The Stars Reach Out, The Sun Pulls In John R. Chism

 

 

PART II - CHAPTER THREE

 

While Mark was perusing his notes in the taxi, one of his buddies noticed an obituary in The New York Times that they had picked up at the D.C. hotel.

"Oh shit," Mark's friend thought.

He showed the obituary to his cohort, who motioned frantically not to show it to Mark.

The taxi passed the U.S. Navy Memorial, the Courthouse, the U.S. Department of Labor. In a few more minutes, they'd be at the hearing.

Mark turned a page of his notes.

A Dr. Iris Davis, (who was an AIDS assessment coordinator at Woodhull Medical and Mental Health Center) had spoken the day before, too, saying that the government's drug trials "have not had significant minority participation, … nor are they usually located in communities at greatest risk…."

A doctor from Tulsa, Oklahoma (Dr. Jeffrey A. Beal) would complement her point several witnesses later, when he said, "Why is it that we have institutionalized these experimental treatments at very selective centers across the United States?" He stressed that many people with AIDS felt cut off from drug trials geographically.

A doctor named Thomas Merigan, from Stanford University School of Medicine, spoke after Dr. Davis, stressing the government effort, despite some strengths, was seriously underfunded.

Then, the famous Mathilde Krim gave testimony after Dr. Merigan.

Mathilde Krim was one of the best-known figures in the AIDS crisis. Originally born in Italy, she was raised in Switzerland, then moved to Israel with her first husband, where she began her career in biology. She divorced, there, then came to the States with her second husband, Arthur Krim, the famous movie producer. In New York, she continued her career as a researcher. She and her husband were also prominent supporters of the Democratic Party.

As the founder of AmFar, Krim was a star fundraiser in New York for AIDS research. She delivered her testimony, speaking with her Continental accent. The ultimate target of her criticisms was the White House.

"An estimated 1.5 million American citizens are now infected with this virus…," she said. She added that the death toll in the U.S. could "surpass that of all the wars in which the United States has fought, even if the infection does not spread any further."

She expressed some admiration for one government agency, the National Cancer Institute, and especially for a top researcher, there - Doctor Samuel Broder. She complained that although the government's AIDS research originated at the NIH under NCI's auspices, major responsibilities were transferred later to another NIH group - Fauci's agency - the National Institute for Allergic and Infectious Diseases, (NIAID), in a move she found frustrating, to say the least.

"NIAID protocols were developed very slowly… In the meantime, many people languished and too many died, without access to what they considered their only faint chance at effective therapy." She said the source of these terrible barriers and shortcomings in AIDS research could be found in none other than, "the executive branch of the Federal Government." She emphasized, "A lack of interagency coordination has existed that was created by an absence of a clear mandate from the highest authority in this land."

"Down with Reagan," Mark thought, grinning, ear to ear. People stirred in their seats. Many suspected she was referring to Reagan's administration.

Krim widened her aim by criticizing the Office of Management and Budget, the General Services Administration and the Office of Personnel Management, too, for when it came to AIDS, they "obviously did not share the sense of urgency felt by the public and by the NIH itself." She scored other points, too, during her testimony, and when she finished, there was applause.

Mark had copied down some of the facts in the Thursday testimonies.

Ted Weiss said at that point in the day, "Dr. Merigan, what is the average, per patient cost of clinical trials on AIDS drugs?"

Dr. Merigan answered, "… it is projected to be about $10,000 to $12,000 per patient…."

Weiss said, "Generally, would you say that AIDS drug trials are much more expensive than the average drug trials?"

"Yes, I think they are, because we have had to set up a medical infrastructure to train people, to set up laboratories. This is an area where we have had to bring new science to bear..."

Weiss continued, "I understand also that tests themselves are extremely expensive. The culture for HIV, for example, costs $200 as compared to the herpes culture which costs $10 or $15, and that four or five of these cultures must be done on each patient in each trial. T-4 cell counts are also expensive, averaging $80 each and five or six must be done for patients."

While answering the Congressman's questions, Dr. Merigan concurred and repeated that the government wasn't funding the fight against AIDS adequately.

"There's no question that we are going to be limited by funds in this coming year," he said. "We have more protocols and more populations to test, and more questions to ask that we cannot do because of inadequate, available funding."

According to Mark's notes, a lawyer from the American Civil Liberties Union named Nan Hunter spoke next. (Mark knew of her. He and she crossed paths a few times way back in his early days of activism.)

She reminded the panel that AIDS trials are not just scientific research, but also potential treatment for participants. She said, "It is for that reason that the systematic denial or exclusion or underrepresentation of certain population groups from access to these trials is so distressing and, in fact, so cruel...."

Mark liked the points that were made that first day.

Several gay activists in the AIDS movement spoke next - focusing not only on infrastructure, budgeting or accessibility, but on drug inefficacy.

These AIDS activists implied that the federal research program hadn't prioritized the drugs well.

For example, Kevin Armington of GMHC (who spoke as a substitute, because the original GMHC speaker - Dr. Barry Gingell -- was too ill with AIDS to appear) said some grim things about AZT and its toxicity. Presenting Gingell's testimony, Armington said, "A recent study on the original group of AZT recipients who took the drug for more than 1 year provides us with these sobering figures. Fully, 50 percent of patients experience serious hematological toxicity after 1 year of therapy, and 25 percent have to be discontinued entirely … AZT causes serious bone marrow suppression…"

He named other shortcomings in AZT, too, and said, "However, fully 80 percent of patients in NIH-sponsored clinical trials are taking AZT…."

Armington said a review committee had even told Fauci in June, 1987, "more drugs were needed in clinical trials other than AZT." It was now April, 1988!

David Barr of the gay rights group called Lambda Legal Defense and Education Fund said that despite so-called FDA regulation reforms made in '87, "…only one AIDS-related drug, trimetrexate, has been granted treatment IND status." One drug in almost a year's time!

Martin Delaney from San Francisco's Project Inform gave testimony, then answered questions from the panel. He talked about the dramatic increase in the number of people with AIDS who were turning to the drug underground for help. He said, "The numbers of people receiving treatment in the underground is at an all time high right now. Probably in San Francisco alone, we are talking at least 5,000 people… In NY, I assume similar numbers…"

Others gave testimony from the New York branch of the AIDS community. Then a woman from Mark's coalition got up to speak.

Her name was Dr. Lila Innis. She was a middle-aged retiree from the research industry (with a degree in biology). She was pale and plump, had short, wavy hair, and a slight stammer. Her message that day came through loud and clear, however.

She gave a solid description of the coalition and the treatment committee that she was part of. She analyzed the red tape that impeded progress at the NIH and the FDA. She criticized poor representation of minorities and of women and children in the trials. She spoke sharply against the lack of leadership from the White House. Mark was delighted with her. Despite her bookish nature, her speech before Ted Weiss was a perfect balance between data and polemics.

There was applause. The session adjourned at 5:10 that Thursday afternoon.

It was 9:15, Friday morning, by the time the maroon taxi pulled up to Capitol Hill, not far from Independence Drive. There, the meridian strips were so well-tended to, they looked like gardens. As gray as the morning was, the area seemed lush and inviting.

The cab driver, a lean and elderly black man, jumped out of the cab, spryly, and opened the door for the three activists. They tipped him well.

"Genteel, wasn't he," said one of Mark's buddies, as the driver rode off.

"Well, this is a southern city," said Mark's other friend. "More hospitable than our neck of the woods."

Mark said, "Hey - we got some time, don't we? Let's go to the capitol building. I wanna see it."

"Now?" said his buddies. Mark was like a little kid trying to wear out his guardians.

"Don't you want to get to the Rayburn Building to find a good seat?" said one of the others.

"I wanna see the Capitol Building!" Mark insisted.

He was off, before they could stop him. They wondered where this sudden display of stubbornness had come from.

  

 

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