AIDS Research at a Key Juncture

It has been 13 years since the dreaded disease that has come to be called acquired immune deficiency syndrome, or AIDS for short, was first diagnosed. Few then would have thought that the strange malady would soon become a worldwide pandemic or have imagined the human suffering it would cause.

Despite major gains in treatment of symptoms and in public education, the AIDS virus continues to rampage, particularly in poorer nations and among minorities in this country. And despite billions spent on research, the unhappy fact is that the stealthy virus’s method of operation remains largely a medical mystery.

“A turning point has now been reached,” comments Dr. William E. Paul, director of the Office of AIDS Research at the National Institutes of Health. “Simple continuation of the policies of the past is likely to bring us only slow, fitful progress.”

Dr. Paul’s words, voiced in a policy paper on federal AIDS research priorities published in the journal Science, reflect a growing view among scientists and even many clinicians that research on AIDS must return to basics--to a better understanding of the virus’s molecular workings and the disease’s etiology--before any real cures or vaccines can be promised or realized.

Paul suggests heavier investment in fundamental primate research, immune response, cell kinetics, the factors that cause immune collapse and behavioral research into why this preventable disease still spreads.

He also says the National Institutes of Health will welcome more unsolicited research proposals from scientists instead of trying to direct it all centrally.

These are all welcome ideas. The only trouble is that Paul hopes that this back-to-basics approach can be achieved without any substantial cutbacks in efforts to find drugs and other treatments for those already infected with HIV or suffering from AIDS. (Just this week, for example, government researchers reported some success in using the protein interleukin-2 to increase white blood cells in infected people and thereby strengthen their immune systems.) Paul wants to have his cake and eat it too. That will be a difficult political task in Washington’s stringent fiscal environment.