AIDS medication didn’t kill more people than the virus itself

CLAIM: The majority of AIDS patients died from medication developed when Dr. Anthony Fauci led the nation’s response to the emerging epidemic, not from the virus itself.

AP’S ASSESSMENT: False. While it’s true that Fauci had been a leading researcher when AIDS emerged in the 1980s, the claims that azidothymidine, commonly known as AZT, killed more people than the virus itself are baseless. Public health agencies from the Centers for Disease Control and Prevention to the World Health Organization, as well as prominent AIDS organizations and researchers, told The Associated Press the drug remains in use today as it’s been shown to be effective at keeping HIV in check when used in combination with other medications.

THE FACTS: Social media users are once again sharing the long debunked notion that Fauci, the face of the nation’s response to the coronavirus pandemic, advocated decades earlier for a drug to combat the emerging AIDS epidemic that turned out to be more deadly than the virus itself.

Many are sharing a video clip from a newly-released conspiracy theory film called “Plandemic 3,” a sequel to a 2020 video that spread misinformation about COVID-19 online.

The clip features old footage of a young Fauci speaking about the safety and efficacy of AZT, which at the time was the first drug developed to treat HIV, the virus that causes the immune system-damaging disease AIDS.

The caption of the clip includes the claim that “hundreds of thousands of innocent people died” as a result of the medication, which it said Fauci “pushed” on the American public.

“AZT is what killed a majority of the AIDS patients. Not the virus,” wrote one user on Instagram who shared the video clip.

“Same actors. Same performance. Same pusher…From AZT to Covid,” wrote another Instagram user who also shared the video clip.

But public health officials, AIDS advocates and longtime researchers of the virus say the claim that AZT was responsible for most AIDS deaths is not backed by scientific evidence.

Kathy Donbeck, a spokesperson for the National Institute of Allergy and Infectious Diseases, said the false claim has “long been trotted out by AIDS ‘denialists’ and debunked repeatedly over the years.”

Chanapa Tantibanchachai, a spokesperson for the U.S. Food and Drug Administration, which approved the antiretroviral drug in 1987, concurred, adding that AZT remains an approved drug for the treatment of HIV.

She noted that the FDA-approved package label for Retrovir, the brand name for the drug, which is also known as zidovudine, states that the drug wasfound to reduce the risk of HIV progression compared to a placebo.

A New England Journal of Medicine study from 1987 also concluded that patients who received AZT died at a much lower rate compared to those who received placebo.

Fauci, who served as director of NIAID from 1984 until his retirement last year, declined to comment. But health experts also acknowledged the development of better medications to treat HIV diminished AZT’s use over the years.

Longer-term research, such as a 1994 study published in Lancet, found that AZT’s effectiveness waned when used as a standalone treatment, explained Marlène Bras, a director at the International AIDS Society, an advocacy group based in Geneva, Switzerland.

Many patients in the early years of its use ultimately developed AIDS and succumbed to the illnesses as the virus became resistant to AZT.

“As a single drug treatment it turns out it wasn’t that great,” Bras wrote in an email. “We wouldn’t say that it ‘killed people,’ but there’s not a lot of evidence that as a single drug treatment it was helpful.”

Researchers eventually came to understand that a combination of medications — not just one — was needed to keep HIV in check, said Tarik Jasarevic, a WHO spokesperson.

Today, AZT is among some 40 drugs approved for HIV treatment, he said, though it’s generally reserved for patients for whom new medications fail. The drug is also used to prevent disease transmission in certain situations, such as from an HIV-positive mother to a developing fetus.

“This claim is completely inaccurate and there is no evidence that AZT caused the death of people with HIV who took it,” Jasarevic wrote in an email. “In fact, despite not being largely used anymore, this drug has avoided many HIV infections and significantly helped to reduce the suffering and increased the survival of millions of persons living with HIV.”

Health experts weren’t able to provide any statistics or estimates for how many people died as a result of AZT, but Kristen Nordlund, a CDC spokesperson, said a number of factors contribute to AIDS-related deaths, including late diagnosis, limited access to healthcare and co-infections.

“It is crucial to consider the broader context and advancements in HIV/AIDS treatment when analyzing the impact of specific drugs,” she wrote in an email. “AZT was just one component of the evolving treatment strategies for HIV/AIDS, and its use has significantly evolved over time.”

GlaxoSmithKline, the maker of Retrovir, similarly dismissed the claims as “unsubstantiated.”

“Did Fauci support the use of AZT? Yes,” wrote Warren Gill, a spokesperson for AIDS United, an advocacy group based in Washington, D.C. in an email. “Was that backed by science? Also, yes.”

But even as AZT prolonged the lives of early AIDS patients, it was far from painless, he acknowledged.

“I think it’s safe to say this history of AZT is nuanced. It wasn’t perfect,” Gill wrote. “Taking it alone extended people’s lives, but had some terrible side effects, including drug resistance. But as we discovered using it in combination with other drugs, it became more effective. And the science we learned through its use has allowed us to discover new drugs that are more powerful and have fewer negative side effects.”

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This is part of AP’s effort to address widely shared misinformation, including work with outside companies and organizations to add factual context to misleading content that is circulating online. Learn more about fact-checking at AP.