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Re: recetnly poz
Sep 1, 2005

I disagree entirely with the comments made by Larry. I applaud the pharmaceutical industry and the medical community for endeavouring to de-stigmatise HIV and for reinforcing the fact that being HIV+ is not the end of the world. I was diagnosed in 1998 and in the 7 years hence I have seen a remarkable change in how HIV is managed and discussed - this is absolutely a positive development (if you pardon the pun). When I found out about my status I was utterly desolate, all I could remember were those painful and terrifying 80s ads describing AIDs and its associated slow, painful death. In short I assumed I would not have much time left. This was unhealthy, debilitating and destructive. Much better to impart positive and upbeat messages to the newly diagnosed, to instil a sense of hope and thus reinforce the fact that HIV is manageable and that it is possible to lead a normal and healthy life. 7 years later I remain off medication, although plan to start fairly soon. The difference for me is that I start with a positive mindset, confident that with excellent adherence my prognosis is very good. I am also cognisant of the fact that the science of HIV is evolving apace and that the existing arsenal of already powerful treatment options will only expand.

It's all too easy to cast blame and I strongly believe that the pharmaceutical industry is unfairly impugned by medical and media commentators alike. Fundamentally, these are profit-making machines it is true, but they also employ armies of dedicated R&D professionals whose sole focus is on ameliorating human suffering. It is thanks to GSK, Merck, Roche, Abbott, Gilead, Boehringer Ingelheim and others that we are fortunate enough to have now a broad range of treatment options for HIV and these options are transforming HIV from a terminal disease to a chronic, but manageable condition. Moreover, these companies, as well as a whole host of emerging biotechs, continue to invest 100s of millions every year in developing new and better drugs as well as exploring vaccines, gene therapies and so on. Come on, lets get real, people do not get infected with HIV because of images promulgated by the pharma industry intimating that HIV can be effectively managed. They get infected because they are unlucky - that's it, end of discussion. Rather than wallowing in self-pity though (which is what my natural recourse was on hearing my diagnosis), the better option surely is to pull yourself together, take each day as it comes, be thankful for the fact that treatment is possible and do your best to continue leading a full and productive life.

Our culture is obsessed with casting blame - this is unhealthy and entirely counter-productive. Yes, the pharma industry has issues and yes it would be nice if these companies operated in an entirely altruistic fashion, but that is not the nature of the capitalist world in which we live. Fact: it costs $800-1bn to develop a drug from inception to market. Fact: of those compounds which even go as far as clinical development, 90% fail to demonstrate efficacy/tolerability. Fact: our respective national governments do not have sufficient resource to pay for the costs associated with drug development. Hence, the reality is that without profits and without intellectual property protection, medical innovation would dry up and new drugs would fail to materialise. If you want this to change lobby government to invest more heavily in R&D - blaming the industry is far too simplistic.

Fundamentally, I want to applaud the excellent work that the medical profession, pharmaceutical industry and others have provided - you have given me hope and I have re-claimed my future.

Response from Dr. Wohl

It is interesting to read about your personal reaction to the pharma ads and your take on the industry as a whole. Of course, the companies do not create these ads in a vacuum. They spend lots to have every detail vetted by likely consumers (read: people like you). So, someone must approve of them and their sunny message.

Others, as we have heard, find them misleading and rose tinted. Perhaps these are individuals who have had a more difficult time with their diagnosis and/or treatment? In my own view, I agree that these ads do not lead people to fling themselves at others in fits of carefree copulation. But, that does not mean they are helping when it comes to prevention - even if they do send positive messages about what HIV can look like.

Your comments regarding the contributions of pharma (including to the funding of the website your are currently reading) are also very well taken. A devil's advocate (no pun intended here either) would say that recent controversies regarding the pricing of HIV medications, claims of price gouging domestically and strong arm tactics with foreign governments and the less than universal access to meds especially for those who are less able to lobby effectively need also to be included in such an assessment. It is an old and enduring debate. Perhaps, the next step is to ask what industry can do to actually help prevent the spread of HIV - a virus they have spent billions to treat.

DW



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