Aids: Ask the scientist

Professor Robert Gallo, one of the scientists who first published evidence that HIV causes Aids, answered your questions.

Read the transcript

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Scientists from around the world have gathered in Paris for one of the largest ever conferences on Aids.

The four-day meeting, organised by the International Aids Society, marks the 20th anniversary of the discovery of the Human Immunodeficiency Virus (HIV).

The developed world has been criticised for failing to provide enough funds to fight the Aids epidemic.

Former South African President, Nelson Mandela, speaking at the conference on Monday, called on European leaders to match a United States' financial pledge on action against HIV/Aids.

Is enough being done to fight Aids? What should be done to improve access to drugs in the developing world?

You put your questions to Professor Robert Gallo.

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Transcript

Chris Hogg:
Hello and welcome to this BBC news interactive forum. I'm Chris Hogg. It's 20 years since scientists pinpointed the HIV virus as the cause of Aids, yet we still have no vaccine to protect against the disease or drugs to cure it. Those therapies developed to keep Aids patients alive are still not available to many of those who need them most - those who contract the virus in sub Saharan Africa and elsewhere in the developing world.

In Paris this week thousands of Aids scientists and researchers are gathering for what's in effect a council of war on how to tackle the Aids pandemic. Despite the fact that we know more about the HIV virus than almost any other there are still some important gaps in our knowledge and until those gaps are plugged, there's little chance of significant advances.

Professor Robert Gallo is one of the scientists who first published evidence that HIV causes Aids. He joins us now from the conference in Paris. Professor Gallo, there's been some controversy over the last two decades about just who can claim to have actually discovered HIV. Can you set the record straight?

Professor Robert Gallo:
Sure. We absolutely have no disagreement - the French group led by Montagnier or myself - and we published it in Science Magazine, the history, in November of last year. In fact there hasn't been any controversy since 1988. So that the question keeps resurfacing is a product of people who want it to resurface not because of us. We've been collaborating for seven or eight years, these past years, and have absolutely no disagreement on the history

If you can take an answer that is a little complex, a very simple answer would be that the Montagnier group published the first detection of this virus in 1983. But the technology to do so, the idea to look for this kind of virus, came from my group and the evidence that the virus was the cause of Aids came in early in 1984 from my group. The consequence of that is that we've both agreed that it's co-discovery.

We have absolutely agreement on who did what, when and we have had so for a long time and I would encourage anybody who wants the facts just to go back and read Science, November 2002 and there are no less than four papers - one from Nobel Prize winner, Stanley Prusiner, one from Luc Montagnier, one from myself and then one from both of us together. The details are there and I think any rational and fair person would understand that there is no controversy. So we call it co-discovery.

There was controversy that was principally based on blood test patent arguments. The patents were awarded to our group uniformly and understandably so there was unhappiness on the other side and that led to a contentious period. But that contentious period ended 15 years ago so it is remarkable that this still hangs.

Chris Hogg:
We've had two e-mails from the UK on the same subject, one from Ross Hamilton and another from Mark Slayford, both of them saying: When Aids was first recognised 20 years ago, the general consensus seemed to be that within a few years there would be a cure. Why hasn't that happened?

Professor Robert Gallo:
I'm sorry that anyone would have got the impression that a cure would be just a few years away back when these announcements were made. We knew the cause of the disease by early 1984. The virus, as I said already, was first detected in 1983 by the French group and then demonstrated to be the cause of Aids by our group in early '84 and as I indicated, we had earlier provided ideas and technology.

Now one of the things that maybe causing confusion, is that the Secretary of Health at that time, suggested that there might be vaccine trials within a few years' time. That was not unreasonable and indeed there was from an immunologist in Paris - Daniel Zagury. So it was actually a true statement. No one said that the problem would be solved. Knowing that it's a retrovirus - it's a special kind of a virus, made it very clear that the challenges would be phenomenal. People talk about a viral cure - they may mean prevention - a successful vaccine. How many viral illnesses do you or anyone know, that have cured - virtually none. Do we cure influenza today? But if you got smallpox, do you think we'd cure you? When you have the common cold, do we cure you? No viral disease - rabies or anything else - almost none are cured.

What people probably mean is why is there still not a successful, preventive vaccine. But when you talk about treatment, in fact therapy for HIV is the lead ship in all antiviral therapy in the world. This is a tremendously difficult virus that causes tremendous harm and yet there is, in the industrial world, decent therapy against HIV and I promise you that extremely interesting new approaches are being developed. For example, a compound called Fuzeon, coming from Roche, with a small American biotech company called Trimeris, will be going forward into larger chemical trials. These things are doing more positive effect for people in the industrial world than any viral disease I know of. But a preventive vaccine remains a major obstacle and if somebody asks me that question, I'd be glad to comment why.

Chris Hogg:
Hemraj Bhandari has contacted us from Nepal - also Albert P'Ryan, who is an Indian living in Rwanda. Both of them talking about the same issue: Is it all about money? Is the lack of progress that we've seen towards a vaccine or a cure for Aids due to funding problems or is it because the scientists and the politicians are mainly in the developed world and this is a problem which mainly affects people in the developing world?

Professor Robert Gallo:
I can't speak for the entire population of the scientists, or the entire population of drug companies or the entire population of political leaders. I can only tell you that I have never seen that attitude. Needless to say the scientist that is here in front of you talking about it to you now and the scientists at that meeting, we've been involved since day one. I worked on this problem since the beginning of the epidemic. That is principally now involves people in developing nations doesn't mean we don't care. I work full time on this - my whole institute is working 90% of their time on it.

By the way the statement is untrue. It may be principally in developing nations but the city I work in, Baltimore, has neighbourhoods where 10% of the population are infected. That approaches some of the African nations. So it's not limited to the developing nations by any stretch of the imagination. And as you know rising epidemics are occurring in Russia as well as China. So no, I don't see that, but if you're talking about would there be more money if the problem were predominately in the industrialised nations - the answer is probably yes. Probably more money would have put in earlier if the problem existed, as it does let's say, in parts of Africa, in the industrial world because the markets would have been bigger and because more people would have been able to have available money to put in. The pharmaceutical companies are going to lose a lot of funds in making therapy available for developing nations. But as I see it, at least the good ones are now willing to do so. And with the crisis emerging, particularly in Africa and coming elsewhere, it's interesting and wonderful in a way and I'm pleased to see that President Bush is putting in $15 billion for the underdeveloped nations for this purpose and Europe is already talking about sizeable increases. But no doubt, if there were this many infected people in Europe and the United States, it would have had greater attention earlier. It's not just because of money. But you know when the problem affects your home and family, people tend to get more involved.

Chris Hogg:
A couple of questions now about antiretroviral drugs - the drug treatment that's available to try to help people who have contracted the HIV virus. One from Simmo in the UK who contacted to ask: What's the real prognosis for someone diagnosed with early-stage HIV infection today, assuming the best treatment, assuming that they can get access to these drugs?

And Ebenezer Aryee from Ghana with another question about HIV but a different issue of course for the developing world. He says: Everyone is talking about improving access to anti-retroviral drugs. But what's the point if there isn't the infrastructure to make sure that they can deliver them to people?

Professor Robert Gallo:
The last question is a great question and an important question from Ghana. So let me start with the last question first. It is absolutely true that we can't just throw the drugs - it's not just money and here's the drugs for everybody in Africa. If you do that, we'll have a lot of happy people for two, three, four, five years. But if the infrastructure is not there, we're going to create multi drug resistant mutants. So at the same time that we have the drugs for developing nations, we've got to help build their infrastructure. This is vital. That question from Ghana could not be more timely or more important.

As regards the first question, in the developed world, the industrial world, if a person today gets diagnosed with HIV, there are enough drugs and enough trained physicians that that person can have, as far as we can see, a reasonably normal life. They have to take the drugs as ordered. Resistance still may occur and some toxicity may occur therefore the scientific community and the pharmaceutical industry must keep developing new approaches. And I mentioned one already earlier in this interview - they will continue to develop new drugs - we will and the pharmaceutical company will. So more or less a person in the industrialised world diagnosed today can have HIV, in the vast majority of cases, well contained - we can't say lifetime yet, because not enough years have gone by. But in my view, it may become very close to that. But we can't become less vigilant in having new approaches come in case there's resistance that develops or too much toxicity to the current drugs.

Chris Hogg:
OK that's all we have time for. Many thanks to you Professor Robert Gallo in Paris and to all of you for your many questions. From me, Chris Hogg and the rest of the interactive team here in London, goodbye.