproven African green monkey theory was especially suspect and led many people to react against the presumptions of mainstream medicine. Douglass' alternative, however, is a bizarre cocktail of half truths, distortions, and lies. He fails to recognize a basic distinction in epidemiology between the cause of AIDS (a virus) and a means of transmission (dirty needles) (p. 171). He evidently thinks that all RNA viruses are retroviruses (p.230) which is like thinking that all fruits are citrus. And his pronouncements on the possibility of transmission by insects display fundamental ignorance of the science involved. There is also something radically wrong with his statistics; he offers five different figures for the number of HIV infected people in the US (pp. 53, 60, 63, 168, 170) without trying to reconcile the variations. He also" proves" that HIV is a splice of two other viruses by comparing shapes as depicted in his own crude sketches (p. 231), when the scientific method for determining the degree of relatedness of different viruses is to make a detailed
comparison of the sequence of the base pairs of nucleic acid in the DNA. Such an analysis disproves the splice theory.


FRAUDULENT "SCIENCE"

Douglass goes beyond mere distortion when he reaches the core of his conspiracy. His "smoking gun" is an article from the Bulletin of the World Health Organization. In a blatant distortion of the 1972 article, Douglass claims that the World Health Organization called for the engineering of a retrovirus to cause AIDS. He is unequivocal: WHO is talking about "retro viruses" and is asking scientists to "attempt to make a hybrid virus that would be deadly to humans. ...That's AIDS. What the WHO is saying in plain English is Let's cook up a virus that selectively destroys the T-cell system of man, an acquired immune deficiency.' " (Emphasis in original.) He presents an almost identical description in his book. (p. 80) Aside from the unlikelihood of conspirators' publishing their evil plans, Douglass' characterization borders on fraud. The WHO article in question is not primarily about retroviruses; it is not at all about engineering new viruses; it never discusses making hybrids; and it is absolutely not about making a virus to destroy the human immune system. Anyone who takes the time to look at the original will find that it details a number of existing viruses that cause various illnesses in humans and other mammals. Evidence was emerging by 1972 that some of these viruses, in addition to their direct damage, impacted the immune system. The only call the article makes is to study these secondary effects. He offers only one quote from the original. Not only does he change the context, he omits the list of viruses under study. All the listed viruses were related to already recognized illnesses; most are not retroviruses; none is a retrovirus that affects humans; and none is a suspect in any of the proposed scenarios for HIV splicing. Douglass has created a bogeyman out of thin air.


DEADLY LIES

Douglass' disinformation becomes a deadly threat when he discredits the very prevention measures needed to save lives: "It is possible, " he wrote, "that even the government propaganda concerning intravenous drug use is a red herring. If the intravenous route is the easiest way to catch AIDS, why does it take as long as five to seven years for some recipients of contaminated blood to come down with AIDS?" (p. 171) Here, he seems to forget the well established incubation period between infection with HIV and onset of AIDS, although he manages to remember it later when he refers to a "latency" period of 10 years. (p. 245) And arguing that there isn't a perfect correlation between the number of acts of intercourse and infection, he declares "AIDS is not a sexually transmitted disease. "(p. 243) Then, after sabotaging prevention efforts by disparaging the well established danger of needle sharing and unprotected sex, Douglass fuels hysteria with claims that AIDS can be contracted by casual contact. "The common cold is a virus," he says in his article. "Have you ever had a cold? How did you catch it?" By failing to differentiate between airborne and blood borne viruses, he is conjuring up a scare tactic as scientific as warning that your hand will be chopped off if you put it in a goldfish bowl because, after all, a shark is a fish. He also asserts, citing no evidence, that "the AIDS virus can live for as long as 10 days on a dry plate," and then asks, "so, are you worried about your salad in a restaurant that employs homosexuals?" People are understandably skeptical of government reassurances on any matter. But we can turn instead to the experiences of families of people with AIDS and of grassroots AIDS activists: There are hundreds of thousands of us who have worked closely with infected people for years without catching the virus. The unwarranted fears about casual contact deter sorely needed support for our brothers and sisters living with HIV infection and divert attention from the most common means of transmission: unprotected sex and shared drug injection equipment.


REACTIONARY POLITICS

Despite the apparent irrationality, there is a coherence to Douglass' distortions and fabrications. They are driven by an ultra-right-wing political agenda that goes back to the 1960s, when he was a member of the John Birch Society and ran a phone line spouting 90 second "patriotic message." In it, Douglass railed against the civil right movement and denounced the National Council of Churches and three presidents as part of a "Communist conspiracy." Among the nuggets he offered callers in at least 30 US cities was the likelihood "that those three civil rights workers [presumably Schwerner, Chaney, and Goodman] in Mississippi were kidnaped and murdered by their own kind to drum up sympathy for their cause." In another message he predicted that "The Civil Rights Act will turn America into a Fascist state practically overnight." Two decades later he was blaming gays for AIDS in The Spotlight, the organ of the ultra-right-wing Liberty Lobby, for which he wrote regularly and in which he ran advertisements for "The Douglass Protocol," his cure all medical clinics. In 1987, he wrote, "some have suggested that the FDA is waiting for the majority of the homosexuals to die off before releasing ribavirin," a drug he was at the time promoting as a miracle cure for AIDS. Douglass, however, opposed withholding a "suppressed" cure "although I feel very resentful of the homosexuals because of the holocaust they have brought on us." Later Douglass began promoting a strange cure all treatment (pp. 251-52), photoluminescence, in which small amounts of blood are drawn, irradiated with ultraviolet light, and reinjected. Treatments at his Clayton, Georgia, clinic can span several weeks and cost thousands of dollars. By 1992, when he wrote AIDS: End of Civilization, hes aw AIDS as part of the "entire mosaic of the current attack against western civilization" (p. 14); the term "western" being a thinly veiled code word for "white." He had also shifted blame from homosexuals to communists, and portrayed AIDS as a diabolical plot perpetrated by WHO, which "is run by the Soviets." (p. 118) In these later writings, Douglass weaves an elaborate and intricate plot describing how the communists much like an invading virus took over the machinery of the US Army's CBW labs at Ft. Detrick and the US National Institutes of Health in order to use them to create and propagate HIV.
Douglass is so mired in anti communism that he fails to revise this scenario for his 1992 edition after the collapse of the Soviet Union. He even charges that a Russian, Dr. Sergei Litivinov, headed WHO's AIDS control program in the late 1980s, when, in fact, it was led by an American, Jonathan Mann, whose writings Douglass cites favorably on a number of occasions. In the guise of a program against AIDS, Douglass proposes a basket full of policies favored by the ultra right and neo-Nazis: support and strengthen the powers of local law enforcement (p. 139); make preemptive military strikes against Russia (p. 138); abolish the UN and WHO (p.120); and stop all illegal Mexican immigration into the US (p. 253). Then there are his more specific proposals: mandatory testing for HIV (p. 66); quarantine of all those with HIV (pp. 165-66); removal of HIV infected children from school (p. 161); and incarceration, castration, and execution to stop prostitution. (p. 158) He argues that if we don't overcome a tradition "where civil rights are more revered than civil responsibility," hundreds of millions will die. (p. 165) While such proposals may further the right's law-and-order agenda, a wealth of public health and activist experience has shown that such repressive measures are counterproductive. Discrimination and repression drive those with HIV and its high risk activities underground, making people unreachable for prevention, contact notification, and care. And here is the final appeal in his book: "[I]t appears that regulation of social behavior, as much as we hate it in an egalitarian society such as ours, may be necessary for the survival of civilization." (p. 256)


SIGN OF THE TIMES

As bizarre, self contradictory, and refutable as his pronouncements are, Douglass is not an isolated crackpot. A fellow conspiracy theorist with whom he shares much common ground is Lyndon LaRouche, a notorious neo-fascist with documented links to US intelligence agencies. LaRouche's "National Democratic Party Committee" organized the intensely homophobic campaign in 1986 for California's Proposition 64, which, had it not been rejected by voters, would have mandated an AIDS quarantine. In 1989, Douglass and many key LaRouchites spoke at a conference which focused on various conspiracy theories for the origin of AIDS. The "scientific" source that the LaRouchites used for their reactionary campaign is Robert Strecker, M.D., who also addressed the conference Douglass has worked closely with Strecker, considers him a mentor, and dedicates AIDS: The End of Civilization to him. Michael Novick reported in White Lies/White Power that within the far right, it is "The LaRouche groups that are particularly dangerous because, despite their fascist orientation, they have been attempting to recruit from black groups for some time." The political analysis of Bo Gritz, head of the "Populist Party" is another source for AIDS conspiracy theorists. As Novick's book shows, the "Populists" use anti business rhetoric to try to recruit among the left, but the organization has deep roots in the ku klux klan and strong ties to the extreme white supremacist christian identity. When such forces propagate AIDS conspiracy theories among African Americans, one result is to divert people from the grassroots mobilization around prevention and education that could foster greater cohesion, initiative, and strength within the black community. At the same time, the right fans the flames of homophobia which combines with the problem of racism within the predominately white gay and lesbian movement to undermine a potentially powerful alliance of the communities most devastated by government negligence and inaction on AIDS. We live in a strange and dangerous period when the attractive mantle of "militant anti-government movement" has been bestowed on ultra-right-wing, white supremacist groups. The main reason they can get away with such a farce is that their big brother the police state did such an effective job in the blood- soaked repression of opposition groups such as the Black Panthers, which was rooted in the needs and aspirations of oppressed people. With people's movements silenced, the right has co-opted the critique of big government and big business to achieve new credibility. The seedbed of discontent comes from the erosion of the previous guarantee of economic security and relative privileges for a wide range of white people in the middle and working classes. The right, however, portrays the threat as coming from the inroads made by women, immigrants and people of color. Thus their vehemence and militancy spring from the same legacy of white supremacy and violence that is the basis of the government they criticize and their program is in essence a call to return to the pioneer days' ethos that any white male had the right to lay a violent claim to Native American land, African American labor, and female subservience. Whatever the right's motives, the practical consequences are clear: There is a definite correlation between believing these myths and a failure to take proven, life saving preventive measures. In the end, the lies promulgated by the likes of Douglass, Strecker, and LaRouche kill.


THE REAL GENOCIDE

The New York Times, in an editorial expressing alarm that an "astonishing" number of African Americans believe in conspiracies with AIDS as a prime example could only understand the phenomenon as "paranoia." Educated white folks, to the degree they are aware of such matters, tend to be "amazed" by such beliefs. But what is truly amazing is that so many whites are so out of touch with the systematic attack by the government-medical-media establishment on the health and lives of African Americans. The stone wall of calculated ignorance and denial that blacks face every day is a fine surface on which to write conspiracies, and may explain why some people become vested in a plot scenario that seems to crystallize the damage. But the problem is far more powerful and pervasive than any narrow conspiracy theory can capture. And although the health horror this society imposes on African Americans is not a "mainstream" public issue, black people know what they are experiencing. They also know that the radical gap between the life expectancy of African Americans and that of white Americans was there even before AIDS burst onto the scene. A 1980 Health and Human Services Department report showed that there were 60,000 "excess deaths" among blacks. This is the number of black people who would not have died that year if blacks had the same mortality rate as whites. That figure marks more unnecessary deaths in one year alone than the total number of US troops killed during the entire Vietnam War. The black body count is a direct result of overwhelming black/white differences in living conditions, public health resources, and medical care. The infant mortality rate a good indication of basic nutrition and health care is more than twice as high among black babies as among whites, while black women die in childbirth at three times the rate of whites. There are also major differences in prevention, detection, treatment, and mortality for a host of other illnesses, such as high blood pressure, pneumonia, appendicitis and cancer. Comparisons are even starker when class as well as race is factored, and, of course, the health status of both Latinos and poor whites is worse than that of more affluent whites. The situation has worsened since 1980 with the advent of AIDS and the new wave of tuberculosis. TB, long considered under control in the US, began a resurgence in 1985. One big factor was the greater susceptibility of HIV infected people to TB. But TB is an important example for another reason: It has always been closely linked to poverty. Crowded tenements, homeless shelters, jails, inadequate ventilation, and poor nutrition all facilitate the spread of this serious disease. Given the distribution of wealth and privilege, it is not surprising that the rate of TB for black Americans is twice that for white Americans, African Americans are also assailed by a range of problems such as high stress, poor nutrition, and environmental hazards. One significant example of environmental hazards is the excessive blood levels of lead in children a condition with proven links to lowered academic performance and to behavioral disorders. In 1991, 21 percent of black American children had harmful quantities of lead in their blood, compared with 8.9 percent of all US children. In addition to disease, the high rate of black-on-black homicide a secondary but particularly painful source of needless deaths is in its own way a corollary of the frustration and misdirected anger bred by oppression.


STDS AND DRUGS

The evidence is clear that far from being a mysterious new development, AIDS and other epidemics and health hazards flow most easily along the contours of social oppression. There are two particular ways in which the racist structure of US society fosters the spread of HIV: The public health system fails to stem the spread of sexually transmitted diseases (STDs); and the legal system seeks only to punish drug abusers rather than treat them or ameliorate the underlying social and economic causes. A major risk factor for HIV transmission is untreated STDs. These infections can concentrate HIV laden white blood cells in the genital tract and can also cause genital sores, which are easier points of entry for HIV. Although STDs can be readily contained by responsible public health programs, rates began to soar for blacks in the mid-1980s, with, for example, a doubling of syphilis for Blacks from 1985 to 1990. At the same time, rates have remained stable for whites. This grave racial difference probably results from the lack of adequate STD clinics and the failings of public health education, along with the more general breakdown in social cohesion and values that can affect communities under intense stress. Drugs, along with the violence and police repression that accompany them, constitute a plague in their own right for the ghettos and barrios. However, the public perception that illicit drug use is more prevalent among non whites is wrong. Household surveys conducted by the National Institute of Drug Abuse show that African Americans, 12 percent of the US population, comprise 13 percent of illicit drug users. Where there is a tremendous difference, though, is in incarceration. Seventy four percent of the people in prison for drug possession are African American. There is also a major racial disparity in terms of drug related infection by HIV. While partially a result of which drugs are used and how they are used, there is certainly a big and deadly difference in access to new (sterile) needles and syringes through either pharmacies or personal networks. Also, on the street, the police are much more likely to stop and search Blacks and Latinos. This practice deters injection drug users of color from carrying personal sets of works (in states where they are illegal) and pushes them instead to share needles at shooting galleries.


CRIMINAL NEGLIGENCE

The latest example of the public health failing concerning AIDS is hardly known beyond the immediate circles of AIDS workers. Studies completed in 1993 showed that the previously recommended and widely disseminated protocol for cleaning needles with bleach does not work. Yet there has been no wide scale effort to sound the urgently needed alarm about this grave danger. The literature since 1993 has delineated a new, more effective bleach method that entails using 100 percent undiluted bleach (as opposed to a 10 percent solution) and holding the bleach or rinse water in the needle and syringe, while shaking and tapping, for a full 30 seconds for each step of the nine step process. However, most IDUs do not even look at new handouts because they believe they already "know" the bleach method. In addition, public health authorities have taken no responsibility for the type of training it takes to get an IDU, anxious to get high, to properly complete such a complex and time consuming process. One reason the authorities haven't trumpeted warnings about the problems with bleach may have more to do with politics than public health: The assumption that there is an easy method of bleach sterilization serves as a buffer against pressure to implement sorely needed needle exchange programs. There is impressive evidence that these programs, which allow IDUs to obtain new, sterile needles and syringes, are highly effective in reducing HIV transmission, while there is no evidence that they lead to any increase in drug use. Needle exchange programs could even serve as an outreach and contact point for reducing drug use if "anti drug" politicians allocated funds for treatment instead of incarceration. Despite the clear public health evidence, many politicians have opposed needle exchange programs out of fear of being labeled "soft on drugs." Meanwhile, the rate of HIV among IDUs in states where needle are proscribed is five times higher than in states where they are legal. Tens of thousands of IDUs their lovers, and their children have been condemned to die because health agencies won't advertise their mistakes and because politicians posture for political advantage by banning the use of federal AIDS funds for needle exchange programs. Shared needles is just one area of potential risk reduction. For overall prevention to work, the most effective and documented method of sharply reducing HIV transmission in peer education. Homeboys and home girls with appropriate training in HIV/AIDS information speak the same language, live in the same situations, and can work with the people in their communities in the consistent, caring way needed to change risky behaviors. Meanwhile, prisons provide fertile ground for peer education. They have some of the highest HIV rates in the US, and people who might have been constantly on the move in the street are now stationary and congregated. The vast majority of prisoners eventually return to their outside communities where they can spread either AIDS awareness or AIDS. But prison administrations have generally been hostile to peer led HIV/AIDS education; only a pitiful handful of such programs exist, and those are often hamstrung by bureaucratic restrictions. Allowing misinformation about cleaning needles to persist, blocking needle exchange programs, failing to treat STDs, and thwarting prison peer programs are major examples of the continuing official criminal negligence with regard to AIDS and in particular, how this plague has been allowed to explode in the ghettos and barrios.


FIGHT THE POWER
Waiting for the government to act is suicidal. The peer education model shows that when we take responsibility for ourselves, our families, and our communities, we can make a big difference. Through grassroots organizing communities can ally to demand social use of social resources instead of allowing tax dollars to go to massive military budgets and corporate welfare schemes. What we don't need are the fundamentally right wing conspiracy theories of Dr. Douglass and the like that lead us on a wild goose chase for the little men in white coats in a secret lab. The false information they purvey that HIV is spread by casual contact but not by sex and drugs generates cruelty toward people with AIDS and fosters support for a police state. In a bitter twist, these conspiracy theories divert people from identifying and fighting back against the real genocide. While US government plots such as the secret radiation and Tuskegee experiments do in fact exist the damage they've done is small compared to the high human costs of the everyday functioning of a two tiered public health system that is rooted in racism, sexism, and profiteering. Overall, the living conditions of people of color in the US are a concatenation of epidemics that cascade through the ghettos and barrios: AIDS-TB-STDs; unemployment, deteriorating schools, homelessness; drugs, internal violence, police brutality, wholesale incarcerations; violence against women, teen pregnancies, declining support structures for the raising of children; and environmental hazards. These mutually reinforcing crises flow from decisions made by government and business on social priorities and the allocation of economic resources. Government policies that have such a disparate impact on survival according to race can be defined as genocide under international law. Whatever term is used, the cruelty of tens of thousands of preventable deaths is unconscionable. This reality is the basis for the scream of a people that "mainstream" society seems unable or unwilling to hear. These conditions are the real genocide in progress that must be confronted.