AIDS TREATMENT NEWS No. 059 - July 1, 1988
The "IV International Conference on AIDS", June 12-16 in
Stockholm, Sweden, included over three thousand scientific
presentations--more than twice as many as last years' meeting
in Washington, D.C. We covered these conferences to gather
information on promising treatment possibilities and related
scientific research. This article gives our overview; details
will follow in the next several installments, starting below
and continuing every other issue.
Despite largely pessimistic press reports, we found more good
news than bad from the Stockholm conference:
* Tremendous nuts-and-bolts progress in basic research
represents major advance toward an eventual cure or highly
effective treatment--for AIDS and many other diseases as
well. Little of this progress makes headlines, however.
* The conference reflected a new stage of effective worldwide
mobilization in many areas of AIDS. (Unfortunately there are
also glaring deficiencies, illustrated below.)
* In civil liberties and related areas (outside our treatment
focus) the world's experts have developed strong consensus
which recognizes the concerns and dignity of persons with
AIDS. For example, balancing the rights of infected persons
against those of the uninfected is seen as a false issue; on
the contrary, antidiscrimination protection is regarded as
absolutely crucial to effective control of the spread of the
virus. Far from being opposed, the interests of those with
AIDS and the larger society correspond.
The developing consensus easily crosses national borders. For
example, telephone hotlines throughout the world are now
providing roughly the same information.
This writer is too busy covering treatments to give
nondiscrimination and related issues the attention they
deserve. Those working in these areas should examine the
Stockholm results and other forums for ammunition against the
political demagoguery still very much with us.
Behind the Bad News: Analysis and Comment
The bad news is the lack of major treatment advances in the
Most commentators have assumed that lack of progress on
treatments reflects the difficulty of the disease. But
analysis of the Stockholm presentations contradicts this
assumption. The evidence suggests another cause for lack of
If the intractability of the disease were responsible, we would
have expected to see a string of treatment failures at
Stockholm--many reports of drugs or other therapies which were
tried but failed to work. In fact there were very few such
reports. Very few new treatments failed in the last year.
Very few were tried at all.
The problem is political, not technical. The impressive
worldwide mobilization around basic research, prevention, and
other areas has glaringly omitted any serious mobilization or
commitment to save the lives of those now infected or ill.
These people were written off several years ago, and since then
there has been no institutional constituency for mobilizing
research to save lives.
The major thrust of the scientists at Stockholm has been to
find a cure through elegant molecular biology, maybe in five to
ten years. There is no urgency or mobilization to test the
dozens if not hundreds of treatment possibilities widely agreed
to be available now--dozens of which could be tested within the
next few months if only there were the will.
Some of the scientists now realize that there is a problem, in
that current policies all but guarantee that hundreds of
thousands of people will die of AIDS during the next few years.
Some have reached the "isn't it a pity" stage. But few have
broken through the aura of inevitability to see the problem as
resulting from human attitudes and decisions which can and
should be changed.
The one common factor behind virtually every treatment attempt
receiving serious research attention--AZT, vaccines,
interferons, CD4, Ampligen, IMREG-1, and a few others--is hot
prospects for commercial gain. No major institution,
government as well as private, will seriously consider a
treatment solely on its medical and scientific (as opposed to
commercial) merit. If it's a plant that anyone could pick, a
food in general use, a common industrial chemical, or a
healthfood product, it won't be considered, no matter what the
Scientists as well as corporations have vested interests. It
has unfortunately always been hard to find financial support
for basic biological and medical research--work which doesn't
make headlines, but on which future progress depends. AIDS is
now driving huge advances in fundamental knowledge of viruses
and the immune system, as well as related technology such as
improved scientific tests. The research community involved in
this effort has never had it so good.
No one is deliberately conspiring to keep AIDS going to feed
the multi-billion dollar research and pharmaceutical
industries. No one has needed to. For the interests of the
powerful are only threatened by doing what needs to be done--
creating a mechanism to promptly test the dozens of promising
treatments already known and available, regardless of
commercial prospects--each with perhaps ten to 20 volunteers.
The problem isn't money--this testing wouldn't need to cost
much--but pervasive obstructionism throughout the institutions
This problem may seem so big as to be hopeless. But there is a
key place to start, where attainable public effort can have
critical results: namely the lobbying of AIDS, gay, hemophilia,
and physicians' organizations to investigate and address the
issues of clinical trials and treatment access for saving the
lives of the millions of people already infected with the AIDS
The decision to write off those already ill probably started
from homophobia. But now it continues from its own momentum,
due to the almost total lack of institutional support to change
it. We saw this lack in Stockholm, when scientists didn't even
feel the need to address the issue of the "drugjam" in clinical
Like the first candle in a dark room, the first advocacy makes
all the difference when there has been none before.