About This Issue

AIDS TREATMENT NEWS skipped its scheduled April 7 publication; the last published issue was #76, dated March 24. All subscriptions will be extended one issue to compensate.

We never cancel an issue because of lack of news to report. At this time there is more news than ever, more than we can keep up with. We skipped the last issue because of the unusual difficulty of integrating and making sense of what is going on at the present time.

Today we have the best news ever on treatment developments. But the human and organizational failures in both the medical-research establishment and the AIDS community itself are so profound that it is hard to see how the potential advances now in view will get to the persons who need them, except through grassroots or underground movements.

These human and organizational failures are not new; they have been pervasive since the beginning of the epidemic. But today's improved prospects for treatment development are greatly increasing the cost in human life of squandered opportunities and institutional bankruptcy.

In "The Drug-Trials Debacle" (below) we provide a simple mathematical model supporting a conservative estimate of fifty thousand unnecessary deaths over the next several years -- barring policy changes or lucky developments, such as a much better treatment becoming available underground. We show that behind the flimsiest fig leaf, provided as a service for those who prefer denial, the research establishment has written off people with AIDS. Besides the remarkable lack of urgency, we propose that the crux of the problem is a scientific and medical issue, in which the research establishment is correct in its own terms, but wrong in its choice of terms. We show that the refusal to accept the fact that patients and physicians must and do make decisions under uncertainty -- and the narrow insistence that all drug-treatment research be geared to developing statistical proof of safety and efficacy -- has inadvertently turned the commendable effort to develop a more proven, scientifically-based medicine into a gruesome public disservice.

We will suggest practical ways, through coalition building and through community-based research, for bringing the real issues of AIDS research into the light of day where they can be discussed and decided on their merits.

The interview with friends of Terry Sutton, a San Francisco treatment activist who died this month, brings a human and spiritual perspective to the issues of drug access and clinical trials, and of the AIDS community's slowness to face these issues and insist that deficiencies be corrected.

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