Right of Reply: Dr Girish Kotwal

I reported on July 03, 2006 on this blog a paper published in the prestigious journal nature medicine. It pertained to activities Dr Girish Kotwal, at the time at the University of Cape Town, was engaged in. Dr Kotwal has since contacted me and requested that I either withdraw the blog entry or offer him the opportunity of a reply. I am unable to investigate the matter further currently one way or another. I have chosen therefore to publish here Dr Kotwal's response. As the old saying goes, 'let the buyer beware'. Your call.

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Dear Prof. Schuklenk
Thank you very much for the opportunity to respond to your highly misleading blog which has been around for close to a year unnoticed by me, about my role in testing natural products and Secomet in particular. I would like to protest the highly unethical practice of journalists and in this particular case by an editor, Dr. Juan Carlos of a high impact journal viz. Nature Medicine, a number of newspapers and a website called AIDStruth of presenting a one sided story weaved without first checking the facts with the person whose human rights violation the false allegations happen to be. Nature Medicine first published an article that was poorly researched by a free lance journalist, Ms Natasha Bolognesi, with no basic background in Virology and no prior article in any prestigious journal but a mean manner of playing and placing words, to distort the impressions and conclusions, exagerating linkages and trying to malign the hard earned reputation of a person who had no intention to deceive, profit or make false claims for personal gains but to do something about the most politicised and prevailing evil of a devastating disease known to humankind. Someone at Nature Medicine must have received some favours in this regard to allow a complete novice to come up with this misinfomation and lies, while several top scientists with years of research experience do not even get an opportunity to have their articles peer-reviewed . My repeated attempts to ask Nature Medicine to rectify the falsehoods in the article have not been appropriately addressed. Instead of publishing my letters to the editor, the editor would just hand them over to Ms Bolognesi material for new articles that concealed the fact that there was misinformation and downright lies in the original article. This I thought was another unethical behaviour, to me it was like taking the original ideas of one person and handing it over to another to publish them. The other newspapers just had a party and did not check the scientific facts and apart from one newspaper, which after presented a whole lot of thrashy lies allowed me to respond, only to cut short my response and twist it again. So here are the facts as I know them.

I had at the beginning of 2001, etablished a capability in my laboratory to test in vitro (in cell culture) several natural products for antiviral activity including lectins, mucins, herbal medicines, pomegrante juice, plant acids etc. Secomet was one on them. I did convene the First International Conference on Natural Products to encourage my colleagues to evaluate using evidence based science the potential of therapeutic activity. The speech of the democratically elected Hon Health minister of South Africa was read at the end of the meeting and she did not promote any alternatives to HIV in the speech and she did not thrash ARVs. I therefore resent the impression that your blog gives a reader with a cartoon of the minister that it was the meeting where garlic and beet root was promoted. It was not. The speech is on the web site and it empahsizes the value of researching and exploring traditional and natural medicine and of regaining cultural asset of South Africa.

The human treatment was carried out by Secomet Pvt. ltd. under the supervision of qualified and reputed physicians Drs. Brink, Arbuckle and Hellstorm. I did not administer the treatment to any of the many patients who have received the treatment and continue to receive it. I have not seen a single patient who received the treatment. I did not recruit the patients and I did not recommend the treatment to anyone. I have never endorsed the product but have advocated that proper clinical trials are needed in order to fully explore the potential from laboratory work and I had strived to develop a safer product than the original that was first given to me. .

I did not work for Secomet under my personal capacity and was not a holder of equity, shares and received no personal gains. The University of Cape Town did have a royalty agreement but I was not a personal beneficiary.The University conducted an extensive investigation and none of the final investigations found me guilty of any ethical misconduct. There were some procedures used by Secomet which I believed in good faith were appropriate but the University committees felt that some of the procedures could have been done differently. The law unforcement authority of the Medicine Control Council of South Africa extensively investigated Secomet Pvt ltd and made recommendations to amend claims made on labels but there was no punitive action. I have been informed that all the 3,000 compliant patients are surving and leading almost normal lives. Overall, Nature Medicine article made a mountain out of a molehill. No laws were broken and deliberate attempts to subvert an ethical issues. There was definately no malicious intent. On the other hand Professor Greg Hussey, Director IIDMM either lied or made a false statement or the statement was falsely included by Ms Bolognesi of Nature Medicine about my working with Secomet in my personal capacity when there was an overwhelming record contrary to that and the University had an agreement and a memorandum of understanding for evaluating and developing their antiviral products. There was also a statement from a Professor at the Stellenbosch University which was placed out of context and with the false presumption that I had something to do with the human patients.

I did not rely on my data alone to make any conclusions and instead there was a worldwide collaborative network that provided confirmation and further investigation.

I believe then and I do now that HIV in South Africa is not going to be eradicated by a one track extremist policy of providing antiretroviral supervised and unsupervised treatment to all the patients. Instead, I believe that one needs a multipronged approach. Kindly take the time to read a scientific paper authored by a person with 27 years of experience working on several different viruses by one of the most prestigious medical journal viz. The Journal of the Royal Soc. of Medicine, which calls for a multipronged approach, which includes evidence based natural medicine as one of the potential prongs. The free web link is as follows.
http://www.jrsm.org/cgi/content/full/97/1/1

So before anyone indulges in an unethical practice of jumping to conclusions and defaming the hard earned reputation of people based on tabloid style thrashy journalism, please do your research carefully and do not rely on journalists with no background in public health or medical sciences but working as a mouth piece of some organisation with a set biased agenda. Thank you for at least having your email available. There is a website called aidstruth which should be in reality AIDS mistruth does not even give an opportunity to respond. Good luck with your work, I will forgive you for this blunder but keep ethics in center stage, it cuts both ways and finally, I would like to make a statement that ethics is in the eyes of the beholder and if the beholder decides to exploit an ethical issue whether real or not it tarnish another person or bring down another person for personal gains that in my eyes is the most unethical misconduct and that should also be exposed and not tolerated.

Sincerely, Girish J. Kotwal, Ph.D..