AmFAR Will End Support of CBCT Network, Begin New Clinical Program

The American Foundation for AIDS Research (AmFAR) will end support of its Community Based Clinical Trials network at the end of the current three-year contract cycle in January 1998, except for funding to finish, analyze, and publish the trials still underway. AmFAR will begin a new clinical research program in which it will sponsor studies, but not be involved in their day-to-day management.

AmFAR president Arthur J. Ammann, M.D., said the change is being made because "AmFAR felt strongly that at this point in the epidemic, it needed flexibility to put out requests for proposals for very specific areas. Continuing to study drugs for their effectiveness -- the kinds of trials being done by government networks and by pharmaceutical companies -- is very expensive and beyond the Foundation's capabilities."

AmFAR has spent $30 million on CBCT trials since it started that network in 1989. Some of the 12 sites currently being funded also have other support from government or industry; others do not.

AmFAR plans to start the new clinical research program with an RFP (request for proposals) issued in January 1998 for funding in July, and to issue new RFPs annually. This funding will be open to all qualified research groups, not only community-based groups. The kinds of studies which this program will fund "will be determined by outside advisory committees based on urgent research priorities in the epidemic." Grants will be investigator initiated and peer reviewed, and may be in the range of $150,000 to $200,000 for 12 months, renewable; they could be used to fund small, single-site proof of concept trials.

According to Dr. Ammann, the total AmFAR funding for clinical research under the new program is expected to be comparable to what is being spent currently.

In addition, AmFAR plans grants to community-based organizations, starting in January 1998, "for outreach and education activities...to enhance the recruitment and retention of individuals into clinical trials available in their communities." This program will focus particularly on outreach to disadvantaged groups currently underrepresented in clinical trials.

Comment

The AIDS community, including donors and treatment activist organizations, needs to pay attention to the development of the annual RFPs, and to the composition of the committees involved in selecting which clinical research will be funded.

A critical role for medical research supported by public donations is to enable studies which are scientifically sound and can improve medical care, but are not done elsewhere because of lack of financial incentive, or institutional, cultural, or personal biases. This difficult mission requires both expertise and vision. It is easy to miss the mark.