Before the AIDS conference started, Richard Harmon had said that Jesse Eisenger would have a field day. I'm surprised that Jesse waited so long.
There was an interesting article in the New York Times yesterday which I believe is related to all this negative hype.
In yesterdays New York Times:
>>"Health Agency Urged to Review Spending
"New York Times (07/09/98) P. A24; Pear, Robert
An advisory panel appointed by the Institute of Medicine, a branch of the National Academy of Sciences, recommended on Wednesday that the National Institutes of Health review its $13.6billion annual budget, placing more emphasis on patient and citizen needs. The panel investigated death rates, prevalence, and spending, finding large differences in the amount spent per person by NIH. In 1996, NIH spent $43,206 for every AIDS-relateddeath on AIDS research, while only $1,160 was spent per death from heart disease, which killed over 700,000 more people in the United States than HIV that year. However, David Zingale, executive director of AIDS Action, noted, "Allocating dollars for deaths is an overly simplistic way to approach biomedical research. We also need to consider which diseases cause the most suffering, the years of life lost and the chances of scientific breakthroughs." The panel found that despite the major advances in biology the agency has contributed to over the past 50 years, NIH was not responsive enough to ordinary citizen needs. It recommended that NIH form a "council of public representatives" to increase citizen input. It also noted that it is important for NIH to define its spending priorities more clearly, since the agency will most likely see an increase in its budget in the future. Funding for NIH has doubled since 1991. The chairman of the panel, Dr. Leon E. Rosenberg, said that these changes should not necessarily take away from funding for projects that have no obvious or immediate practical applications. He said that research in this area has led to important discoveries in many fields. >>
There was a recent article before the world AIDS conference:
"Slicing up the Pie: Congress Asks Watchdog Agency to Report on NIH's Allocation of Scarce Research Dollars. In the face of criticism that the National Institutes of Health (NIH) has unfairly favored certain diseases -- particularly AIDS -- in its yearly allocation of research dollars, TAG Policy Director Gregg Gonsalves traveled to Washington, D.C. early last month with the charge of defending research priority-setting mechanisms at the agency. thebody.com
I certainly do not want funding for HIV research cut, but many are afraid this may happen and it is a big issue in Congress now, apparently. A lot of this negative hype was planned. If any listened to the pre-conference press briefing given by Thomas Coates, Jay Levy et al from UCSF, they say very clearly that they intend to burst the bubble of euphoria from Vancouver and they said that were planning on releasing articles timed to press releases to burst the bubble. Although even among that group there was not agreement, as Paul Volboring (?? I don't have the article now) was surprised at how well patients are doing and was apologetic that he had to praise HAART, while Coates and Levy focused on the negative.
That conference call was available at the HIVINSITE until recently, but unfortunately it has been removed this week.
hivinsite.ucsf.edu Then click on World Conference.
Just imagine if the sentiment at Geneva had been very positive, if study after study showed the improved survival rates with the new cocktails, if studies focused on the optimism many have on new data on immune reconstitution, on the belief that patients may be able to rebuild their immune system if treated early, properly, with HAART and not have to take drugs for the rest of their lives, would the NIH continue to allocate these proportions. I am not saying present treatments have no problems. But the problems and the negative have being blown out way out of proportion. Yes there are side effects to protease inhibitors. You have to be pretty stupid not to know that. But treatment for other diseases also has side effects. Chemotherapy for many cancers has many more side effects too, but it saves lives and is used. And I don't think any prominent oncologist would make public statements knocking present chemotherapy, when there were not safer more effective alternatives available.
I am not a desperate long. I do have confidence in the company, mainly because I am more familiar with current research than the majority. I've been out of town since the 4th and to me this is just another overreaction and misinterpretation by those who are not familiar with the actual research.
The press did the same thing at ICAAC in October 97 when the media headlines blared:
53% failure rate on AIDS cocktail with protease inhibitors. Deeks used that retrospective study of patients in SFGH to show why the patients failed and what factors caused treatment failure. They were: 1.High initial baseline viral loads; 2.adding drugs to current regimens (consecutively) and not changing all the drugs; and 3. failure to adhere. The success rate was actually very high - 80% to 90% - when these issues were addressed.
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