Funding Medical Research and Drug Development

For improving medical research, the place to start is to ask researchers what problems they face when they are trying to get important work done. Remember that often they cannot be activists or try to improve the system, because they must protect relationships with those who control their resources. Someone else must do the reform.

One of the greatest problems holding up medical research and development is the difficulty of getting the first human experience with promising new ideas. What usually happens is that academic researchers develop potential treatment approaches, often with Federal funding. They publish one or more papers in scientific journals. Then progress stops, because no one does the first test in a human being. Government usually avoids practical drug development, leaving that to industry -- but industry seldom picks up development unless it already has human proof of principle. Potentially lifesaving treatments can sit on the shelf indefinitely, and no one pays attention.

Possibly medical research needs a role like that of a producer -- one who handles the business of getting a project done, but in this case for cures for diseases, instead of for movies or plays. AIDS activists have sometimes stepped into that role when necessary. A notable example was the late Bill Thorne of ACT UP Golden Gate, who was largely responsible for the completion of a pivotal clinical trial that had stalled, and for FDA approval of human growth hormone for AIDS-related wasting. Everybody involved knew that he was the key person in making it happen. (His work was entirely volunteer; others made the money from the grossly overpriced drug.)

In vaccines, IAVI (the International AIDS Vaccine Initiative) has taken on the role of making projects happen. In cancer, the U.S. National Cancer Institute has long studied early clinical use of new agents. But much of medical research today is like an entertainment industry without producers, where the artists themselves must do all that work, or no one will.

ISSN # 1052-4207

Copyright 2002 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.

Back to the AIDS Treatment News January 25, 2002 contents page.