AIDS Panel Recommends a 'Mid-course Correction'By Brett Altschul
Last week, a government-appointed panel released its advisory report on the state of the nation's $1.4 billion AIDS research program. The panel, which included Professor of Biology David Baltimore '61, called for significant changes in the way the program is run.
"The AIDS program has gone well but not perfectly," Baltimore said. "It is in need of a serious mid-course correction and that is what the panel recommends."
A pioneer in virology, Baltimore received the Nobel Prize in physiology or medicine in 1975 for his discovery of retroviruses, the group of viruses that includes HIV, which causes AIDS.
The report said the AIDS research program had accomplished impressive things, but there is still room for improvement.
The panel criticized the National Institutes of Health, the government agency responsible for the majority of public sector AIDSresearch. It said the NIH needed more input and involvement from non-governmental scientists.
The panel worked with the full support of NIH Director William Paul, Baltimore said. "The director of the office of AIDS research as well as the director of the NIH have committed themselves to a careful review of the recommendations," he said.
"Their commitment is real and public and I would expect that a majority of the changes will be implemented," Baltimore said.
Outside involvement needed
The report said the NIH needed more involvement from scientists outside the government. It called for the NIH to double the amount it gives in grants to outside scientists. Such grants currently make up 20 percent of AIDS expenditures at the NIH.
"Much of the intelligence of the research community lies outside of NIH, so bringing outside people closer to the decision-making process will strengthen that process," Baltimore said. "There are many senior and junior scientists whose programs could contribute to the AIDS effort but who have not been encouraged to get involved."
The report also called for changes in the NIH's programs for developing new drugs and vaccines. It recommended a reduction in the budget for research into new AIDS drugs, because pharmaceutical companies could do the same research.
It said that the drug discovery program hadn't produced any important and novel new drugs since AZT, which has been used to treat AIDS for about 15 years.
The vaccine development program received criticism for having too few human studies. The panel recommended that a nongovernment scientist be appointed to oversee the vaccine program.
AIDSresearch needs organization
"AIDS research has not been coordinated over the units that make up the NIH," Baltimore said. "That has led to unnecessary duplication. That is one of the organizational issues," he said. "Another is that the definition of AIDS-related work has been different across the Institutes."
The report called on the NIH to establish a more universal definition of AIDS. It said differing definitions caused some AIDS funding to go to research projects only marginally related to AIDS, although Baltimore admitted that the severity of this problem is unclear.
"How much money is going to work that should not really be considered AIDS-related is uncertain," Baltimore said. "Once there is a consistent definition of AIDS-related research, that will become clearer."
The panel was made up of 114 leading scientists, drug company representatives, and people from AIDS action and community groups.