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SOUTHERN VOICE NOVEMBER17/1994
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AIDS experts want CDC to be
restructured
Atlanta—As the Centers for Disease Con
trol and Prevention grapples with how to fight
the spread of AIDS, critics say the agency’s
approach thwarts the efforts of its own scien
tists.
A panel of public-health experts recently
took the most extensive look at the CDC’s
AIDS activities since 1986. They said that the
current system may be “dysfunctional,” forc
ing researchers to compete against each other
for money and obscuring the chain of com
mand.
“Restructuring is long overdue,” said Tho
mas Coates, director of the Center for AIDS
Prevention Studies at the University of Cali
fornia, San Francisco.
The CDC’s AIDS efforts are spread among
10 offices, concentrating on who’s infected
and where the virus is spreading, and on pre
vention and public education.
Coates and numerous other AIDS research
ers complained that the arrangement not only
leaves them confused, but holds up prevention
efforts when responsibilities weren’t clear.
While the panel called for change, others
said the CDC must protect the creative col
laborations that can arise from sprinkling AIDS
researchers throughout its centers.
The outside reviewers, drawn from public
health experts around the country and from
the CDC’s AIDS advisory committee, exam
ined aspects of the agency’s efforts to slow the
spread of HIV, the AIDS virus.
“It was hard to know who was doing what,”
said Dr. Don Des Jarlais of New York’s Beth
Israel Medical Center, recalling his attempts
to find who to work with at the CDC on stud
ies of intravenous drug use and AIDS.
Those aren’t the only problems, critics said.
Coates said the CDC often is slow on fol
lowing through. After learning that young gay
men were taking sexual risks, it took the CDC
a couple of years to try to examine why.
“All of this should happen more quickly
and more seamlessly,” he said.
The CDC’s current system “has helped edu
cate the CDC about AIDS, but hasn’t helped
educate the United States public about AIDS,”
charged Dr. Richard Marlink, executive direc
tor of the Harvard AIDS Institute. “It’s not
treated as a war, with a chain of
command...they’ve watched it grow. They’ve
learned a lot about it, but they haven’t turned
the tide.”
That AIDS is a sexually transmitted dis
ease creates its own bureaucratic problems.
The CDC, which lumps much of its AIDS
efforts with sexually transmitted diseases,
could move AIDS to its own department, or
put it with other infectious diseases. That would
recognize AIDS’ link with factors such as in
travenous drug use or tuberculosis, and would
strengthen the spotlight on AIDS, Marlink and
others say.
“The CDC has lacked clarity of mission,”
said Cornelius Baker of the National Associa
tion of Persons with AIDS, who contributed to
the review of the CDC. Without a clearly de
fined plan, the CDC’s message on AIDS—
how to prevent infection—gets lost to the pub
lic, he said.
The CDC’s director, Dr. David Satcher,
said he will act soon on the panel’s sugges
tion.
One AIDS researcher, epidemiologist Dr.
Alfred Saah of Johns Hopkins’ School of Pub
lic Health, said he feared that changing the
agency’s structure would damage the collabo
ration that arises when specialists from differ
ent fields work together to create scientific
breakthroughs.
“Part of its strength is that fluidity,” he
said. “The real goal here is to help the CDC
perform its mission effectively.”
Reorganizing the CDC’s AIDS efforts
would be a huge undertaking, reshuffling both
people and money. AIDS accounts for 23 per
cent of the CDC’s $2 billion budget, and some
offices could be decimated if they lose their
AIDS resources, said Dr. James Curran, the
CDC’s associate director for HIV/AIDS.
Curran, who has not said what action he
favors, would be among the first affected by a
reorganization.
A.J. HOSTETLER
Cancer drug may work against HIV
Washington, DC—Test tube experiments
at a National Institutes of Health laboratory
show evidence that a drug called hydroxyurea
may block or slow the replication of HIV,
researchers report.
In a study published Nov. 4 in the journal
Science, researchers at the tumor cell biology
laboratory at the National Cancer Institute re
port that the human immunodeficiency virus
is unable to reproduce in cells exposed to
hydroxyurea, a cancer drug that has been used
for about 30 years.
Dr. Robert Gallo, senior researcher in the
study, said in a statement that hydroxyurea
could be given in tablet form and would be
much less expensive than other drugs now
used for AIDS therapy.
The study said the anti-HIV effect was
achieved with nontoxic doses of hydroxyurea.
The drug can cause anemia and vomiting in
some patients at dose levels used in cancer
treatment.
NIH researchers also found that cells be-
cafne even more resistant to HIV replication
when they were exposed in the test tube to
both hydroxyurea and to didanosine, or ddl, a
drug now used to treat HIV infection.
All of the studies reported in the Science
report were conducted in laboratory cell cul
tures. The paper reports no HIV clinical tests
of hydroxyurea.
ASSOCIATED PRESS
Forum will look at AIDS fraud
Atlanta—The last in the AIDS Survival
Project’s HIV Survival Series this year will
focus on “Combating AIDS Fraud.” Dr. John
Renner, president of the Consumer Health
Information Research Institute, will be the
speaker.
Renner will offer tools to decipher the
massive information about AIDS and AIDS
therapies to help determine which offer real
hope and which are nothing more than quack
ery.
The forum will be held Sunday, Nov. 20
from 2-4pm at the Sheraton Colony Square
Hotel, and will be cosponsored by Georgia
AIDS Thearapies Information Network.