And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition (77 page)

By coincidence,
The New York Times
science writer, Lawrence Altman, had been at the CDC in Atlanta a week earlier. Mason had told Altman then that the Pasteur Institute’s work with LAV was “highly significant” and that it looked “like they have the AIDS virus.” Late in the afternoon on Friday, April 20, Altman called Mason. He had heard of the hubbub surrounding the impending HTLV-III announcement and wanted to put Mason’s earlier comments in the Sunday
Times.
Mason knew that it would look as though he were upstaging Heckler’s announcement and asked Altman not to print the story.

“Anything you say I say will get me in trouble,” Mason said.

April 20

S
AN
F
RANCISCO
D
EPARTMENT OF
P
UBLIC
H
EALTH

By that Friday afternoon, Dr. Selma Dritz had heard of the imminent HTLV-III press conference. The news brought a natural end to the phase of the epidemic that had involved people like herself, Dritz thought. It seemed appropriate that this was her last day of work. With the cause of the disease found and the routes of transmission established, the focus of the next phase of AIDS research would shift to the lab, where scientists could develop the vaccine and treatments. Selma Dritz’s legacy was written into the notebooks she had carefully kept since the first day she had heard of the mysterious case of Kaposi’s sarcoma in Ken Home. Dritz felt a serenity with her retirement. She had done her share of the world’s work, she felt, and she had done a good job.

At her retirement dinner, somebody recalled a talk he had heard Dritz give in 1980 at UCSF about venereal diseases in gay men. In the talk, Dritz had warned that “too much was being transmitted” and there would be “hell to pay” if any new infectious agent made it into this population. The statement showed uncanny prescience, the colleague noted. Selma Dritz didn’t remember.

April 23, 1984

H
UBERT
H. H
UMPHREY
B
UILDING,
U.S. D
EPARTMENT OF
H
EALTH AND
H
UMAN
S
ERVICES
,
W
ASHINGTON
, D.C.

Bob Gallo was weary and nervous when he arrived in the office of Health and Human Services Secretary Margaret Heckler. He had come straight from the airport, having flown all night from Italy, where he had delivered the closing remarks at a human retrovirus conference. Only yesterday had he learned that his presence was required this morning at a press conference in which Heckler would announce the discovery of HTLV-III. Gallo was stunned to hear that the previous day’s
New York Times
carried a page-one story in which Dr. James Mason from the Centers for Disease Control gave credit to the Pasteur Institute for isolating the AIDS agent. Knowing that the
Times
writer who broke the story, Dr. Lawrence Altman, was a former CDC staffer, Gallo figured the leak was a salvo meant to upstage his research at the NCI. And Gallo had no doubt that Don Francis, who was collaborating with the Pasteur, was the man behind the
Times
story.

Indeed, James Mason, who had flown to Washington for the press conference, was made aware in no uncertain terms by HHS officials that his comments in the New York daily were not appreciated. Before the press conference, a shouting match had broken out between Bob Gallo and one of Heckler’s top aides when the HHS staffer had the temerity to scold Gallo, NCI Director Vincent Devita, and NIH Director James Wyngaarden about the leak. After the hollering subsided, the scientists briefed Heckler and walked down to the massive auditorium in the Hubert H. Humphrey Building.

Gallo had never seen so many reporters, lights, and cameras. He quickly realized that the announcement would be a major international news story and that the French scientists would be furious with him. Heckler opened the press conference with a six-page statement that had both a nationalistic and political tenor.

“Today we add another miracle to the long honor roll of American medicine and science,” she declared. “Today’s discovery represents the triumph of science over a dreaded disease. Those who have disparaged this
scientific
search—those who have said we weren’t doing enough—have not understood how sound, solid, significant medical research proceeds. From the first day that AIDS was identified in 1981, HHS scientists and their medical allies have never stopped searching for the answers to the AIDS mystery. Without a day of procrastination, the resources of the Public Health Service have been effectively mobilized.”

The doctors who accompanied Heckler to the podium blanched visibly when she proclaimed that a blood test would be available within six months and a vaccine would be ready for testing within two years. None of the doctors with Heckler on the stage believed this claim, and nobody could determine where she had conceived such deadlines, which they knew would never be met.

Because of the CDC’s prodding, Heckler had added a nod to the efforts of the Pasteur Institute. Heckler went out of her way, however, to enumerate why the NCI research was particularly “crucial.” She noted, accurately, that Gallo alone had figured out how to reproduce the virus in large quantities, a feat that continued to elude the French. Only this ability made the mass production of a blood test kit possible. Somehow, however, Heckler also managed to deduce that the Pasteur Institute’s research “has in part been working in collaboration with the National Cancer Institute.” With further studies, Heckler added, scientists expected that LAV and HTLV-III “will prove to be the same.”

After the years of frustration, the announcement of the HTLV-III discovery deserved elation, Don Francis thought as he watched the live Cable News Network coverage of the Heckler press conference in the CDC’s television studio with other members of the AIDS Activities Office. Instead, he felt burdened by the conflicts he saw ahead. The French were being cheated of their recognition and the U.S. government had taken a sleazy path, claiming credit for something that had been done by others a year before. Francis was embarrassed by a government more concerned with election-year politics than with honesty. Moreover, he could see that suspicion would play a greater, not a lesser role in the coming AIDS research. Competition often made for good science, Francis knew, lending an edge of excitement to research. Dishonesty, however, muddied the field, taking the fun out of science and retarding future cooperation.

The New York Times
echoed the concern in an editorial shortly after the announcement. “What’s going on?” the piece asked. “Since even certain discovery of the guilty virus will not produce a vaccine for at least two years, and even better blood screening cannot occur for months, what you are hearing is not yet a public benefit but a private competition—for fame, prizes, new research funds…. Some kind of progress is surely being made. The commotion indicates a fierce—and premature—fight for credit between scientists and bureaucratic sponsors of research. Certainly no one deserves the Nobel Peace Prize.”

In Paris, the Pasteur scientists were aghast at the short shrift their work was given. Willy Rozenbaum considered Heckler’s performance no more than a political stump speech. “Elect us and we give you antibody test in six months,” he mimicked bitterly. “Elect us and we give you vaccine in two years.”

Three days later, Luc Montagnier revealed his own suspicions when he told UPI, “I don’t say Gallo took our virus. He worked independently.”

Officials at the National Cancer Institute had no reluctance about taking center stage in the discovery of the AIDS agent. The French would never have been able to find their LAV without Gallo’s earlier work. It was Gallo’s own comments about a possible connection between HTLV and AIDS that led the French to even look for a human retrovirus in the first place. They thought the Pasteur and NCI did not deserve equal credit because the NCI clearly had done more extensive and definitive work on the virus. Beyond perfecting the means for its mass production, Gallo had cultured many more isolates and perfected a more sensitive blood test. Complaints from the Pasteur and the CDC were sour grapes, they thought.

How timely was the discovery of the long-sought AIDS virus? Partisans of the scientific establishment and the Reagan administration pointed out that the mystery of the AIDS epidemic was solved much faster than for any comparable disease. This is an accurate observation. Such analysis, however, ignores the fact that AIDS did not emerge in the days of Antonie van Leeuwenhoek or Louis Pasteur. Rather than compare the research on AIDS to disease research in earlier eras, it is more to the point to look at the chronology of the actual AIDS research.

As it turned out, the AIDS virus was not a particularly difficult virus to find. The French took all of three weeks to discover LAV and had published their first paper on it within four months. This early publication lacked the certainty of a definitive discovery, but the French had enough evidence to assert they had found the cause of AIDS by the summer of 1983, seven or eight months into the research process.

Nor was the NCI research marked by great longevity. Gallo’s announcement of forty-eight isolates of HTLV-III came just twelve days past the first anniversary of the April 11, 1983, NCI meeting in which the researcher swore he would “nail down” the cause of AIDS. Meanwhile, at the University of California in San Francisco, it took Dr. Jay Levy about eight months to gather twenty isolates of a virus he called AIDS-associated retrovirus, or ARV, which he too believed to be identical to LAV. Levy’s research was hampered by lack of resources and did not begin in earnest until after the arrival of his long-sought flow hood and the release of UC research funds impounded the previous autumn. On the date of the HTLV-III press conference, Levy also was on the verge of announcing his discovery.

Therefore, by April 1984, isolates of the AIDS virus had been made at the Pasteur, NCI, CDC, and UCSF, all of which were discovered after substantially less than a year of research.

What delayed the NCI, therefore, was not the difficulty in finding the virus but their reluctance to even look. Most CDC researchers privately believed that if the NCI had begun serious laboratory efforts in 1981, the virus could have been detected by 1982, before it had made its vast penetration into American life. Although all the scientists who made the viral isolations certainly deserved applause, the discovery of the AIDS agent ultimately was not a contest for accolades but a race against time. Once again, time, the true adversary, had won.

As of April 23, 1984, there were 4,177 cases of Acquired Immune Deficiency Syndrome in the United States, the CDC announced that afternoon. Of these, 1,101 had been reported in 1984. The disease had spread to forty-five states. About 20 new cases were reported on every working day. Thus far, 1,807 AIDS deaths had been counted nationally. New York City reported nearly 1,657 cases. That week, the numbers of AIDS cases in San Francisco surpassed 500.

May 4

U
NIVERSITY OF
C
ALIFORNIA,
S
AN
F
RANCISCO

Within days of the HTLV-III announcement, Marc Conant had issued invitations to a high-powered group of health educators, AIDS specialists, and media professionals for a symposium to develop an “AIDS Prevention Media Project.” Supervisor Britt would try to secure city funding for the project.

The gay press, still angry at Conant’s involvement with bathhouse closure in March, counterattacked with a savage character assassination, rehashing Conant’s efforts against the bathhouses. The headline in the
Bay Area Reporter
announced: “MD’s Plot ‘Behavior Modification’ for Tricking Gays,” and characterized the campaign as an Orwellian conspiracy for thought control. Sensitive to anything that might upset gay voters in an election year, the board of supervisors began wavering on the program.

The prevention program was not the only controversy snaring the mayor in May. The bathhouse issue was stalled, as was the city’s AIDS prevention campaign. Silverman subsequently said he was disappointed with the AIDS education campaign mounted by his department and the San Francisco AIDS Foundation, although he never expressed his reservations in public. He felt he had no choice but to include all the various gay factions in his considerations, aware that any one of the groups would move to sabotage prevention efforts if they felt excluded. As he said later, it was better to have all the Indians inside the tent pissing out than to have them on the outside pissing in.

It was about this time that Steve Del Re, the young man who had so bitterly chastised Conant for wanting to close the baths, appeared in Conant’s office. By now, Conant had heard the rumors about the twenty-seven-year-old’s liaison with Rock Hudson, but Steve hadn’t come to gossip.

“I have this purple spot,” he said.