Elsevier to Editor: Change Controversial Journal or Resign

The editor of the journal Medical Hypotheses—an oddity in the world of scientific publishing because it does not practice peer review—is about to lose his job over the publication last summer of a paper that says HIV does not cause AIDS. Publishing powerhouse Elsevier today told editor Bruce Charlton that it won't renew his contract, which expires at the end of 2010, and it asked that Charlton resign immediately or implement a series of changes in his editorial policy, including putting a system of peer review in place. Charlton, who teaches evolutionary psychology at the University of Newcastle upon Tyne in the United Kingdom, says he will do neither, and some on the editorial advisory board say they may resign in protest if he is fired.

Elsevier's move is the latest in an 8-month battle over the journal; it comes after an anonymous panel convened by Elsevier recommended drastic changes to the journal's course, and five scientists reviewed the controversial paper and unanimously panned it.

Medical Hypotheses, which says it "will consider radical, speculative and non-mainstream scientific ideas provided they are coherently expressed," is the only Elsevier journal not to practice peer review. Scientist, entrepreneur, and author David Horrobin, who founded the journal in 1975, believed reviewers tend to dislike what lies outside the scientific mainstream and thus are reluctant to embrace new ideas, however promising. Charlton, who succeeded Horrobin in 2003, takes the same view: He decides what gets published himself—although he occasionally will consult another scientist—and manuscripts are edited only very lightly. As the
journal's Web site explains, "the editor sees his role as a 'chooser', not a 'changer.' "="#description">

It's a policy that leads to the occasional wild and wacky paper—a 2009 article for which the author studied his own navel lint became an instant classic—but the journal is also a "unique and excellent" venue for airing new and valuable ideas, says neuroscientist Vilayanur Ramachandran of the University of California (UC), San Diego, who published in the journal 15 times himself and sits on its editorial advisory board. "There are ideas that may seem implausible but which are very important if true," Ramachandran says. "This is the only place you can get them published."

But the journal got in hot water in July when Charlton “chose” a paper, previously rejected by the Journal of Acquired Immune Deficiency Syndromes, in which molecular virologist Peter Duesberg of UC Berkeley and colleagues assert that HIV does not cause AIDS and that medical statistics and demographical data do not support the existence of a massive AIDS epidemic in South Africa. Duesberg, a so-called "AIDS denialist," has disputed the link between HIV and AIDS since the 1980s; his paper was an attack on a study by Harvard University scientists claiming that more then 300,000 lives were lost because the South African government dragged its feet in the introduction of anti-HIV therapy.

Charlton says he is "agnostic" on the question whether HIV causes AIDS but adds that even papers that are wrong can make interesting points—and that can make the reader rethink his or her own viewpoint. "If he believes that, he should have a great big health warning on every page saying, 'This may be rubbish,' " says Nicoli Nattrass, an economist at the University of Cape Town and the author of another study on the price of AIDS denialism in her country. Nattrass and others say publication in a scientific journal gives Duesberg's paper an undeserved air of respectability and credibility that can harm public health. "This is not just some stupid academic debate," she says. "Many people in South Africa still don't believe HIV causes AIDS because there are scientists who say so. And they are dying because of it."

After the paper's publication, prominent HIV scientists John Moore of Weill Cornell Medical College in New York City and Nobelist Françoise Barré-Sinoussi of the Pasteur Institute in Paris wrote Elsevier to ask that the paper be withdrawn. Others asked the National Library of Medicine to delist Medical Hypotheses from MEDLINE, the world's foremost database of biomedical literature, and called on scientists to urge their librarians to cancel the journal. (They also took aim at a second AIDS paper by molecular biologist Marco Ruggiero of the University of Florence, which they say had denialist tendencies as well.)

Following the advice of an external panel whose membership has not been made public, Elsevier wrote Charlton on 22 January to say that Medical Hypotheses would have to become a peer-reviewed journal. Potentially controversial papers should receive especially careful scrutiny, the publisher said, and some topics—including "hypotheses that could be interpreted as supporting racism" should be off limits.

Elsevier also had its flagship medical journal, The Lancet, organize a formal review by five anonymous experts. The reviews, which have not yet been released publicly but were obtained by Science, were unanimously harsh—especially about the Duesberg paper, indicating that it is riddled with errors and misinterpretations. "It might entertain their friends and relatives on a cold winter evening, but it does not belong in a scientific journal," one reviewer wrote. On 24 February, Elsevier wrote Duesberg that his paper—which had not yet been printed and had been taken down from the journal's Web site in August—would be "permanently withdrawn." Ruggiero received a similar letter 5 days later.

Charlton disputes the validity and objectivity of the review—which he calls a "show trial"—and says the publisher had no right to override his editorial decision. He says he has received letters from more than 150 Medical Hypotheses authors who support him, a selection of which he has published on his Weblog.

A majority of the journal's Editorial Advisory Board is behind Charlton as well. On 12 February, 13 of the Board's 19 members wrote Elsevier to demand that the papers be returned to the journal's Web site and to reject the proposed changes to its editorial policies. Not having peer review "is an integral part of our identity, indeed our very raison d'être," the group wrote. That does not mean they're all happy with the paper, says board member David Healy, a professor in psychological medicine at Cardiff University School of Medicine in the United Kingdom. "It's a defense of Bruce, not of the Duesberg paper," he says.

At least one of those on the board strongly disagrees with the majority, however. Antonio Damasio, head of the University of Southern California's Brain and Creativity Institute in Los Angeles, says that the paper should never have been published but acknowledges that he has not kept up with the affair.

Duesberg—who has not published anything on HIV the past decade except for one paper in a journal published by the Indian Academy of Sciences—says Elsevier's measures are the latest example of "censorship" imposed by the "AIDS establishment." But Medical Hypotheses' critics applaud the publisher’s latest step. "It seems clear that Elsevier has come to realize that there is a problem with Medical Hypotheses and that they are doing what they can to rectify it," says Moore.