The Sound and Fury of HIV
By Bernadine Healy M.D.
Posted Sunday, August 6, 2006
U.S. News & World Report
It was the biggest public-health crisis of our time. Scientists had been breathlessly chasing a mysterious agent that popped up out of nowhere to claim thousands of lives, with no sign of relief. The medical community was clueless as to why gay men were dying, immune systems blasted to smithereens. Or why hemophiliacs were similarly dropping like flies, and some children were wasting away after blood transfusions. AIDS terrified the public and stumped the smartest docs, who raced from one blind alley to another.
The historic announcement in 1984 was one of those you-never-forget moments. Then a cardiologist at Johns Hopkins School of Medicine, I was riding in the back seat of a taxi as the driver and I listened raptly to the radio. Scientists at the National Institutes of Health, led by virologist Robert Gallo, had just nailed down the virus that causes AIDS, a beast soon christened HIV. More important, they had created something we were desperate for: a test to screen out AIDS-infected blood. By then it was known all too well that the disease was transmitted via blood as well as through sexual contact.
Deadly roulette. I was big into blood back then. My heart patients needed it during surgery, but so did many other patients. Ordering blood or blood products (like clotting factors for hemophiliacs) in those days was deadly roulette--life-saving blood at the risk of a life-ending virus. To caregivers, the AIDS find was not about kudos or prizes. It was about understanding a killer: learning its silent carriers; preventing its spread; designing drug therapies. These are the discoveries that make medical research downright heroic.
But as quickly as this was hailed as monumental, its all too human heroes fell into a nasty battle over bragging rights. Shortly before Gallo's work came to light, Luc Montagnier of the Pasteur Institute in Paris identified a similar retrovirus from the swollen lymph nodes of a suspected AIDS patient. But Montagnier did not think it was the cause of the disease. As time would tell, Gallo rediscovered that same virus. But he immediately made the next big leap by culturing the virus as no one had, designing the blood test, and carrying out numerous human studies to prove HIV was the malignant seed at the heart of AIDS.
When I took over as head of NIH in 1991, I found myself now in the front seat, witnessing Gallo under siege and resisting repeated pressure to have him fired. Gallo had always acknowledged the Pasteur virus as the same or similar to his own. In fact, in 1987, the U.S. government shared the patent for the new blood test with the French. But that did not keep allegations from smoldering in the gossipy world of science that Gallo's lab had "stolen" the Pasteur virus. Slurs went back and forth. Scientific review committees assembled, Congress urged criminal prosecution, and lawyers for the French piled on. The government's Office of Scientific Integrity searched high and low for fraud, and the media turned various players into angels and demons. For four years, the NIH laboratory was paralyzed by inquiries and inquisitions.
After all was said and done, there was no evidence that Gallo or his senior colleague Mikulas Popovic had stolen any virus. And claims of misconduct--lab records were not always clear, minor mistakes had crept into publications, unconventional techniques were used, and Gallo was in too much of a rush--were summarily tossed out by a final appeals board. It closed the case with appropriate sarcasm: "One might anticipate that from all this evidence, after all the sound and fury, there would be at least a residue of palpable wrongdoing. That is not the case."
So the controversy ended where it began. Gallo and Montagnier were deemed codiscoverers, with Montagnier the first to identify the virus and Gallo the first to show it caused the disease. What has not been owned up to is that this bitter controversy clouded one of science's greatest triumphs and drained energy from its brightest stars. Who knows the opportunities that were missed or the patients that may have been lost.
U.S. News Health Editor Bernadine Healy is the former head of the NIH and the American Red Cross.