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UNIVERSAL IMMUNIZATION
Medical Miracle or Masterful Mirage
By Dr. Raymond Obomsawin

(This book first appeared at the Soil and Health Library, an important source of books
on holistic agriculture, holistic health, self-sufficient living, and personal development)

BIOGRAPHICAL SKETCH OF: RAYMOND OBOMSAWIN

PREFACE
ABSTRACT
Introduction
The Unresolved Issue of UCI/EPI Effectiveness and Impact
The Unresolved Question of Potential Adverse Effects
The Unresolved Issue of Long-Term Adverse Effects
The Unresolved Issue of Safer and More Effective Alternatives
The Unresolved Question of Ethics
Conclusion

SECTION I: MIRACLE IN THE MAKING: REALITY OR DELUSION?
Introduction
EPI--Field Evaluation Experience
UNICEF's General EPI Strategy and Stated Achievements
Field Observations
Contra-Indications Screening
A Case History
Vaccine Scheduling
Immunization's Impact in the Declension of Infectious Diseases
Incomplete Statistical Reporting
The Developmental Implications of UCL/EPI
Is Immunization Effectiveness a Certainty?
Early Theoretical Foundations Re-Examined
Artificially Induced Immunity--Reality or Delusion?
An Historic Overview of the Bacterial/Viral Theory of Disease Causation
The Bacterial/Viral Versus the Cellular/Ecological Theory of Infectious Disease
Infectious Disease Tables I--XVIII
Immunization Effectiveness Data
  Data on Diphtheria
  Data on Measles
  Data on Polio
  Data on Pertussis (Whooping Cough)
  Data on Tetanus Toxoid and Immune Globulin
WHO Smallpox Eradication Success Reconsidered
Vaccine Associated Dangers--General Observations
Of What Do Vaccine Products Consist?
Some Observed and Potential Adverse Effects of Spacific Vaccines and Toxoids--Diagnosable in the Short Term
Extent and Nature of Observable Vaccine Damage
Long Term (Delayed) Potential Adverse Effects of Immunization
Evidences for Immunization Induced Immune Malfimction
The Ethics of Universal Childhood Immunization
Bane or Boon? Selective Medicine in Primary Health Care

SECTION II: TOWARDS MORE APPROPRIATE PRIORITIES IN
DEVELOPING WORLD PRIMARY HEALTH CARE

Eclipsing the Spirit of Alma Ata
Emerging--A More Practicable Primary Health Care Model

SECTION III: A CONSIDERATION OF ALTERNATIVES TO ENSURING NATURAL IMMUNITY

The Soil as Chief Determinant of Health and The Foundation of Public Health Policy
Insightful Experiments
Soil Re-Mineralization--A Return To Primeval Conditions
Soil Dietetics and Disease
Key Nutritional Measures in Preventing Infectious Disease
Vitamin A
Vitamin C
  I. Viral Infections
  II. Bacterial Infections
  III. Phagocytotic Activity
  IV. Conclusion
  A New and Better Strategy
General Conclusion on Appropriate Alternatives
Conclusion
References to sections 1,2 & 3

ANNEX 1: PROBLEMS WITH DEVELOPING WORLD MEDICALIZATION AND THE TRADITIONAL MEDICINE ALTERNATIVE

The Disturbing Dilemma of Developing World Medicalization
India--An Alarming Case In Point
A Compelling Voice of Protest
The Traditional Medicine Alternative
Critical Conclusions and Directions
References

ANNEX II: AGROCHEMICAL AGRICULTURE--THE NEED FOR A SANER ALTERNATIVE

The Dilemma of Chemical Fertilization
Pesticide Poisons
Biologically Sound Alternatives To Pesticides
The Promise of Clean Organiculture Methods
A Recent International Initiative in Clean Organiculture
References

BIOGRAPHICAL SKETCH OF: RAYMOND OBOMSAWIN

Raymond Obomsawin was born in the United States on August 16, 1950 and holds dual US and Canadian citizenship. He married Marie-Louise in August of 1976, and they have three, vibrant children: Sunrise, Sunbeam and Sundown. These children--two are still in their teens, and one is twenty-one--have never received the prescribed regimen of childhood vaccines, and due to a healthful lifestyle have exhibited total immunity to the diseases that are common to the childhood years. (Time and again they've been physically exposed to those ill from some of these very diseases.)

Dr. Obomsawin holds over two decades of cross-cultural experience--both in North America and internationally--in the primary disciplines which impact on human bio-social development. He holds a Baccalaureate Degree in Health Education and Communications, Masters Degree in Development Education, and PhD with concentrations in Health Science and Human Ecology.

He is currently serving as President of the Circle of Nations Institute of Life Sciences & Sustainable Development an international R&D institution legally established in Hawaii, and has previously served as: Manager of Overseas Operations for CUSO (Canada's largest International Development NGO); Evaluation Analyst in the Canadian International Development Agency; Evaluation Manager with the Department of Indian Affairs & Northern Development; Executive Director in the California Rural Indian Health Board system; Director of the Office for National Health Development NIB (Now Assembly of First Nations); Founding Chairman of the National Commission Inquiry on Indian Health; and Supervisor of Native Curriculum for the Government of the Yukon Territory.

PREFACE TO THE THIRD EDITION

(MAY 1998)

Dr. Raymond Obomsawin, PhD

This extensive report focuses on the current massive international effort to administer artificial immunization to the children of the world. The actual launching of the World Health Organizations's Universal or "Expanded Program on Immunization" (EPI) occurred in the year 1983. Its overriding purpose was to achieve maximum immunization coverage of the world's children. Under the influence of the WHO--which is a United Nations created and sustained multilateral agency--all national political leaders (then representing 158 nation states) made a commitment to achieve 80% immunization coverage in their respective countries by the year 1990. In that year the WHO set a new standard for the governments of the world, ie, a more intensified goal of achieving 90% immunization coverage by the year 2000. As a review document, this report poses an open challenge to the scientific, developmental, and humanitarian basis of this global public policy, in turn urging national governments to establish a far more rational, effective and harmless inter-sectoral approach in seeking to ensure that the children and families of our world community enjoy lifelong natural immunity to infectious diseases.

The research covered in this document tackles the issue of universal immunization from a very broad perspective, thereby going well beyond the more obvious realities of its being a "medical racket" hatched by a pharmaceutical industry beholden to its investors, and religiously dispensed and defended by allopathic medicine men. Through employing trans-disciplinary and integrative analyses it draws upon wide-ranging disciplines and fields of thought as it considers the purposes, policies and practices surrounding mass immunization. The effort to research and pull together this report occurred while I was serving as an Evaluation Analyst in the Evaluation Division at the Canadian International Development Agency. My initial research began early in 1991, contextual to conducting a field evaluation of the EPI component of a major UNICEF project then affecting several hundred communities in Northeast Thailand. The report is being distributed and or sold in its present form under the auspices of a non-profit public health advocacy organization, the Health Action Network Society, Burnaby, British Columbia, Canada. (As author, I will receive no royalties from either its sale or distribution.)

Since the first edition came out in the early 1990s, the many serious issues and concerns which are raised in this study have not by any means been properly addressed or resolved. The medico-industrial complex has neither wavered nor modified its posture of providing a white washed endorsement and promotion of what is largely an unproven technological fix of dubious origin, which carries its own seeds of disease and death. For the most part, the same can be said for the public sector policies whereby government such as that of the United States place themselves in an untenable conflict of interest position by playing a direct role in the development of new vaccines, the active promotion and enforcement of mandatory artificial immunization, and the monitoring of vaccines for adverse side effects thereby setting its own criteria and degree of liability in the compensation of victims. (Only one in four vaccine injury victims, who apply for compensation under US law, are compensated for their often catastrophic vaccine injuries. Government qualifying rules require that the onset of adverse symptoms must have occurred within four hours of the administration of the vaccine. Despite these severe limitations in legal liability, since passage of the National Childhood Vaccine Injury Act of 1986, up to February 28, 1998, compensatory payments have totalled $871 million 800 thousand.)

Sad to say, the public sector's world-wide reliable monitoring for adverse side effects (not excluding that of the US Government) does not appear to have noticeably improved from its abysmal state since the initial issuance of this report. As well, multilateral development agencies such as UNICEF continue to push this unproven and essentially spurious technology on a largely uninformed and intimidated public throughout the Developing World nations. On a positive note, within First World nations public awareness of the problems and dangers associated with mass immunization programs appear to have broadened and intensified. Vehicles of the information revolution, such as the Internet have helped considerably. Even physicians themselves are at long last waking up to and advocating the truth, e.g., in France, 200 doctors have called on their govemement to immediately halt the hepatitis B vaccine program because of the many cases of neurological disorders and multiple sclerosis being caused by this vaccine, and in Switzerland, 500 doctors continue to oppose their govemement's MMR vaccine campaign.

Lawsuits for vaccine damages have as well become increasingly common. In the summer of 1997, various news reports in the Commonwealth countries reported that Dawbams law firm in Norfolk, England is carrying forward a major class action lawsuit for widespread damages arising from Britain's 1994 MMR campaign. In a public statement issued by this law firm it is affirmed that:

We know of hundreds of children who were fat and well before being vaccinated, but who are now chronically ill or seriously mentally or physically disabled. Of some 600 cases: the most common are autism (202); serious digestive problems (110); epilepsy (97); hearing and vision problems (40); arthritis (42); behaviour and learning problems (41); ME (24); diabetes (9); paralysis (9); blood disorders (5); brain damage (3); and death (14).

Bolstering the firm's case is the fact that the affected children's pediatricians and neurologists continue to state in British radio and TV documentaries that the children's varied injuries were in fact caused by administration of the MMR vaccine.

Additionally, growing numbers of affected parents and professionals have been instrumental in the emergence of multiple research and activist organizations such as the Immunization Awareness moni Society (IAS), New Zealand; Vaccine Awareness Network (VAN), Australia; Association for Vaccine Damaged Children (AVDC), Canada; Global Vaccine Awareness League (GVAL), California; and the National Vaccine Information Center (AWIC) in the Greater Washington DC area. This phenomena tells us that there are still some heroic and honest hearted people left in our world who are willing to stand together for the right, and make personal sacrifices of their time, resources, and reputations in the face of the combined efforts of government and industry to both slander and silence them. In fact, in recent weeks a prominent member of the IAS has been in touch with me, and shared information which included the fact that a 1992 survey by their organization found an almost 500% greater incidence of asthma among New Zealand children who've received routine childhood vaccines, than among those who haven't.

It is also of interest that on September 13-15, 1997, more than 500 parents, physicians, university scientists, health officials, legal experts, ethicists, journalists and activists from 34 states and five countries convened for the First International Public Conference on Vaccination. This historic session was organized under the auspices of the National Vaccine Information Center (NVIC). According to information provided by the NVIC, the Conference inter alia examined issues such as vaccines and infant dealth; biological mechanisms of vaccine injury; vaccines and learning disorders; hepatitis B vaccine injuries; viral vaccinces and chromosome damage; polio vaccine contamination; and vaccine regulation. A number of the more important observations made by the presenters at the conference further corroborate and complement the alarming findings that are raised in my report. Some key observations follow:

The "P" in the old DPT vaccine is so highly toxic to the human brain that the whole cell pertussis vaccine should be immediately withdrawn from the market.
Vaccines which cause brain inflammation and severe brain damage, such as DPT, are also biologically capable of causing milder forms of brain damage, such as learning disabilities and Attention Deficit Disorder.
Live viral vaccines are implicated in brain injuries, such as the MMR vaccine which is now linked to autism, while the same vaccine has never been fully investigated for its long term effects on human immune and neurological systems.
Live viral vaccines may also be implicated as a cause of genetic damage in humans.
There are many reports of adults in Canada, who have suffered central nervous system and immune dysfunction or death following hepatitis B vaccination.
Polio vaccines contaminated with monkey viruses may have caused the development of HIV- I and rare forms of bone, brain and lung cancers in humans.
Children injured by vaccines and other toxic insults, have disturbances in biochemistry such as imbalances in fatty acid metabolism and neurologic dysfunction such as autistic spectrum disorders and seizure disorders.
Data from New Zealand and several European countries suggests that early childhood vaccination has caused an increase in juvenile diabetes.
A combination of multiple vaccinations and multiple exposures to environmental and chemical toxins may cause immune and neurological dysfunction in the general population like that being suffered by Gulf War veterans.
Government health officials in federal health agencies have withheld information about vaccine risks from the public.
The general consensus among research scientists in attendance was that current immunization programs are causing injuries and deaths because of inadequate vaccine safety research, testing, manufacturing and monitoring for long term effects. What's new? (Conference proceedings are available to the public from the National Vaccine Information Center: #206-512 W. Maple Avenue, Vienna, VA, USA, 22180, Telephone: 1-800-909-SHOT.)

It also bears mentioning that I recently came across a June, 1995 interview with an old acquaintance, the veteran physician to the Aboriginal People of Australia, Dr. Archie Kalokerinos. The interview was published in the International Vaccination Newsletter (Krekenstraat 4, 3600 Genk, Belgium). Archie is in many ways a man deserving of great recognition for his brave struggle with the establishment forces in his country, who attempted to block his efforts to expose and reverse the massive death rates (as high as 50%) being caused by mass immunization in a population at great risk to its dangers. In this interview he states that it was this "extreme hostility" that:

. . . forced me to look into the question of vaccination further, and the further I looked the more shocked I became. I found that the whole vaccine business was indeed a gigantic hoax. Most doctors are convinced that they are useful, but if you look at the proper statistics and study the instances of these diseases you will realize that this is not so . . .

My final conclusion after forty years or more in this business [medicine] is that the unofficial policy of the World Health Organization and the unoffical policy of the 'Save the Children's Fund' and ... [other vaccine promoting] organizations is one of murder and genocide. . . . I cannot see any other possible explanation. . . . You cannot immunize sick children, malnourished children, and expect to get away with it. You'll kill far more children than would have died from natural infection.

Although the public sector in Canada hired a biomedical protagonist of artificial immunization to attack and undermine the original findings and observations contained in this document, nothing was effectively challenged or disproven in this determined effort, nor has there been any challenge from any other quarter since. Furthermore, I've received some very good news from a reliable source in Montreal, Canada, that a number of practicing physicians in that city have ceased using vaccines in their practice after having read this report. I fully trust that it will prove of lasting value in informing and influencing other professionals, parents and interested lay persons who may be honestly seeking to explore both sides of the controversy for the first time.

Finally, it is my sincere hope that the re-issuance of this document will provide a considerable source of valuable documentation and commentary for those who are at the forefront in the battle for biomedical truth and right in a world largely beholden to the bottom line of capitalists who value their profits above seemingly everything else. In the end, the truth with prevail.


"Discovery Consists In Seeing
What Every body Else Has Seen
And Thinking What Nobody
Else Has Thought . . . "

Albert Szent-Gyorgi


ABSTRACT

Introduction

Despite the widely accepted view that millions of children now enjoy freedom from various life threatening infectious diseases, and thus improved health, because of highly effective and safe vaccine programs, at the outset of the 90's an Evaluation of Canada's International Immunization Program Phase I (CIIP--I), concluded that in fact there are "many pressing questions which remain to be investigated within EPI (Expanded Programs of Immunization) and Primary Health Care." A range of critical issues relative to Universal Childhood Immunization (UCI) and EPI programs have been examined and responded to in the main report. These follow:

The Unresolved Issue of UCI/EPI Effectiveness and Impact

The verifiable measurement of UCI/EPI effectiveness and impacts, has been pervasively deficient in the major immunization programming investments made by The Canadian International Development Agency (CIDA)--approaching $150 million--in the 1986-1991 time period. The aforenoted CIIP--I evaluation study further noted that the actual impact of UCI/EPI on mortality levels remain essentially undetermined and unsubstantiated. To quote: "at present it appears that there is no conclusive evidence on the impact of immunization on child mortality from all causes. . . . It may be that EPI's effect is merely to bring about replacement mortality, whereby children . . . succumb to other diseases instead. The uncertainty over the impacts of EPI remain a major question in PHC [primary health care] programming." In light of the compelling need for the proper and periodic evaluation of the impacts of publicly financed programs, this deficiency remains a very serious one.

Unexpected and unexplainable outbreaks among "immunized" persons, have led immunologists to now seriously question whether their current understanding of what constitutes reliable immunity is in fact trustworthy. For example, the admission is being made that immunity (or its absence) cannot be determined reliable on the basis of history of the disease, history of immunization, or even history of prior serologic determination. There is as well an emerging body of mathematically based epidemiological research which suggests significant problems with UCI/EPI targeted efforts for the control and eradication of measles in the Developing World, where in spite of high measles immunization coverages, measles epidemics are being reported with surprising frequency.

Vaccine failures in the Oman polio epidemic could not be explained by failures in the cold chain, nor on suboptimum vaccine potency. It was further observed that the efficacy of OPV in inducing humoral immunity has been lower than expected, and that primary reliance on routine immunization may be inadequate to achieve the goal of eradicating polio by the year 2000. (Similar polio outbreaks have been occurring in other highly vaccinated populations, e.g., the Gambia, Brazil, and Taiwan.)

The Unresolved Question of Potential Adverse Effects

Another basic issue that has never been addressed in UCI/EPI programming is the need for the effective monitoring and evaluation of potential vaccinal adverse effects. Past estimates on the degree of adverse reactions are both unreliable and optimistic since actual monitoring efforts have generally been negligible. Furthermore, many physicians and nurses are not cognizant of the importance of reporting untoward reactions, and or remain unaware of their clinical features. Overall, the evidence strongly suggests that the chronic underreporting of vaccine-induced morbidity, disability, and mortality is in fact the norm, whether in the Developing or Developed Worlds. The first definitive policy statement on this issue by the World Health Organization (issued on April 1991) indicates the WHO's recognition of the significance of this problem. It should be considered as a priority issue in future UCI/EPI research, monitoring and evaluation.

The Unresolved Issue of Long-Term Adverse Effects

A minority of qualified scientists are now postulating that the full vaccine schedule as routinely employed in early childhood vaccination inevitably weakens the immunologic system of the child, leaving this system crippled in its ability to protect the child throughout life, and in turn opening the way for other infectious diseases due to such immunologic dysfunction. It is also being postulated by such scientists that mass immunization is directly contributing to the now widespread escalation of various auto-immune, degenerative disease and allergic conditions.

The Unresolved Issue of Safer and More Effective Alternatives

Sufficient evidence now suggests that an increasing awareness of the potential dangers that are being increasingly associated with mass vaccination programs, will serve to precipitate public demand for greater research investments in the further exploration and testing of promising and danger-free alternative prophylactic methods. A considerable body of literature on lifestyle (especially nutrition) based prophylaxis and treatment for both bacterial and viral infectious diseases suggest that this is the optimum alternative to the artificial immunization dilemma.

The Unresolved Question of Ethics

UCI/EPI--as presently conceived and executed--represents two major departures from the time honoured ethics and traditions of medicine:


Conclusion

The foregoing observations indicate that there is a genuine need for world governments to reconsider their policies with respect to universal childhood immunization, ensuring particular focus on clarifying the vital issues of the short and longer term impacts of UCI/EPI, and the pressing need to establish far safer and more effective alternatives.


SECTION l

MIRACLE IN THE MAKING:
REALITY OR DELUSION?



INTRODUCTION

Universal Childhood Immunization (UCI)--in its more localized context referred to as Expanded Program of Immunization (EPI)--stands worldwide as a top health programming priority among various multilateral, bilateral, and nongovernmental (NGO) international development agencies. This appears to be the case because immunization programs are widely accepted and actively promoted as offering recipient beneficiaries more substantive disease prevention benefits than any other modality in the arsenal of modern medicine, coupled to its unique capacity to offer the surest and "quickest" results. When compared to the more basic intersectoral and developmental requisites for public health sustenance and disease prevention, UCI/EPI is generally considered to be the easiest to implement programmatically, promote publicly, and defend politically. The World Health Organization (WHO) has gone on record to affirm that, "Immunization is one of the most powerful and cost-effective weapons of modern medicine. Immunization services, however, remain tragically under-utilized in the world today."
1

Despite the Canadian govemment's confirmed support of the comprehensive primary health care approach--as defined in the Alma Ata Declaration--the majority of increases in the Canadian International Development Agency (CIDA) Health Sector disbursements, in the last half of the 1980s, have been for the selective and vertical modality of UCI/EPI. In fact, according to observations made in the 1989, Evaluation Assessment of CIDA Investments in the Health Sector, immunization has become the dominant health activity supported by CIDA. "Annual disbursements over the past three years have risen from $3 to $22, to $49 million."
2 The lion's share of this increase stemmed from the launching of Canada's International Immunization Programme (CIIP), covering the period of 1986-1991. (An October 10, 1991 Fact Sheet on Canada's Role in Immunization, states that of the $43 million expended by CIIP in the period 1985-1990, involved the execution--by more than 30 nongovernmental organizations--of over 100 projects in more than 50 countries. When we include the government-to-government [bilateral] program, total CIDA funds committed to UCI/EPI in the 1986/1987-1990/1991 fiscal year periods equal some $143 million. At the end of 1991/1992 it was the intention of the government to expend roughly another $50 million on UCI/EPI over the next five years, with about $30 million for CIIP II.) According to a Mid-Term CIIP Operational Review completed November 20, 1989, UNICEF took almost $27 million from the Program for 37 EPI projects, amounting to 67% of CIIP funds. Additional CIIP funding passed indirectly to UMCEF, via Rotary for vaccine purchases, and via Canadian partners who purchased project equipment from UNICEF stockpiles.3

Speaking of this major shift in priorities, wherein by the end of the 1980s immunization support accounted for one half of all health sector disbursements, the CIDA Health Sector Evaluation Assessment recommended that "this situation merits examination on the grounds of both the heavy focus by CIDA on this one type of health program and the nature of immunization efforts . . . Primary Health Care is more complex and multifaceted then the provision of this one . . . technology."
4 This need to re-examine immunization support was further affirmed when the Assessment identified certain "important am that merit further review," including: case studies of the health impact of projects involving or crossing varied sectors; the level of sustainability achieved in completed CIDA health projects; and areas of large spending or of controversy, i.e., immunization."5

Although the Assessment did not go on to define the nature of the controversies surrounding immunization, mass immunization programs have been seriously questioned on both developmental and scientific grounds. It will be the purpose of this report to proceed with a detailed examination of the issues of controversy, draw some conclusions, and make appropriate recommendations. The critique of these issues stems from a careful review and evaluation of wide ranging biomedical literature sources of relevance to the subject. This work has been carried out in the spirit of honest inquiry, thus affording a fresh and critical analyses of the fundamental issues.

Although the conclusions as reached visibly sustain "one side" of what is largely a hidden and professionalist dominated debate on immunization, the reader should note that this is done in order to provide a long neglected and constructive counterbalance to the predominating supportive declarations of the establishment, and in turn the parroted promotion of the same view by the popular media.

It must further be appreciated that past and ongoing investments in the drive for universal immunization extend well beyond the mere allocation of substantial government and publicly donated funds (which translates into biennial expenditures of a billion US dollars, 63 percent of which comes from Developing World countries themselves)
6 to include:

UNICEF's Executive Director has gone on record in many fora to herald the substantive value and potency of immunization. In advance of the inception of Canada's current and greatly expanded International Immunization program he gave a full and unqualified assurance that "Expanded immunization--using newly improved vaccines" will "prevent the six main immunizable diseases from killing an estimated 5 million children a year and disabling 5 million more."8

The front page of the January/February, 1988, issue of Development Forum, published by the U.N. Department of Public Information, unequivocally affirms that "immunization is the success story of the decade. In the Developing World immunization has reached 50 percent for DPT vaccine and 40 percent for measles, and is now saving over 1.3 million lives annually." Everyone is encouraged--bordering on religious fervor--to get on the bandwagon.

UNICEF.. calls for a 'Grand Alliance' of all possible resources teachers, and religious leaders, mass media and government agencies, voluntary organizations and people's movements, business leaders and labour unions, women's groups and health services to create an informed public demand for. . . the methods which could now bring about 'a revolution' in child survival and development. In Turkey, for example, 200,000 school teachers and 54,000 imams have helped to treble the nation's immunization coverage. In Syria and Egypt, television has succeeded in getting the immunization message into every home . . . UNICEF argues that 'there is no greater cause in which to march.' 9

Indeed, immunization has of late gained the distinction of being considered the "leading edge" in primary health care, and is extolled by its advocates as "the single most successful component of the child survival program." Its high acceptance and apparent success relate to a number of factors:

A technological package that is easily understood and readily available . . . the fact that vaccination does not require substantial behaviourial change; the relative ease of measuring coverage and its offer of an opportunity for political leadership at all levels to be visibly involved. Finally, it is the single component of PHC that provides the greatest opportunity for the private sector to participate through the supply or production of vaccine and cold chain equipment.10

It is accepted wisdom among medical professionals and in turn the public, that millions of children now enjoy improved health and freedom from various life-threatening diseases because of safe and effective vaccines. In the words of Fulginiti, "morbidity and deaths secondary to the contagious diseases have either been eradicated, measles greatly reduced in occurrence, and rubella, mumps, pertussis, and other diseases significantly lessened in terms of their impact."11


EPI--FIELD EVALUATION EXPERIENCE

This general examination of Immunization as a central modality in the prevention of common infectious diseases in the Developing World will begin with some salient extracts taken from the writer's findings in a field evaluation he carried out on a UNICEF--Expanded Program of Immunization and Primary Health Care initiative in Northeast Thailand, in March of 1990. The data derived from evaluating the EPI component is being provided as basic background information because it provides some useful insights on comparable UNICEF-EPI initiatives that are now occurring throughout the Developing World, and points to some critical issues meriting further investigation. (EPI was one of eight components in the Integrated Services Project for Children, extending over a five year period, at a cost exceeding $8,500,000.(Cdn). This funding was primarily provided by the Canadian Government, and supplemented with public contributions. The Project was executed by UNICEF Thailand, in cooperation with the Royal Thai Government.)

The EPI in Northeast Thailand proved to be a considerable undertaking. It included: the execution of a cluster survey on immunization coverage in all 59 districts (in which there are over 900 villages); provision of EPI training for 600 Village Health Volunteers, Village Health Communicators, and religious leaders; similar training for 200 health care providers, and 40 multiple WHO staff, EPI information strengthening and finally social mobilization to vaccinate, viz. provide BCG/OPV/DPT and measles coverage for all 59 districts. It further involved the equipping of 373 tambon (subdistrict) health centres with sufficient numbers of. refrigerators; vaccine carriers with four icepacks; BCG vaccine kits; thermometers; cold chain monitoring cards; and steam sterilizers.
The EPI initiative placed its strategic concentration on the following areas:

  1. EPI training of village and religious leaders
  2. emphasis on reaching progressively higher annual vaccination targets
  3. provision of cold chain equipment and support to targeted Tambons
  4. information campaigns in primary and elementary schools
  5. public education campaigns in targeted villages
  6. increased vaccine production; and
  7. strengthening the EPI information system at the district and provincial level.

In reviewing figures for the project covering the first three years (1985-1987), the priority emphasis on immunization is evident. Project expenditures for this component reached 126 percent of the original target for immunization, compared to only 28 percent for primary health care. Food and nutrition fared somewhat better at 60 percent of the target, a little under the project average of 61 percent. A budget analysis conducted on the project for this period states that "Implementation of the community action component is . . . low. However, the savings obtained here will be passed on to the EPI and pre-school components . . ." The reason given for exceeding the original budget projections for EPI, was "because of the demands and opportunities for support presented."12

Recognizing the central importance of "health care outcomes," both the evaluation exercise and this broader examination of the issues have purposely focused on concerns surrounding the qualitative issue of EPI health care outcomes and effectiveness. However, it became readily apparent in the evaluation of the Program that--due to the absence of base line data on any sample of the recipients, let alone the additional need for a comparable control group, and the control or monitoring of intervening variables it was not really possible to proceed with any accurate or verifiable determination of health care outcomes (i.e., to establish a cause and effect relationship) for EPI.

This need to provide verifiable measurement of a program's health care outcomes appears to be pervasively deficient throughout most health programming directed to the Developing World. The implications of this general deficiency to the specific measurement or determination of EPI effectiveness, remains a serious one, and will be addressed more thoroughly at later points in this report.

UNICEF'S GENERAL EPI STRATEGY AND STATED ACHIEVEMENTS

In a UNICEF sponsored research study on immunization coverage conducted in Thailand in the mid 80's, the following general observation is made:

[The] immunization programme has been proven to be an efficient, and relatively inexpensive method of disease prevention in both developing and developed countries. In the last decade, we have seen an increase in immunization usage, public acceptance, improved delivery techniques and more stable vaccines. The more extensive use of vaccines has resulted in a dramatic decrease of many leading communicable diseases in all parts of the world. However, this condition is by no means true in developing countries where most of the vaccine preventable diseases like diphtheria, pertussis, neonatal tetanus, poliomyelitis and measles remain to be a serious health menace among infants and children in these countries."13

The view as expressed here--during the early stages of this project--provides a fair representation of the rationale behind UNICEF'S resolve to proceed with its universal disease eradication drive, via vaccine induced immunization. (It is of no passing interest that WHO and UNICEF sponsored literature, such as above, now embody a new nomenclature, in which one does not refer to preventable diseases, but more precisely "vaccine preventable diseases" thus tending to convey the unsubstantiated conclusion that such diseases are only preventable through the use of vaccines.)

In UNICEF's Fourth Progress Report on this project issued in 1989, it was affirmed that, "Impressive progress has been made towards the achievement of Universal Child Immunization (UCI). Immunization coverage has been increased and the incidence of immunization diseases reported has reduced." This achievement was reported as taking place despite such persistent obstacles as: insufficient "awareness and knowledge among health officials and community leaders;" inadequate "availability of vaccines and cold chain in remote areas;" and the problem of "drop-out due to ignorance, distance, and fear of side effects."

FIELD OBSERVATIONS

On the basis of structured and semi-structured interviews in five provinces, five districts, and nine villages visited, the following facts came to light:

CONTRA-INDICATIONS SCREENING

Evidence indicated that the EPI program did not incorporate adequate measures for contraindications pre-screening and post-monitoring.

  1. All infants received the vaccines regardless of their weight or nutritional status (only one village indicated that vaccines were not given to infants severely underweight, and only one province reported post-vaccination monitoring of infants under 3 kg).
  2. Actual nutritional status assessment does not appear to be conducted on infants (excepting the body weight factor) before administering vaccination.
  3. There did not appear to be any procedural requirements for checking family histories to determine whether there existed any history of neurological disorders before administering vaccination.

The official view historically held and still articulated by the World Health Organization (WHO) is that both the provision of screening for contraindications, and post operation monitoring for adverse reactions are uncalled for in the context of Developing World EPI campaigns. The underlying rationale has been that the life saving benefits of EPI so far outweigh any risks, that attention to potential risk factors and the potential for vaccine induced damage in vaccinates remains impracticable, and thus a non-issue.14

Despite this unqualified optimism, according to information provided by CIDA's Health and Population Directorate sector, the WHO effective October, 1990, instituted a policy for "adverse event monitoring" in Developing World Immunization activities. A definitive policy statement on this issue titled Monitoring of Adverse Events Following Immunization, has been available since April 1991. (The implications of WHO's recognition of the significance of this issue in setting UCI/EPI research, monitoring and evaluation priorities should be apparent.)

It is thus important to point out that there is by no means a consensus on this issue within the Bio-science community (including the inconsistencies exhibited in the public pronouncements, and policies of the WHO). In one of the most recent scholastic manuals available on immunization practice, noted authority, George Dick--Professor Emeritus of Pathology, London University--provides the following cautions relative to the traditional assumptions of the WHO:

He further confirms that in the following conditions, the EPI vaccine as noted should not be administered. (Obviously pre-vaccine screening measures must be in place in order to ensure that these guidelines are met.) Dick's recommendations follow on Table A.

TABLE A -- GUIDLINES FOR CONTRAINDICATIONS SCREENING
Diphtheria acute febrile illness (fever)
   
Whooping Cough
(pertussis)
acute febrile illness
  a history of seizures, convulsions or cerebral irritation in the neonatal period
  any neurological defects
  any severe local or general reaction to a previous dose of pertussis
  "Children whose parents or siblings have a history of idiopathic epilepsy or neurological defects require careful assessment as to the advisability of imunization."
   
Polio acute illness including diarrhoea, or other (OPV) acute intestinal dysfunction
  sever hypogammaglobulinaemia
  anyone on corticosteroids or immunosuppressive therapy
   
Measles acute febrile illness
  immune mechanism deficiencies
  anyone on corticosteroids or immunosuppressive therapy
  Hodgkin's disease and leukaemia, or other diseases of the lymphoid, or mononuclear phagocytic (reticuloendothelial) system

Preliminary PHC and EPI research conducted for CIDA's Evaluation Division indicates as well that vaccines should not be administered to children who are suffering from malnutrition due to associated immunodeficiency problems (of which--inter alia--chronic infections are symptomatic). However, the official WHO position on this point is that "Fever, respiratory tract infections, diarrhea, and malnutrition should not be considered as contraindications to immunization." This is based on the relationship between immunodeficiency status and increased risk of natural infection.16, 17, 18 (For a cross-sampling of other reference sources which support a counter-view to the WHO stance on immunodeficiency and contraindications to vaccines, please see ref.18)

The Project's failure to address this issue--in a responsible manner--has undoubtedly caused some very real harm, when only good was meant, as the following shows.


A CASE HISTORY

Upon completing the briefing session with a large contingent of Surin provincial and Northeast regional health officials--at which the chief provincial spokesperson confirmed that although post-vaccination shock was a problem in other provinces, there were no known cases being reported in his province evaluation team members departed for their respective village destinations. Upon entering the village of Kanjarong, in the Chom Phra district (only 35 miles distant from the provincial capital) in company with the UNICEF Integrated Services Project Monitor, we encountered and met with the village Head Man and the Deputy Head Man.

In the course of the interview, the Deputy Head Man, with some intensity explained that his own son had experienced what he considered as very serious damage as a result of immunization. The Project Monitor and I returned the following day, at which time we both interviewed the mother and observed the affected child during the interview. As a result of this more careful and thorough interview, the following facts of the case were ascertained:

The following comments should be made with respect to points (a)-(e) above:

The reported growth stunting effect was also visibly obvious, as the child appeared to be at most the size of a one year old. (In that impaired growth is generally not identified in the literature as a vaccine related or induced hazard, this condition may well have been principally related to other factors bearing on the child's nutritional intake and or assimilative capacities.) The mother reported that his weight at birth was 4 kilos (a very heavy baby by Thai standards) and at 5 months, 9 kilos. At the time we visited--though now I year and 2 months older--his weight was unchanged, still at 9 kilos.

It is also worth noting that the mothers three month old grandson, who was present during the interview, had been experiencing high fever, and continuous colds since having received recent inoculations. Given that I visited only 9 out of over 900 participating villages, and then only raised this issue with a fraction of respondents, poses serious concern as to just how widespread and serious the problem of adverse side effects is.

It is known for instance that when mass immunization programs were enforced in Australia's Northern Territory among what was a generally malnourished Aboriginal population (the most notable concern being Vitamin C deficiency) death rates doubled, in some areas approaching 50 percent i.e., "Every Second Child." According to the author of a book by that title and veteran physician to the Aboriginals A. Kalokerinos:

A health team would sweep into an area, line up all the Aboriginal babies and infants and immunize them. There would be no examination no taking of case histories, no checking on dietary deficiencies. Most infants would have colds. No wonder they died Some would die within hours . . . Others would suffer immunological insults and die later from pneumonia, 'gastroenteritis'or 'malnutrition'.19

In Northeastern Thailand, in the villages visited practically all mothers were breastfeeding, and were to some extent including fresh garden vegetables and fruit in their diets. This in turn provided a fair degree of protection from the kind of severe reactions and mortality just noted among Australian Aboriginals. Nonetheless, it is apparent that there still remains a sizable number of malnourished. To quote C. Guthrie:

Malnutrition seems to be declining in the Northeast... Still, malnutrition is widely prevalent. One does not need to go looking for it. In one school . . . in Don Luang, 50 percent of the children were suffering from one level of malnutrition or another. I found it somewhat disturbing to find that the objective expressed by most officials was restricted to the eradication of 3rd degree malnutrition, in spite of the wide prevalence of 1st and 2nd degree malnutrition.20

It appears that the mass coverage obsession common to UCI and EPI, have run roughshod over the repeated qualifications, and warnings that have been issued against administering vaccines to inimunodeficient infants and children, of which malnutrition is a prime indicator. The fact that a March 1988 Annual Report on this Project (p. 5) indicated that a WHO/UNICEF review team found that EPI "drop out rates were high, because of the fear of side effects as expressed by mothers," suggests that the prevalence of vaccine induced complications and morbidity in Northeast Thailand, may well be more significant than heretofore thought. (The broader question and implications of vaccine induced morbidity and mortality will be examined in more detail, later in the report.)

VACCINE SCHEDULING

The rationale behind administering multiple vaccines and toxoids throughout the first 14 week period of an infant's life (excepting measles) is that in the first year of life--when the immune system is still relatively immature--a child is considered more susceptible to most infectious diseases. However, this view fails to admit the corollary that the immune and nervous systems of infants, are immature thus making them potentially more vulnerable to the toxic effects of vaccines and toxoids.

Nonetheless, the argument is commonly raised that vaccines must be administered in accord with the recommended schedule," (particularly in the Developing World), as the risk of dangers is so marginal, and the dangers of widespread and unchecked infectious diseases so great that the infant must have the vaccines--or else. Of course this view is acceptable only insofar as the multiple beliefs surrounding UCI/EPI are valid, i.e., that there are no better disease preventative measures; that the presence of such infections cannot be safely handled or treated; and that vaccines are both highly effective and very safe.

The current WHO recommended schedule vaccination follows:
At birth BCG (Tuberculosis) and OPV-0 (Polio--Live Oral, Trivalent)
6 weeks DPT#L (Diphtheria Toxoid; Pertussis/Whooping Cough; and Tetanus Toxoid) and OPV#L
10 weeks DPT#2 and OPV#2
14 weeks DPT#3 and OPV#3
9 months Measles

It is instructive to consider the experience of Japan in this regard. Delay of DPT immunization until 2 years of age in Japan has resulted in a dramatic decline in adverse side effects. In the period of 1970-1974, when DPT vaccination was begun at 3 to 5 months of age, the Japanese national compensation system paid out claims for 57 permanent severe damage vaccine cases, and 37 deaths. During the ensuing six year period 1975-1980, when DPT injections were delayed to 24 months of age, severe reactions from the vaccine were reduced to a total of eight with three deaths. This represents an 85 to 90 percent reduction in severe cases of damage and death. 21

Although it is obvious that conditions in Japan remain distinctive from that of most Developing World countries, it must be noted that insofar as susceptibility to infectious disease remains greater in lesser developed countries, it clearly follows that susceptibility to vaccine damage will also be proportionally greater. Thus the lesson from Japan carries a valid message relative to the prevention of vaccine damage in Developing World EPI campaigns.

IMMUNIZATION'S IMPACT IN THE DECLENSION OF INFECTIOUS DISEASES

Statistics indicate that over the life of this project, Thailand (and presumably the Northeast region, for which direct figures were not available) has exhibited some degree of declension in childhood infectious diseases (excepting measles) for which immunization has--in recent years--been made generally available. However, it must be borne in mind that prima facie improvement in morbidity levels--in end of itself--falls far short of proving any actual interventional cause and effect relationship for EPI.

Direct discussions with the International Development Research Centre's Health Sciences Division confirms that in selective primary health care activities, such as EPI, there exists "no good base line data from which to measure health care outcomes. SPHC (Selective Primary Health Care) programs in the implementation of EPI appear to ignore this whole issue," Due to the strong and widely maintained assumption that interventions such as EPI serve inextricably and directly as the basis for health improvement outcomes, there has been a general failure since the inception of the first vaccine programs to establish genuinely verifiable evidence for their long term effectiveness, and safety.
22

The general nature of this problem in Selective Primary Health Care activities is well expressed by prominent Medical Sociologist J. Williamson, when he says there has been a failure to "assess explicitly the degree of validity and sufficiency of the evidence linking care structures (facilities, personnel), and processes (what providers do, e.g., EPI) to outcomes of care in general and to health outcomes in particular."
23

Epidemiological science is largely predicated on the reality that changes in morbidity and mortality in populations are necessarily linked to a whole series of contributive factors." (Noted authority George Dick states that: "Many infectious diseases can be prevented without immunization, because once the natural history of the disease is understood, the source may be eliminated or transmission prevented [e.g.,] . . . . When it was discovered that cholera and typhoid epidemics were regularly transmitted by faecal contamination of water, the provision of clean water supplies nearly eradicated these diseases from many countries without recourse to immunization.")
24 It is widely acknowledged that factors such as: nutrition, sanitation, potable water; the natural and social environments (e.g., agricultural practices, food supply, education and income), all play vital roles in determining the onset, severity, and eradication of both infectious and degenerative diseases. Diseases such as cholera and typhoid, have been strongly linked to water and sanitation, whereas evidence continues to accumulate that nutrition remains likely the most critical determinant factor in the full range of infectious and degenerative human diseases.25

The very fact that in this UNICEF project--as in many others--EPI is implemented over a period of years in the midst of a whole series of other natural and basal socioeconomic improvement measures, each having their own critical impact on any population's health status (including epidemicity levels) suggests that EPI could actually be playing a negligible or even a negative role, and no one would really know the difference.

According to the recently completed comprehensive Program Evaluation of the Canadian International Immunization Program--Phase 1, this poses a situation in which the relative impact of expanded immunization programs on mortality levels in the Developing World remain largely unsubstantiated. To quote: "at present it appears that there is no conclusive evidence on the impact of immunization on child mortality from all causes . . . It may be that EPI's effect is merely to bring about "replacement mortality," whereby children . . . succumb to other diseases instead. The uncertainty over the impacts of EPI remain a major question in PHC programming."
26

In a similar vein, Debabar Banerji, Chairman of the Centre of Social Medicine and Community Health at Jawaharlal Nehru University raises serious concerns with the UNICEF sponsored Universal Childhood Immunization program in his own nation. He suggests that:

If we turn to the epidemiological analysis of UCI-90 in India, we are astonished to learn that such a gigantic program has been launched without having even the most basic data on infectious diseases . . . Then how will it be possible to determine the cost-effectiveness of the program? Actually, there ought to have been much more detailed analysis. . . .

For example, with regard to disease levels and factors, he urges that very basic questions should have been addressed before implementing UCI, such as: . . . how different are the rates in different parts of the country and what are the ecological, cultural, social and other factors which affect the rates--through influencing the balance between the host, the parasite [i.e., virus or microbe] and the environment. Information should have been provided on what are the trends in the epidemiological behaviour of the different diseases over a time period, what should be the epidemiological strategy for intervention in the natural histories of the diseases, and so on. Paying scant attention to such critical epidemiological considerations, the crusaders of UCI-90 have opted in favor of saturation spraying with "silver bullets " [vaccines]. Over and above this, there are also the important questions of efficacy of the vaccines. . .

Administratively, the exponents of UCI-90 seem to indulge in collective amnesia to wish the bitter experiences of major vertical [top down] programs like the mass BCG Campaign, the National Malaria Eradication Program, and the three [national] efforts at eradication of smallpox . . . Also actively shunned are the many lessons from the failures of vertical programs for trachoma, leprosy, filariasis, cholera, and sexually transmitted diseases."
27


INCOMPLETE STATISTICAL REPORTING

Selectively slanted and incomplete reporting of the true statistical picture is not an infrequent problem in the promotive oriented reporting on EPI impact data. For example, the following Tables B and C, were based on data presented in Section 4.3 "Expanded Programme of Immunization," in UNICEF's Fourth Progress Report CUC/CIDA Development of Basic Services for Children in Thailand, covering the period January--December, 1988.

Table B -- Immunization Coverage for Measles in Thailand
Year of Coverage

1982

1983

1984

1985

1986

1987

1988

Percentage Immunized  

06

26

44

60

63

 
Table C -- Incidence of measles in Thailand
Year

1982

1983

1984

1985

1986

1987

1988

Number

27,691

34,713

47,205

32,156

19,659

42,051

32,498

Case Rate Per 100,000

(57.1)

(70.2)

(93.7)

(62.2)

(37.1)

(78.1)

59.1)

The following comment is made with respect to the expansion of the measles vaccination program, ". . . the immunization coverage for measles has increased from 6 percent in 1984 to 63 percent in 1988, leading to a reduction in measles prevalence from 93.7/100,000 in 1984 to 37.1/100,000 in 1986."

What the report fails to indicate though is that although the 1986 inununization coverage of 44% had increased by 1987 to 60%, the measles infection rate in the same period actually more than doubled, with an increase from 37.1 to 87.1 per 100,000. It is also noteworthy that the culminating maximum immunization coverage of 63% achieved in 1988, correlates with a 1988 infection report rate of 59.1 /100,000--which in fact poses higher level of measles infection than the 1982 reported infection rate of 57.1 /100,000, which was a time when measles immunization was not being provided in Thailand. (The higher per capita infection rate--after five years of expanding coverage--obviously reflects very negatively on the assumed efficacy of the vaccine, and may have been deliberately obfuscated in the reporting. No evidence was seen to suggest that the post-immunization increases in disease rates were attributable to case reporting improvements.)

THE DEVELOPMENTAL IMPLICATIONS OF UCI/EPI

Clearly, Universal Childhood Immunization stands in contradiction to the strategically development based primary health care principles as embodied in the Alma Ata Declaration. (The issue of intersectoral primary health care versus selective medicine remains an area of major controversy. It will be examined in considerable detail later in this paper). In fact, Developing World analysts such as D. Banerji, forcefully contend that short term, "top down" approaches to health care--such as EPI threaten to reverse Alma Ata's historic gains for more self-directed and sustainable health care. In his view the shifting emphasis toward selective medicine including UCI/EPI:

In his own words, the Universal Childhood Immunization initiative, constitutes the efforts of ruling interests in Donor nations:

. . . to hit out at the very core of the philosophy of primary health care by imposing technocentric vertical programs against a few diseases in the name of saving children . . .This movement not only tends to fragment a health care system and take it away from a wider ecological, intersectoral, and integrated approach, but it also actively hinders community self-reliance and seriously erodes the democratic rights of the people to participate in decisions which so vitally concern them. This is perhaps the most malignant facet of the present efforts to impose specialized . . . programs from outside, using social marketing techniques to sell them." 29

Researchers like Rifkin and Walt maintain that interventions such as EPI, are essentially based on the (now fading) view that human health is dependent upon and arises from a force of elite professionals who hold privileged knowledge--coupled with corresponding power and control--to effect their disbursal of technocentrically contrived benefits, to relatively ignorant and passive recipients.30 It goes without saying that any programmed encouragement of this mind set--despite the very best of intentions--constitutes an inimical force to those principles and processes whereby intelligent self-development, and informed self-care can prevail.

In reference to the developmental implications of UCI/EPI, medical sociologist L.J. Chetelat notes that:

Health professionals, by taking and promoting easily executed interventions, such as immunization, create a demand for these programs and raise expectations which are seldom realized.. SPHC by identifying specific techniques (such as EPI) and strongly supporting them, diverts attention and resources from the process of development, to highlighting specific programs with exaggerated and often unpredictable outcomes. In reality, technocratic and "instant" successes, put into danger the long slow process that leads to sustained improvements. They are creating a climate of short-term expediency, rather than long term change.31


IS IMMUNIZATION EFFECTIVENESS A CERTAINTY?

It can well be said that real "ignorance is not knowing, but knowing what isn't so." The question of whether vaccines in fact protect recipients from the diseases for which they are given, might seem absurd on the face of it. As already noted, when we closer examine the question of statistical evidence for immunization's effectiveness, there remain significant epidemiological uncertainties. The literature further reveals some critical problems in data gathering, interpretation and reporting practices. These basic concerns are succinctly summarized by Professor Gordon Stewart, recent head of the Department of Community Medicine at Glasgow University:

What kind of immunization is this for which success is being claimed?... What kind of epidemiology is this which advocates immunization b excluding, consideration of factors other than immunization? . . . "at kind of editorial policy is this which publishes incomplete data and promotes far reaching claims about the efficacy of immunization, but refuses to publish collateral data questioning this efficacy? 32

We are thus confronted with an unenviable situation where in the general absence of verifiable multifactored and controlled studies, EPI remains today--scientifically speaking--as a basically unproven program intervention. In fact, there is a substantive and growing body of data that call into serious question the soundness and effectiveness of mass immunization programs. This data not only calls into question EPI effectiveness, but further details adverse side effects and potential long term dangers of this widely implemented medical intervention.

EARLY THEORETICAL FOUNDATIONS RE-EXAMINED

In order to better grasp the issue of vaccine effectiveness, it would prove helpful for us to go back to the early theoretical foundation upon which current vaccination and disease theories originated. In simplest terms, the theory of artificial immunization postulates that by giving a person a mild form of a disease, via the use of specific foreign proteins, attenuated viruses, etc., the body will react by producing a lasting protective response e.g., antibodies, to protect the body if or when the real disease comes along.

This primal theory of disease prevention originated by Paul Ehrlich--from the time of its inception--has been subject to increasing abandonment by scientists of no small stature. For example not long after the Ehrlich theory came into vogue, W.H. Manwaring, then Professor of Bacteriology and Experimental Pathology at Leland Stanford University observed:

I believe that there is hardly an element of truth in a single one of the basic hypothesis embodied in this theory. My conviction that there was something radically wrong with it arose from a consideration of the almost universal failure of therapeutic methods based on it . . . Twelve years of study with immuno-physical tests have yielded a mass of experimental evidence contrary to, and irreconcilable with the Ehrlich theory, and have convinced me that his conception of the origin, nature, and physiological role of the specific 'antibodies' is erroneous.33

To afford us with a continuing historical perspective of events since Manwaring's time, we can next turn to the classic work on auto-immunity and disease by Sir MacFarlane Burnett, which indicates that since the middle of this century the place of antibodies at the centre stage of immunity to disease has undergone "a striking demotion." For example, it had become well known that children with agammaglobulinaemia--who consequently have no capacity to produce antibody--after contracting measles, (or other zymotic diseases) nonetheless recover with long-lasting immunity. In his view it was clear "that a variety of other immunological mechanisms are functioning effectively without benefit of actively produced antibody."34

The kind of research which led to this a broader perspective on the body's immunological mechanisms included a mid-century British investigation on the relationship of the incidence of diphtheria to the presence of antibodies. The study concluded that there was no observable correlation between the antibody count and the incidence of the disease." "The researchers found people who were highly resistant with extremely low antibody count, and people who developed the disease who had high antibody counts.
35 (According to Don de Savingy of IDRC, the significance of the role of multiple immunological factors and mechanisms has gained wide recognition in scientific thinking. [For example, it is now generally held that vaccines operate by stimulating non-humeral mechanisms, with antibody serving only as an indicator that a vaccine was given, or that a person was exposed to a particular infectious agent.])

In the early 70's we find an article in the Australian Journal of Medical Technology by medical virologist B. Allen (of the Australian Laboratory of Microbiology and Pathology, Brisbane) which reported that although a group of recruits were immunized for Rubella, and uniformly demonstrated antibodies, 80 percent of the recruits contracted the disease when later exposed to it. Similar results were demonstrated in a consecutive study conducted at an institution for the mentally disabled. Allen--in commenting on her research at a University of Melbourne seminar--stated that "one must wonder whether the . . . decision to rely on herd immunity might not have to be rethought.
36

As we proceed to the early 80s, we find that upon investigating unexpected and unexplainable outbreaks of acute infection among "immunized" persons, mainstream scientists have begun to seriously question whether their understanding of what constitutes reliable immunity is in fact valid. For example, a team of scientist writing in the New England Journal of Medicine provide evidence for the position that immunity to disease is a broader bio-ecological question then the factors of artificial immunization or serology. They summarily concluded: "It is important to stress that immunity (or its absence) cannot be determined reliable on the basis of history of the disease, history of immunization, or even history of prior serologic determination.
37

Despite these significant shifts in scientific thinking, there has unfortunately been little actual progress made in terms of undertaking systematically broad research on the multiple factors which undergird human immunity to disease, and in turn building a system of prevention that is squarely based upon such findings. It seems ironic that as late as 1988 James must still raise the following basic questions. "Why doesn't medical research focus on what factors in our environment and in our lives weaken the immune system? Is this too simple? too ordinary? too undramatic? Or does it threaten too many vested interests . . ?"
38
ARTIFICIALLY INDUCED IMMUNITY--REALITY OR DELUSION?

Physiologist, S.K. Claunch raises an reasonable postulate when he suggests that the body's capacity to initiate a "vigorous reaction" (i.e., the acute processes of elimination associated with viral and infectious diseases) hinges essentially on its level of vitality, and thus such reactions are most commonly found in children. In contrast, it is generally acknowledged that the very feeble and or chronically diseased--who have significantly lower vital energy levels--tend to remain relatively free from such acute reactions. This observation in turn lead him to express the concept that:

If any child has its vitality lowered and its health impaired to the degree that it is no longer strong enough to develop an acute disease, it is, for the time being, at least "immune." This is the exact clinical picture one observes when serums, vaccines and "biologicals" are shot into a child . . . its vitality is so lowered that it is no longer healthy enough to protest or react against them. So long as its vitality stays down, it will be "immune." 39

A number of detractors have legitimately raised the question of how the injection of foreign disease matter into the human system can constitute a legitimate approach to the sustenance of human health. After all, we don't seek warmth of icebergs, is there thus any more logic in seeking health from substances which are intimately associated with disease and death? The articulate view of physiologist H.M. Shelton is that:

To interfere with the all-important composition of the blood in the haphazard manner serologists do, results in incalculable disturbance of its physiological equilibrium . . . health depends, not upon killing bacteria [& viruses] but upon building up the soundness . . . integrity [and] functional vigor . . . of our own tissues and organs. . . . Normal resistance can be achieved only by use of the same means by which it was originally built and maintained.

Nature makes no mistakes and violates no laws. She is uniformly governed by fixed principles and all her actions harmonize with ... [nature's governing] laws . . . The best, indeed the only method ofpromoting public health is to teach people the laws of nature and.. how to preserve health. Immunization programs are futile, and are based on the delusion that the law of cause and effect can be annulled Vaccines and serums are employed as substitutesfor right living; they are intended to supplant obedience to the laws of life. Such programs are slaps in the face of law and order."
40

AN HISTORIC OVERVIEW OF THE BACTERIAL/VIRALTHEORY OF DISEASE CAUSATION

In order to provide some further background to the reader, this section will briefly recount some of the most significant observations of earlier scientists on the broader question of what is the actual role bacteria and viruses play in human infectious disease. The debate on this issue--although an old one remains highly relevant and timely in that the whole edifice of Western selective medicine, both preventive and therapeutic, hinges upon a correct perspective on and resolution of the question.

Indeed, it remains remarkable that whether we go to recent or more distant history, we find that fundamentally critical scientific discoveries and observations which serve to clarify these issues, and point in a more appropriate direction, continue--at least in practice--to be largely unknown and or ignored. (Some researchers would suggest that this failure arises because such discoveries--if genuinely applied--would significantly curb what amounts to annual income totaling multiple billions of dollars in the exploitation of human disease.) However, it is apparent that the factors underlying this failure are in reality much broader and more complex.

Due to the need for brevity, only two cases of historic significance will be considered. Earlier in this century, C.E. Rosenow of the Mayo Biological Laboratories began a series of experiments in which he took distinctive bacterial strains from a number of different disease sources and placed them in one culture of uniform media. In time the distinctive strains all became one class. By repeatedly changing cultures, he could individually modify bacterial strains making them some harmless or "pathogenic" and in turn reverse the process. He concluded that the critical factor allowing demonstration of the polymorphic nature of bacteria was their environment and the food they lived upon. These discoveries were first published in the year 1914 in the Journal of Infectious Disease."
41

Rosenow's work was corroborated and expanded upon about two decades later by R.R. Rife, developer of the Universal Microscope which was developed concurrent with RCA's initial marketing of the electron microscope. Rife's alternative was a 5,682 component, 150,000 power (60,000 diameters of magnification) instrument which made live bacteria visibly "clear as a cat on your lap." This microscope was a light transmitting instrument with a resolution of 31,000 diameters (traditionally electron microscopes had resolutions of up to 25,000 diameters) which overcame the chief weakness of the electron scope, i.e., the inability to view living cells structures and bacterial and viral organisms in their unaltered living state.(An alternative was required, as living matter when viewed under the electron scope, becomes altered and distorted due to bombardment by a virtual hailstorm of electrons, with such distortions increasing proportionally with the intensity of magnification. Consequently, the extremely high magnification levels found in the latest electron microscopes actually serve to exacerbate this major flaw.)

Modern microscopy texts suggest that with light microscopes it is impossible to obtain extremely high magnifications of objects and still retain visual clarity. For example Novikoff and Holtzman affirm that in such instruments a point is reached after which the image is "increasingly blurred and nothing is gained by further magnification. Thus, light microscopes are rarely used at magnifications greater than . . . 1500 X."
42

However, Rife's invention with its 14 separate crystal quartz lenses and prisms, was able to bend and to polarize light in such a way that a specimen could be illuminated by extremely narrow portions of the spectra, and even by a single light frequency. This combined with the shortening of projection distance between prisms, and other innovative technical features permitted high resolutions without distortion at extremely high magnifications, never before or since attained in light microscopy.
43

Rife showed that by altering the environment and food supply, friendly bacteria such as colon bacillus could be converted into varied "pathogenic" bacteria.
For example, Rife also observed that bacillus coli could in time be modified into the bacterial agent associated with typhus, and the process actually reversed. In Rife's words:

In reality, it is not the bacteria themselves that produce the disease, but we believe it is . . . the unbalanced cell metabolism of the human body that in actuality produce the of disease. We also believe if the metabolism of the human body is perfectly balanced . . . it is susceptible to no disease.44

This observation closely parallels Alexis Carrel's earlier research at the Rockefeller Institute where he was able to control the rates and levels of infectious disease mortality among mice. Beginning with the standard diet he observed a corresponding death rate of 52 percent. By making specific dietary improvements he was able to reduce mortality rates downward to 32 percent, then 14 percent, and finally to a rate of 0.45

Not too long after Rife's and Carrel's reported observations, scientist Rene Dubos (also at the Rockefeller Institute) reaffirmed their open and direct challenge to the conventional thinking and practice of the scientific community at large. He suggested that the presumed relationship between microbes and the onset of human disease has been "so oversimplified that it rarely fits the facts of disease. Indeed it corresponds almost to a cult . . . undisturbed by inconsistencies and not too exacting about evidence." He expanded upon this view in suggesting that we need to objectively account for the fact that extremely virulent:

. . . pathogenic agents [i.e., bacterial and viral micro-organisms] sometimes can persist in the tissues without causing disease, and at other times can cause disease even in the presence of specific antibodies. We need also to explain why microbes supposed to be non-pathogenic often start proliferating in an unrestrained manner if the body's normal physiology is upset. . . .

During the first phase of the germ theory the property was regarded as lying solely within the microbes themselves. Now virulence is coming to be thought of as ecological . . . This ecological concept is not merely an intellectual game; it is essential to a proper formulation of the problem of microbial diseases and even to their control "
46

Indeed, Dubos--in time--came to voice the conclusion that "Viruses and bacteria are not the cause of disease, there is something else." In his classic work Mirage of Health, he states "The world is obsessed by the fact that poliomyelitis can kill and maim . . . unfortunate victims every year. But more extraordinary is the fact that millions upon millions of young children become infected by polio virus, yet suffer no harm from the infection."47 This view closely corresponds to the oft quoted conclusion arrived at in later life by R. Virchow (popularly reputed as father of the "germ theory") when he stated, "If I could live my life over again, I would devote it to proving that germs seek their natural habitat, diseased tissues, rather than being the cause of disease."

Since Dubos' time, researchers have estimated that the quantity of symptom free exposure to viruses out number clinical illnesses by at least one hundred-fold.
48 This conclusion is based on the "high proportion of adults who have virus-neutralizing substances in their serum and the number who, during an epidemic, excrete virus without becoming ill.49

Further corroborative conclusions have been recently reached by some prominent scientists in their critical examination of the popular view that Human Immuno-deficiency Virus (HIV) is the key, if not the singular cause of the Acquired Immuno-deficiency Syndrome (AIDS). Evidence is in that the popularized view that HIV causes AIDS is far more a political necessity, than a genuine scientific conclusion. (Although the observed action and effects of viruses, and retroviruses--such as HIV--do in fact significantly differ, what is being called into question is the validity of labeling microbes--of whatever form--as the key and or sole "cause" for disease, or as in this case of acquired immunodeficiency.)

Peter Duesberg (Professor of Molecular Biology at the University of Calif.- Berkeley; considered by many to be the world's leading expert on retroviruses; and Nobel Prize candidate for his work in discovering oncogenes in viruses) provides compelling evidence that lifestyle based factors serve as the primal determinants in the evolution of the 20 plus neoplastic and degenerative diseases that are now associated with AIDS. Employing his own research--complemented by 196 cited references--an article entitled "HIV and AlDs: Correlation but not causation," was published in 1989 in the Proceedings of the National Academy of Sciences USA. This article indicates that "Free" HIV virus (Free meaning that the retrovirus is already part of the genome) is not detectable in most cases of AIDS;" "Pure HIV does not cause AIDS upon experimental infection of chimpanzees or accidental infection of healthy humans;" and "Epidemiological surveys indicate that the annual incidence of AIDS [to be understood as a condition symptomized by various secondary infections for which natural immunity has been lost] depends critically on non-viral [related] risk factors . . . defined by lifestyle, health, and country of residence."

In an interview published nearly five years later Dr. Duesberg is more convinced than ever that the HIV retrovirus is not the cause of AIDS, or of the mortality associated with AIDS. Some of the key points he makes in this important interview follow:

  1. There are roughly seven and a half million people world wide who are known carriers of HIV, and who continue to remain free of the immune deficiency symptoms associated with AIDS, and there's not one authenticated case "where you get infected today and get a disease. . . years later . . . infectious agents work immediately or never."
  2. HIV has been found to be totally absent in the system of over 4,600 persons diagnosed with AIDS, so to save political face the US Centers for Disease Control have been forced of late to give such cases a new name i.e., "idiopathic CD 4 Iymphocytopenia."
  3. There are a million Americans with HIV and their T cells are normal, indeed, "HIV is one of the most harmless viruses you could possibly have. It never claims more than one in 1,000 cells every other day" during which time your body replaces "at least 30 out of 1,000" cells.
  4. AIDS is not an infectious disease, but rather arises from "party swinger lifestyles" that includes: the widespread and abundant use of various immune- depleting drugs both legal and illegal such as cocaine, alcohol, marijuana, amphetamines, aphrodisiacs, amyl or butyl nitrites (poppers), combined with correlated conditions of malnutrition, inadequate sleep, and poor hygiene.
  5. Another key cause of AIDS and the mortality arising from it is medical treatment in itself, viz. AZT has become "AIDS by prescription" and design. In other words in the US alone 200,000 persons (most of whom have normal health) who've tested positive for HIV antibodies, are given 250 mg of AZT every six hours. This highly toxic drug destroys bone marrow, as well as red blood cells thus precipitating cellular oxygen starvation destroys white blood cells; causes anemia, weight loss, muscle loss, nausea, and worsening immune system deficiency coupled with the ensuing infectious diseases commonly associated with AIDS, and finally death. (The very same sequence of rapid physiological deterioration, immune deficiency and infections has been documented in healthy persons who were tested positive for HIV, and quickly submitted to medical treatment, but were later confirmed as false positives.)50

Bio medical scientist and AIDS researcher Joseph Sonnabend speaks of ". . . the failure of our scientific and medical institutions to have provided an even rudimentary understanding of the pathogenesis of this disease in the eight years since its first description, let alone to have developed interventions...that might significantly alter its course." His well researched conclusions include the view that "The association of HIV seropositivity with AIDS could . . . derive from the possibility that the expression of HIV (and consequent seroconversion) is an effect, rather than a cause of AIDS. . ."51

In summary, if we retum to Robert Koch's 19th century postulates of the "Germ Theory," viz. in order to cause disease particular "bacterium:" a) must be found in every case of the disease; b) must never be found apart from the disease; and c) must consistently produce the same disease as that manifested by the body from which the disease related germs were taken; we find that in reality each postulate has been disproved time and again by varied experience and experimental data.
52

Nonetheless, it appears that to this day there remains only a marginal acknowledgment or practical recognition that it is the condition of the body-mind complex and its internal and external environments, which are the principal determinants of the nature, prevalence and role of bacteria, viruses, and even retroviruses.

THE BACTERIAL/VIRALVERSUS THE CELLULAR/ECOLOGICALTHEORY OF INFECTIOUS DISEASE

As a result of the re discovery of many of these earlier scientific investigations, as well as more recent observations in molecular biology, there has arisen among more independent scientists and primary health practitioners a new concept that has been coined as the cellular theory of infectious disease. This seemingly more logical and updated view, poses a serious challenge to the present unquestioned emphasis on supporting mass selective medicine approaches (including artificial immunization) in the Developing World.

The traditional Bacterial--Viral and the emerging Cellular--Ecological theories of disease are contrasted in the table which follows. The practical acceptance of the cellular theory as delineated would entail a substantive shift away from both preventive and therapeutic interventions which are heavily predicated on Western selective medicine, i.e., vaccines and drugs, and toward fundamental health improvement measures such as sound nutrition, potable water, sanitation and overall enhancement of the human physical and social environments.
53

Considerable experimental, historical and epidemiological evidence supports the cellular ecological theory, as outlined in Table D.

TABLE D --- INFECTIOUS DISEASE THEORIES CONTRASTED

Bacterial/Viral Theory
of Infectious Disease

Cellular/Ecological Theory
of Infectious Disease

1. Disease arises from micro-organisms originating outside the body. 1. The evolution of and susceptibility to disease arises from conditions arising within the cells of the body.
2. As the primary cause of disease, micro-organisms are generally considered as vicious, needing to be destroyed. 2. These micro-organisms are primarily endogenousto more complex living organisms and normally function to assist the life sustaining and/or metabolic processes of such bodies.
3. The appearance and function of specific micro-organisms is constant. 3. The appearance and function of these micro-organisms undergo pathogenic changes when the host organism is weakened or injured, which injury may be mechanicallly, biochemically or emotionally induced.
4. Every disease is associated with a particular micro-organism. Every disease is asssociated with particular factors and conditions.
5. Micro-organisms are primary causal agents. 5. Micro-organisms become pathogenic, i.e., associated with disease, only when the integral health of the body deteriorates. Hence, psycho-physical integrity is of first importance, as it constitutes the key factor in the prevention, or the remediation of human disease in all its forms.
6. Disease is inevitable and can "strike" anybody, anytime. 6. Disease arises from the persistent violation of natural laws, and correlated unhealthful conditions.
7. To prevent and cure disease, it is necessary to war upon pathogenic micro-organisms (using toxic aqnd pathogenic weaponry) that as well, destroys the health of the body-mind complex. 7. To prevent or cure all forms of disease, one need only to ensure that the primal requisites of health ore met, which includes sysstematic compliance with natural physical, psychological, and spiritual law.

In that major declines in infectious disease took place before the advent of specific vaccines and antibiotics, scientists and or physicians such as Dubos, Dettman, Illich, McCormick, Taylor, Buttram, and Hoffman agree that the overall eradication of varied infectious diseases were due to basic improvements in nutrition, sanitation, housing, education and related socioeconomic conditions. For example, Canadian physician W.J. McCormick was able to make this telling observation at midpoint in the present century.