Declan Butler, reporter This is the personal blog of Declan Butler, a senior reporter at Nature. All views expressed here are mine, and not those of Nature. Contact me at

December 5, 2007

The Freeing of the Tripoli Six: The inside story of how scientists saved medical workers from the firing squad.

Filed under: HIV,Justice,Libya — admin @ 9:06 pm

I haven’t been blogging for a while; been taking some time out for other projects, and the blog had become almost entirely devoted to original posts on the Libya death penalty case, a hard act to follow. An article in the November issue of Discover magazine, now free online, provides an opportunity to close that chapter, and start blogging on more mundane matters. The long article, by John Bohannon, a journalist colleague who writes for several science publications including Science, tells the story of scientists’ actions in the Libya case. It covers many of the events blogged here as they happened — see summary here — but as a gripping detective story — it makes a good read.


Late in September 2006, Nobel Prize–winning molecular biologist Richard Roberts was thumbing through the journal Nature when he read an article by one of their senior reporters, Declan Butler, about a group of foreign medics on death row in Libya. Butler’s article, along with an anonymous editorial entitled “Libya’s Travesty,” described how the medics’ appeals were nearly exhausted. “I had been aware of the situation through the media,” says Roberts, the chief scientific officer at New England Biolabs in Ipswich, Massachusetts. “But the case seemed so open-and-shut, I’d assumed that diplomacy would sort the situation out.” But as the editorial warned, “Diplomacy has lamentably failed to deliver,” and “scientific leaders need to use all their influence” to persuade their governments to take action.

“It was a call to arms,” says Roberts. So he picked up the phone and contacted Butler, who painted a grim picture of the situation. Ever since the death sentence was handed down in 2004, the absurd case had been bouncing between Libya’s courts as the medics languished in jail; there had been at least one suicide attempt among them. Butler was glad Roberts wanted to help. After watching the Libyan affair from a journalist’s vantage point, says Butler, “I found myself in a position to be useful. What was needed was for someone to work behind the scenes, connecting influential scientists with each other and with diplomats involved with the case.”

Roberts began by calling on his fellow Nobel laureates to sign an open letter to Qaddafi. The letter described the case as a “miscarriage of justice” and called on the Libyan government to recognize the scientific evidence. Getting the laureates to do something in concert “is like herding cats,” he says, but Roberts managed to make contact with 125 of the 160. Within two weeks, he had 114 signatures—the most signatures ever obtained from science laureates for such a joint statement. It was published November 9, 2006, in Nature. “That had a big impact,” says Butler, “particularly on the politicians involved. It helped to ratchet up the pressure.”

And on the new science we published in December 2006, exonerating the medics

The analysis was finished on November 3, 2006, and the conclusion was brilliantly clear. The arrival of the virus at the hospital predated the arrival of the medical workers in Libya. The molecular clock resoundingly exonerated the medics. Every model the Oxford group tested put the age of the viral outbreak before March 1998, many as early as 1995. In fact, the pattern looked like that of a protracted hospital outbreak in which patients had been infecting each other over many years, with viruses becoming isolated, building up very different signatures of mutations, and reinfecting patients via surgical equipment or blood supplies.

If the foreign medical workers didn’t start the HIV outbreak, who did? Colizzi and others had argued all along that the most likely explanation is that someone—perhaps one of Libya’s many HIV-infected West African refugees, possibly a pregnant mother—checked into the Benghazi hospital in the mid-1990s. Through one of several unhygienic practices there, the HIV in her blood joined a circulating pool of viruses among the hospital’s recurrent patients. DNA sequencing of the children’s HIV had already identified it as sub-Saharan. The hepatitis in the children’s blood matched a strain from Egypt. “Multiple outbreaks had already been going strong at Benghazi for a decade,” says Colizzi.

The trio wrote up their results in three days and submitted them to Nature. The paper went through peer review and was published two weeks ahead of the Libyan court date. “The usual standard of justice is to prove that someone is guilty beyond a reasonable doubt,” said Jeffrey Thorne, a statistical geneticist at North Carolina State University in Raleigh, after reading the paper. “But this shows that the accused medical staff were innocent beyond a reasonable doubt.”

Scientists weren’t the only ones to take notice. “Until then, I was getting the same infuriating question from many of the politicians I spoke with,” says Butler. “?‘How do you know the medics didn’t do it?’?” But once the molecular study was out there, “the atmosphere changed. I never heard that question again.”

That made it all the more appalling on December 19, when the Libyan court, making no reference at all to the Nature study proving the medics’ innocence, rejected their final appeal and confirmed the death sentences.

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