Deciding which experts to follow can be a puzzle

HOW should we respond to our own ignorance? If you are ignorant about a technical subject — such as the efficacy of antiretroviral drugs — and experts disagree about the issue, then how should you, as a lay person, decide whose views to follow?

The question is brought into even sharper focus when you imagine being a president at the end of the ’90s — say, for example, one who is short, smokes a pipe, and has a penchant for Shakespeare — who is forced by the nature of your job to decide who among disagreeing experts to follow.

The mainstream AIDS lobby thinks it is obvious for a leader to take a decision on technical issues. Yet, this is not so and it is worth understanding why.

But first one should note that the puzzle of which experts to follow does not arise when the experts are fake. I am therefore not referring to traditional healers on the streets of Cape Town selling nonsense as remedies for HIV, or the likes of Matthias Rath who, despite being a medical doctor, is not a medical expert on HIV/AIDS.

No leader should take seriously someone like Rath, who says vitamin tablets will cure HIV. We can set aside those who promote quack remedies as unethical egomaniacs. One can’t imagine why a government would want to take them seriously. To the extent that our government humoured these folks, it displayed inexcusably poor leadership.

However, among the AIDS dissidents, there are many award-winning international scientists, as much as many of us do not like them. These include Prof Peter Duesberg and Dr David Rasnick. Now, before anyone gets upset after the satisfying display of rationality on President Jacob Zuma ’s part on World AIDS Day, it is worth stating that the point, in the first instance, is not that these dissidents are right in their convictions about the relationship between HIV and AIDS or the efficacy of antiretroviral drugs.

The point is that many of us, myself most definitely included, know very little or nothing about science and so have no honest basis for adjudicating these disputes. I hardly understand more than one or two lines in the articles that flow between orthodox scientists and these dissidents. That is the heart of my own nonexpertise and ignorance. And, truth be told, this extends to the ultimate policy chiefs very often, including the minister of health and the president.

All of this implies that it was acceptable for former president Thabo Mbeki to take seriously the existence of expert dissidents on an issue of such magnitude as an unfolding pandemic. Of course, only Mbeki’s shrink would know whether this kind of leadership angst, based on an appreciation of the existence of expert disagreement , was the actual reason for his denialism.

More than likely — though here I am speculating — the real drivers of Mbeki’s dalliance with denialism had to do with the now well-rehearsed pop theories about his irrational concern that negative stereotypes about African sexuality motivate the case for the virus’s presence.

Still, the general point remains: it is proper for a responsible leader who knows nothing about a technical issue to reflect on how to respond to disagreement among experts. The situation is not unique to AIDS policy. No leader anywhere in the world will be an expert on more than one or two out of a thousand issues on which he or she will have to adopt a view and policy.

A sensible principle to follow in such circumstances is surely the following: adopt the view endorsed by the majority of experts. This principle is obviously somewhat dissatisfying. It suggests that numbers are indicative of academic or intellectual strength. There is no reason in principle that the majority of scientists cannot be wrong on an issue. So the application of the principle can, indeed, lead to the odd disastrous result. This is particularly serious in the context of a pandemic where the wrong intervention can cause society massive harm.

However, the point about one’s own ignorance necessitates this principle. Given that I have no basis for assessing the challenges of Rasnick or Duesberg as an outsider, I cannot but accept that for purposes of decision-making, the best procedure is to trust that there is a higher likelihood (even if no guarantee) that the majority of experts are right. Even if this turns out false, as a leader my decision to follow the majority remains rational, even with hindsight.

So, given this principle, Mbeki ought to have followed orthodox views on HIV/AIDS rather than to give dissidents a platform. After all, such a platform would not have improved Mbeki’s own chances of deciding who to follow. Presidents are not experts on these issues and so they had better get on with trusting the majority of experts.

History will forgive them if the majority of experts turn out wrong. As it happens, history will not forgive Mbeki for the alternative attitude he settled for.

http://www.businessday.co.za/articles/Content.aspx?id=88803