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Stockholm AIDS Conference: The Untold Story


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.

What's Right? 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 last year.

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 treatments.

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 evidence.

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 involved.

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 virus.

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 trials.

Like the first candle in a dark room, the first advocacy makes all the difference when there has been none before.


Copyright © 1988 -AIDS Treatment News, Publisher. All rights reserved to AIDS Treatment News (ATN), Email AIDS Treatment News .

Information in this article was accurate in July 1, 1988. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.