domenica 6 gennaio 2013


January 2013

Vittorio Agnoletto is a physician, the co-founder of LILA (Lega Italiana per la Lotta contro l’AIDS) and its national chairman from 1992 to 2001, former European Parliament member, a Professor of Health and Human Rights at the University of Milan. Carlo Gnetti is a journalist. Last November, they published a book together – AIDS: lo scandalo del vaccino italiano – which tells the nearly fifteen-year history of the anti-Tat vaccine tested by Dr. Barbara Ensoli at the Istituto Superiore di Sanità (ISS), Rome.

In this book the authors gather the doubts, the criticisms, the precise and detailed objections and the countless unanswered questions that this story has roused since its inception. And they do so through the many articles published in the general press, the few scientific papers closely related to the trial published in specialized journals, the declarations, the missed declarations and the real reticence of some of the protagonists, building what magistrate and President of the Surveillance Court of Bologna Francesco Maisto called “a strongly marked circumstantial trail”. (For the definition given by judge Maisto, see the interview that Emiliano Silvestri made with Vittorio Agnoletto for Radio Radicale, min. 13:55).

The authors’ ultimate aim is to establish the truth of a story that dominated the Italian scientific and media scene in the last 15 years. The main theme of the book, indeed, is an urgent request for clarification; its hope is that those who know will speak, because if the doubts about the conduct of the trial were consistent and demonstrated real, then people involved in the clinical trials – in Italy and especially in South Africa – could be running serious risks.

The book is introduced by a foreword by Robert Gallo, co-discoverer of HIV along with Montagnier and Barré-Sinoussi. Here he summarizes the scientific concerns about a vaccine based on the Tat protein, which was discovered by his own working group. According to Professor Gallo, by the early 1990s and well before the start of the trials of Barbara Ensoli in 1998 it was already known that Tat could give at most a modest therapeutic contribution, but it alone certainly could never be the basis of a preventive vaccine. “An illogical idea for a preventive vaccine” – writes Gallo. Indeed, “after 15 years there are no confirmed results that support this approach, nor is it of use today as a therapeutic vaccine”.

And with combination antiretroviral therapy available since 1995, also the therapeutic contribution of Tat seems to Gallo now essentially useless.

The issues addressed by Agnoletto and Gnetti range from lack of transparency to ethical concerns, from the costs of the project to the extremely swollen times of all stages of the trial, to familism, to media overexposure: all those issues are intertwined. In summary:

·         The lack of transparency of the whole experimentation is highlighted especially in relation to changes of the protocol while the trials were in progress and without notification to the other researchers involved; to the partial publication of data and therefore their lack of validation, with the consequent passage from one phase of the experimentation to another without justifying and explaining the results of the previous phases; to the confusion between trials of a preventive vaccine, then a therapeutic one, then again a preventive one, but completely different from the previous, coming back from a phase II trial to a phase I new trial - with no one of the project Principal Investigators taking the burden of saying “it was a wrong path for these and these reasons, we changed our minds”.

·         The ethical concerns are about the way in which the monkeys were treated during the preclinical phase (which might have distorted the data from the animal model which provided the basis for moving to human trials), and about the fact that the volunteers enrolled in the trials in South Africa might not obtain the same protection enjoyed by the participants to the European trials, because the control mechanisms there, such as ethics committees, might not always provide the same guarantees we enjoy here.

·         The issue of the project’s funding is complicated, because it is interwoven with the political and not only scientific decision to allocate almost half of the total public funding for the fight against AIDS over the past decade to research widely criticized by leading scientists around the world and almost completely absent from the major international scientific conferences. Further perplexity arises from the fact that more than 20 million euros have been added by the Ministry of Foreign Affairs to the funds allocated by the Ministry of Health, which is the ministry that normally deals institutionally with this kind of research and finances it through a peer reviewed mechanism of evaluation and control, in which scientists not involved in the project judge the potential of the research program. The Ministry of Foreign Affairs has taken these 20 million euros away from the funds for international cooperation and allocated them to the construction of a laboratory in South Africa for on-site analysis of the results of the trial. But funds for cooperation are not allocated on the basis of a peer review mechanism. To this must be added the consideration that no pharmaceutical company seems interested in producing this vaccine.

·         The familism might seem like a minor problem, a “simple” scientific malpractice. But it is not, because having the brother of the leader of the research project as the director of the laboratory where data collected from the trial are analyzed poses a serious threat to the interpretation of these data. And this is just one of several cases in which controller and controlled are the same entity and a conflict of interest arises.

A few days before the book arrived in bookstores, Barbara Ensoli sent to a mailing list some Considerations useful to clarity, a summary of which was published in the 27 November issue of La Repubblica and which is, to date, the only (semi)official reaction by the Istituto Superiore di Sanità.
It is a sort of “memorandum” in which Ensoli repeats the official version of the history of the anti-Tat vaccine, that can be read in the dedicated website, but is careful not to respond to the criticisms moved in the book, rather accusing the authors of having falsified and distorted “everything”, adopting the “defamatory obstinacy” of Robert Gallo and Fernando Aiuti, whom Ensoli “knows very well, and she is aware of what they are able to do to gain visibility”.
Agnoletto and Gnetti are also accused of an “obvious” intent to defame “the vaccine, the Istituto Superiore di Sanità (‘ISS’) and its President, Prof. Garaci, but also public institutions: the Ministry of Health and the various ministries who have taken place over the years, the Ministry of Foreign Affairs, the Undersecretary Letta of Prime Minister Berlusconi, the National AIDS Commission, scientists and Italian public research and, ultimately, the Italian system as a whole, which is represented as unreliable” (p. 1).
According to Ensoli, the “book is so defamatory that is natural to ask for what purpose it was written, and if there are economic/political/international interests that could benefit from the mud the authors throw on the Italian system” (ibid.). This induces Barbara Ensoli to conclude her “Considerations” – which were supposed to be “useful to clarity”, but which do not clarify anything but a certain anxiety of their author – wondering who “really” is behind all of this: “Which lobbies are at work? Where do they want to get?” (p. 8). 

Where do they want to get, is a question I thought I could ask directly to Vittorio Agnoletto. But I didn’t ask which lobbies are behind him and if he is an AIDS denialist (according to Ensoli, the book “contains many denialist cues”): I would be ashamed to take seriously the rhetoric of the plots, of the lobbies and “cui prodest?”, as well as the generic and unsubstantiated accusations (which are all classic dialectic tricks of the denialist argumentation) that Dr. Ensoli adopted as a defense strategy.

The following is the result of our conversation.

• I would like some brief clarification on controversial points of the transition from preclinical phase in the testing of the anti-Tat vaccine to phase I and from phase I to II. Let’s start with the problems related to animal experiments.
Each trial, before arriving at clinical stages, passes from a preclinical phase on animals that, in this case, was carried out on monkeys. Among other things, it was an item on a television program that talked about the treatment of monkeys in October 2004 that was the first public and media opportunity to have a look at how this vaccine was progressing, and even then there were some controversies.
The things to say about the monkeys are quite simple. First, there are the testimonies of two people who worked on this project (immunologist Antonio Scardino and veterinarian Antonella Comini), who have been able to verify directly how the trial proceeded within the animal enclosure and have called into question the way in which the monkeys were treated, because the animals must be kept in good health and under certain conditions, so that their reaction to the experimentation could be free from any risk of misinterpretation due to the conditions of life and the state of monkeys’ organism.
The most problematic aspect is that none of the people we tried to contact was willing to talk about two protocols  – called Npt and Id – which used the Tat protein in various formulations. Of these protocols very little is known. It may be that we missed an article, but we did not find a publication that describes from A to Z the development of these protocols. But since they are presented as crucial to the transition to phase I, there is no certainty as to how they were performed. If we had been able to meet Dr. Ensoli, we would have asked her to reassure us on some information that we have no chance to verify: we want to be sure that the monkeys on which the vaccine was tested had the same response, namely that they were not infected, while all the monkeys that were not vaccinated became infected. Indeed, if it should turn out that some monkeys that should not become infected got infected, or vice versa, many question marks would weigh on these two protocols and this would call into question all the rest of the research on humans.
How is it that, at the mention of these protocols, we obtain total silence, everyone is afraid and no one answers? This is a very relevant question, because we have not found any publication describing the whole testing of these protocols. It therefore remains a mystery that could affect the transition to the clinic, especially since the first paper on monkeys in 1999 involved a very limited number of animals, so that other analyses were mandatory.
Another issue that has never been clarified regards the protocol of vaccine administration to the animals, which had been planned in certain doses and at certain times: some researchers reported that their impression was that the doses and the administrations to stimulate the immunization were modified according to the reactions of individual monkeys.
A research project cannot be performed that way. Two associations were denied access to the ISS documentation to make a comparison between the presented protocol and that actually realized.
If we add that some of the researchers – veterinarians and doctors – who have worked with monkeys left the ISS and went to work somewhere else, and if we add the scandal that followed the program Report on monkeys, then the question marks are really many.
Therefore, already with regard to the preclinical phase emerges a recurring question in this whole affaire: why none of the project leaders agreed to answer? If everything has been done properly, why not speak? Why not be proud of such an important research? 

• In this somewhat mysterious way, experimentation moved to a clinical phase I divided into two arms: a preventive vaccine and a therapeutic one. From then on, the preventive vaccine is lost in the mists.
The phase I studies, both of the preventive, both of the therapeutic vaccines, ended in 2005, and both the ISS and the Ministry in various public events claimed that everything went well and that it was necessary to raise funds to proceed to phase II.
There are some publications on phase I, but remains a mystery, after all the optimistic claims and a few data published in articles – that we report in the book – that nobody speaks anymore of the preventive vaccine, until in 2011 we find that a phase I of a completely different preventive vaccine starts.
The key point of confusion in public opinion is the fact that the ISS and the Ministry still say that phase I was successful and they moved on to phase II, but in their communication to media they do not specify that the vaccine in phase II is the therapeutic one (which is not a vaccine, but an immunotherapy). This is confusing to those who play a sensitive role in communication. To recall just a recent example, when our book was published, La Repubblica published a short interview with Dr. Ensoli. The headline of the interview says that they are already in phase II (Completata la fase II, funziona). Anyone who reads this, thinks that they are talking about the preventive vaccine. I consider unethical that the communication of an institution like the ISS is so ambiguous.
Phase I ends, the preventive vaccine in fact stops, and from the clinical point of view the question is this: if we were told that phase I went well, why didn’t they move to phase II and why did a new phase I start many years later with a different preventive vaccine?
From a clinical standpoint is relevant to know on what the expected results of phase I got stranded, because it allows us to understand also the limitations of the research.
This was the fundamental question we wanted to ask the project supervisors. Professor Adriano Lazzarin, responsible for the trial here in Milan, I wished to ask why a phase II for the preventive vaccine never started, and what are the results that have imposed a stop. It cannot be said that this has been due to lack of funds, because money to start a phase II of the therapeutic vaccine has been found.
There are also some clinical concerns about phase II of the therapeutic vaccine: Tat is always administered to patients on antiretroviral therapy and it is at best an adjuvant, a booster of the immune system, always in the hope that it lacks side effects and toxicities, as Professor Gallo is concerned about in the Preface to our book. Even assuming that all goes well, in no event will Tat replace antiretrovirals. 

• What does it mean that data (always partial, ad interim) of this trial have not been validated? Indeed, to publish in PLoS ONE, as Ensoli did, is not the same as publishing in Nature, Immunology or AIDS. It is true that PLoS ONE is peer reviewed (although submissions are not excluded on the basis of lack of perceived importance or adherence to a scientific field), but this journal publishes primary research and its purpose is to create an open access archive of news and open issues, available for scientific community feedbacks and discussions. It is a sort of a book of dreams and hopes of the medical research (PLoS ONE offers to its readers the opportunity to discuss papers online, but Ensoli’s 2010 article - Therapeutic immunization with HIV-1 Tat reduces immune activation and loss of regulatory T-cells and improves immune function in subjects on HAART  - received no comments). In order to be accepted by the scientific community, the studies must be validated through the publication on far different journals, with far different impact factors and greater specialization. And also the fact that there were no reactions from the scientific community, written replies or comments during international conferences, says – beyond the lack of interest that this research raises in the rest of the world – that data have not been validated, doesn’t it? I remember that Gallo in the foreword to the book says that there are no confirmed results that support this approach.
With regard to the modality of data communication, this story does not work from the start. We live in a media society and everything becomes entertainment, but in the world of medical science it is not so: there are practices established at an international level.
The announcement of this project comes in October 1998, and it’s hyped at a congress on AIDS and cancer in the presence of press and television. But nothing had been published yet in scientific journals.
The practice is that communication to public opinion takes place after the work has been completed, at least the step you are talking about, and the article has been sent to a scientific journal, which has approved and published, or is going to publish, it. Here, on the contrary, more than 8 months passed before the publication of data relating to very few monkeys (5 of 7 monkeys that, after being vaccinated and controlled 7 months later, would prove capable of blocking viral replication). In this way the public announcement takes on the appearance of a sensational ad and is, in fact, intended to try to build the image of the people involved, and of course to facilitate the fundraising, rather than being directed to strictly scientific aspects.

This procedure is also found in what you say about PLoS ONE, which is, in my opinion, an absolutely respectable journal for its function and for its social value, also because it is open access. But if you are doing research on a vaccine you must publish these data on specialized journals, with high impact factors.
Beyond the public announcement and publication of data, there is a third aspect in which the international scientific community verifies a trial: the large conferences, the moment of encounter and discussion with other scientists. Here, too, there is a minimal participation at international conferences.
All this involves two collateral aspects: first, there should be attention from the mass media before making high-sounding headlines on this kind of news, because the articles are written always by the same specialized journalists, who know that an announcement on major impact topics must be verified. Second, the authorities funding this project know that scientific projects must match certain criteria, for example the impact factor of the supporting publications. Here, however, even in the absence of these elements, they went on providing financing. 

Immunologist Professor Aiuti, one of the head physicians participating in the clinical phase I, addressed three methodological criticisms to the conduct of the trial: 1) he asked why the first phase of the trial was stopped prematurely, involving far fewer volunteers than was established by the protocol and then exposing the project to the risk that data collected are not verifiable; 2) he has objected that the remarks made by the inspectors of the Agenzia Italiana del Farmaco (AIFA) on “critical deviations” from the original protocol have not been taken into account; 3) he was critical that phase I data might be transmitted to the press before the researchers involved could see them, thereby exposing the project to the risk of the failure of the double-blind. In May 2007 Dr. Ensoli sued Professor Aiuti for libel and a few months ago she lost the case. Now, I would like to understand the significance of this lawsuit and the meaning of a judgment unfavorable to Ensoli: if the court ruled against her, this implies that the scientific criticisms of the trial by Aiuti do not constitute defamation. If it is true that the trial was conducted and communicated improperly, what could (or should) this lead to in practice?
The judgment does not enter into the merits of the criticisms, but simply states that those criticisms are part of a scientific debate and that they were not aimed at creating disrepute. 

But have these criticisms ever been answered?
In response to the heavy remarks by AIFA, Dr. Ensoli sent to AIFA itself a document, which we could not have access to, but which is among the papers of the legal action, not known to Aiuti when he moved his criticisms. AIFA has accepted some of Ensoli’s replies, while on others it said it is still awaiting a clarification.
What is certain is that it is very odd that in the face of a document such as that of AIFA which makes very serious objections to the conduct of the trial the ISS and the Ministry – the sponsors – not only have not demanded public explanations from the director of the project, but the ISS even joined Ensoli in the suit against Aiuti.
So the criticisms of Aiuti are still waiting for a reply. You said that the number of the volunteers in the trial has been reduced compared to that under the protocol. But Aiuti adds that this decision has not even been discussed with those in charge of the trial. Who decided this variation in the protocol?
I wrote it in the book, but it is worth underlining here: I had heavy clashes with Professor Aiuti. In the ‘90s we also had a court case, and our political and cultural approaches are very different. If, starting from such different cultural standpoints, we get to ask the same questions, this strengthens our criticism. 

• It is unusual to sue someone because he makes a scientific criticism of you, isn’t it?
It hardly ever happens in science. But to frighten people with the threat of a civil action or with a lawsuit may be an intimidating method, that is generally used to silence people.
I wrote it in the book: I was given documents from a colleague who communicated to others involved in the research the concerns of Professor Aiuti and immediately received a letter from lawyers, threatening a defamation case. She sent me that letter, but asked not to be named. 

• Dr. Glenda Gray too, who heads a unit at Chris Hani Baragwuanath Hospital in Soweto, spoke of this to journalist Jon Cohen (see "Feud Over AIDS Vaccine Trials Leads Prominent Italian Researchers to Court”, Science, August 10, 2007). So these methods of intimidation have not been used only against Professor Aiuti.
I think the easiest thing would have been that Ensoli had organized a press conference or written an article saying “I was presented those criticisms … I say on the subject …”.
In the book we tell the story that arose around the July 1, 2005 Gala, where it was announced the success of phase I. Aiuti rose up saying that the trial was double-blind, not even those in charge of the trial knew the data, and it was unacceptable to communicate data to the public even before they were known to researchers involved in the project. A press release from the ISS specified that there had been a misunderstanding and data would be presented to the public at a later event. But we were able to demonstrate that a newscast on November 7, 2004 – seven months earlier, then – had already announced that the vaccine was safe as it had no side effects and that this result was the outcome of phase I. Who passed this information? Or if it was an invention of the reporter then the ISS had the duty to retract it because it is a public institution and the announcement given had an impact on public and social behavior. Or this information was passed to the journalist. But in that case the problem is serious and the project director should have been the first to rise up. The impression is therefore that the media management prevailed over everything else.
Since we published the book, many people ask me the reason for this ugly story. My impression is that three different things mixed together: the desire of a group of researchers to emerge at any cost not only on the scientific scene, but also on the public stage; the need of Italian governments to claim a leading role of Italy in scientific research, as an instrument of affirmation of the “grandeur” of Italy, in crisis in other areas – hence the choice of a topic that had the biggest media impact; a political proximity of some researchers to decision-making roles that matter.
My guess is that these mechanisms, once started, became unstoppable. 

• We have seen that the transition from the animal model to the first phase on humans is at the least questionable and that the progression from phase I to II also does not seem to have been justified on the basis of validated data. What, then, are the risks that could affect volunteers enrolled in the trials, both in Italy and in South Africa? From what you have said, this is precisely the reason for the urgency in publishing your book.
We have no documentation stating that this experimentation in itself may be harmful to humans. The point is that if people involved in the trials are told that the putative vaccine has undergone a series of phases, it is obvious that somehow it is taken for granted the hypothetical, possible safety of this product. On the other end, testing of a vaccine is verified because you see that, in real life, the vaccinated do not become infected when they come into contact with the pathogen. That is why phase III must enroll several thousands of people and must be performed in countries with a high prevalence of HIV.
But if this hypothetical protective efficacy was not actually proved and if you were to question some of the previous phases, then you would face here potential risk behaviors of those vaccinated, which would not protect themselves because they are convinced of being immunized. When this preventive vaccine starts again from phase I, starts again with a different design and, what is more, it is started also in South Africa, where the health care system works differently than in  Europe, we have this concern for volunteers.
On the other hand, the agreement with South Africa would provide also an assignment of over 20 million euros for the construction of laboratories. Then, of course, South Africa is interested in having this research, because it receives such funding. So our fears that health surveillance needed in this type of trials is not guaranteed increase even more.
We are worried about the level of “safety” that is or is not guaranteed. If you do not shed light on the early stages of the trial, this question mark continues to weigh on. Hence the need for the book to be published in haste, before the trial steps to the next stages and before they are possibly wasted other public funds to finance a project that you must be sure that is going in the right direction.
Finally, there remain questions about the possible toxicity of Tat used in a therapeutic vaccine for HIV positive people, because Gallo, who has worked a lot on this protein, does not exclude that there might be toxicity.

• What is involved in the diversion of the few available public funds from other research that, perhaps, if properly supported, would have been more productive?
Italy has cut funds for research. For three years it hasn’t paid the money pledged to the Global Fund to fight AIDS, tuberculosis and malaria. There is no serious investment in prevention. We have 160 – 180.000 people living with HIV who are living longer fortunately, but this also increases the risks of transmission.
What results could be achieved by funding other research, I do not know. But, potentially, we could have lost a lot. It can be argued that the huge funding for this vaccine has diverted funds from other projects, thus indirectly bringing damage to Italian research. 

• So we can assume that the funding for this vaccine, presented as a source of pride, has actually impaired Italian research and community.
Yes, and I also speculate that the issue of funds may have something to do with the unwillingness of the vast majority of researchers to talk about this project because obviously those involved do not want to talk - but also those who are not involved fear cuts to the little funding they do receive. 

• I would like to explore the question of the effects, both on general population and on people with HIV, of the communication strategy adopted by ISS in speaking about the vaccine to the media. In particular, I would like to understand the effects that the mistrust generated by unfulfilled promises may have on the emotional balance of people living with a serious chronic illness and on their adherence to treatment. And I would also like to know if a generalized distrust towards research, formed as a result of the succession of deceptive news, might affect the willingness of people to volunteer in clinical trials.
This communication strategy can have the effect of making general population believe that the vaccine is already here, and then of lowering the guard on prevention. See the recent survey by Anlaids  of Roman students, in which we discover that more than 20% of respondents believe that the vaccine exists and is available.
The big scandal in ISS communication is also related to the preventive vaccine. You may ask why HIV positive people should care for a preventive vaccine; but this is actually a very relevant question, because if  there were a preventive vaccine the social stigmatization and every form of discrimination against people with HIV would collapse. This would completely change the daily lives of HIV positive people, because they no longer would be perceived, and perceive themselves, as a threat to others.
The second point is what you say: on a psychological level, expecially now that drugs which greatly extend lifespan are available, it is vital to think that the extended time of your life will be used to make new discoveries, which in turn will further lengthen your time, improving also the quality of your life. Confidence in research and in those who conduct it is essential, and there is no other disease like HIV/AIDS, where HIV positive people are self-organized and sometimes even become “scientific community” in the exchange of information about research. Often this isn’t just a unidirectional relationship, but a mutual exchange with the scientific community. The discovery that such an important research is conducted in such a controversial way may certainly have an emotional impact on people living with HIV, and this also leads to a drop of hope and, of course, to an unwillingness to volunteer in clinical trials.
There are also many studies that show how a situation of prolonged depression impacts on the immune system, either directly, from the organic point of view, or indirectly, due to a worse adherence to antiretroviral therapy.
So those who make public announcements that are regularly proved wrong by facts bear a huge responsibility. 

• Do you have any comments about the “Considerations” sent by Dr. Ensoli to HIV positive people, activists and associations? Don’t you think it’s paradoxical being accused of having written a book that “contains many denialist cues”, and this right by someone who makes a wide use of the rhetoric of conspiracies and occult lobbies, who addresses to you generic and unsubstantiated accusations, who avoids responding to your criticisms preferring to shift the discussion towards the “chief systems” (the “sistema Italia”, even!), posing as a victim of an international plot and even backbiting, someone who, in the past, preferred to sue rather than responding to scientific allegations – all, these, typical denialist rhetorical strategies?
From this document it is clear that she has no remarks to disprove what we have written. What struck me most is that there is not one refutation. There is a personal controversy with Gallo and Aiuti, and it’s very serious that she accuses us of being AIDS denialists, very serious. Clearly, that accusation was made to disqualify our work and, since she says that the book is libelous, what is defamatory for me is the accusation of denialism.

This just shows that Dr. Ensoli had nothing to cling to. There is no reply on the topics we talked about today – those more strictly scientific, which are the most important – but there is not even a reply on issues like the conflicts of interest, the familism, the role of her brother …
To me it seemed, for those who read the book, a serious own goal. 

• The aim of the book, repeatedly stated, is a call for clarity. From who?
For example, I expected, and I still expect, to hear a word from Professor Stefano Vella, who was the president of the International AIDS Society, who was the one who brought to South Africa the World Conference on AIDS, and therefore has a not just Italian perspective. He has all the means to know how a scientific research must be performed and what is the international framework of the research. Moreover, he is totally within the ISS, but not involved in the anti-Tat vaccine trials, so he has all the elements to evaluate this project. 

From the feedback received so far, do you think that something is happening? For example, could the interview with Radio Radicale lead to an involvement of the Radical Party and eventually to a new parliamentary question after the elections?
I am optimistic on three issues: I think some member of the next Parliament will be willing to resubmit an interpellation. Some colleagues contacted me and it seems they are discussing with their own conscience on how to intervene and provide additional information. Finally, I hope that a magistrate will take the lead on the matter. I am aware that it is not easy for a judge to address the scientific aspects; it is certainly easier to deal with this matter starting from the financial aspects and then, from there, address the experimentation. But if a judge opened an investigation, this would facilitate a political intervention in the Parliament and it would also give an incentive to those colleagues who know how things turned out to resolve their crisis of conscience and decide to speak.

venerdì 27 luglio 2012

The investigation of the University of Florence on Marco Ruggiero concludes: not sacked but ...

The investigation of the "Special Commission" on Marco Ruggiero's teaching concludes with a debacle for the professor of Molecular Biology. Ruggiero was not sacked or otherwise sanctioned by a strictly disciplinary point of view for his denialist positions on HIV/AIDS, but

·        the programs of his courses and the graduation thesis of his students will be placed under strict control in order to conform them with the issues and the responsibilities for the degree course;

·        he had to express the intention to revise his program of teaching;

·        he has been admonished not to publish incorrect online news involving the university and damaging its image, as he has done in the past;

·        his name has been referred to the Federazione Nazionale Ordini Medici Chirurghi e Odontoiatri for his alleged “clinical trials” with the GcMAF protein.

“Ordine dei medici” is the Italian denomination for the group of regulatory authorities of the medical profession (licensing and registration of physicians; hearing of complaints about professional conduct).

Similarly to what happens in most Western countries, in Italy administration of treatment for therapeutic purposes is subjected to an authorization system: in the case of clinical trials, to the approval by the ethics commitees of hospitals; in the case of treatments outside of clinical trials, to the fact that these treatments are approved for human use by the Ministry of Health.

Conducting studies or using unauthorized products outside of a research protocol that can guarantee enrolled people's safety, is also a violation of professional ethics (Italian Code of Medical Ethics, see artt. 13, 15, 49).

It's then appropriate that the “GcMAF clinical trials issue” is referred to medical authorities for investigation rather than academic administrators, because it is not strictly “academic” and directly linked to the teaching of Ruggiero, but rather to his “scientific” activity.
The fact that the referral comes from a commission that includes the Vice-Chancellor for Research (Professor Elisabetta Cerbai) of Ruggiero’s own university means that such medical authorities will have to take it very seriously. 

The commission verdict and Professor Tesi’s decisions are setting a very important precedent in the Italian academic world since, henceforth, it will be difficult for the Italian denialist academics to hide behind the sacred cow of academic freedom and to abuse of their position of power over the students they are supposed to educate.

Follows the press release from the University of Florence:

Florence, July 25, 2012

/ Press release /

* University, Ruggiero case *

*The investigation of the University on the professor’s teaching concludes *

The investigation has concluded with regard to Marco Ruggiero, professor of Molecular Biology, Faculty of Mathematical, Physical and Natural Sciences at the University of Florence, who in recent months provided explanations of some aspects of his teaching in the undergraduate degree in Biological Sciences, as a result of special interviews and observations conducted by a commission appointed to evaluate elements of these aspects.

At the end of this procedure, no elements of responsibility emerged which require the issuance of disciplinary sanctions. However, the rector of the University of Florence, Alberto Tesi, in charge of the proceedings, has written a letter to the teacher, making some clarifications on the issues in dispute. In particular, recalling the differences detected between the lessons of Ruggiero and the program of courses of study of the Bachelor of Science in Biological Sciences, the rector, while respecting freedom of research and teaching, has reaffirmed the need for the professor to arrange his university teaching program with the director of the degree course, especially when considering direct lessons for students of biology on clinical aspects. The rector also took note of the professor’s intention to revise his program of teaching.

Similarly, Professor Tesi has asked that the arguments of the degree theses assigned by Ruggiero related to aspects of clinical interest are subjected to more stringent verification procedures to ensure their compatibility with the particular basic themes of the Bachelor in Biological Sciences course. Furthermore, the professor was also admonished for publishing or causing to be published incorrect online news implicating the University and adversely affecting its image, as was done in the past.

Regarding the allegations that the teacher conducted experiments on GcMAF through clinical administration of the protein, the rector considered it appropriate to bring this to the attention of the Medical Board as possibly more relevant to the functions of that body.

Firenze, 25 luglio 2012

/Comunicato stampa/

*Università, caso Ruggiero*

*Conclusa l’indagine dell’Ateneo sull’attività didattica del docente*

Conclusa l’istruttoria nei confronti di Marco Ruggiero, ordinario di Biologia molecolare presso la facoltà di Scienze matematiche, fisiche e naturali dell’Università di Firenze, chiamato a fornire nei mesi scorsi spiegazioni su alcuni aspetti della sua attività didattica all’interno del corso di laurea in Scienze biologiche, a seguito di apposite audizioni e delle osservazioni svolte da una commissione incaricata di acquisire elementi di valutazione.

Alla fine del procedimento non sono emersi elementi di responsabilità tali da richiedere l’emanazione di sanzioni disciplinari. Il rettore dell’Ateneo fiorentino Alberto Tesi, titolare del procedimento stesso, ha però scritto una lettera al docente, formulando alcune precisazioni sui temi oggetto di contestazione. In particolare, ricordando le difformità rilevate tra le lezioni di Ruggiero e il programma dei corsi di studio del Corso di laurea in Scienze Biologiche, il rettore, pur nel rispetto della libertà di ricerca e di insegnamento, ha riaffermato la necessità per il docente di concordare i programmi di insegnamento con il responsabile del Corso di laurea, soprattutto qualora si intenda indirizzare le lezioni destinate agli studenti di biologia su aspetti clinici. Il rettore ha anche preso atto dell’intenzione del docente di rivedere il proprio programma di insegnamento.

Analogamente il rettore Tesi ha chiesto che gli argomenti delle tesi di laurea assegnati da Ruggiero – inerenti aspetti di interesse clinico – siano sottoposti a modalità di verifica più stringenti per garantire la loro compatibilità con le tematiche specifiche del Corso di laurea in Scienze biologiche. Il docente è stato, inoltre, ammonito dal pubblicare o far pubblicare online notizie inesatte che coinvolgano l’Ateneo e ne ledano l’immagine, come già avvenuto in passato.

Circa la presunta effettuazione da parte del docente di sperimentazioni cliniche attraverso  somministrazione della proteina GcMAF, il rettore ha ritenuto opportuno segnalare la vicenda all’Ordine dei Medici per quanto possa sembrare rilevante riguardo alle funzioni di tale organismo.

martedì 10 aprile 2012

The Weak Link Between GcMAF and HIV infection. A Broken Arrow in the AIDS Denialists’ Quiver.

Guido Poli, director of the AIDS Immunopathogenesis Unit at the San Raffaele Hospital and Professor of Pathology, School of Medicine, of the Vita-Salute San Raffaele University in Milano, wrote a paper for SIMIT (Società Italiana di Malattie Infettive eTropicali) on GcMAF, HIV infection and Professor Ruggiero’s team research.

The paper is accessible only to the physicians members of SIMIT, but Professor Poli gave us the authorization to spread it even to non-infectious diseases experts.

The Weak Link Between GcMAF and HIV infection. A Broken Arrow in the AIDS Denialists’ Quiver.

Guido Poli

AIDS Immunopathogenesis Unit, Division of Immunology, Transplantation and Infectious Diseases, San Raffaele Scientific Institute, Milano, Italy

At the recent ICAR meeting held in Florence, March 2011, a poster presented by Gabriele Morucci and Tiziana Punzi of the University of Florence, Italy, discussing “Effect of Cadmium and Gc-Macrophage Activating Factor (Gc-MAF) on Intracellular HIV Targets in Normal and Transformed Human Breast Cells” has raised the voice and enthusiasm of so-called AIDS denialists, i.e. individuals not acknowledging the etiology of AIDS in the infection by the human immunodeficiency virus (HIV) 1. Not as much for the scientific content of their poster, as later discussed,but for incorporating in their conclusions the sentence: “Our data….provide experimental evidence for the words “Our immune system will get rid of the virus within a few weeks, if you have a good immune system”, thus reversing the longassumed cause-effect relationship between HIV and AIDS.” The poster is now displayed in the web site of the Gc-MAF producing company in support of their market to use this molecule to cure “cancer, AIDS and immune diseases”. Here we will revise what is known on Gc-MAF effects on HIV infection in vitro and in vivo.

The first consideration is that in the era of recombinant technology that has allowed the sequencing of the human genome it is unusual that a “relevant” biological activity described in 1987 (by the same group now claiming its efficacy against HIV infection 2) has not lead to identification of a specific gene and related protein. The term “MAF” was commonly used in the ‘70s and it has been essentially abandoned in the field after the demonstration of its identity with interferon-γ (IFN-γ), indeed a main “macrophage activating factor” 3. A paper identifying a MAF distinct from IFN- γ was published in 1988 4, but did not have follow-up. Of course, IFN-γ is not the only “macrophage activating factor” since this function can be exerted by several cytokines, chemokines and factors of non-proteic nature such as prostaglandins and leukotriens.

Second, the “key reference” paper cited by the authors in their poster was published in 2009 5. Almost all references related to GcMAF cited in the paper are self-referred (i.e. they refer to publications by the same group of investigators), a very suspicious indicator of the relevance of the “discoveries” described in the papers. A more technical analysis of their published data reveal the adoption of questionable methodologies to approach a monumental issue such as “viral eradication”, including the use of a cell line-based culture method to determine “the viral load in patient plasma” rather then sensitive PCR-based methods (or equivalents); also when RT-PCR was adopted its cut-off was 400 copies/ml, a standard clearly obsolete in comparison to the common standard of 50 copies or less in use by several years. The implication that “administration of GcMAF normalized the levels of Nagalase activity (an enzyme that, according to the authors, deglycosylate the MAF precursor leading to inactivation of MAF and it is upregulated by HIV infection and “it is an intrinsic component of the envelope protein gp120”) to those of healthy controls, indicating eradication of HIV-infection” is so evidently unproven that the reviewers and the Editor of the Journal of Medical Virology (IF: 2,47) should have required its elimination for the broad implication that such a sentence could have implied. Indeed, the same sentence has been indeed incorporated in the Introduction of the poster by Morucci and Punzi: “Thus, it was demonstrated that GcMAF eradicates HIV infection in asymptomatic HIV-infected patients 5, and here we report for the first time its effects in full-blown AIDS patients (BOX 1).”

This poster Box 1 summarizes the features of two AIDS patients that have spontaneously decided to assume GcMAF. Case report 1 describes the case of a patient resistant to “conventional ARV” (not specified) who experienced a gain in CD4+ cell counts (from 40 to 298 cells/ml – likely meaning “μl”…) and reduction of viremia from 160,000 to 2,343 copies/ml after 10 weeks of suspension of the conventional ARV therapy and assumption of GcMAF by intramuscular injection with improvement of general conditions including peripheral neuropathic pain and limb stiffness. The second case report describes the events occurring in another AIDS patient who, after the third injection of GcMAF after HAART suspension experienced significant systemic inflammatory symptoms following GcMAF injection (flushes, diffused muscle pain, high fever, headache, etc.) relieved by assumption of an antiinflammatory agent. The only additional information provided is that “ever since the patient reports constant improving of her general conditions.” for which the authors astonishingly conclude that “These side effects, although unwelcomed, appear to demonstrate that GcMAF actually induces immune system reconstitution.” Clearly, these two cases do not allow any inference on the efficacy of GcMAF on HIV replication in vivo, since the amelioration of general conditions, the improvement of CD4+ cell counts and reduction (in any case, not eradication!) of viremia in a multidrug experienced patients, although of interest, could be the result of multiple variables not reported in the summary. The second case description strikes for lack of clinical data (viremia? CD4 cell counts?) and raises the concern that GcMAF could induce systemic inflammatory reactions and not “immune reconstitution effects” as incomprehensibly interpreted by the authors. The remainder of the poster describes activating/differentiating effects on a breast cancer cell line (MCF-7) and on a mononuclear phagocyte cell line (MonoMac 6) in response to GcMAF, results that are clearly not related to HIV infection and to the final claim of the authors.

In conclusion, the anecdotal use of GcMAF in HIV infected individuals does not gain any scientific support by the present poster and should not be encouraged by the medical community. On the contrary, the information, based on the present report, that GcMAF may induce a systemic inflammatory syndrome should be communicated to the medical community to further discourage its “experimental” use in HIV infected individuals. 

This conclusion is in line with the comment of the journal Medical Hypothesis that decided to withdraw a paper by the team to which the authors of this poster belong: “This Article-in-Press has been permanently withdrawn. The editorial policy of Medical Hypotheses makes it clear that the journal considers "radical, speculative, and non-mainstream scientific ideas", and articles will only be acceptable if they are "coherent and clearly expressed." However, we received serious expressions of concern about the quality of this article. Given these important signals of concern, we commissioned an external expert panel to investigate the circumstances in which this article came to be published online. The panel recommended that the article should be externally peer-reviewed. Following a peer-review process managed by The Lancet editorial team, all five external reviewers recommended rejection, as a result of which the expert panel recommended permanent withdrawal. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at 1


1. Ruggiero M, Galletti MP, Pacini S, Punzi T, Morucci G, Gulisano M. WITHDRAWN: Aids denialism at the ministry of health. Med Hypotheses. 2009.
2. Yamamoto N, Ngwenya BZ. Activation of mouse peritoneal macrophages by lysophospholipids and ether derivatives of neutral lipids and phospholipids. Cancer Res. 1987;47:2008-2013.
3. Billiau A, Matthys P. Interferon-gamma: a historical perspective. Cytokine Growth Factor Rev. 2009;20:97-113.
4. Jones MP, Gunapala DE, Matutes E, Catovsky D, Coates AR. A novel human macrophage-activating factor: distinction from interferon-gamma (IFN-gamma) and granulocyte-macrophage colony-stimulating factor (GMCSF). Cell Immunol. 1988;113:361-375.
5. Yamamoto N, Ushijima N, Koga Y. Immunotherapy of HIV-infected patients with Gc protein-derived macrophage activating factor (GcMAF). J Med Virol. 2009;81:16-26.

sabato 18 febbraio 2012

La lettera di Snout al Rettore dell'Università di Firenze (febbraio 2011)

Come ben sa chi ha seguito gli ultimi sviluppi della vicenda Ruggiero (I "dissidenti" e l'AIDS: ovvero la triste realtà dei fatti!Contro GcMAF e Ruggiero, parla la medicina ufficialeI malati di HIV e lo yoghurt del professor Marco Ruggiero), esiste un blog, che analizza con grande attenzione molte delle malefatte dei negazionisti.
Il blogger che lo gestisce - Snout - giusto un anno fa, ha mandato al Rettore dell’Università di Firenze una lettera su Ruggiero e sul modo in cui costui cura le tesi di laurea e di dottorato dei suoi studenti.
Questa lettera è così bella e piena di intelligenza, che è utile tradurla e postarla anche in italiano, non solo per il suo stile – che è letterariamente colto e ironico; non solo, inoltre, perché ci spiega benissimo chi è Marco Ruggiero e che cosa faceva, prima ancora di organizzare i suoi "Magic Yoghurt Dinner" con malati di HIV; ma anche perché purtroppo in Italia non ha avuto la diffusione che merita ed è giunta l'ora di fare ammenda, dedicandole un post tutto suo, nello stesso periodo in cui raccontiamo gli sviluppi della medesima, avvilente storia, di un Rattenfänger von Hameln che specula sulle paure di persone malate, nell'indifferenza (se non complice acquiescenza) dell'Istituzione che squalifica e disonora in giro per il mondo.
C'è poi da aggiungere che questa bella lettera ci dice qualcosa di molto utile e interessante anche sul Magnifico Rettore dell'Università di Firenze.

Venerdì, 11 febbraio 2011

LETTERA APERTA AL PROFESSOR ALBERTO TESI, Rettore dell’Università di Firenze, Italia

Prof. Alberto Tesi
Magnifico Rettore
Università degli Studi di Firenze
Piazza San Marco, 4
50121 – FIRENZE

Egregio Professor Tesi,
Le scrivo per esprimere la mia più profonda ammirazione per la coraggiosa posizione presa dalla sua Università nella difesa delle imprese accademiche e del livello di insegnamento dei vostri Molto Competenti, nonché Illustri Scienziati e Ricercatori, Professor Marco Ruggiero e Professoressa Stefania Pacini, di cui ha raccontato di recente la giornalista medico-scientifica-umanistica, vincitrice di molti premi in America, Celia Farber.

Mi è particolarmente gradito notare che, grazie ai loro sforzi e agli sforzi dei loro amici della comunità internazionale dei negazionisti dell’AIDS, la tradizionale e culturalmente sempre viva Arte del Plagio viene promossa e sostenuta con tanta energia e si direbbe insegnata attivamente presso la vostra Università, apparentemente anche – stando all’articolo della Signora Farber – con il suo personale, aperto sostegno.
Per troppo tempo la nobile disciplina di copiare-e-incollare il lavoro altrui e spacciarlo per proprio è stata disincentivata, malvista ed invero crudelmente perseguitata entro i cosiddetti circoli accademici. E mentre Internet, all’inizio, si è rivelata un vantaggio per i praticanti mondiali del Plagio, con il recente sviluppo di un software anti-plagio, è sorto il problema che possa presto diventare un’Arte morente nelle scuole, nei licei e nelle università, dove un tempo fioriva.
È dunque un piacere leggere in Internet la tesi di laurea pubblicata sulla teoria negazionista dell’AIDS da parte di due vostri studenti – i cui relatori sono stati i Molto Competenti, nonché Illustri Scienziati e Ricercatori, Professor Ruggiero e Professoressa Pacini, insieme al Professor Vincenzo Crupi, della Facoltà di Medicina e Chirurgia, e al Dottor Henry H. Bauer, professore emerito presso il Virginia Polytechnic Institute and State University, USA.

Queste opere scientifiche sono state rese disponibili e sono state ampiamente promosse per molti mesi in Rete, quali risplendenti esempi dell’ottimo lavoro fatto dagli studenti presso la vostra Università, anche nel sito personale del Professor Ruggiero e nei siti dei suoi numerosi amici della comunità negazionista.
Veda per esempio le note fatte il 13 luglio 2010 e il 21 ottobre 2010 nel sito del Molto Competente, nonché Illustre Scienziato e Ricercatore David Crowe, Presidente del think-tank scientifico internazionale Rethinking AIDS (nel cui Comitato scientifico il Professor Ruggiero ha recentemente ricevuto l’onore di essere ammesso).

“13 luglio –Nuove intuizioni sul ruolo dell’HIV nell’eziologia e nella patogenesi dell’AIDS
Università di Firenze: [Presentato il 14 luglio 2010, presso l’Università di Firenze, per la discussione di una tesi di laurea] “Nella prima parte di questa tesi, analizzo le ipotesi correnti sull’eziologia e la patogenesi dell’AIDS, utilizzando l’approccio analitico decostruzionista di Jacques Derrida; cioè ho attuato delle letture attente, sensibili, eppure “trasformative” dei testi scientifici sull’HIV e l’AIDS, al fine di determinare quali aspetti di questi testi si trovino in contrasto con la loro apparente sistematicità (unità strutturale) o con il senso inteso (genesi autoriale) … etc.”

 “21/10/2010 –I retrovirus endogeni quali fattori confondenti nella patogenesi dell’AIDS
“È stata discussa con alta votazione il 20 ottobre 2010 presso l’Università di Firenze una nuova tesi di laurea, che studia la questione dei retrovirus endogeni umani in segni e sintomi generalmente interpretati come provenienti da un virus esogeno – l’HIV”.
… o dal sito del Ricercatore, Studioso di Umanità e Farmacologo Autodidatta Clark Baker:

… oppure dal sito web, molto letto e influente, dell’eminente accademico americano, Professor Henry Bauer, un Molto Competente, nonché Illustre Scienziato e Ricercatore, così brillante che non ha certo bisogno di alcuna presentazione:

Postato da Henry Bauer il 21/10/2010
“Che l’HIV non causi l’AIDS viene dimostrato ancora una volta, ora in una tesi di dottorato, ‘Endogenous retroviruses as confounding factors in the pathogenesis of AIDS’, i cui relatori sono la Dr. Stefania Pacini e il Dr. Marco Ruggiero. Il lavoro è appena stato discusso (ricevendo il massimo dei voti) presso l’Università di Firenze. È in inglese ed è stato reso disponibile al pubblico. La discussione è stata in italiano.

La revisione della letteratura esistente ricorda l’opinione di vecchia data di Montagnier, secondo cui il sistema immunitario contrasta l’HIV; un lavoro non pubblicato della Dr. Christl Meyer, che ipotizza che l’HIV sia un costrutto genetico del nostro sistema immunitario (MHC/HLA), che si è adattato in senso evolutivo ed è in parte una variabile attiva, in parte ereditabile; la discussione di De Harven sui retrovirus endogeni umani quali fattori confondenti nella patogenesi dell’AIDS; e la DIMOSTRAZIONE DI YAMAMOTO CHE LA STIMOLAZIONE DEL SISTEMA IMMMUNITARIO PUÒ ERADICARE L’HIV…”

È particolarmente confortante notare che non c’è alcuna incertezza nel plagiare da parte di questi lavori di studenti dissidenti. Ogni testo consiste quasi interamente di passaggi copiati dalla Rete – per lo più da vari siti negazionisti, da articoli “scientifici” e di altro genere, da diapositive di lezioni scaricabili dal Web e perfino da wikipedia.
Qui trova la prima ventina di pagine della prima tesi, con il materiale copia-incollato sottolineato con colori diversi, a seconda della fonte originale: blu per wikipedia, rosso per Ruggiero, marrone per Crupi, verde per Bauer, viola per Duesberg, e così via:

E qui trova le prime pagine della seconda tesi, analogamente sottolineate. Noti che l’amplissima sezione rossa, che il Molto Competente, nonché Illustre Scienziato e Ricercatore professor Bauer ha descritto in termini entusiastici come “revisione della letteratura esistente” è copiata alla lettera (e senza che vi si interpoli alcun commento da parte della studentessa) da un articolo del Dr. Etienne De Harven, di recente pubblicato su un periodico scientifico americano di primo piano e molto rispettato: il Journal of American Physicians and Surgeons:

Come può vedere, entrambe le tesi di laurea sono quasi del tutto incontaminate da un qualsivoglia lavoro originale degli studenti e costituiscono due dei più raffinati e puri esempi dell’Arte del Plagio, quale viene insegnata nella sua Università. Bravo! L’Università dovrebbe essere orgogliosa di aver gratificato questi lavori negazionisti con i più alti onori, e di vederli distribuiti in modo tanto ampio in giro per il mondo in nome dell’Università stessa, quali esempi della qualità dell’insegnamento che ci si può attendere di trovare come standard dell’Università degli Studi di Firenze – grazie agli instancabili sforzi del Professor Ruggiero, del Professor Bauer, del Signor Crowe e dei loro amici.
È una gioia insperata notare degli sforzi indefessi quali quelli dimostrati da questi raffinati ed esemplari mentori e insegnanti di studenti non ancora laureati.
In genere, quando un accademico si trova a confrontarsi con l’evidenza del plagio nello scritto di uno studente, che fino a quel momento egli ha lodato e raccomandato, capisco che sia consuetudine negare con qualche imbarazzo di sapere qualcosa delle pubblicazioni originali da cui è stato tratto quanto è stato copiato. Il Professor Ruggiero, il Dottor Crupi e il Professor Bauer hanno evitato tale pusillanimità in modo che non può dare origine ad equivoci e si sono eretti giustamente orgogliosi delle competenze dei loro protégés nel Ctrl+C e Ctrl+V; anzi, hanno attivamente diffuso nel Web i frutti del loro lavoro.
In effetti, non hanno altra possibilità che riconoscere orgogliosamente il Plagio, dal momento che la maggior parte del materiale di ciascuna tesi è stata ampiamente rubata dai lavori da loro stessi pubblicati in precedenza e da altre ben note fonti negazioniste, fra cui gli articoli del Signor Crowe.
Naturalmente, si tratta di una pratica consolidata fra l’intelligencija negazionista.
Vorrei anche congratularmi con la sua Università per il suo coraggio nell'approvare e finanziare ufficialmente un corso, tenuto recentemente dal Professor Ruggiero, intitolato “Le basi chimiche dell’AIDS”, le cui diapositive sono gratuitamente offerte in dono presso il suo sito Web (cfr. “One chemical AIDS”, “Two chemical AIDS” … “Last chemical AIDS”, etc.).
Qui egli mette orgogliosamente in mostra il sostegno che l’Università ha dato al suo corso:

Come potrà notare passando in rassegna le diapositive

il contenuto del corso ha ben poco a che fare con il campo della chimica o della biologia cellulare, ma consiste invece in una ricostruzione della storia e dell’epidemiologia dell’HIV/AIDS incredibilmente coraggiosa e creativa, allo scopo di imprimere negli studenti la propria personale salda convinzione che l’HIV non sia la causa dell’AIDS. Si tratta di un esempio particolarmente ardito della qualità dell’insegnamento presso la sua Università, che deve essere pubblicizzato nel mondo, soprattutto perché è più che evidente dalle diapositive di questa lezione che né il Professor Ruggiero, né gli altri docenti che l’hanno affiancato, il Dottor Rasnick e il Dottor De Harven (entrambi ex presidenti di Rethinking AIDS) sono appesantiti, neppure di sfuggita, da una conoscenza dei metodi basilari dell’epidemiologia, o hanno la benché minima familiarità con la storia della malattia che è al centro del loro interesse. O, se è per questo, con la logica elementare, per come viene intesa convenzionalmente.
L’influenza enormemente positiva dell’insegnamento del Professor Ruggiero sui suoi giovani e diligenti studenti trova l’esempio migliore nelle sezioni “conclusive” di entrambe le tesi, che consistono in entrambi i casi in una trascrizione letterale delle diapositive 28-32 dell’ultima della serie delle sei lezioni del Professor Ruggiero.
Quale educatore non sarebbe entusiasta e felice davanti al lavoro di un suo allievo, che riproduce tanto fedelmente i suoi propri insegnamenti, soprattutto quando quelle opinioni rischiano di essere scortesemente definite come “profondamente ignoranti” e “intellettualmente disoneste” da parte di un mondo scientifico bigotto e meschino, e la loro promozione attiva e diretta da parte di scienziati e accademici presso persone a rischio di HIV/AIDS come “scandalosamente immorale” e “una grave minaccia per la salute pubblica”?

Come ho detto prima, quel che mi ha spinto a scriverle è stata la recente intervista pubblicata da Celia Farber, una giornalista medico-scientifica-umanistica, che ha vinto molti premi in America.
Da questa intervista risulta evidente che un certo cosiddetto “professore italiano di microbiologia oggi in pensione” ha avuto l’impudenza di scriverle, per attirare la sua attenzione sul Plagio orgogliosamente sostenuto dai professori Ruggiero, Pacini, Bauer, etc. e sul contenuto del loro insegnamento, così innovativo, creativo e originalissimo. Una traduzione in inglese della sua risposta, convincente e del tutto appropriata, a questo presunto “professore di microbiologia” è stata pubblicata interamente nell’articolo della Signora Farber, come le è stata inoltrata dal Professor Ruggiero:

Egregio Professor La Placa,
accuso ricevuta della sua lettera del 16 ottobre 2010 (registrata con n. 20.10.2010). Per quanto riguarda la sostanza della sua lettera, non posso far altro che ribadire che, come lei dovrebbe sapere, la libertà di insegnamento è inscritta nel corpus della nostra legislazione e si connette alla più ampia sfera della libertà di espressione e di comunicazione del pensiero, garantita dalla nostra Costituzione. Fra l’altro, tale libertà riguarda tutte le dimensioni della libera espressione culturale dell’insegnamento come professione, che si realizza all'interno delle leggi e delle regole che codificano la materia.
Prof. Alberto Tesi
Rettore dell’Università di Firenze

Desidero ringraziarla per aver rimesso al suo posto questo cafone di un “professore di microbiologia, ora in pensione”. Bravo!
Leggere la sua risposta mi ha fatto venire le lacrime agli occhi (quasi incredulo per la gratitudine), e la esorto a mantenersi saldo nel respingere qualsiasi pressione che una comunità piena di pregiudizi potrebbe tentare di rivolgerle accusandola, in quelle che potrebbero essere considerate istituzioni meno libere e meno illuminate, di “grave scorrettezza accademica”, o di “creare un grande imbarazzo pubblico”, o di “essere un completo demente”.
È stato anche rassicurante leggere che lei ritiene sia illegale per la Costituzione Italiana intervenire in casi di plagio e di insegnamenti palesemente squilibrati e incompetenti. Mi auguro soltanto che il resto del mondo possa un giorno beneficiare della stessa libertà dalla chiusura mentale e dalle restrizioni della condotta accademica di cui è possibile godere nella città di Galileo.

Con i miei più affettuosi auguri dall’altra parte del mondo, e nello spirito della più estesa sfera della libertà di espressione e comunicazione del pensiero, resa possibile da Internet al di là delle distanze
Per servirla,

P.S.  Come può vedere dalla sua lettera riprodotta nell’articolo della Signora Farber, è divenuto uso comune (negli interessi della trasparenza) pubblicare sistematicamente in Rete la corrispondenza su questioni come queste. Mi sono dunque preso la libertà di pubblicare questa lettera nel mio sito,