Å®ÉúСÊÓƵ

RESEARCHERS took to the streets of San Francisco this weekend to protest
at the US’s travel restrictions on people with HIV. Delegates to the Sixth
International Conference on AIDS, led by the two chairmen, joined a Unity
March organised by 75 agencies in the city on Saturday. Banners in the crowd
read ‘Discrimination kills’, ‘Stop AIDS not people with AIDS’ and ‘AIDS
is a global crisis’.

John Ziegler, one of the chairmen and a researcher at the University
of California, San Francisco, said the immigration laws were ‘discriminatory
and medically insupportable’. Among the marchers was Jonathan Mann, former
head of the World Health Organization’s Global Programme on AIDS. He had
just received a standing ovation for a speech arguing that AIDS had become
‘a crucible in which the future of health is being forged’.

Mann said people with HIV and AIDS had ‘declared their firm intent to
participate in, rather than simply submit to, processes of prevention, care
and research’. He told the conference that ‘the shockwaves from this courageous
determination to participate have not subsided; they have challenged clinical
research and shaken deeply our assumptions about the role of infected and
ill people’.

The scientists’ march came near the end of a conference in which basic
scientists and clinicians shared a platform with AIDS activists for the
first time. Ziegler said that the major breakthrough this year had been
a new dialogue between these groups.

Last year’s AIDS conference in Montreal was disrupted by protesters,
so that many scientists had considered not going again. This year, however,
all scientific sessions went ahead with contributions from activists being
part of the formal proceedings.

The only major disruption came in the closing ceremony. An address by
the US health secretary, Louis Sullivan, was rendered inaudible when members
of the radical group ACT UP, the AIDS Coalition to Unleash Power, blew whistles
and hooters and chanted ‘Shame!’. Sullivan finished the speech. ACT UP accuses
him of complacency and failing to push to get the travel restrictions scrapped.

Not all of the campaigners appreciate ACT UP’s approach. Pierre Ludington,
who served on the planning committees and is HIV positive, said he would
have preferred to hear what Sullivan had to say, however much he might have
disagreed with it. ‘Sullivan matters,’ said Ludington.

But the incident did not destroy the overall optimism of the conference.
Jay Levy, a virologist from the University of California, San Francisco,
and one of the organisers, said on Sunday: ‘I think we turned the tide after
Montreal.’ Researchers who did not normally come into contact with patients
had found it helpful to meet and talk to people with HIV, he said.

Outside the convention and elsewhere in the city, protesters kept up
a steady stream of marches, sit-downs and lie-ins. On the eve of the conference,
about 500 ACT UP protesters demonstrated outside the offices of the Immigration
and Naturalization Service.

Later a smaller group of them blockaded the entrance to the Marriott
Hotel, part of the conference site. For about two hours, 50 demonstrators
blocked the main reception area, sitting under the chandeliers and paddling
in the fountains. The conference planners had distributed 375 free passes
to the five-day event, but the demonstrators wanted more: in the end, they
won another 150. About 1000 of the 10 000 delegates were HIV positive.

In the conference halls, activists such as Martin Delaney, from a group
called Project Inform, debated with clinicians on the main areas of disagreement
between them. The groups have often accused doctors and the official approvals
body, the Food and Drug Administration (FDA), of dragging their feet in
assessing experimental drugs that they believe might help to prolong their
lives. They also claim that white, middle-class gay men are overrepresented
in drug trials, while women and black people tend not to be enrolled.

Anthony Fauci, the director of the National Institute of Allergy and
Infectious Diseases, who is responsible for coordinating trials and liaising
with the FDA, told the conference that activists had something to say and
could contribute constructively. ‘When it comes to clinical trials, some
of them are better informed than many scientists can imagine,’ he said.

‘To tell scientists that they are not doing enough because they are
not immediately fulfilling the needs of HIV-infected persons, many of whom
need help now, is to tell them that they are inadequate,’ said Fauci. ‘This
is devastating to a physician or scientist who has devoted years to AIDS
research, particularly when they see so many of their patients suffering
or dying.’

‘ŮÉúСÊÓƵs cannot and should not dismiss activists merely on the basis
that they are not trained scientists . . . scientists do not have a lock
on correctness,’ he said. ‘Activists bring a special insight into the disease
that can actually be helpful in the way that we design our scientific approaches.’

There was some concern among delegates that national – and even local
– politics had dominated an international meeting. The global pandemic presents
researchers and health workers with a huge problem. By the end of the decade,
there will be between 15 and 20 million people worldwide infected with HIV
– at a conservative estimate, said Michael Merson, the new head of the WHO’s
Global Programme on AIDS.

Mann said that the total budget of the average national AIDS programme
in developing countries is less than the cost of caring for only 15 people
with AIDS in the US. Therese Mulandi of the Kenyan AIDS Control Programme
said: ‘There is no vaccine, there is no cure available yet, the world has
to think globally.’