National Task Force Appointed

On February 4, Health and Human Services Secretary Donna E.
Shalala named the members of the National Task Force on AIDS
Drug Development -- the new high-level panel to look at all
aspects of AIDS medical research, and implement or recommend
improvements in both government and private programs to speed
the discovery and testing of important treatment advances.
The first meeting is planned for late March, but the all-
important work by professional staff at the FDA, NIH, and
other government agencies, has already begun. (For background
on this Task Force, see AIDS TREATMENT NEWS #188, December 3,
1993.)

This Task Force, which reports directly to Secretary Shalala
in President Clinton's Cabinet, differs from previous efforts
in that it can bridge the gap between the detailed knowledge
of what happens in medical research (needed to understand the
problems), and the high-level attention and authority,
missing until now, which is often needed to resolve them. For
example, on the government side, the Task Force includes the
Director of the National Institutes of Health, the
Commissioner of the Food and Drug Administration, and, above
them, the Assistant Secretary for Health. From industry, it
includes the president of Merck Research, the vice president
for clinical research of Bristol-Myers Squibb, and the CEO of
Genentech.

The 18 members, chosen to represent "government, academia,
the pharmaceutical industry, medicine, and the AIDS-affected
communities," are:

* Moises Agosto, Research and Treatment Advocacy Manager,
National Minority AIDS Council, Washington, D.C.;

* Arthur Ammann, M.D., Director, Ariel Project, Pediatric
AIDS Foundation, Novato, California;

* Stephen K. Carter, M.D., Senior Vice President, Worldwide
Clinical Research and Development, Bristol-Myers Squibb,
Princeton, New Jersey;

* Ben Cheng, Information and Advocacy Associate, Project
Inform, San Francisco, California;

* Deborah J. Cotton, M.D., M.P.H., Assistant Professor of
Medicine, Harvard Medical School, Boston, Massachusetts;

* Mindy Fullilove, M.D., Research Psychiatrist, HIV Center,
New York State Psychiatric Institute, New York, New York;

* David Ho, M.D., Director, Aaron Diamond AIDS Research
Center, New York, New York;

* Daniel Hoth, M.D., Senior Vice President, Cell Genesys,
Foster City, California;

* David A. Kessler, M.D., Commissioner, U.S. Food and Drug
Administration;

* Philip R. Lee, M.D., Assistant Secretary for Health, U.S.
Department of Health and Human Services;

* Theresa McGovern, Director, HIV Law Project, New York, New
York;

* Charles Nelson, Sisterlove Women's AIDS Project, Atlanta,
Georgia;

* G. Kirk Raab, CEO, Genentech, South San Francisco,
California;

* Robert Schooley, M.D., Director, Colorado ACTU, University
of Colorado, Denver, Colorado;

* Edward Scolnick, M.D., President, Merck Research
Laboratories, Rahway, New Jersey;

* Peter Staley, Founding Director, Treatment Action Group,
New York, New York;

* Harold Varmus, M.D., Director, U.S. National Institutes of
Health;

* Flossie Wong-Staal, Ph.D., Professor of Medicine and
Biology, University of California, San Diego, California.

Comment

This task force has three basic ways to make changes:

* The group includes persons who can "commit at the table" to
implement much of what needs to be done to develop a more
coordinated and productive approach to drug development.
These leaders, brought into close coordination for the first
time, should be able to solve a number of problems directly,
by their own decisions and agreements, instead of filing a
report and hoping that someone else takes action.

* When cooperation is needed from other organizations, such
as other pharmaceutical companies, the Task Force should be
influential enough, and realistic enough in what it asks for,
to have a good chance of obtaining the cooperation needed to
address other problems which the members cannot resolve on
their own. (Dr. Scolnick of Merck can be especially helpful
here, because of his role in the Inter-Company Collaboration
for AIDS Drug Development, a pharmaceutical-industry
association which is improving coordination among companies
engaged in AIDS research.)

* Finally, when government action is needed, the Task Force
can make recommendations to Health and Human Services
Secretary Shalala. If legislation is necessary, the
Administration can go to Congress -- although usually this is
a last resort, since legislation takes much longer than
administrative action by government agencies or private
organizations.

What do we hope to see from the Task Force? We believe that
the central problem in medical research is that some of the
most promising leads -- individual treatments and overall
research directions -- are left in limbo for years, not for
any medical, scientific, or even economic reason, but because
they have not yet amassed the commercial and political clout
required to push through the jumble of roadblocks and hurdles
which impede any medical research today. Somewhere among
government, industry, academia, foundations, etc., the
intellect and energy must be found to give a few well-chosen
areas the strategic push they need to quickly prove
themselves and acquire the stature to proceed on their own.

Also, the Task Force will discover endless correctable
problems if it listens to working scientists describe what
they do every day, and explain the obstacles and
frustrations, such as mindless red tape, that impede their
work. Hopefully the scientists will recognize that these
problems can now be addressed, and will be able to articulate
requests that would have been useless before, even after
years of doing things the wrong way when that was how the
world worked, when they had no choice. Hopefully, also, the
scientists will not blow this opportunity by using it only to
ask for more money -- always the easiest request to make, but
sometimes the hardest to fulfill. Certainly more money is
needed for medical research; but the way to get it is to
produce the major practical advances that save lives and save
resources as well.