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NATURE MEDICINE VOLUME 10 | NUMBER 7 | JULY 2004 657

In a move that has angered AIDS researchersworldwide, the US government has slashed itscontribution to the 15th International AIDSConference, to be held in July in Bangkok.

The US Department of Health and HumanServices (HHS) has limited the number of itsemployees at the conference to 50, down from236 at the last meeting in Barcelona in 2002.The measure primarily affects researchers at theUS National Institutes of Health (NIH) and theCenters for Disease Control and Prevention,many of whom had already had abstracts peerreviewed and accepted. Attendees from otheragencies and universities and HHS employeesin Asia are not affected.

As of early June, more than 50 presentationsfrom US government researchers have been can-celed. Direct financial support from the US, pre-viously the meeting’s biggest contributor, hasbeen cut to $250,000 from $1.1 million in 2002.The European Union, Canada, Sweden andThailand all contributed more than thatamount,says conference director Mats Ahnlund.

The Bangkok conference is not the only one tohave lost US government support. At the GlobalHealth Council meeting in June, the organiza-tion’s president Nils Daulaire blasted the HHSand other US agencies for cutting funds after “asmall clique of right-wing extremists” objectedto participants who don’t oppose abortion.

HHS spokesman Bill Pierce says the travelrestrictions stem from a new policy, decided lastyear. In order to spend tax dollars in a more“responsible way,”the HHS now limits to 40 thenumber of employees who can travel to anyconference abroad, he says, but the Bangkokcontingent was extended to 50 because of themeeting’s exceptional scale.

The decision to cut attendees was first relayedto NIH personnel in an e-mail dated 9 February,but made no mention of other internationalAIDS conferences, including an April meetingin Whistler, Canada. That meeting’s list of atten-dees includes the names of 107 HHS employees.

But many AIDS researchers, including conference co-chair Joep Lange, say they doubtthe cuts are driven by budget considerations.Instead, says Lange, president of theInternational AIDS Society, “religious fanatics”within the US administration are to blame.

Lange says it is “inconceivable”that a countryspending $15 billion on fighting AIDS wouldlimit travel because of financial constraints. Headds that he has received no reply to a 3 Mayletter to HHS secretary Tommy Thompson, inwhich the society and the Thai governmentoffered financial assistance to HHS researchers.

The administration may have been irked

when they failed to land prominent spots forfaith-based approaches in the meeting program,Lange suggests.For instance,he says,officials hadsuggested that the organizers invite FranklinGraham, son and successor of evangelist BillyGraham, as a keynote speaker—an idea Langesays he respectfully declined. “I did not thinkthis speaker would have been representative

for religions worldwide,”he says.Some in the administration are still upset over

activists’ heckling of Thompson in 2002. In anopen letter to Lange in May, five Republicanmembers of the House of Representatives com-plained about Thompson’s “rude reception” inBarcelona and about “a seeming bias against thescientifically proven success of programs thatpromote [sexual] abstinence and faithfulness.”

Pierce says suspicions that the administra-tion’s motives were political are off the mark. Itis perfectly normal for the US government, as aprincipal conference sponsor, to suggest speakers, he adds. “Ultimately it’s up to theorganizers whom to invite,” he says. “There isno policy of consequence.”

Whatever the real reasons, the commotionover US attendance “has tainted the conference’soverall message of cooperation and solidarity,”says Mario Stevenson, a molecular biologist atthe University of Massachusetts. “HHS mayindeed be shifting money from travel toresearch—in principle, I’m all for that,” he says.“I just hope that was their motive.”

Peter Vermij, Amsterdam

Scientists rip US for cutbacks to global AIDS summit

NIH mulls plan to lower cost of AIDS drugsResponding to controversy over the steepprice hike of a popular AIDS drug, the USNational Institutes of Health (NIH) isassessing whether an obscure law gives theagency the right to ‘march in’ and force thedrug’s patent holder to license its patent togenerics manufacturers.

The US government and pharmaceuticalindustry face mounting global pressure toprovide affordable AIDS drugs. The US haslong insisted that its aid money fundexpensive patented medications, but in asurprise policy shift in May, the governmentannounced it would allow cheap generics thatclear an expedited review process. Fivecompanies also agreed last year to slashantiretroviral drug prices in 16 Caribbean andAfrican countries. Jamaica in May became thefirst country to benefit from that deal.

Meanwhile, last year’s 400% price increasefor the eight-year-old drug Norvir, made byIllinois-based Abbott Laboratories, hit theNIH radar after letters poured in fromactivists, politicians and physician groups,says Mark Rohrbaugh, head of the NIH’stechnology transfer office. Norvir is a proteaseinhibitor that has become integral forboosting the activity of other AIDS drugs.

The NIH held a public forum on the issue

when Essential Inventions, a Washington-basedadvocacy group, urged the NIH to use the 1980Bayh-Dole Act to intervene against Abbott.Atissue is a provision of the act that says thegovernment can “march in”if government-funded innovations are not made “available tothe public on reasonable terms.”The NIH gaveAbbott nearly $3.5 million for preclinical workon Norvir.

Rohrbaugh and other NIH officials plan toprepare recommendations on whether theagency should intervene on Bayh-Dolegrounds, but Rohrbaugh declines to say when.

Abbott executives counter that the argumentdoes not apply because Norvir is available in 60countries.“There is no legal basis for march-inrights,”says John Leonard,Abbott’s vice-president for development of globalpharmaceutical research and development.Leonard says the price hike better reflectsNorvir’s real contribution to fighting AIDS.“[Essential Inventions] has tried to twist theBayh-Dole Act’s words into a vehicle to imposeprice controls,”says Leonard, adding that, at$8.57 per day, Norvir costs less than other AIDSdrugs. Bristol-Myers Squibb’s proteaseinhibitor Reyataz costs $22 a day andGlaxoSmithKline’s Lexiva is priced at $32.

Paroma Basu, New York

Protests at the last AIDS meeting may be the reason for a poorer US presence in Bangkok.

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