Prof Tim Noakes. Picture: The Noakes Foundation

By Marika Sboros

When some doctors run out of science or nasty things to say about Prof Tim Noakes, they resort to a canard:

They claim that Noakes is “anti-vax”. Or “anti-vaxx” as it more commonly appears.

Anti-vaxx is a loaded, pejorative term. It should be used for anyone who, as the name suggests, opposes vaccinations for whatever reason.

Instead, critics use it as an attack term to silence anyone who even mentions the word vaccines, unless in unqualified, glowing terms. It’s pretty serious stuff for a doctor to be accused of being anti-vaxx.

The Health Professions Council of South Africa (HPCSA) could charge such a doctor with unprofessional conduct. It could strip that person of the licence needed to practise medicine.

Thus, say legal experts, and depending on the context, calling a doctor anti-vaxx can be highly defamatory. Or slanderous, if anyone says it publicly as some doctors do. Of course, it’s really only defamatory if the claim is untrue or malicious. That is, if there is a deliberate intention to denigrate and damage the doctor’s standing and reputation.

Yet Noakes has made it clear that he is not anti-vaxx. He has stated publicly that vaccination is one of modern medicine’s greatest life-saving achievements. He had vaccinations, as his children and grandchildren have had.

Paediatrician gets in on the act

Despite that, some doctors and academics continue to claim otherwise. Many, if not most, are from Noakes’s alma mater, the University of Cape Town.

Leading the latest charge these days is Cape Town paediatrician and UCT graduate Alastair McAlpine, a long-time troll of Noakes on Twitter. McAlpine regularly attacks Noakes’s medical and scientific credibility and knowledge in inflammatory, defamatory terms.

He also recently acquired a new vehicle from which to launch attacks on Noakes: the Medical Brief website. Of six columns he has written since January, McAlpine devotes four to attacking Noakes. (One is an attack on me but includes  Noakes.)

His latest column repeats his claim that Noakes is “anti-vaxx”. (Click here for Noakes’s full response.)

Twitter trolls

It’s probably no coincidence that Medical Brief’s target market is orthodox doctors and medical and pharmaceutical industries. It is probably also no coincidence that McAlpine is close to another of Noakes’s obsessive UCT Twitter trolls: Jacques Rousseau. Rousseau is a junior “ethics” lecturer in the UCT commerce faculty.

McAlpine’s latest column purports to be about the dangers of doctors who oppose vaccination. Not surprisingly, his major focus is Noakes because, without Noakes’s name, McAlpine has no hook on which to hang the column. McAlpine has since disingenuously claimed that the column isn’t really about Noakes.

But what exactly has Noakes said that makes doctors like McAlpine insist, Goebbels-like, that he is anti-vaxx? And just why does the HPCSA allow them to defame Noakes with impunity? After all, the HPCSA’s own code of conduct expressly forbids one doctor from denigrating another by name in public.

Perils of single tweets!

It all comes down to a single tweet Noakes made on the topic way back in August 2014. And if anything sounds familiar about single tweets getting Noakes into trouble, it is. More below as it’s likely the reason for the ongoing false “anti-vaxx” claim.

In August 2014, Noakes tweeted: “Dishonest science. Proven link between autism and early immunisation covered up?” He included a link: bit.ly/1AJvbB3.

Therefore, the tweet is not about vaccines but about bad (dishonest) science. But you’d know that if you were a scientist, which Noakes is and McAlpine is not.

You would also know that Noakes is not just any scientist, but a world-renowned one. And you would know his National Research Foundation rating is A1 as a scientist. That is a world ranking and it acknowledges him as a world authority.

But back to the tweet. It is also in the form of a question, says Noakes, because he was indicating that he was “uncertain of the validity of the claim (of bad science)”.

Question of science

Thus, Noakes’s tweet is a question of science. He is not promoting the avoidance of any particular medical therapy. He is not encouraging anyone to avoid vaccination – as the definition of anti-vaxxer requires.

It’s worth noting here that Noakes joined Twitter in 2012 and has tweeted more than 49,000 times. Only one of his direct tweets (the August 2014 one) indirectly included the topic of vaccines. Somewhat ironically, any further tweets about vaccines have been simply reiterating the fact that he is NOT “anti-vaxx”.

And all in response to claims Rousseau, McAlpine and others continue to make, Trump-like, to claim falsely that he is.

There’s another important point about the bad science that Noakes focuses on in his tweet: The pharmaceutical source at its heart, be it steroids, statins or vaccines, is immaterial.

Noakes says that his interest has and always will be “the disassembling and exposure of bad science”. That is, after all, what he has been doing for more than 40 years in his distinguished scientific career.

Cover-up claims

Thus, the focus of the bad science in the tweet is also clear – or should be to this reading it without a hidden agenda. It is an alleged cover-up at the US Centres for Disease and Prevention (CDC).

Dr Alastair McAlpine

If you were a medical scientist (which McAlpine demonstrably isn’t) you’d know instantly why any hint of a CDC cover-up would raise red flags sky high. You’d know the awful history. In particular, what the CDC got up to in its previous incarnation as the US Public Health Service (PHS).

PHS doctors ran the notorious Tuskegee experiment from 1932 to 1972. One media report called it “perhaps the most enduring wound in American health science”. It is that and more.

The experiment involved hundreds of poor, African-American men who had the sexually transmitted disease, syphilis, without knowing it. PHS doctors recruited them with the promise of free care, told them they had “bad blood” and gave them placebos.

Because the researchers wanted to track the disease’s full progression, they proactively denied the men effective treatment. They did so even after penicillin became available in the 1940s.

As a consequence, the men went blind or insane. Or they experienced other horrific health problems from untreated syphilis. It took a PHS venereal disease investigator to blow the whistle by leaking the story to the media in 1972. The public outrage rightly forced the study to close.

Tuskegee has since rightly become a byword for racist, unethical medical experimentation.

Interestingly, the alleged CDC cover-up to which Noakes’ tweet referred also had a racial overtone. African-American children appeared to be particularly susceptible to injury produced by the MMR vaccine – more susceptible than “white” Americans.

One would have thought that paediatricians such as McAlpine would be far more concerned with at least investigating that link to protect their tiny patients. Instead, they choose to divert attention by accusing Noakes of being anti-vaxx. That speaks volumes about motivation and in whose interests they operate.

Tuskagee shocker

But what does Tuskegee have to do with vaccines? Nothing. Just as Noakes’s tweet has nothing to do with vaccines.

Both Tuskegee and the tweet are really about shining a light on the darkness of dishonest science that many doctors and scientists say is rampant. And not just at the CDC.

Stanford University professor of medicine and of health research and policy John Ioannidis isn’t afraid to shine that light.
In 2005 in the PLoS (Public Library of Science) One journal, Ioannidis published a searing indictment of the modern research process. Titled Why most research findings are false, it makes disturbing reading.

In it, Ioannidis says that it is “unavoidable that most research findings are false”. A major problem, he says is the impossibility of knowing with 100% certainty what the truth is in any research question.

In this regard, the pure “gold” standard is “unattainable”, he says.

So why, when Noakes raises the issue of possible suppression of data, do his critics immediately create a diversion by calling him anti-vaxx?

Remember the definition of anti-vaxx given above? Anti-vaxx should mean anti-vaxx, which Noakes isn’t. Quite the contrary. Anti-vaxx really means “thou shall not be allowed to mention vaccines in anything less than eulogies”.

Intelligent people could spot the difference between expressing concern about the CDC and bad science and the specific intervention at the centre of that bad science. Decent people could do the same.

If you’re bizarrely obsessed with Noakes and looking to cause as much trouble for him as possible, you will be unable to see sense in your overwhelming desire to cause harm.

Enemies muster – and bluster

An aggravating factor in the debate, say the experts, is doctors who are not scientists or scientific in their thinking. McAlpine is one of those.

Then there are the wannabe’s. Like Rousseau. He is not a doctor – or a scientist but likes to present himself as one on his private blog. So far, he has written more than 30 articles on that blog devoted to attacks on Noakes. (I get off lightly. He devotes only one to me alone.)

Prof Jacques Rossouw

It’s probably no coincidence that Rousseau is the son of one of Noakes’s most implacable foes. His father is UCT graduate Prof Jacques Rossouw, now with the US National Institute of Health. Rossouw has spent many millions of dollars trying and failing to prove that low-fat diets favour heart health. In fact, they can do the opposite. Read US science writer Nina Teicholz on that canard.

(And no, the different spellings of their last names is not an error. Noakes and I give Rousseau’s explanation for the difference in the book we have co-authored, Lore of NutritionChallenging Conventional Dietary Beliefs.)

One of the problems that shows up strongly in the vaccine debate – and in our book – is doctors who subscribe unthinkingly to the pharmaceutical model of disease. It’s a good model and appropriate for acute conditions, of course. It is also very good for bottom lines of pharmaceutical companies and the doctors and scientists in their thrall or pay.

The model’s success rate for chronic non-communicable diseases (NCDs), on the other hand, is less than stellar. That’s apart from aforementioned bottom lines of drug companies and doctors and scientists in their thrall or pay.

NCDs, obesity, type 2 diabetes and heart disease among them, are epidemic globally. Doctors have now added dementia to that list. Because of the documented link with diet, they now call dementia type 3 diabetes.

They call NCDs “diseases of lifestyle” precisely because of robust evidence showing the link with diet. In particular, evidence showing that low-fat, high-carb dietary guidelines and processed foods have played a major role in those epidemics.

Unwelcome message

They say that dietary change can be even more helpful than drugs to treat and prevent these diseases. That’s a message that pharmaceutical and food industries that make a living off the conventional guidelines don’t like to hear.

It’s probably no coincidence, then, that doctors who challenge conventional “wisdom” on diet to treat or prevent NCDs also question bad science within the industry. And that doctors in the thrall or pay of pharmaceutical companies quickly label anyone who raises health risks of vaccines as “anti-vaxx”.

It’s that “let nothing go unanswered” strategy if someone mentions vaccines without the requisite standing ovation. It’s not difficult to spot it in action, so transparent are those who use the strategy.

And it doesn’t take a forensic medical scientist to work out why the HPCSA won’t act against doctors who defame other doctors. It is far too busy still trying and failing to help dietitians shut Noakes up on the science for low-carb, high-fat (LCHF) therapies to treat and prevent NCDs.

Which brings me around to why the idea of a single tweet getting Noakes into a spot of bother sounds so familiar:

He made a single tweet earlier that year same, in February 2014. In it, he said that good first foods for infant weaning are LCHF (low-carb, high-fat). That so “horrified” Johannesburg dietitian Claire Julsing Strydom that she reported Noakes to the HPCSA a few hours later.

Strydom was president of the Association for Dietetics in South Africa (ADSA) at the time. She set off a trial against Noakes that the HPCSA has dragged on for more than four years. The public quickly dubbed it the Nutrition Trial of the 21st Century.

Strydom and ADSA are implacably opposed to Noakes and LCHF as they see him as a threat to their business. And rightly so. Noakes’s views on LCHF directly challenge and threaten the status quo and all the vested interests that benefit from it.

Real target

Strydom and ADSA wanted the HPCSA to shut Noakes up about LCHF in public but the trial has had the opposite effect. That’s one of many lessons in unintended consequences for those who seek to curtail the freedom of speech that doctors and scientists should enjoy.

Noakes and I have documented the trial and attacks that preceded it in Lore of Nutrition. Therein probably lies the source of the anti-vaxx canard

The rationale of these doctors, scientists and dietitians seems to be that if they can discredit Noakes on one serious health issue, it will generalise. The public won’t take him seriously on others. It’s a common enough strategy. And as we show in our book, their chief target has been to silence Noakes and the science for LCHF.

It hasn’t worked. That’s mostly because many people are just not that gullible.

The HPCSA has appealed its own committee’s comprehensive vindication of Noakes in April 2017. At the close of the appeal hearing in February 2018, committee chair advocate Justice Mogotsi said he that he would rule “some time before the end of March”.

I must confess I didn’t think to ask him what year. I just assumed it would be March 2018, not 2019 or sometime in the distant future.

That deadline has come and gone – despite the scientific and medical world watching. The HPCSA, not too surprisingly, given its behaviour throughout, has said not a word of apology or explanation to Noakes or his legal team for the delay. Noakes’s instructing attorney, Adam Pike, of Pike Law, says that the team is “in communication” with the HPCSA concerning the reason for the delay.

Noakes believes that the anti-vaxx campaign against him is yet another instance of the cyber and academic bullying or “mobbing” he has experienced since his “Damascene moment” in 2010. We document it all in our book.

It involves doctors, dietitians and academics at three of South Africa’s top universities: UCT, Stellenbosch and Wits. It’s a murky tale of medical and scientific misconduct at the highest levels.

Click-bait and ‘anti-vaxx’ power

McAlpine has been on the periphery of that mobbing and bullying but appears keen to move into the front line. His use of the Medical Brief website is an interesting development.

The site’s managing editor, William Saunderson-Meyer, is probably better known for his Jaundiced Eye syndicated political columns. As a journalist with many years’ experience, Saunderson-Meyer well knows – or should by now – the attraction and numbers that flow from “click-bait” headlines and articles attacking Noakes. Especially those that are negative.

Saunderson-Meyer declined to say if he or anyone else pays McAlpine for his columns. Nor would he say whether his site receives any revenue – advertising or sponsorship – from pharmaceutical companies.

He has also said that treatment of Noakes has been “evenhanded” on the website. That’s not strictly true.

Saunderson-Meyer refused to explain preferential treatment given to McAlpine but not to Noakes. He allowed McAlpine to see and respond to Noakes’s response to the “anti-vaxx” column before publishing it. He, therefore, once again gave McAlpine yet another golden opportunity to attack Noakes as anti-vaxx without facts recorded in a response at the end.

Defamation focus

Saunderson-Meyer also says that McAlpine’s anti-vaxx columns are “not defamatory”. He would not say whether he took legal advice to get that opinion. He also says that the columns are not “part of any conspiracy by MedicalBrief, the pharmaceutical industry, or any other party”.

I’m not sure why he mentions the word, “conspiracy”, here. I don’t see any conspiracy. It’s clear enough what McAlpine’s intentions are and on whose behalf he writes – and it isn’t good science. It’s about propping up the status quo. But if I were keen to protect myself and my business from possible lawsuits down the line, I’d say something similar.

McAlpine has experienced his own bout of cyber mobbing of late but it has all been positive.

Last year, MacMillan palliative care nurses in the UK wrote a report on their terminal patients’ dying wishes. Before that, Australian palliative care nurse Bronnie Ware recorded her patients’ dying epiphanies in a blog. It gathered so much attention that she put her observations into a book, The Top Five Regrets of the Dying.

Earlier this year, McAlpine did something similar. He created a Twitter thread on what he says his terminally ill child cancer patients told him. They said similar things to what patients told the MacMillan nurses. One was: “Be kind.” The Twitterverse responded in kind and celebrated him for caring for his little patients.

Perhaps McAlpine should follow his patients’ advice and not just tweet it!

  • In Part 2 tomorrow, I look at transparent strategies that McAlpine and others use to try to persuade the public that doctors are anti-vaxx when they clearly are not. One strategy is to bring up the MMR (measles, mumps and rubella) vaccine whenever the opportunity arises – and even when it doesn’t. Another is simply to claim that vaccines are proven safe and ignore any evidence to the contrary.
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