Heimlich courts

Famed scientist Henry Heimlich and doctors in several African countries believe a curable form of malaria, a mosquito-borne disease, may be able to help with the fight against AIDS.

Famed scientist Henry Heimlich and doctors in several African countries believe a curable form of malaria, a mosquito-borne disease, may be able to help with the fight against AIDS.Dr Henry Heimlich, inventor of the famous anti-choking manoeuvre, is working with doctors in several African countries to begin human tests of a controversial AIDS therapy in which patients are deliberately infected with malaria. The method has drawn the ire of the medical establishment, but the 83-year-old head of the Cincinnati-based Heimlich Institute believes that using a curable form of the mosquito-borne disease to induce high fevers can stimulate the immune system to fight off HIV. His research on the topic has lead to partnerships with African doctors who are launching trials of the technique. But not everyone in the health industry is as confident as Heimlich. Executive director of Treatment Action Group, an AIDS research advocacy organisation, Mark Harrington said: “This comes up periodically, but malaria has never worked for anything.””If Heimlich is really doing this, he should be put in jail,” he said.He and other AIDS experts question the ethics of subjecting already ill people to another deadly disease, possibly without the informed consent disclosures required in the United States. In 1993, the US Centres for Disease Control and Prevention issued a memorandum saying malarial therapy could not be justified because it might well do more harm than good. The technique was used between 1918 and 1975 to combat syphilis that had spread to the brain, but that disease is now stopped at a much earlier stage by antibiotics. Heimlich, citing 1990s studies showing improved survival for African children who were HIV positive and had malaria, said in an interview that inducing high malarial fevers stimulated the immune system, but he was not sure why. He argued that infecting someone with one disease to cure another was not that unusual. “Cowpox is used to prevent smallpox,” Heimlich said, referring to the smallpox vaccine. A Heimlich pilot study of the malarial therapy was carried out in China between 1993 and 1996 on eight HIV-positive patients, but they were followed for only two years. “After treatment, levels of…T-cells increased rapidly,” Heimlich said. HIV cripples the immune system by destroying those cells. Ethical debateCritics are quick to take issue with Heimlich. Mark Harrington, executive director of Treatment Action Group, said: “Malaria kills three million people every year and there seems to be evidence that malaria worsens HIV…these are huge, huge ethical issues.” But Heimlich says the trial must go ahead because the Chinese trial participants were not treated with anti-retroviral drugs and investigators did not have access to equipment for measuring the amount of HIV in blood.Some 10 years later, there is even more need for effective AIDS treatment alternatives, Heimlich said. “We need to treat the immune system. With anti-retrovirals we have reached the roof,” he said. These drugs interrupt the life cycle of HIV by blocking enzymes used by the virus to replicate after it enters healthy human immune cells. The drug cocktails can keep AIDS at bay for years, but the virus mutates and eventually evades treatment. A significant percentage of chronic HIV patients in developed countries have become resistant to existing medicines. Conference on AIDS treatmentIn October, Heimlich presented his research at the Pan Africa AIDS conference in Nashville, Tennessee. “Subsequently, we have had visits from doctors from four African countries and have been making arrangements with a fifth country,” he said. Heimlich said visiting doctors returned to their home countries with the intention of launching malaria/AIDS trials that would carefully monitor patients. “We should hear of some positive results within a year,” Heimlich said. Meanwhile the University of California at Los Angeles (UCLA) is investigating whether two of its medical researchers took part in the Chinese malarial therapy trial. The university said a medical review board is looking into whether Dr John Fahey and Dr Najib Aziz violated policies that regulate tests on humans. On February 16, the Cincinnati Enquirer published an article in which Heimlich described his work in China and said Fahey was involved. “He is a fine person who gave of himself and helped tremendously,” Heimlich said.”It is exceedingly reprehensible for him to be challenged in this way.”In a statement, UCLA said it had never approved any research pertaining to malarial therapy studies for HIV. Heimlich said his non-profit institute, at an annual budget of $US100,000 to $US150,000, would soldier on with the controversial AIDS research, but he hoped to uncover additional funding. “If all of your peers understand what you’ve done, you haven’t been creative,” he said.(Source: ABC, April 15, 2003)