|By John S. James|
AIDS Treatment News
Twenty commentaries on the current status of AIDS research, by "researchers, clinicians, and community members from varying disciplines, experience and backgrounds" appear in the Summer 2001 issue of CRIA Update, published by the Community Research Initiative on AIDS. These brief summaries offer diverse and informed views of what is happening today in AIDS research -- and what may happen over the next several years.
You can find these summaries at http://www.criany.org, or mail a request to: CRIA, 230 West 38th St., 7th floor, New York, NY 10018 (ask for the AIDS research issue).
Comment on Research
One idea largely missing from these commentaries (including our own) is the possibility of a treatment breakthrough -- and the question of how to organize research to facilitate a major, unexpected advance.
For example, one possible area for such a breakthrough could be a treatment to disrupt the process by which, in most patients, HIV eventually turns off the immune system's original ability to control it well (a possibility discussed in the CRIA Update by Sean R. Hosein of CATIE, the Canadian AIDS Treatment Information Exchange, on excessive levels of IL-10 in HIV disease, and the possibility of treatments to lower them). Such an immune- based treatment could work in both developed and developing countries (where it might not need to wait for antiretroviral combinations to become available).
The big problem here would be the legal obstacles created by a clinical-trial system designed for big-company drug development. For example, the right kind of trial might be in one patient, looking for an efficacy result even from the first human volunteer, with no attempt to prove efficacy first in animals.
The existing rules serve two purposes -- to protect the public from unethical corporate experimentation, and to protect the same corporations from competition by making it almost impossible for anyone else to finance the whole drug-development process. Of course, if anyone could show truly convincing data, ways could be found to move fast. The problem is getting permission to do the earliest proof- of-principle human studies -- without entanglement in the gold-plated clinical trial system which already has its own mindset, investments, pipeline, and calendar in place, and naturally resists encroachment on its well-manicured turf.
So we continue to fight an epidemic with rules and procedures designed for routine, non-emergency research and development.
AIDS Treatment News
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useful links: http://www.aidsnews.org/ Editor and Publisher: John S. James
Associate Editor: Tadd T. Tobias Statement of Purpose: AIDS Treatment News reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations that work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. AIDS Treatment News is published 24 times per year, on the first and third Friday of every month, and print copies are sent by first class mail. Email is available (see below). Back issues are available at http://www.aidsnews.org/ To subscribe, you can call 800-TREAT-1-2 or 415-255-0588: