Prime Time Replay:
Mark Wainberg, Ph.D.
International AIDS Society
MsgId: *breakthrough(2)
Date: Wed Jul 23 21:59:29 EDT 1997
From: moderator At: 152.163.194.151
Welcome to Breakthrough Medicine. I'm your moderator, Madeleine Lebwohl, and tonight Mark Wainberg will be speaking to me in an in-studio interview about the worldwide issues that the International AIDS Society will address this year.. Hi, Dr. Wainberg!
MsgId: *breakthrough(3)
Date: Wed Jul 23 22:00:30 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: Hi, I'm pleased to be here.
MsgId: *breakthrough(4)
Date: Wed Jul 23 22:01:41 EDT 1997
From: moderator At: 152.163.194.151
Let's start by talking a little about the International AIDS Society (IAS). What is its mission? What are your goals as president this coming year?
MsgId: *breakthrough(5)
Date: Wed Jul 23 22:03:40 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: The IAS has a goal of trying to coordinate research and health care access in HIV/AIDS throughout the world. One of our major objectives is to improve drug access. As you know, 95% of the worlds HIV infected population has virtually no access to anti-viral drugs at this time. This situation is clearly intolerable, and is unacceptable to those of us who are committed to waging war against this disease. We need to encourage pharmaceutical companies to develop drugs that will be more affordable than those that are currently in use.
MsgId: *breakthrough(7)
Date: Wed Jul 23 22:07:22 EDT 1997
From: moderator At: 152.163.194.151
How is the international scientific community trying to influence pharmaceutical drug companies toward this goal?
MsgId: *breakthrough(8)
Date: Wed Jul 23 22:09:28 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: We need to encourage industry to accept greater responsibility in developing world committments. In fact, many companies have already recognized the need to participate together with the IAS in a variety of joint ventures of mutual interest. These include educational programs, and other types of HIV awareness initiative to help prevent the spread of HIV in the developing world.
MsgId: *breakthrough(9)
Date: Wed Jul 23 22:10:31 EDT 1997
From: moderator At: 152.163.194.151
Are you getting a lot of help from governments around the world?
MsgId: *breakthrough(10)
Date: Wed Jul 23 22:12:23 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: Of course there are many governments that are simply too poor to afford drugs for their people or to participate in the types of HIV awareness programs that are sorely needed. So the IAS has to try to fill in the gaps some of the time. This is something that we do in collaboration with other international organizations, including the UN AIDS program, and the World Health Organization.
MsgId: *breakthrough(11)
Date: Wed Jul 23 22:13:50 EDT 1997
From: moderator At: 152.163.194.151
Because of cost, do all countries go the same route in prevention and treatment?
MsgId: *breakthrough(12)
Date: Wed Jul 23 22:16:39 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: Certainly, in regard to awareness programs, there are many similarities among many countries. However, one must take into account ethnic differences and societal differences that exist in many parts of the world. In some cases, different religious values are also an issue. This means that it is not possible to speak in explicit sexual terms in explaining the risks of HIV in some societies. This makes it rather more difficult to explain risk factors to citizens of such countries. At the same time, we must recognize that these differences are part of the world in which we live, and must do our best to get the message out on a country by country basis.
MsgId: *breakthrough(13)
Date: Wed Jul 23 22:18:12 EDT 1997
From: moderator At: 152.163.194.151
Is the speed with which these educational and prevention programs are being implemented affecting the spread of the epidemic?
MsgId: *breakthrough(14)
Date: Wed Jul 23 22:34:20 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: There is no such thing as a too rapid implementation of awareness programs. In many countries official government policy was one of denial for too long. The result is that several countries now face massive epidemics that have spread or are likely to spread out of control.Examples are India, which now faces an explosive HIV epidemic. Another worrisome area of the world is China. Poverty and malnutrition are key factors in the spread of HIV. We know, for example, that sex workers who spread HIV are engaged in that profession for no other reason that it provides a means of sustenance for an invidual and family members.
MsgId: *breakthrough(16)
Date: Wed Jul 23 22:38:05 EDT 1997
From: moderator At: 152.163.194.151
Will you be traveling to these areas of explosive HIV problems?
MsgId: *breakthrough(17)
Date: Wed Jul 23 22:39:42 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: I already travel extensively. For example, I am frequently in Geneva to help with the planning of next years International AIDS conference that will take place in that city. I have several trips planned as well to Africa during the next year.
MsgId: *breakthrough(18)
Date: Wed Jul 23 22:40:25 EDT 1997
From: moderator At: 152.163.194.151
When you go to Africa, will you be working with other scientists or seeing patients?
MsgId: *breakthrough(19)
Date: Wed Jul 23 22:42:19 EDT 1997
From: moderator At: 152.163.194.151
Dr Wainberg: In part, it is for the purpose of collecting viral samples and it is also to help African physicians participate in clinical trials. We need not only to provide improved drug access for developing countries, but also to teach health professionals in those regions how to participate in clinical trials. Hopefully, the pharmaceutical industry will participate with us on a priority to achieve this goal.
MsgId: *breakthrough(21)
Date: Wed Jul 23 22:44:18 EDT 1997
From: moderator At: 152.163.194.151
What are your goals this year for your own research?
MsgId: *breakthrough(22)
Date: Wed Jul 23 22:46:11 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: We would like to develop a vaccine to protect people against HIV infection. The approach we favor is similar to that of the Sabin vaccine for polio. It is a live viral vaccine that can replicate to minimal extent, without causing disease, but that can generate a strong immune response to protect against viral infection.Because drug access is such a frustrating issue for the developing world, it is imperative that a vaccine be available to protect against this disease as soon as possible. Of course, the vaccine must also be cheap in order to be widely available.
MsgId: *breakthrough(24)
Date: Wed Jul 23 22:49:40 EDT 1997
From: moderator At: 152.163.194.151
Do countries that have problems with poverty and population to drugs that western countries countries can provide more easily, ask you for a different approach?
MsgId: *breakthrough(25)
Date: Wed Jul 23 22:51:27 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: No. I think our agendas in fact coincide. The problem is essentially one of resources. Poor countries wish they had more resources, and we wish we had the money to give them to implement programs in HIV and drug access with suitable dispatch.
MsgId: *breakthrough(26)
Date: Wed Jul 23 22:54:23 EDT 1997
From: moderator At: 152.163.194.151
Do you see participation by local community groups in these endeavors?
MsgId: *breakthrough(27)
Date: Wed Jul 23 22:56:50 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: Yes. We have always recognized the importance of community groups that have worked hand-in-hand with the IAS toward attainment of shared goals. They have expertise that we lack and vice-versa. We have to continue to develop a positive interchange in years to come in order to enhance each of the AIDS awareness, drug access, and vaccine development programs that are now in place.
MsgId: *breakthrough(28)
Date: Wed Jul 23 22:57:59 EDT 1997
From: moderator At: 152.163.194.151
Where do we stand now in the problem of drug resistance?
MsgId: *breakthrough(29)
Date: Wed Jul 23 22:59:51 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: We are learning to use combinations of anti-viral drugs to better advantage than previously. At the very least, we can now forestall the development of drug resistance in many patients by at least several years. We still need to continue our efforts to develop new drugs that will do an even better job in the future.
MsgId: *breakthrough(30)
Date: Wed Jul 23 23:00:50 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg, our time is up. Thank you for joining me.
MsgId: *breakthrough(31)
Date: Wed Jul 23 23:01:39 EDT 1997
From: moderator At: 152.163.194.151
Dr. Wainberg: Goodnight, I've enjoyed doing this.
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