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

October 25, 2006

Exclusive: Nature article demolishes prosecution’s scientific evidence in Libya HIV death penalty trial

Filed under: HIV,Justice,Libya — admin @ 6:37 pm

Nature has obtained an Arabic to English translation of the ‘scientific evidence’ which has been key to the prosecution’s case in the trial of six medics in Libya, and asked top international AIDS and health scientists to assess it. They unanimously conclude that the evidence is a compilation of conjecture and supposition, that could not even justify suspecting the medics, let alone holding them in prison for 7 years on death penalty charges. The next, and last, session of the trial is next Tuesday (31 October), and a verdict will come in the days or weeks after.

Nature took this exceptional action of asking internationally-renowned scientists to review prosecution evidence, because the Tripoli court has denied requests by defence lawyers to have evidence from international scientists heard. So if the Libyan court refuses to hear what independent top scientists have to say, I feel it is my duty to at least have them aired before the international community, so that it can judge for itself.

I also air the international scientific evidence which demonstrates the medic’s innocence. The result is an almost 2000-word lead news story in tomorrow’s issue of Nature, ‘A shocking lack of evidence.‘ This article is on free public access.

I obtained a complete copy of a report commissioned by the court in 2003, from 5 Libyan doctors. The report — Final Report by The National Experts Committee Regarding The Scientific Expert Opinion required In Case 607/2003-Felonies/Bengazi” Presented to The Benghazi Appeals Court (December 28th, 2003) — has played a key role in the prosecution case.

In 2003, the Libyan report led to the court rejecting a report coauthored by Luc Montagnier, the discoverer of the AIDS virus, which concluded the medics were innocent. But the court threw Montagnier’s report out, after the Libyan report disputed its conclusions, and dismissed it as “hypothetical” and “lacking precision.” Nature has the conclusions of the Libyan report here, and Montagnier’s here.

And whereas *no* international scientists have been allowed to testify since, the 5 Libyan experts testified in August, that they stood by the conclusions of their 2003 report.

And remember that while we are placed in the situation of having to struggle for a fair trial, and a proper hearing of rigorous scientific and forensic evidence, that would prove the medic’s innocence, the basis of law, and a fair trial, is that it is the prosecution that should provide evidence of proof in the first place. Leaving aside the fact that Amnesty International has repeatedly declared that this has not been a fair trial by any means, this article goes on to demonstrate that the prosecution have not even the beginnings of scientific evidence on their side, while the weight of independent international scientific expertise backs the defence case. But the latter is not being heard, leaving a trial based on confessions which Amnesty says were extracted under torture.

So I sent the Libyan report for review by leading scientists in the United States, France, Italy, the United Kingdom, and Switzerland. My article describes in detail their assessment, and you really need to read the entire article to follow the thread, and the arguments. But here are just a few excerpts to give you an idea of their reactions:


“I don’t see any evidence in it,” says Janine Jagger, an epidemiologist and MacArthur fellow who heads the International Health Care Worker Safety Center at the University of Virginia in Charlottesville. “It wouldn’t meet the lowest standards of epidemiological evidence for establishing any causal relationship.”

Robin Weiss, an AIDS virologist at University College London, concludes: “There are no grounds for suspicion of deliberate infection by any staff, and strong evidence of hospital-acquired infection before the arrival, and after the departure, of the Palestinian physician and the Bulgarian nurses.”


The purported ‘smoking gun’ in the Libyan report is the detection of HIV antibodies in vials allegedly found at one of the nurses’ homes during a raid in 1999, but not tested until 2003. Both Montagnier and Colizzi have seen the results of a western blot, a test to detect proteins: they are “indeterminate”, says Montagnier. “They say nothing,” adds Colizzi. In 2002 Libya promised that they could test the samples independently, but neither has ever been given access.

Even a positive test could detect only antibodies to HIV. It would not show that the vials had contained the virus, points out Massimo Amicosante, a biologist also at Tor Vergata. “This is one of the main weak and controversial points of the Libyan report,” he says. Finding the virus would require testing for HIV RNA, which has not been done.


The report argues that HIV and hospital hygiene were not a problem in Libya (the prosecution describes the Al-Fateh Hospital as a “model”) and that the outbreak is so large that deliberate, malicious infection of HIV cannot be excluded. “I don’t agree with that statement,” says Weiss. “And even if I did, it does not amount to sufficient evidence to incriminate the accused medical staff.”

The Libyan report also suggests that because the genetic sequence of the Benghazi HIV strain is different from any lodged in public databases, there are grounds for suspecting foul play. “That’s tosh,” says Weiss. Montagnier agrees, pointing out that the virus was a new natural recombinant of a highly infectious strain common in Central and West Africa, which has replaced most other strains in the region over the past few years.


Luc Perrin, a clinical virologist at Geneva University Hospital in Switzerland, who has treated many of the infected children, describes the Libyan report as “a lot of generalities that are not always correct”. The report also fails to provide any evidence for its assertion that HIV infection has not been seen in children at other Libyan hospitals, he says.

Perrin is an expert on primary HIV infection. He has analysed samples from 148 of the infected children, collected in September 1998, and has obtained further data on 37 of them and 46 of their parents, when they were treated in Switzerland. Perrin says his genetic data support Colizzi’s analysis, and that many of the 1998 samples have protein profiles corresponding to infections well over a year old: “I can tell for sure that the HIV infection cases occurred before September 1997 and the first cases most likely before 1996.” The accused medics first arrived in Libya in March 1998.

The Libyan report is also silent on the prevalence of hepatitis at Al-Fateh Hospital and other Libyan hospitals, notes Perrin — who found that half of the HIV-infected children were also infected with hepatitis B or C. He says these high levels “clearly indicate” that the children were exposed to infection via contaminated blood or other medical material. Moreover, many of the children were infected with several subtypes of hepatitis, suggesting they were exposed to hospital contamination on multiple occasions, possibly when receiving vaccination injections. “If a single source of contaminated blood had caused the HIV outbreak, all the children would be infected by the same hepatitis C subtype,” says Perrin. “What we observed can [instead] be explained by the reuse of syringes or poor sterilization procedures.”

I feel that this is the article that has so far been missing in this case. There are now just 6 days until the next, and last session, of the trial, so the time to act is now. I’ve compiled addresses and other action resources here to help. Perhaps fax/email the Nature article to government and Libyan officials, to let them know the world is watching.

PS BBC World Service radio has this evening covered the article in its hourly news headlines. This is important as this is broadcast worldwide, and also in Arabic to the Middle East and North Africa, so it will bring this news to many in the region.

Written BBC story here

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