Totila, original name Baduila (died July 1, 552) was King of the Ostrogoths from 541 to 552 AD. A skilled military and political leader, Totila reversed the tide of Gothic War, recovering by 543 almost all the territories in Italy that the Eastern Roman Empire had captured from his Kingdom in 540.

A relative of Theudis, sword-bearer of Theodoric the Great and king of the Visigoths, Totila was elected king by Ostrogothic nobles in the autumn of 541 after King Witigis had been carried off prisoner to Constantinople. Totila proved himself both as a military and political leader, winning the support of the lower classes by liberating slaves and distributing land to the peasants. After a successful defence at Verona, Totila pursued and defeated a numerically superior army at the Battle of Faventia in 542 AD. Building on his victories, Totila followed these victories by defeating the Romans outside Florence and capturing Naples. By 543, fighting on land and sea, he had reconqured the bulk of the lost territory. Rome held out, and Totila appealed unsuccesully to the Senate in a letter reminding them of the loyalty of the Romans to his predecessor Theodoric the Great. In the spring of 544 the Eastern Roman emperor Justinian I sent his general Belisarius to Italy to counterattack, but Totila, captured Rome in 546 from Belisarius and depopulated the city after a yearlong siege. When Totila left to fight the Byzantines in Lucania, south of Naples, Belisarius retook Rome and rebuilt its fortifications.

After Belisarius retreated to Constantinople in 549, Totila recaptured Rome, going on to complete the reconquest of Italy and Sicily. By the end of 550, Totila had recaptured all but Ravenna and four coastal towns. The following year Justinian sent his general Narses with a force of 35,000 Lombards, Gepids and Heruli to Italy in a march around the Adriatic to approach Ravenna from the north. In the Battle of Taginae, a decisive engagement during the summer of 552, in the Apennines near present-day Fabriano, the Gothic army was defeated, and Totila was mortally wounded. Totila was succeeded by his relative, Teia, who later died at the Battle of Mons Lactarius. Pockets of resistance, reinforced by Franks and Alemanni who had invaded Italy in 553, continued until 562, when the Byzantines were in control of the whole of the country. The country was so ravaged by war that any return to normal life proved impossible, and only three years after his death most of the country was conquered by Alboin of the Lombards, who absorbed the remaining Ostrogothic population.

Most of the historical evidence for Totila consists of chronicles by the Byzantine historian Procopius, who accompanied the Byzantine General Belisarius during the Gothic War.

Early life[link]

Totila razes the walls of Florence: illumination from the Chigi ms of Villani's Cronica

"Totila" was the nom de guerre of a man whose real name was Baduila, as can be seen from the coinage he issued. "Totila" is how he was referred to by the historian Procopius. According to Henry Bradley, `Totila' and `Baduila' are diminutives of `Totabadws'.^[1] Born in Treviso, Totila was a relative of Theudis, king of the Visigoths. Elected king of the Ostrogoths in 541 after the death of his uncle Ildibad, having engineered the assassination of Ildibad's short-lived successor, his cousin Eraric in 541. The official Byzantine position, adopted by Procopius and even by the Romanized Goth Jordanes, writing just before the conclusion of the Gothic Wars, was that Totila was a usurper: Jordanes' Getica (551) overlooks the recent successes of Totila.^[2]

Initial victories[link]

His life's work was the restoration of the Gothic kingdom in Italy, and he entered upon the task from the very beginning of his reign, collecting together and inspiring the Goths, defeating a poorly led Byzantine attack on the Gothic stronghold of Verona in the winter of 541, and scattering the stronger Byzantine army at Faenza (Battle of Faventia) in the spring of 542.^[3]

Having gained another victory in 542, this time, avoiding stoutly defended Florence, in the valley of Mugello, where Totila showed his nature by treating his prisoners so well that they were induced to serve under his banner, he left a well-defended Tuscany with his enlarged forces, while three of the Byzantine generals withdrew from Florence, dividing their forces, to Perugia, Spoleto, and Rome, cities which Totila would have to take by siege.

In the meantime, instead of pursuing the conquest of central Italy, where the Imperial forces were too formidable for his small army, he decided to transfer his operations to the south of the peninsula,^[4] where he captured Beneventum and received the submission of the provinces of Lucania and Bruttium, Apulia and Calabria, essentially the whole of the Greek south; their Imperial taxes were now diverted to his benefit.

Totila's strategy was to move fast and take control of the countryside, leaving the Byzantine forces in control of well-defended cities, and especially the ports. When Belisarius eventually returned to Italy, Procopius relates that "during a space of five years he did not succeed once in setting foot on any part of the land... except where some fortress was, but during this whole period he kept sailing about visiting one port after another."^[5] Totila circumvented those cities where a drawn-out siege would have been required, razing the walls of cities that capitulated to him, such as Beneventum. Totila's conquest of Italy was marked not only by celerity but also by mercy, and Gibbon says "none were deceived, either friends or enemies, who depended on his faith or his clemency." After a successful siege of a resisting city, such as at Perugia, however, Totila could be merciless, as the Byzantine historian Procopius recounts. Procopius also left a word portrait of Totila before his troops drawn up for battle:

The armor in which he was clad was abundantly plated with gold and the ample adornments which hung from his cheek plates as well as his helmet and spear were not only purple, but in other respects befitting a king ... And he himself, sitting upon a very large horse, began to dance under arms skillfully between the two armies. And as he rode he hurled his javelin into the air and caught it again as it quivered above him, then passed it rapidly from hand to hand, shifting it with consummate skill.

Taking Naples[link]

Portrait of Totila in the 14th century Nuova Cronica

Procopius's picture is given an uncharacteristic setting, for Totila generally avoided formal battles with opposing armies drawn up in battle array and excelled at skirmishing. A siege was required at Naples, however, where the report of Totila's courteous treatment of Romans at Cumae and other surrounding towns undermined morale. Justinian was alarmed, but jealousy kept his one brilliantly competent general Belisarius at Constantinople. An attempt to relieve Naples by sea was badly bungled when Totila was informed during unnecessary delays, and a storm dispersed a second attempt, delivering the general, Demetrius, into Totila's hands. Totila offered generous terms and Conon's starving garrison at Naples opened their gates in the spring of 543.

On this occasion Totila exhibited a considerable humanity which was not to be expected, as the historian Procopius remarks, from an enemy or a barbarian. He knew that if an abundance of food were at once supplied, the famished inhabitants would gorge themselves to death. He posted sentinels at the gates and in the harbor and allowed no one to leave the city. Then he dealt out small rations, gradually increasing the quantity every day until the people had recovered their strength. The terms of the capitulation were more than faithfully observed. Conon and his followers were embarked in ships with which the Goths provided them, and when, deciding to sail for Rome, they were hindered by contrary winds, Totila furnished horses, provisions, and guides so that they could make the journey by land.^[6]

The fortifications were partly razed. Totila spent the following season establishing himself in the south and reducing pockets of resistance, while the unpaid Imperial troops in central Italy made such poor reputations pillaging the countryside that when Totilas turned his attention to taking Rome, he was able proudly to contrast Goth and Greek behavior in his initial negotiations with the senate. They were refused, however, and all the Arian priests were expelled from the city, on suspicion of collaboration.

Siege of Rome[link]

Towards the end of 545 the Gothic king took up his station at Tivoli and prepared to starve Rome into surrender, making at the same time elaborate preparations for checking the progress of Belisarius who was advancing to its relief. Pope Vigilius fled to the safety of Syracuse; when he sent a flotilla of grain ships to feed the city, Totila's navy fell on them near the mouth of the Tiber and captured the fleet. The imperial fleet, moving up the Tiber and led by the great general, only just failed to relieve the city, which then was forced to open its gates to the Goths.

It was plundered, although Totila did not carry out his threat to make it a pasture for cattle, and when the Gothic army withdrew into Apulia it was from a scene of desolation. But its walls and other fortifications were soon restored, and Totila again marched against it. He was defeated by Belisarius, who, however, did not follow up his advantage. Several cities including Perugia were taken by the Goths, while Belisarius remained inactive and then was recalled from Italy. In 549 Totila advanced a third time against Rome, which he captured through the treachery of some of its starving defenders.

Totila's meeting with Benedict of Nursia at Monte Cassino is preserved in Pope Gregory I's Dialogues (ii.14-15). It occurred either before or soon after the siege of Naples; the Benedictines' traditional date is March 21, 543. It includes a telling of the abbot's discernment of an aide of Totila's, his sword-bearer Riggio, dressed in royal robes, as an imposter, and also his predictions for Totila, who knelt to him. This event was a favorite subject for Italian painters.

Death[link]

Portrait of Totila in the Nuremberg Chronicle, 1493

His next exploit was the conquest and plunder of Sicily, after which he subdued Corsica and Sardinia and sent a Gothic fleet against the coasts of Greece. By this time the emperor Justinian I was taking energetic measures to check the Goths. The conduct of a new campaign was entrusted to the eunuch Narses; Totila marched against him and was defeated and killed at the Battle of Taginae (also known as the Battle of Busta Gallorum) in July 552, which brought an end to the long struggle between Byzantium and the Ostrogothic Kingdom in Italy, and left the Eastern Emperor for the time being in control of Italy.

Aftermath[link]

Totila was succeeded by his relative, Teia, who later died at the Battle of Mons Lactarius. The Goths were later absorbed into the Lombard Kingdom.

References[link]

•  This article incorporates text from a publication now in the public domain: Chisholm, Hugh, ed. (1911). Encyclopædia Britannica (11th ed.). Cambridge University Press. 

Footnotes[link]

External links[link]

Wikimedia Commons has media related to: Totila

• Encyclopaedia Britannica 1911: Totila
• Edward Gibbon, The Decline and Fall of the Roman Empire: vol 4.xliii.3 (Totila takes Rome)
• (Italian) La guerra gotico-bizantina
• (Italian) Le sepolture regie del regno italico (secoli VI-X) - Totila (541-552)

v t e Kings of Italy between 476 and 963 Non-dynastic Odoacer (476–493) Ostrogoths Theodoric (493–526) Athalaric (526–534) Theodahad (534–536) Vitiges (536–540) Ildibad (540–541) Eraric (541) Totila (541–552) Teia (552–553) Byzantines Justinian I (as Emperor) (553–565) Lombards Alboin (565–572) Cleph (572–574) Interregnum (574–584) Authari (584–590) Agilulf (590–616) Adaloald (616–626) Arioald (626–636) Rothari (636-652) Rodoald (652–653) Aripert I (653–661) Godepert (661–662) Perctarit (661–662) Grimoald (662–671) Garibald (671) Perctarit (671–688) Cunipert (688–689) Alahis (689) Cunipert (689–700) Liutpert (700–702) Raginpert (701) Aripert II (702–712) Ansprand (712) Liutprand (712–744) Hildeprand (744) Ratchis (744–749) Aistulf (749–756) Desiderius (756–774) Carolingians Charles I (774–814) Pepin (781–810) Bernard (810–818) Lothair I (818–855) Louis I (855–875) Charles II (875–877) Carloman (877–879) Charles III (879–887) Arnulf (896–899) Ratold (896) Non-dynastic (title disputed 887–933) Unruochings: Berengar I (887–924) Guideschi: Guy (889–894) Lambert (891–897) Welfs: Rudolph (922–933) Bosonids: Louis II (900–905) Hugh (926–947) Lothair II (945–950) Anscarids: Berengar II (950–963) Adalbert (950–963)

Medal record
Edward Gal with Totilas
Competitor for  Netherlands
Equestrian
World Championships
Gold	2010 Lexington	Team Dressage
Gold	2010 Lexington	Individual special dressage
Gold	2010 Lexington	Individual freestyle dressage
Silver	2006 Aachen	Team Dressage
European Championships
Gold	2009 Windsor	Team Dressage
Gold	2009 Windsor	Individual freestyle dressage
Silver	2005 Hagen	Team Dressage
Silver	2009 Windsor	Individual special dressage

Edward Gal (born March 4, 1970 in Rheden) is a Dutch dressage rider.^[1] He and his most recent mount, the stallion Moorlands Totilas (nicknamed "Toto"), were triple gold medalists at the 2010 FEI World Equestrian Games,^[2][3] becoming the first horse-rider partnership ever to sweep the three available dressage gold medals at a single FEI World Games.^[2] Going into the 2010 Games, they had amassed multiple world-record scores in international competition, leading one American journalist to call them "rock stars in the horse world".^[4]

Career[link]

Gal began his equestrian career as a jumper at age 14, beginning with ponies and graduating to larger horses at age 20. However, when he discovered his horse did not like jumping, he switched to dressage. While enjoying solid success in national and international competition, he did not become a truly dominant rider until he began competing with Totilas in 2008. Gal would later say that he and his team understood that Toto was a special horse after their first Grand Prix competition.^[4]

Since then, Gal has replaced his countrywoman Anky van Grunsven as the dominant rider on the world dressage circuit. In July 2009, he and Toto broke van Grunsven's world record score in Grand Prix Freestyle^[5] with an 89.50% mark at Hickstead, England, and shortly thereafter followed it up with another record score of 90.75% in the same discipline at that year's European Championships.^[6] In December 2009, at the fourth leg of the 2009–10 FEI World Cup Dressage series at Olympia in London, they extended their record in GP Freestyle to 92.30%, more than 10 points above the second-place finisher.^[6] While not setting a world record, they easily won that season's FEI World Cup final in GP Freestyle at home in the Netherlands, winning by more than 7 points with a score better than their first world record.^[7] The pair also have a world-record score in the Grand Prix Special discipline to their credit, having recorded 86.460% at Aachen in July 2010.^[2][5]

Gal and Totilas were installed as the overwhelming favorites in the 2010 FEI World Games in Lexington, Kentucky, USA, their first competition outside Europe. Klaus Röser, head of the German dressage team that has long dominated the discipline, said about Gal, "That we can beat Edward; I don't think so, I don't believe so. We have to be realistic."^[4] Röser's assessment proved correct, with Gal and Toto first leading the Dutch team to gold in the team competition, and then easily winning gold in Grand Prix Special and Grand Prix Freestyle.^[2][3]

In a piece in The Courier-Journal of Louisville, Kentucky that ran before the 2010 Games, dressage trainer Susan Posner pointed out that Toto was only in his second year in dressage despite being 10 years old, and said that his success illustrated how capable Gal was as a rider.^[4]

Personal life[link]

Gal is in a long-term relationship with teammate Hans Peter Minderhoud. Gal has been interviewed in several Dutch media outlets about his homosexuality and his relationship with Minderhoud.^[8]

References[link]

Wikimedia Commons has media related to: Edward Gal

Matthias Rath (born 1955 in Stuttgart, Germany) is a doctor,^[1] businessman, and vitamin entrepreneur.^[2][3][4][5] He earned his MD degree in Germany.^[6] Rath claims that a program of nutritional supplements (which he calls "cellular medicine"), including formulations that he sells, can treat or cure diabetes, cardiovascular disease, cancer, and HIV/AIDS.^[7][8] These claims are not supported by any reliable medical research.^[9][10] Rath runs the Dr. Rath Health Foundation, has been closely associated with Health Now, Inc.,^[11] and founded the Dr. Rath Research Institute.

The Sunday Times (Johannesburg) has described Rath as an "international campaigner for the use of natural remedies" whose "theories on the treatment of cancer have been rejected by health authorities all over the world."^[12] On HIV/AIDS, Rath has disparaged the pharmaceutical industry and denounced antiretroviral medication as toxic and dangerous, while claiming that his vitamin pills could reverse the course of AIDS. As a result, Rath has been accused of "potentially endangering thousands of lives" in South Africa, a country with a massive AIDS epidemic where Rath was active in the mid-2000s.^[1] The head of Médecins Sans Frontières said "This guy is killing people by luring them with unrecognised treatment without any scientific evidence"; Rath attempted to sue him.^[9][13][10]

Rath's claims and methods have been widely criticized by medical organizations, AIDS-activist groups, and the United Nations, among others.^{[4][5][14][15]} Former South African President Thabo Mbeki and former Minister of Health Manto Tshabalala-Msimang have also been criticized by the medical and AIDS-activist community for their perceived support for Rath's claims.^[14][16][17] According to doctors with Médecins Sans Frontières,^[18] the Treatment Action Campaign (a South African AIDS-activist group)^[19] and a former Rath colleague,^[20] unauthorized clinical trials run by Rath and his associates, using vitamins as therapy for HIV, resulted in deaths of some participants. In 2008, the Cape High Court found the trials unlawful, banned Rath and his foundation from conducting unauthorized clinical trials and from advertising their products, and instructed the South African Health Department to fully investigate Rath's vitamin trials.^[19][21] In 2008, Rath expanded his advertising to Russia, a country where the incidence of HIV/AIDS has been increasing.^[1]

Background[link]

Rath studied at the Hamburg University Medical School in Germany^[22] After graduating from Hamburg, Rath began researching arteriosclerosis at the University Clinic of Hamburg. He subsequently joined two-time Nobel Prize laureate Linus Pauling at his research institute in California.^[22] Ultimately, Rath had a falling-out with the Linus Pauling Institute; after a series of lawsuits and countersuits, Rath was ordered in 1994 to pay the Institute $75,000 and was assigned several patents.^[6] Rath subsequently developed his own branded nutrient products, set up the Dr. Rath Health Foundation and Dr. Rath Research Institute, and funds nutrition research with patent development in what he calls "Cellular Medicine".

Rath has offices in California, the United Kingdom, the Netherlands, and South Africa (Cape Town). His foundation also advertises its products in Spain, France, and Russia.^[1][23] According to Eversheds, Rath's solicitor, the Dr. Rath Health Foundation is "a not-for-profit body which conducts research into science-based natural therapies,"^[24] but the foundation is estimated to have earned "millions" through nutritional supplement sales.^[18]

Claimed discoveries[link]

Cardiovascular disease[link]

In a self-published book, Why Animals Don't Get Heart Attacks...But People Do, Rath claims to have discovered through comparative studies that animals with the ability to synthesise vitamin C do not suffer heart attacks. Humans do not have this ability, and thus need to obtain vitamin C from a balanced diet. Rath advocates increased intake of vitamin C to prevent atherosclerosis, heart attack, and stroke.^[25][26] In 1990, Rath and Linus Pauling proposed that vitamin C deficiency in Western diets causes microscopic lesions in the artery walls, which instead of being repaired are filled up with fats. These deposits, according to the hypothesis, later harden through dystrophic calcification, leading to typical symptoms of high blood pressure (reduced artery wall elasticity) and heart disease complications.^[27] Rath also believes that arrhythmias are primarily caused by nutritional deficiencies and can be prevented by optimizing the intake of such nutrients as vitamin C, coenzyme Q10, magnesium and vitamin B complex.^[28]

Cancer[link]

Rath claims to have discovered that high-dose nutritional supplements can block the spread of cancer cells in laboratory conditions (called metastasis when it occurs in the body). He argues that the growth and metastasis of cancer are facilitated when the balance between mechanisms breaking down and building the connective tissue shifts towards breakdown. He points out that the body makes widespread use of these mechanisms during normal (physiological) conditions, e.g. a) during ovulation, when egg cells migrate from the ovary to the fallopian tube; b) during the restructuring of the uterus and the breast in pregnancy and lactation, when huge amounts of tissue have to be remodelled; c) during infections when white blood cells (leucocytes) migrate through the tissue to the site of infection.^[29] He argues that in case of cancer, normal control of these mechanisms fails and the tissue degradation continues uncontrolled.

Rath claims that the uncontrolled release of degrading enzymes in cancer can be blocked by the natural amino acid lysine. He says that a high daily intake of lysine – in particular in combination with vitamin C – can block cancer cells from spreading.

Rath has published a series of articles claiming in vitro evidence that supplements can slow the spread of more than 30 cultured, immortalized cell lines derived from human cancers. These studies, Rath claims, have also identified in vitro synergism between lysine, polyphenols present in green tea extracts like EGCG and other micronutrients.^[30] Organized in vivo clinical studies using this new approach to cancer have not been published. An independent review of Rath's claims by the Swiss Study Group for Complementary and Alternative Methods in Cancer (SCAC) in 2004 found "no proof that the vitamin preparations of Dr. Matthias Rath have any effect on human cancer" and advised against their use.^[31]

Immune deficiencies[link]

Rath and his research team advocate the use of micronutrients to improve the immune response against infections and help fight immune deficiencies. Rath and his colleagues report that chicks infected with avian flu and given a mixture of micronutrients develop audible pulmonary symptoms later than control animals.^[32]

In a special feature article published in the 2007 Commonwealth Health Ministers Book, Rath and colleagues claim that "studies conducted with both single and multiple nutritional supplements have shown that micronutrients act to control HIV infection and AIDS in three specific ways, which include: (i) suppression of virus multiplication and spread; (ii) restoration of cell-mediated immune responses and (iii) slowing the rate of AIDS progression and reducing the severity of AIDS-defining and disease-related symptoms."^[33]

International politics[link]

According to Rath, events of the last century in the international arena have been driven by pharmaceutical and oil companies. Rath claims that World War II was started and exploited by these interests.^[1] In court filings, Rath and his lawyers write that the pharmaceutical industry then started apartheid in South Africa as part of a global conspiracy to "conquer and control the entire African continent." Former Nazi officials and the German chemical company IG Farben are specifically mentioned as playing a central role in the alleged conspiracy. In these documents, Rath also compares his adversaries in court to Hitler's storm troopers.^[34]

Rath suggests that the pharmaceutical industry continues to control international politics today, allowing 9/11 to occur and starting the Iraq War to divert attention from what Rath considers the failures of drug companies.^[20] On his website, Rath states that United States President George W. Bush and Vice President Dick Cheney, at the behest of what Rath calls the "pharmaceutical cartel", were planning a nuclear war in advance of the 4 November 2008 elections in the United States. Similar claims are made by Rath in the New York Times and other major newspapers around the world in the form of large advertisements reportedly designed to resemble newspaper editorials.^[6]

Awards[link]

In 2001, Rath was presented the Bulwark of Liberty Award by the health freedom advocacy groups the American Preventive Medical Association and the National Foundation for Alternative Medicine.^[35]

Controversies[link]

Rath's theories, claims, and research, particularly his efforts to persuade South Africans to use his vitamin supplements to treat HIV/AIDS, have been controversial.^{[4][5][36][37]}

Illegal AIDS trials in South Africa[link]

In 2005, according to Reuters, Rath's foundation distributed tens of thousands of pamphlets in poor black South African townships, such as Khayelitsha, claiming that HIV medication was "poison" and urging HIV-positive people instead to use vitamins such as those Rath sells to treat HIV/AIDS.^[38][39] People with "advanced AIDS" were then recruited by the Rath Foundation and its surrogates for what the Rath Foundation called "a clinical pilot study in HIVpositive [sic] patients"^[40] Personnel of the South Africa National Civic Organisation (Sanco) administered the programme in Khayelitsha as "agents for the Rath foundation."^[40]

Patients were recruited for the study with offers of money or food,^[40] and were instructed to stop taking conventional HIV/AIDS medications.^[1] Luthando Nogcinisa, a local Communist Party official, said that Rath agents recruited known HIV-positive individuals, "often with a pack of groceries, and they encourage the person not to take the antiretrovirals, but to rather take the vitamins".^[40] Mike Waters, Democratic Alliance health spokesperson, states that Rath gave patients "food parcels to convince them to give up their antiretrovirals and take his vitamin C supplements instead."^[41]

Rath Foundation employees reportedly infiltrated HIV/AIDS clinics in Khayelitsha and paid clinic staff to provide them with names of patients.^[20] The Guardian described a case in which a pregnant woman newly diagnosed with HIV was visited at home by Rath Health Foundation employees and convinced to stop taking her antiretroviral medication in favor of Rath's vitamins; she died 3 months later.^[42] The Rath Foundation disputed that patients were asked to stop taking effective antiviral medication. Rath's lawyers also claimed that the trial was actually a "community nutrition programme" to which Rath contributed vitamins.^[43]

Five trial participants stated in sworn affidavits that they were stripped to their underwear, photographed, and had blood drawn without their permission. They were told to take pills containing what were said to be high doses of vitamins, including Rath's VitaCell. Demetre Labadarios, who leads the Human Nutrition programme at Stellenbosch University, questioned the safety of administering high doses of supplements to already-sick patients.^[40]

During and immediately following the vitamin trials, "many people died,"^[44] deaths attributed by Rath's adversaries to a lack of effective medication.^[45] Sanco-Rath clinic workers reportedly instructed patients to return to the clinic in the event of medical emergency, rather than going to hospital.^[44]

The Treatment Action Campaign (TAC) and the South African Medical Association (SAMA) took the Rath Foundation to court to prevent further unauthorized trials and to stop the foundation's claims that vitamins could treat or cure HIV/AIDS. Rath's lawyer however said that he had never claimed his vitamin products were a cure for HIV/AIDS, adding that Rath's only involvement in the affair was the donation of vitamins to the South African National Civics Organisation.^[46] TAC and SAMA prevailed in court over Rath and the Medicines Control Council on unauthorized trials and advertising of Rath's nutrients as a replacement therapy for HIV.^[19]

In September, 2008, Rath was ordered to pay court costs in an unsuccessful libel action against The Guardian (UK) after the paper reported on his foundation's unauthorized drug trials in South Africa.^[1]

Efficacy and marketing claims[link]

SKAK[link]

In 2004, the Swiss Study Group for Complementary and Alternative Methods in Cancer (SKAK), an independent group which evaluates alternative medical treatments, examined Rath's vitamin preparations and the marketing claims made by Rath.^[31] The Study Group reported that they "found no proof that the vitamin preparations of Dr. Matthias Rath have any effect on human cancer" and "advise against their use in cancer prevention and treatment while recommending a diet rich in fruit and vegetables."^[31] Specifically, the Swiss Study Group report criticized Rath for:

• Making sweeping, unsubstantiated claims of efficacy. Rath has claimed that his vitamin treatments can cure all forms of cancer, as well as most infectious diseases, including AIDS.^[47][48]

• Citing anecdotal reports of success which could not be confirmed. In the case of one patient allegedly "cured" by Rath's methods, the Study Group found that "it is not even certain from a medical perspective if cancer was present."

• Using a self-developed test of efficacy, rather than using widely accepted and verified tests and endpoints.

The conclusion of the Swiss Study Group regarding Rath's vitamin formulations was:

A cancer-curing effect has not been documented for any of these substances. Nor is there any proof that the preparations sold by Matthias Rath, some with high dosages, are useful in cancer prevention – leave alone curing cancer. Rath still owes proof regarding the correctness of his claims. Proof of effect cannot be provided by analogy with in vitro, animal or cell experiments. Because there is no proof for effect nor for the harmlessness of the preparations, SKAK advises against their use.^[31]

Harvard multivitamin study[link]

To support the use of multivitamins in HIV/AIDS, Rath has cited a study conducted by the Harvard School of Public Health, published in the New England Journal of Medicine,^[49] suggesting that multivitamin supplementation slows the progression of HIV to AIDS.^[50]

In May 2005, the study authors released a statement condemning Rath's "irresponsible and misleading statements, as in our view they deliberately misinterpret findings from our studies to advocate against the scale-up of antiretroviral therapy."^[51] The study authors felt that Rath had misused their study results to argue that multivitamins should be used in place of antiretroviral medication. In their statement, the study authors affirmed the central role of antiretroviral medication in the treatment of AIDS, and indicated that multivitamins should be, at most, a supplementary treatment.^[51]

Use of published medical literature[link]

A 1998 article in the British Medical Journal examined some of the claims made by Rath and Health Now in support of Rath's multivitamin supplement blend.^[11] The authors found that Rath listed 40 citations to support his product; however, on examination, only 8 of these citations were of actual clinical trials. After examining these clinical trials, the authors concluded that despite Rath's claims to the contrary, "no general clinical benefit of vitamins C and E and carotene can be proved from the works cited by Health Now."^[11]

Claims of WHO and UN support[link]

Rath's advertising material has suggested that his nutritional supplements are superior to antiretroviral therapy in the treatment of HIV/AIDS and implied that his claims were endorsed by the World Health Organization, UNICEF, and UNAIDS. However, these agencies issued a joint statement condemning Rath's advertisements as "wrong and misleading".^[52][15][53]

Criticism[link]

Credentials[link]

The Democratic Alliance (DA), official opposition party in South Africa, said Rath was representing himself as a medical doctor in his literature distributed in South Africa, and claimed that this was against the law since he was not registered as a doctor in South Africa. The DA filed complaints with the Health Professions Council of South Africa and the police. The Health Professions Council said it could not discipline Rath since its jurisdiction is restricted to registered doctors.^[54]

A lawyer representing Rath responded to the complaints by stating that the title 'Dr.' referred in Rath's case to "a PHD doctorate he had obtained and his position as a researcher, not a medical doctor."^[55][56]

Other sources, however, describe Rath as a "qualified doctor"^[1] and state that he "became a researcher first at the University Clinic in Hamburg and then, during 1989 and 1990, at the Berlin Heart Centre."^[6]

South African Council of Churches[link]

To address the "confusion" created by Rath's advertising campaign, the South African Council of Churches issued a statement that Rath's activities in South Africa "can only be interpreted as misguided strategies to promote Rath's own brand of nutritional supplements." The Council affirmed the importance of both antiretroviral medication and good nutrition for people with HIV, and pointed out that multivitamins are distributed by public health services and need not be obtained from Rath's organization.^[57]

Legal cases[link]

Rath has been involved in a number of legal cases.

• In 2000, the Court of Almelo in the Netherlands ordered Rath to stop making unfounded, false, and defamatory statements about the Dutch pharmaceutical company Numico.^[58][59]

• In 2002, the British Advertising Standards Authority found that advertisements by Rath contained a series of misleading and false claims and ordered the claims removed.^[58][60]

• In 2002, the United States Food and Drug Administration notified Rath that he was promoting his supplements in a manner that violated the Federal Food, Drug, and Cosmetic Act, by making claims of efficacy without undergoing the appropriate scientific and regulatory review.^[58][61]

• In 2005, the Advertising Standards Association of South Africa (ASASA) issued three separate rulings against Rath, finding that he had made false and misleading claims regarding the effectiveness of his supplements and describing his advertisements as "reckless in the extreme".^[8][58] Rath continued the advertisements, leading the ASASA to rule that, "in light of the gravity of [Rath's] breaches", he was required to submit all further advertising to the ASASA for prior approval.^[62]

• In 2006, the High Court of South Africa found that Rath had defamed the Treatment Action Campaign (TAC), an AIDS non-profit organization, by publicly making false and misleading statements about the TAC. Rath was ordered to cease his defamatory remarks "to ensure that the TAC's continued participation in the debate is not hamstrung by defamatory and unfounded allegations."^[58][63]

• In 2006, the July 22 issue of the British Medical Journal (BMJ) published a news item reporting that Rath had gone on trial in Hamburg, Germany "for fraud" in relation to the death of Dominik Feld. However, the BMJ subsequently retracted the news item "on legal advice" and issued an apology to Rath, stating that the BMJ accepted that "the allegations we published were without foundation."^[64] A subsequent libel claim by Rath was settled by the BMJ for £100,000.^[65][66]

• In 2006, Rath was prosecuted in Germany for distributing vitamins over the internet without a pharmaceutical licence, and for claiming on the website that the vitamins could cure cancer. Rath settled the case with a EUR33,000 fine, paid to an organisation helping disabled children, and amended the website. The judge noted that the case had not given an impression of "charlatanry", but rather of excessively aggressive marketing.^[67]

• In 2007, the German Federal Constitutional Court issued a ruling in favour of Rath. The Federal Constitutional Court found that the prohibition of the brochure and poster "Stop the pharmacartel" and "Stop the codex-plans of the pharmacartel" by judgements of courts in Berlin in 2000/2001 was unjustified as it violated Rath's fundamental rights, e.g. the right of free speech.^[68]

• In 2008, the Cape Town High Court issued an interdict barring Rath from advertising his products as a treatment for AIDS, and stating that the clinical trials he has been running in black townships are illegal. The ruling also found that "Health Minister Manto Tshabalala-Msimang and her department had a duty to investigate Rath's activities."^[69][70]

• In 2008 Ben Goldacre and The Guardian were sued for libel by Matthias Rath for the content of three articles describing Rath's activities in South Africa.^[71][72][73] In September 2008, Rath dropped his suit and was ordered to pay costs, an interim amount of about £220,000.^[1] Goldacre has expressed interest in writing a "meticulously referenced" work on Rath, and South African AIDS denialism in general, based on material which had been excised from his column during the litigation.^[74] A chapter of Goldacre's Bad Science, omitted from the first edition due to the litigation, was reinstated in the paperback edition in early 2009, made available on his website, and licenced for free distribution.[1]

References[link]