Throughout this retrospective, our purpose is to illuminate an evident knowledge handicap, cutting across the diagnostic procedures, reportage and mathematical modelling of chronic illness affecting African public health demographics, which we trace to three epistemic injustices (methodological, documental, and professional) in the way medical research in Africa is managed and monitored by foreigners. We propose that the mutual reinforcement of these three different kinds of epistemic transgression underlies the chronic failure of immunologists and public health practitioners to subdue the inflated rates of morbidity and short life expectancy persistent throughout Africa. Substandard data collection and implausible infection modelling count as injustices because they are traceable to a routine disregard for best scientific practice at the upper echelons of global health authority, which is betrayed by an inordinately high tolerance for diagnostic error concerning populations that are disproportionately disadvantaged as a norm, who are therefore regarded as low credibility risks in the global production and dissemination of medical knowledge. To ground these claims, we rely upon direct observations and anecdotal evidence culled from two different sorts of public health crisis in Africa which have received widespread publicity: (i) the eighteen-month-long international emergency response to a West Africa Ebola outbreak in 2014-2015, and (ii) attempts over the last quarter century to quell an extensively researched African HIV/AIDS pandemic.

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Nature 366, 716; 1993) state that Duesberg's claim that drug use rather than HIV is the cause of AIDS has been firmly rejected, but we do not agree. They rely in part on the Vancouver study (Lancet l3 March 1993) but Duesberg has pointed out that that study does not provide controls (verified drug-free AIDS cases). does not quantify drug use and ignores Zidovudine use. Garnett and Anderson also refer to one of us (J. S.) as a " television presenter" and use the phrase "non-expert opinion". J. S. has specialized in AIDS issues for seven years, and has made seven television documentaries analysing scientific knowledge about AIDS. Our work in preparing for the British network television documentary referred to involved consulting expert opinion from all the countries we visited as well as that of our special consultant Dr Harvey Bialy. The remarks by Garnett and Anderson about Bialy are totally unjustified. Bialy spent six years working in West Africa on the epidemiology of plasmidmediated antibiotic resistance among enteric pathogens, and in recent years has travelled extensively in Africa for WHO, UNESCO and UNIDO. He is an acknowledged expert on the implementation of biotechnology in Africa and has a wide knowledge of biotechnology-produced diagnostic tests.