Review of House of Numbers
Talha Burki
The Lancet Infectious Diseases, Volume 9, Issue 12, December 2009, Page 719 

Directed by Brent W Leung.
Knowledge Matters Productions, 2009. 89 min. 

Strange, perhaps, for The Lancet Infectious Diseases to review House of Numbers. It is a threadbare documentary that claims there is no connection between HIV and AIDS. It arrives at this conclusion through a toxic combination of misrepresentation and sophistry. At best, it is a misguided and misbegotten film; at worst, it is downright malevolent.

All of which makes a fine case for ignoring it. HIV/AIDS denialism is an ideology in disgrace; the ravings of what Stephen Lewis-former UN Special Envoy for AIDS in Africa-describes as a "lunatic fringe". To debate House of Numbers is to attend the film with an honesty and dignity that is entirely alien to its nature. Far better to leave it mouldering in the clutches of cranks and conspiracy theorists.

Only, denialism kills. A study published in the Journal of Acquired Immune Deficiency Syndromes found that South Africa's former reluctance to roll-out antiretroviral-drug programmes-a consequence of former President Thabo Mbeki falling under the sway of the denialist movement-cost more than 330 000 lives. Today, South African policy is very different; "the era of denialism in South Africa is completely over", stated Barbara Hogan upon her appointment as Health Minister after Mbeki's removal. But it is not inconceivable that the denialist movement might gain ground elsewhere, with similarly catastrophic results.

House of Numbers purports to be an investigative piece by Brent Leung, a filmmaker with "unanswered questions" about the AIDS pandemic. But the disreputable credo of denialism is easy to recognise. The belief system can be summarised as follows: AIDS is not caused by HIV. It is instead a disease related to poverty, malnutrition, and homosexual lifestyles. Antiretroviral drugs are poisonous-"AIDS by prescription" claims Peter Duesberg, spearhead of the denialist movement, and a prominent figure in this film-the pharmaceutical industry is in on the conspiracy, as are the major health organisations. "Could it be that the real epidemic is extreme poverty not HIV?", Leung disingenuously asks.

Leung's methodology is simply shabby. He cites falsehoods: HIV tests are fundamentally unreliable, and there is a schism within the scientific community over whether HIV causes AIDS. He cuts together interviews with AIDS experts so as to present insignificant disagreements as irreconcilable differences. 18 of film's interviewees have signed a statement asserting that "House of Numbers is an inaccurate portrayal of the truth about HIV and AIDS", adding "Mr Leung persuaded us to take part in it by acting deceitfully and unethically". The film fattens its fraudulent argument with genuine but irrelevant facts. It notes that unprotected sex between someone infected with HIV and someone who is not infected with HIV, does not necessarily lead to the uninfected party becoming infected. From which we are supposed to deduce that HIV does not exist, at least not in the form we have been led to believe. It is difficult to know how to respond to that, it is so simplistic. Presumably swine flu is a conspiracy too, since if it did exist everyone in the world would have it by now.

Even more ridiculous is the film's contention that there is no such thing as HIV because there is not a clear image of the virus. If you cannot see it, it does not exist. Which raises the question: does Leung believe in gravity?

House of Numbers is unpleasant and dishonourable. It seeks to dissuade individuals infected with HIV from crediting mainstream medical science. People like Christine Maggiore. Maggiore tested positive for HIV in 1992. She questioned the efficacy of the test, and refused to take anti-AIDS drugs, even when pregnant. She neither had her daughter Eliza Jane Scovill tested for HIV, nor had her prescribed antiretroviral drugs. After the girl died in 2005 at the age of 3 years, the Los Angeles County Coroner ruled that the cause of death was an AIDS-related illness. It did not shake Maggiore's beliefs. She appears several times in House of Numbers mouthing denialist mantras. But what we do not learn is that Maggiore died late in 2008 from pneumonia, her death certificate recorded two other AIDS-related infections.

Doubtless denialists have an explanation for this, just like they do for Eliza Jane's death, and for the millions of other fatalities that we attribute to AIDS-amyl nitrate (poppers) a drug popular in the homosexual community is one cause advanced by the film; poor sanitation is another. Readers of TLID will not be taken in, but others might be. After all, who would not want to believe their HIV diagnosis is a fraud? I am not clear what motivates the denialist movement, whether there is some kind of prejudice bubbling away or whether it is a straightforward delusion. But there are more than 330 000 reasons to keep an eye on them.