In order to advocate properly, one must study and show evidence of the history of the government institutions who are supposed to be protecting the public health so advocacy people know exactly what they are dealing with. I’ve been doing that by getting books that were written during the height of the AIDS epidemic and showing them to fellow advocacy people as well as friends.
I was an active RN during the height of the AIDS epidemic. I saw just how much those gov’t institutions protected the public health-> NADA. What I saw was an assembly line of death that came in through the hospital doors and left via the morgue.
I must also mention this as well, many hospital workers, doctors, nurses, etc… were becoming ill with co-morbid infections of AIDS patients such as Mycoplasma, never recovered, became disabled and unable to work. Thus, the health care workers were not properly protected either.
One guess: Nina Pham!
I would probably be ostracized if I was active in the profession now and voiced exactly what I saw. Things haven’t changed! The government institutions still ignore “controversial illnesses,” instead of finding out what they are, researching treatment, thus, the patients suffer from->”Its all in your head” theory unless there is a profit involved. No profit, no relief for patient suffering.
During the AIDS epidemic, the patients were blamed, just like “CFS” patients today are blamed and even doctors have been quoted as saying “I’m tired too,” when “being tired” has nothing to do with the illness. It is a total fabrication, misinformation, and propaganda campaign which is orchestrated directly by the government agencies. AIDS was called “The gay disease,” just like CFS (which is really M.E.) has been called “The Women’s Disease.”
It makes you wonder:
-Since when do infectious diseases discriminate between who gets them?
-Where do these agencies think of this utter nonsense?
-Why do the people who work for the government agencies even go into the healthcare related fields if they have no interest in the patients and are going to mock the patients?
The rest of this post is a book review written by Neenyah Ostrom about Bruce Nussbaum’s 1990 book: “Good Intentions: How Big Business And the Medical Establishment are Corrupting The Fight Against AIDS” that gives an inside view of the workings of the drug companies and the NIH during the AIDS epidemic.
Bruce Nussbaum is an award winning writer who served in the Peace Corps from 1967-1969, and was a senior writer for Business Week at the time the book was published.
Seventy-Five percent of the source material of the book were from interviews conducted in person between 1988-1990 in New York, Washington D.C, Bethesda, and Raleigh North Carolina as well as anonymous sources including people from the gay community who were from all walks of life- bankers, lawyers, business owners, soldiers, journalists, scientists, etc…
A Book Review by Neenyah Ostrom:
Former Business Week writer Bruce Nussbaum has written a damning critique of the “AIDS” research establishment in Good Intentions: How Big Business and the Medical Establishment Are Corrupting the Fight Against AIDS, Government scientists – like Sam Broder, Tony Fauci, and Ellen Cooper – and university scientists like Margaret Fischl are depicted as corrupt, power-hungry incompetents anxious to please greedy pharmaceutical companies to collect their portion of the glory and the dough. And that’s just for starters.
“I didn’t begin the book angry, but I did finish it that way,” Nussbaum writes in the second sentence of the introduction. Plunging into the world of “big-time” medical research, “the corruption,” he found, “was startling.”
Indeed, Good Intentions reads like a thriller; once started, it is difficult to put down. The personalities leap off the page. Nussbaum captures Broder whining about not getting the credit due him for “discovering” AZT; Fauci’s determination to grab media attention and his complete befuddlement about how to conduct a clinical trial; Robert Gallo’s arrogance; Burroughs Wellcome’s David Barry’s shark-like progress through the Food and Drug Administration approval process and the stooges in that agency who assisted him; and much, much more.
“It is a polite fiction that scientists at the NIH and the drug companies work for the public health,” Nussbaum asserts. “They really work for credit and cash.”
Nussbaum chronicles how AZT was singled out a group of “maybe twenty” anti-“AIDS” drugs for the development in the early 1980s. The person most responsible for “ramming through a second-rate, mediocre drug called AZT” was Sam Broder at the National Cancer Institute (NCI).
Broder’s first real job was at NCI, where he joined the Commissioned Corps of the Public Health Service in 1971. And, “with $20 billion pouring in to cure cancer by the end of the decade,” Nussbaum points out, “… Broder never left.”
As a young scientist, Broder cultivated a reputation as someone who could work with even the most difficult of personalities, like Gallo. Nussbaum describes Broder’s early years at NCI as “an exercise in the care and feeding of powerful, difficult men.”
But it wasn’t until “AIDS” that Broder came into his own. The only question about “AIDS” for Broder was according to Nussbaum, “Would it propel Broder to a higher station in life?”
The answer, apparently, was yes, and Nussbaum has done a painstaking job of tracking the Byzantine path of AZT from manufacturer to patient: from Burroughs Wellcome through Broder’s drug-testing laboratory, via the usurpation of clinical trials by Fauci, the drug’s progress through the FDA’s approval process with a minimum of scrutiny, until it reached the hapless, desperate “AIDS” patients it was foisted upon as an effective treatment – which, according to Nussbaum AZT never was shown to be.
The first mediocre, dangerous drug that Broder tried to push through the system was the anti-viral Suramin, which appeared to block of the spread of HIV in the test tube. In fact, Broder was so enthusiastic of Suramin that his nickname around NCI during this period of time was “Mr. Suramin.”
(It would later, of course, become “Mr. AZT.”)
But while Broder enthusiastically pushed Suramin, a clinical trial of the efficiacy of Suramin was showing that “the drug was not just a little toxic, it was really toxic in AIDS patients.”
So, when Suramin bit the dust, Broder began his search for another anti-viral. But he learned a lot from the Suramin fiasco about gaining FDA approval for a drug, according to Nussbaum: “Find a drug that had been tested for a previous disease. Make sure it had a big corporate sugar daddy behind it. Push the bureaucracy like hell to move it along. And talk it up. Talk it up.”
If Nussbaum portraits of Broder is unflattering, his depiction of Fauci is horrifying.
Fauci couldn’t bear the fact that NCI was conducting the “AIDS” clinical trials in 1985 just because they had done the laboratory work; clinical trials should be conducted by his agency, the National Institute of Allergy and Infectious Diseases (NIAID). After all, “AIDS” was an infectious disease not cancer, Fauci reasoned. After all, “It was a matter of prestige,” Nussbaum notes.
And so Fauci mounted a Machiavellian campaign to take control of “AIDS” clinical trials, a campaign that Nussbaum captures in all its repellent detail.
In 1985, when Congress appropriated $234 million for “AIDS” research for the fiscal year 1986, Nussbaum writes, “To Dr. Anthony Fauci the money spelled opportunity with a capital O.”
Fauci assumed his position as director of NIAID in early 1984, supplanting Dr. Richard Krause. And according to Nussbaum, “Tony Fauci was as different from Richard Krause as shark is from goldfish.”
The difference was typified by apparel. Jeans, running shoes, and “threadbare dress shirts” under lab coats is the usual uniform at NIAID, according to Nussbaum.
Fauci, however, “looked as if he had just stepped out of a limousine,” Nussbaum writes. “… Fauci’s tailored suits, cufflinked shirts, and aviator glasses set him far apart from the rest of the scientists and administrators at the NIH… Fauci stood out in sartorial splendour, even if he was a bit short.”
In keeping with his appearance, Fauci wasn’t inclined to dirty his hands with the details of laboratory work.
“In fact, Fauci hated details,” Nussbaum points out. “… He was, as one high ranking NIAID official puts it, ‘a hit-the-front-page-every-day kind of guy.”
For Fauci, according to Nussbaum, “AIDS” was an opportunity to increase the size and power of his institute. Not known for his brilliant science, “This lacklustre scientist was about to find his true vocation – empire building.”
Nussbaum isn’t being trivial in his criticism of Fauci: Fauci’s actions (and lack thereof) had wide-reaching impact on the health of the nation in the late 1980s.
To transform NIAID from an institutional weakling into an NIH powerhouse, Fauci had to fight for a bigger piece of the AIDS research pie.
When Congress began to appropriate big money in 1985, Fauci went about securing a large portion of those funds for his own institute. He started the most important bureaucratic battle in the history of the fight against AIDS. The outcome of this single fight had enormous consequences for the live of thousands of people. Had it turned out otherwise, many people who died might have lived.
So Fauci began to do battle with Dr. Vincent DeVita, head of the NCI – a battle which soon became grist for the rumor mill at NIH. “Lab chiefs describing what was taking place in their little world were suddenly making references to the old Godfather movies, which cracks about ‘Don’ DeVita and the new challenger, Fauci,” Nussbaum recounts.
When the Mafia-esque manoeuvring was over, a deal was struck: NCI would screen drugs and do the early clinical testing (Phase I safety trails). NIAID, despite its lack of experience, personnel, and facilities, would run the multi-center clinical trials to determine the efficacy of those drugs.
“Fauci would build himself an entirely new trial system,” Nussbaum writes. “Then he would learn how to run it.”
Nussbaum describes how a small number of “PIs,” Principal Investigators in government lingo, control the direction of drug development and testing. The PIs wanted to test AZT; why, Nussbaum inquired, did they focus on this drug?
A researcher who would not allow his name to be used explained t this way: “Clinical testing is all about money. Burroughs Wellcome, for example, controls clinicians [investigators] by paying them money. If you work for Wellcome, then you’re not going to test other companies’ drugs because you’re not being paid by other people.”
What does this have to do with clinical trials conducted by the government? As Nussbaum found out, “many of the Wellcome PIs came to dominate NIAID’s clinical trial system. They formed a web linking Wellcome, the drug AZT, and the NIH. They came to sit on the institute’s key drug selection committee, and they voted on whether to give high or low priority to the testing of each anti-AIDS drug, including those that might possibly compete with AZT in the marketplace. The PIs were a power unto themselves. They were, in fact, out of control.”
Fauci’s incompetence would lead to NIAID’s clinical trials network earning the nickname, “the HUD of the nineties.”
“Money was spent, but trials went underenrolled, drug treatments never seemed to emerge, and people with AIDS continued to get sick and die,” Nussbaum reports. “… In the end, Fauci barely survived by handing over control of the government’s only AIDS drug trial program to a handful of PIs with close ties to Burroughs Wellcome and AZT.”
It was one of these PIs who assigned by Fauci to do a small clinical trial of AL721 – to “debunk” it, per Fauci’s instructions – after the AZT PIs voted AL721 such a low priority that it would not even be tested. “No one saw any problems with conflict of interest,” Nussbaum points out.
The PIs were “accountable to no one except themselves” under Fauci’s non-management of the government’s “AIDS” clinical trials.
“Where was Tony in all of this?” Nussbaum inquires. “Two miles down the road, trying to be a ‘hit-the-front-pages’ kind of a guy… And still nothing was coming out of the government to treat AIDS.”
While AZT went through the FDA approval process, Ellen Cooper of the FDA worked extremely closely with Burroughs Wellcome’s David Barry. In fact, according to Nussbaum, “Barry was able to negotiate a lower amount of required data… Both Cooper and [FDA Commissioner Frank] Young wanted AZT to succeed so much that they agreed to lower standards.”
Cooper also masterminded the FDA hearing that resulted in approval of AZT; it was a charade from the start to finish. As the meeting began, Cooper criticized Burroughs Wellcome strongly for not being able to describe how AZT worked and for having less than the normally acceptable amount of data; she “made it clear that under normal circumstances, Wellcome would never even have gotten a hearing of the FDA advisory committee.”
“Unfortunately, none of the voting members of the committee knew that Cooper was putting on a show for the record,” Nussbaum asserts. “They didn’t know that Wellcome had worked everything out with the FDA before stepping inside the room that morning.”
Nussbaum describes how New York physician Dr. Joseph Sonnabend, an early pioneer in “AIDS” treatment research, was edged out of the mainstream because he didn’t believe that HIV was the sole cause of “AIDS.” Sonnabend’s early work was impetus for the formation of the AIDS Medical Foundation (AMF), established by Dr. Mathilde Krim primarily to support his work, according to Nussbaum.
But in 1985, Rock Hudson died of “AIDS,” and that was when really big money began to flow into non-profit organizations like AMF, and Krim, like her government counterparts, was unable to resist the lure of the power.
It was Sonnabend who pioneered community-based research, leading to the formation of New York City’s Community Research Initiative (CRI). “We became convinced that it was perfectly feasible to do community research,” Krim told Nussbaum. “Sonnabend led the way.”
“Then Krim dumped Sonnabend for Liz Taylor,” Nussbaum comments. He reports that Krim dropped Sonnabend when AMF merged with a West Coast foundation, resulting in the creation of the American Foundation for AIDS Research, AmFAR.
“The new foundation would support AIDS research by giving grants to scientists in established laboratories and by informing the public about AIDS and its treatments, but it wouldn’t do any clinical trials of its own,” Nussbaum recounts. “That was over. It would no longer support Sonnabend’s research.”
Helping Sonnabend prove that community-based research was both possible and effective was singer Michael Callen, who had been diagnosed with “AIDS” in 1982. Callen was politically instrumental in the establishment of CRI and Callen, like Sonnabend, was outspokenly critical of Fauci’s lack of progress.
In February 1989, Callen presented testimony to the FDA about a meeting he and other “AIDS activists” had with Fauci in May 1987.
“We asked him – no, we begged him – to issue interim guidelines urging physicians to prophylax those patients deemed at high risk for PCP,” Callen told the assembled scientists, who had gathered to evaluate CRI’s data on the effectiveness of aerosolized pentamidine. Fauci had refused to issue the guidelines; there wasn’t enough data, he told Callen in May 1987.
So in February, Callen presented the FDA with data on prophylaxis using aerosolized pentamidine that had been gathered in community-based clinical trials in New York and San Francisco (which garnered FDA approval for the drug). Fauci had yet to enrol a single person in a clinical trial of pentamidine, Callen told the FDA.
“The community has rolled up its sleeves and done an end run around federal incompetence and indifference,” Callen told the FDA.
It was a comment that would come back to haunt Callen and Sonnabend and the CRI; when the government decided to fund community-based research, CRI, the prototype organization, received not a penny of government funding.
Fauci accomplished this by choosing Margaret Fischl, Chief PI for Burroughs Wellcome’s Phase II AZT trial, to be the chairperson of the committee that decided whether to fund CRI. Sonnabend, in particular, had been scathingly critical of the quality of Fischl’s AZT research, a fact she was quite aware of.
“In no way should she have been overseeing a peer review panel that judged a proposal by CRI,” Nussbaum points out. “It was an institutional and personal conflict of interest.”
“What goes around, comes around,” Fauci is quoted as telling PIs who voiced criticism of him. Callen and Sonnabend dared to criticize Fauci; Fauci made sure they didn’t get any federal funds.
The outrage uncovered by Nussbaum expose a morass of financial and ethical impropriety. The role ACT UP played in influencing the speeding-up of drug approval is recounted in great detail. Fauci and ACT UP began as bitter enemies. But the wily Fauci figured out how to use ACT UP, how to seduce them with power, if not money, as Nussbaum documents.
During the summer and autumn of 1989, “[Project Inform’s] Martin Delaney would spend many days talking with FDA Commissioner Frank Young about how to relax the rules of drug regulation,” Nussbaum writes. “… Fauci himself would begin going to ACT UP meetings. He began appointing [ACT UP members] Jim Eigo and Martin Delaney to AIDS committees in NIAID.”
Why should he bother?
“Fauci had spent hundreds of millions of dollars building drug-testing network that didn’t work… In an attempt to salvage his reputation, if not his career, Fauci was now ready to change tack and adopt the AIDS medical treatment agenda of AZT UP and the CRI.”
Nussbaum points out in a final chapter that Sonnabend has never received any government money to support his research on a multifactorial theory about the cause of “AIDS,” even though the NCI, “at Gallo’s urging, requested millions of dollars to investigate viruses that might act as cofactors in AIDS. Each dollar was a redemptive nod to Sonnabend for his original work on the cause of AIDS,” writes Nussbaum.
Indeed, as Good Intentions went to press, Nussbaum wrote that, “The entire foundation of the scientific explanation of AIDS is actually under attack.” Researchers are finding KS without HIV, HIV without KS, and no one can explain it; the Army’s Dr. Shyh-Ching Lo has found a new agent that may be a co-factor, or “may play a more fundamental role, as Lo suggests.”
A decade into the “AIDS” epidemic, AZT (and limited AZT analogues) is still the only drug to come from the government’s multi-billion dollar research effort.
“Scientists who have made their entire careers in AZT have sat on committees voting on potential commercial competitors. Scientists who have had financial dealings with Burroughs Wellcome or other pharmaceutical companies have come to dominate the government’s entire clinical trails network,” Nussbaum points out.
“Scientists do what they do totally without oversight because Congress and the public have accepted their argument that only they are knowledgeable to police themselves,” Nussbaum concludes. “The United States has never accepted this kind of argument from its military; it should not accept it from its biomedical establishment.”
Good Intentions should be required reading for every United States taxpayer. The “polite fiction” that government scientists work to improve public health should be exposed, and Nussbaum has accomplished a great deal towards this end. Sections of Good Intentions quoted here are from uncorrected proofs supplied to Christopher Street and some may change in the final publication. Hopefully, the teeth will not be pulled from the hardbound edition of Nussbaum’s biting investigation. *
Reviewed by Neenyah Ostrom
Source: Christopher Street #150
“The Other Side Of The Stretcher” (c) 2015
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