Rutgers Global Health Institute’s director discusses how rejecting scientific facts can undermine progress in public health – and how the medical profession can further public understanding of science

Richard Marlink, a global HIV/AIDS expert, is director of Rutgers Global Health Institute.
Nick Romanenko / Rutgers University

"The medical profession should focus more on understanding people’s beliefs and acknowledging their right to those beliefs. Until we do that, we cannot effectively convince people to trust science."
Richard Marlink

Childhood autism diagnoses are rising and New Jersey leads the nation in prevalence. One out of every 34 children in the state are affected, according to a recent report by the Centers for Disease Control and Prevention that included research from Rutgers. 

Meanwhile, concerns about a link between vaccines and autism, though scientifically disproven, are not going away. A study published in JAMA Pediatrics earlier this year found that following an autism diagnosis, the affected children and their younger siblings are less likely to be vaccinated.

Such instances of science denialism can have serious health consequences, as Richard Marlink, director of Rutgers Global Health Institute and global HIV/AIDS expert, has seen. He will discuss the importance of advocating for science when it comes to health at a “Science Denialism, Public Policy, and Global Health” event co-presented by the institute and the New York Academy of Sciences on June 28 in New York City.  

In what ways has science denialism affected your work fighting AIDS worldwide?

Three decades ago, University of California, Berkeley, virologist Peter Duesberg contended that the HIV virus was not the cause of AIDS. Among the alternate theories he proposed were that recreational drugs and even the antiretrovirals used to treat HIV were causing AIDS rather than HIV itself. Alternate theories are an important part of the scientific process, but Duesberg’s were pseudoscience widely discredited by the scientific community. Still, Duesberg dug his heels in and many lay people believed him. President Thabo Mbeki of South Africa, who was influenced by Duesberg and science denialists, refused to implement the AIDS treatments provided by the United States. That refusal was estimated to cause the premature deaths of 330,000 South Africans. There were others in the United States who joined Duesberg’s movement and some of them died of untreated AIDS.

How difficult is it to educate people if they perceive medicine as a risk? 

It can be very difficult to change a person’s belief system. Take, for example, Christine Maggiore, a vocal U.S. HIV/AIDS denialist and HIV-positive mother who refused to take medication during pregnancy that might have prevented her newborn child from getting infected with HIV. After her daughter was born with HIV, she also refused to have her treated. She asked to talk with me as one of the scientific directors of the Elizabeth Glaser Pediatric AIDS Foundation because we were scaling up HIV treatment programs in Africa and elsewhere, and she was lobbying for us to stop. I told her that I’ve seen many people, both in my practice in the United States and across Africa, rise from their deathbeds and go back to normal, productive lives – and kids not getting infected during childbirth and breastfeeding – because of anti-AIDS drugs. She was not happy with that answer. She had found a belief system that worked for her. Sadly, her daughter died of untreated AIDS at age 3, and Christine, too, later died of AIDS.

What parallels do you see between HIV/AIDS denialism and today’s anti-vaccine movement?

Pseudoscience may have fueled both, but it feeds into a belief system. With South Africa, I think Mbeki’s underlying belief was distrust of the West. With vaccines, I think there is a belief that having a foreign agent injected into your child’s body is not natural and may be dangerous. And with both HIV/AIDS denialism and vaccine denialism, there is also a distrust of the establishment  – a belief that drug companies, rather than individuals, are benefitting, or even that the government is promoting the drug companies’ interests. Another thing that now fuels the fire is that with the internet, the age of the expert is finished. Vast information on almost any topic is widely available online. Of course, knowing how to separate fact from fiction can be difficult.

What would you tell anti-vaccination proponents?

It’s their life and they can make certain choices as long as they don’t harm anyone else. However, we have already seen a resurgence of vaccine-preventable diseases due, at least in part, to vaccine refusals, and that is a real cause for concern. I would also say that vaccines are extremely safe. The safety of vaccines is actually tested to a much higher degree than other pharmaceuticals.

I think the medical profession should focus more on understanding people’s beliefs and acknowledging their right to those beliefs. Until we do that, we cannot effectively convince people to trust science.