Censoring research on AIDS in USA

[Guest guest]

Censoring research on AIDS

San Francisco Chronicle - Thursday, November 6, 2003

S. Padian**

I was in Bangalore, with a team of international researchers who are

working to prevent the spread of AIDS on the Indian subcontinent, when I

learned that my name and my research were on a " hit list " of researchers

and projects apparently targeted for additional scrutiny and possible

loss of funding by the National Institutes of Health, the federal agency

that sponsors the research.

The targeted projects mainly deal with sexual behavior and risk of

infection from sexually transmitted diseases, including HIV/AIDS. The

assault on NIH-sponsored projects was particularly chilling because my

research, like that of my colleagues at UC San Francisco who were also

targeted, had gone through extensive scientific and ethical peer review

before receiving NIH funding. Why were the red flags being thrown at

this point in the game?

It soon emerged that the " hit list " was prepared by the Traditional

Values Coalition, a conservative advocacy group. The TVC objects to

homosexuality, all forms of abortion and all contraceptive

interventions. In fact, the TVC objects to all sex outside marriage --

hence its effort to withdraw funding from any project that attempts to

mitigate health problems associated with sex outside of marriage by

using any means other than abstinence.

The TVC's unprecedented scare tactic sent a wave of anger and resentment

through the entire international community of public health and medical

researchers. Even more alarming, although the TVC has acknowledged

authorship of the list, NIH is still preparing a report for Congress

about the research projects listed.

One may ask how a lobbying organization with such a strong sectarian

political and religious viewpoint could initiate an investigation of

approved research projects. Evidently the TVC feels that it enjoys an

open invitation to change the priorities and goals of

government-approved scientific research, outside all established

procedural channels.

To understand why this tactic is so insidious, the public needs to

understand how scientists win federal funding for NIH-sponsored

scientific research projects, and what is at stake if this system is

eroded for ideological reasons.

All the projects targeted by the TVC -- indeed, all government-funded

science projects -- go through rigorous academic peer review. That is,

as proposals compete for funding, they are judged by teams of

accomplished, unbiased and internationally respected scientists in

related fields. The results of these investigations are continually

reported in international, peer-reviewed medical journals.

The integrity and independence of this peer-review process is essential

for the continued vitality and quality of American medical and

public-health research. It cannot be subjected to an extremist litmus

test.

Disease does not respect political or religious affiliations, nor does

it observe any international boundaries. Medical research is bound by

the strictest ethical standards. It must have the freedom to find

answers to how diseases are caused and spread, and how to develop

ethical and effective treatments for them.

Infectious diseases attack whole populations, not just individuals.

Thus, controlling infectious diseases means focusing on all of the

populations affected. It is neither morally nor medically defensible to

withhold research or treatment just because the behavior of one segment

of society is distasteful to another. The ever-present risk of the

spread of infection from any segment to the larger community --

including people who fear and dislike those affected by disease --

requires understanding how disease spreads and how to develop

appropriate, effective interventions for everyone. Rigorous scientific

research makes successful interventions possible.

All of the research targeted by the TVC witch-hunt promotes the

improvement of public health. No outcomes are prejudiced in advance by

the research; lack of bias is a hallmark of quality scientific

investigation. The overarching goal of all of the research in question

is to change behavior in order to save lives, a long-term goal of

American and international public- health policy and practice. The

targeted programs have included thousands of vulnerable individuals at

risk for sexually transmitted infections, including HIV. We have already

seen benefits of much of this work at national and international levels.

It is amazing that these values, which are truly traditional and

durable, even need explanation, let alone defense.

It is time for the Bush administration to distance itself firmly and

explicitly from any kind of scientific McCarthyism. The unthinkable

alternative is the erosion of this country's high standards for public

health and medical research, and higher rates of infection from diseases

that need to be cured and controlled. There is too much at stake to play

politics.

** S. Padian, a professor of obstetrics, gynecology and

reproductive sciences at UCSF, is director of international research at

the UCSF AIDS Research Institute.

http://www.aegis.org/news/sc/2003/SC031103.html