How to Reduce Deaths in the Next Pandemic

Dear Professor Jeffrey Sachs,

            I met you at the Sheraton Hotel at the Durban International AIDS Conference in 2000 on my first trip to Africa. We chatted for about ten minutes about my research on aspirin, NF-kappaB inhibitors, and selenium and how they offered a low-cost, additional way to treat HIV disease in Africa and worldwide. It is unfortunate that this science was not taken up at that time. If both these affordable effective methods of treating viral disease had been adopted more widely, it would have reduced the mortality rate of Covid-19 in the US by 60-70% and avoided the historic tragedy our nation recently suffered.

            Despite aspirin having been used to treat colds and flu for over a century, the idea that aspirin is an effective antiviral drug sounds naïve. However, in 1989 when Dr. Donald Kotler showed aspirin has significant antiviral activity, two-thirds as much as AZT, that cracked open the door to a whole class of drugs that are in some cases hundreds of times more powerful than aspirin. Among many others, those include dexamethasone, 210 times as strong as aspirin. Dexamethasone was widely used to treat hospitalized Covid-19 patients. Unfortunately at least ten other drugs in this class that could have been used to treat early Covid infection and reduce hospitalizations were not used. Meanwhile US health authorities falsely claimed no drugs existed to treat early Covid. Although NF-kB inhibitors (NF-kBIs) include both nonsteroid and steroid anti-inflammatory drugs, NIH scientists failed to inform the public that these drugs also work as antiviral drugs. These drugs are effective because any medicine that inhibits the NF-kB protein reduces both inflammation and viral replication. Thus all NSAID and steroid anti-inflammatory drugs also work as antiviral drugs. Why haven’t we realized or informed people of this before?  Immensely different in strength, both aspirin and dexamethasone are effective antiviral drugs, as is the chemotherapeutic NF-kBI drug tamoxifen. My book Dear Bill Gates, How to End Serial Pandemic Failure, HIV-1 to Covid-19 contains a list of many NF-kBI drugs and their comparative strengths on page 48.

            This knowledge would have had tremendous implications for improving survival of Covid-19 if it had been applied. It was not. That was because the NIH focused solely on new drug development rather than informing the public about obvious, existing, variously effective therapies to save lives. This was not the first time. The widespread use of cheap, available, effective, broad-spectrum antiviral NF-kBIs could have been used from day one of infection and a pandemic. Those drugs could have prevented many hospitalizations and reduced the impact of the follow-on pandemic of Long Covid. However the most potent therapeutic way to prevent deaths during Covid would have been to use selenium to treat patients with severe Covid. Research shows 100% of severe and hospitalized Covid patients are selenium deficient. This deficiency progresses rapidly as Covid progresses towards end-stage disease.    

            In 2014 I was the only person in the world to provide an effective therapy for Ebola virus disease. Early in the epidemic, after reviewing my analysis, the Liberian Ministry of Health asked me to bring selenium from Johannesburg to Monrovia. Within hours of my arrival, Dr Jerry Brown started treating patients with 1.2mg daily of the selenium I brought, adding it to the existing WHO standard of supportive care. Within two weeks the mortality rate at the ELWA-2 Ebola treatment unit fell by 42.8%. The Ministry immediately ordered one bottle of selenium for each Ebola patient Liberia had at that time, 2462 bottles. Dr Brown was named Time magazine’s Person of the Year for 2014 representing all those who fought the battle against Ebola. Brown was director of ELWA-2, the first Ebola clinic in Liberia. But our clinical success with selenium was not mentioned in the Time’s article.

When Dr Brown and the American physician whose organization sponsored the ELWA-2 clinic took the impressive result of the informal clinical trial of selenium to the NIH and CDC offices in Monrovia, US health officials were dismissive. They ignored it. Why? The NIH had four drugs that were in development to treat Ebola, but those were not quite ready to test. As with NF-kBIs during Covid, the NIH did not want another remedy to be known to be successful before they had a chance to test their own four potentially highly profitable candidate therapies for Ebola. Four years later when they finally had a chance to test their developmental drugs in Kivu Province, DRC Congo, one of the four turned out to be very effective. That was Remdesivir, a drug they also tried against Covid-19. Remdesivir was not effective against Covid, and therefore it is not a broad-spectrum antiviral.

 A full course of Remdesivir costs $1000 and requires intravenous – IV - administration in a clinical setting. A full course of selenium costs $7 and does not require any special apparatus or extra clinical care. The more effective, safe dose of 2.0mg of selenium – instead of 1.2mg - should have been used. It should have reduced Ebola mortality rates by closer to 65%. Using selenium, saving each additional life from Ebola would have cost less than $14. Except for Ebola patients who were in clinics run by the Liberian Ministry of Health, patients in clinics run by Doctors Without Borders, the US, the Chinese, and those with Ebola in Sierra Leon and Guinea, never received the benefit of selenium therapy. Failing to provide selenium doubled the death toll of that West African epidemic and continues to cost lives in Ebola epidemics in Africa today. To protect new drug discovery, the NIH ignored selenium therapy for Ebola virus disease (EVD), despite the impressive reduction in mortality it demonstrated. The NIH prioritizes safeguarding new drug development and potential pharmaceutical profits above saving ordinary people’s lives. They have maintained this unspoken policy in every epi-pandemic - HIV, Ebola, and Covid-19. That self-defeating policy endangers American lives. This should be a national security concern. Why is it not?           

            I was first infected with HIV in 1983 and joined as a participant in the Multi-centered AIDS Cohort Study (MACS) at UCLA in April 1984. When they finally developed the HIV test in 1985, I was in one of the first cohorts ever tested. I started taking AZT on New Year’s Day 1989 and six months later started to conduct one-person trials of potential therapies on myself. Each one-person trial and washout period took six months. My first two trials testing St John’s wort and N-acetylcysteine showed no benefits. However on my third trial aspirin almost doubled my CD4/CD8 ratio - a Eureka moment. In 1992 at the Amsterdam International AIDS Conference my abstract was the first ever to report that an NF-kBI, aspirin, could significantly increase CD4 count and improve the CD4/CD8 ratio. That cracked open the door to NF-kBIs as antiviral immune boosting drugs, but no one walked through. NSAIDs are just too cheap. Why study them? Who would want to take aspirin or another stronger, safe, affordable NSAID antiviral when they could take relatively toxic, barely effective AZT at one thousand times the cost? While AZT was determined to be too toxic for cancer patients, HIV patients accepted anything that was tantalizingly promoted as a breakthrough medication by the NIH. AZT was not a breakthrough. It was closer to a fraud – not even as effective as aspirin in improving immunity. Many existing NF-kB inhibitors would have been vastly superior as anti-HIV drugs, but their potential was ignored in the rush for extraordinary profits from AZT. Years later my research with Dr Elopy Sibanda in Zimbabwe showed that the weakest NF-kBI, aspirin alone was superior to AZT. Aspirin can increase CD4 count twice as high and for twice as long as AZT. At a toxic price of $1,000 a month versus $1 per month, which one won? Naturally the most toxic, overpriced, patented one – AZT.      

            How did I know to try aspirin? Dr Donald Kotler of Columbia University and the Community Research Initiative on AIDS (CRIA) New York published two abstracts on an aspirin (ASA) analogue, Asacol (5-ASA), one in 1989, and one in 1990. Rajan Sen working in the laboratory of Noble laureate David Baltimore discovered the primary viral replication factor NF-kB in 1986. Dr Kotler was one of the first to test the anti-virial potential of inhibiting this protein. NF-kB inhibitors worked. Unfortunately, Kotter was persuaded that NF-kBIs would not be needed to help against HIV because protease inhibitors would soon revolutionize AIDS therapy and leave NF-kB inhibitors in the dust, so he dropped this immensely promising line of research. They had no profit potential. HIV researchers were unaware that much stronger NF-kBIs existed. Other NF-kBIs are dozens and hundreds of times stronger than Asacol and aspirin, but tragically, no one supports research on off-patent medicines. Nevertheless, these broad-spectrum antivirals could have been used immediately to save lives of those with HIV, both in the US and Africa. However no one knew about NF-kBIs. They still do not because these are off-patent medications without huge profit potential. The failure to follow through with NF-kBI antiviral research was one of the biggest mistakes in modern medical history. It delayed effective HIV therapy getting to Africa by almost fifteen years. Millions died.  Had NF-kBIs been more generally used against HIV disease, today this would have been widely known medical knowledge and could have contributed to saving 700,000 American lives from Covid-19. The above mistakes represent serial pandemic failure at its worst - a zero-learning curve from AIDS, to Ebola, to Covid-19. No physicians learned about a significant, broad-spectrum way to treat viral disease. That does not even consider the coverup of selenium’s dramatic breakthrough results in a Harvard/Nigeria clinical trial of selenium concluded in 2006. In that study in advanced AIDS patients, adding only one 200mcg tablet of selenium to a three-drug HAART therapy regimen increased CD4 count 140% more than highly active antiretroviral therapy (HAART) alone. Compared to HAART only, adding selenium tripled the increase in hemoglobin. That improvement in hemoglobin would have provided important benefits against Covid-19 and might help in sickle cell anemia. However that Nigerian research was covered up and never published as a medical journal article because it made selenium look too good in comparison to HAART therapy. Likewise, medical authorities including the WHO continue to ignore research from Rwanda reported 2016 in the journal AIDS that showed that just one 200mcg tablet of selenium can slow HIV progression by 43.6%.                  

            The secret of deadly viral diseases and how they kill is that their Env – envelope - viral gene genetically encodes a selenium containing selenoprotein to form their outer protective envelopes. As viral replication escalates exponentially, depletion of selenium does too. Viral destruction of cellular anti-oxidants causes damage to cellular structures and functions, the loss of selenium, the decline of CD4 count, and eventually immune system collapse. That provokes massive programmed-cell-death, release of toxins, the cytokine storm, sepsis, multiple-organ-failure and death. This is a natural sequence of cause and effect. It proceeds at various speeds in different deadly viral diseases. However it does not occur in all viral diseases because various viruses carry molecular keys to receptors to enter different cells. Thus not all viral infections provoke this cause-and-effect cascade towards death. Ebola does and Covid does sometimes. As a lentivirus, a slow virus, HIV proceeds with a delay of years. Like Covid, influenza can do this, depending on the viral strain and co-morbidities. Viral depletion of selenium in the body and immune system to the point of extreme deficiency triggers this death spiral. Conversely, selenium supplementation can revere this phenomenon and save lives. Selenium is the strongest medication to prevent or revere sepsis and multi-organ-failure.          

            So are selenium and NF-kBIs the solution to Covid and future viral pandemics? Yes. They provide half the therapeutic solution. They both are broad-spectrum antiviral medicines that have proved themselves repeatedly against various deadly viral diseases. What else can help? Paxlovid is extremely effective against Covid but evidently needs to be used within five days of initial symptoms. It has side effects and many contraindications. Paxlovid works as a protease inhibitor and most protease inhibitor drugs are specific, not broad-spectrum. However, Paxlovid was developed by combining two different HIV protease inhibitors. Thus it might be effective against future deadly viruses. We do not know. But why should physicians only use one protease inhibitor? Why not NF-kBIs and selenium too? They used dexamethasone to save thousands of lives. But what about the dozen other NF-kBIs? Is it not medically self-defeating to ignore all other effective drugs, or is this gross medical and scientific negligence? Ranging in strength from a rating of “1” for aspirin to “567” for Tamoxifen, there is a huge range of powers of NF-kBIs to choose from. Most are suitable for early therapy. If we had only known! Anthony Fauci should have known because I reminded his deputy about NF-kBIs and selenium by an email in March 2020. Instead of informing the public of this possible option, Fauci remained silent to protect new drug development, just as the NIH had done first with HIV and again with Ebola. New emerging diseases are opportunities for new drug development and potentially big new profits. Unfortunately, based on NIH precedent, obfuscation of effective, broad-spectrum antiviral interventions always results in pandemic failure. The ultimate national catastrophe will arrive with a future super-pandemic. Will that be H5N1 avian influenza with its current 40-50% mortality rate? Or will it be Nipah virus, a more deadly Covid variant, or something totally unanticipated? When will the next major pandemic occur? Will the NIH again corruptly lie to the public, claiming existing life-saving medications do not exist?  

            What a difference a patent makes. If it is a high-cost patented medication, even if it does not work, the NIH will advise people to try it, as they did with Remdesivir for Covid. If it is an off-patent cheap medication, even if it works great and can save thousands of lives, they fail to inform the public. Our national health care system is broken, corrupted by agency capture by the pharmaceutical industry. It starts at the top with the NIH. In fact NIH is a misnomer. The NIH is actually the National Institutes of Corporate Welfare for Drug Research. Yes, the NIH does do a lot of great work, but it suffers from a gapping conflict of interest and an ethical blackhole because it puts the welfare of the pharmaceutical industry ahead of the welfare of ordinary Americans. With Covid-19, an estimated 700,000 more Americans died than necessary due to the failure to use NF-kBIs and selenium.                

            The bottom line with anti-inflammatory, antiviral NF-kBIs is obvious. They are broad-spectrum antiviral drugs that should be used at appropriate strengths from day one of contagious viral infections. The bottom line with selenium is that selenium is key to both cellular health and immune system strength. The vast majority of cellular antioxidants that keep cells healthy by maintaining the homeostasis and oxidative balance of cells contain selenium at their active sites. Cells also require selenium for their structural integrity. Selenium improves all aspects of immune function, especially by increasing CD4 count through its direct effect on the thymus gland. Because viruses cause death in large part by severely depleting selenium and damaging cellular functions, physicians can prevent many deaths from advanced viral disease by supplementing sufficient selenium back into the body – just like what we do with water or oxygen in cases of their deficiency. As one expert explained, when a person loses 20% of their selenium they develop immune deficiency, as in AIDS. When they lose 30%, they are finished. The same thing happens when a person loses an equivalent amount of oxygen or water. They die. This is scientifically indisputable but quite arcane, so it goes unrecognized by medical professionals. Why? Selenium is not profitable enough, and this is not taught in medical schools. Unfortunately, due to economic disincentives, hugely beneficial but only marginally profitable medical research is never conducted. If it is, it is ignored, covered up, or forgotten due to competitive interests. Serial pandemic failure is not just a medical problem. It is an economic one as well. How many trillions did Covid cost the United States treasury? It cost three to five trillion at a minimum. Thirty percent of that could have been saved if we had reduced hospitalizations and deaths by 60-70% by using NF-kBIs and selenium.      

            What about Long Covid? Long Covid affects approximately fourteen million people in the US and will present a cost burden on the American medical system for decades to come. In his new book, Song of the Cell Siddhartha Mukherjee suggests that disease starts in the cell. I agree. That includes damage to the alveoli cells in the lungs and every cell that SARS-CoV-2 infects in the body. Those include most cell types because most cells include ACE2 receptors. When SARS-CoV-2 infects those cells, it uses its protease cutting enzyme to cut the selenium out of cellular antioxidants allowing it to reprocess that selenium for its own selfish destructive campaign of viral replication. Thus Covid damages every organ system in the body at their cellular level by destroying their protective antioxidants. That causes the phenomenal array of disease sequalae we commonly refer to as Long Covid. It would be common sense to try to treat Long Covid using selenium supplements daily in combination with whatever other therapies researchers are testing. This is logical because the underlying cause of many if not most of these illnesses is oxidative damage to cells caused by loss of selenium. Selenium is known as a partial remedy to many of the illnesses and conditions caused by Covid, so this strategy should be medically obvious. It is not.   

            Can the United States afford another pandemic like Covid? Can the US afford a pandemic like H5N1 avian influenza that may be thirty times more deadly than Covid? When will we recognize we are ill-served by the current prioritization by the NIH that supports the welfare of Big Pharma while neglecting the interests of tax paying citizens? American citizens need someone on their side putting their health first. We need a National Health Care Ombudsman or agency representing their health interests. We need a national program to test off-patent medications to determine new uses for old drugs. Every dollar in profit earned by a pharmaceutical company subsidized for new drug development by the NIH in the last pandemic cost American taxpayer ten dollars. That is not a great return on investment. Novel drugs can be developed in parallel as medical doctors use slightly less perfect broad-spectrum antivirals to save lives. Why did we fail to take this commonsense, life-saving approach with Covid? We should not allow the hoped for, supposedly perfect solution for viral therapy be the enemy of the existing, good solution for saving lives during pandemics. That is self-defeating. Regrettably a convoluted NIH therapeutic development policy defeated our nation during Covid-19 leaving 700,000 extra deaths on the battlefield. It was the greatest own goal in history.     

            Pandemic disease is extremely costly in too many ways. We must do better. The US national health system failed miserably with Covid-19. We cannot allow this to happen again. My voice is small. Who can help amplify this appeal to scientific common sense? Please do not confuse this science with ivermectin, chloroquine or the anti-vax movement. My research extends back over three decades. If you have any questions about anything I have written, please let me know. I invite you to read portions of the book I have enclosed, Understanding Covid-19, How 500,000 American Lives Could Have Been Saved, especially the scientific references and excerpts found on pages 156, 231, 366, 372, and 373. Visit the following website to see my activity in Africa - winagainstebola.com. If you have trouble getting through, visit winagainsthiv.com and click through to winagainstebola.com.

            I have been researching how viral disease affects the immune system and human health for thirty-three years as if my life depended on it. It did. Critical thinking and skepticism are important aspects of science. Cynicism and close mindedness is self-defeating. Please consider this science seriously. The cost of failing to recognize this simple science is incalculable, as is the continuation of serial pandemic failure into the future. That will cost untold trillions. America and its taxpayers deserve better.

Thank you for your consideration. 

            Scientifically yours,   

Howard S. Armistead