IN MEMORIAM: NATHANIEL PIER, 1952-1989

Nathaniel Pier, M. D., one of the strongest advocates for faster development of AIDS treatments, died of AIDS complications on December 27, 1989.

We first spoke with Dr. Pier in 1986, while researching lentinan. He had long urged trials for this drug, an immune modulator derived from the shiitake mushroom and widely used in Japan in treating cancer. In February 1988 Dr. Pier presented the history of his four-year efforts to spark research on lentinan to the Presidential Commission on the HIV Epidemic. (Recently clinical trials of lentinan were conducted at San Francisco General Hospital, and at New York's Community Research Initiative.)

Dr. Pier, who had a large AIDS practice in New York, was also a founder of the Community Research Initiative, a model organization for conducting clinical trials outside of the usual research centers, through the help of practicing physicians. Dr. Pier and the other founders carried the organization through the first difficult year before it was popular, and stayed with it afterwards.

AIDS TREATMENT NEWS published interviews with Dr. Pier on January 1, 1988 and August 12, 1988. The conclusion of the August interview suggested the "parallel track" later proposed by NIAID director Anthony Fauci, M. D., as well as the criticism of mainstream clinical AIDS research which is now becoming more common:

"The current system simply has not produced the goods. And if Dr. Frank Young's prediction (of few new drugs approved by 1991) is any indication, it will not produce the goods for a long time to come. This consigns large numbers of people to death without giving them a dignified chance to fight back. It is not an acceptable human or reasonable approach to doing research in this epidemic.

"After five years of being on the front lines, my heartfelt feeling is that the top priority for people with AIDS and people who care about AIDS is to demand access to experimental therapies to try to save their lives.

"I appeal to people to organize this effort immediately, to bring it forward in their local groups, then present the case to their political people, and to the people who are running the present medical system of testing drugs. It's time we told them that the emperor has no clothes, that the current system is not working. It's time to insist on wider access to promising therapies, and rapid testing of existing drugs to develop better treatment options."

In our last conversation, shortly before his death, Dr. Pier told us that hypericin herbal extracts appeared disappointing to him and other New York physicians -- they were not seeing the results that had been hoped. Earlier, Dr. Pier had been the first to tell us that AL 721, and later dextran sulfate, appeared disappointing.

Dr. Pier graduated summa cum laude from the University of California at Berkeley in 1974, and received his M. D. from the Albert Einstein College of Medicine in 1977. He is survived by his lover, Michael Hannaway.

STATEMENT OF PURPOSE

AIDS TREATMENT NEWS reports on experimental and complementary treatments, especially those available now. It collects information from medical journals, and from interviews with scientists, physicians, and other health practitioners, and persons with AIDS or ARC.

Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available.

We also examine the ethical and public-policy issues around AIDS treatment research and treatment access.