Wishful ignorance: “Cure research” on HIV/AIDS
Posted by Henry Bauer on 2013/03/03
Pundits, politicians, and people almost everywhere are woefully mistaken about how science works and what it can do. Specialist science writers and journalists rarely expose (do they even detect?) the all-too-frequent unrealistic, misleading assertions by public figures — including spokespeople for scientific and medical institutions — about what money can buy in the way of research results. Honest work over time and with some luck, in the activity we call “science”, enabled humankind to progress in understanding how the world works; but science cannot deliver answers on demand to every question we would like to have answered, no matter how much money we throw into the action.
Useful applications of science rest on scientific knowledge and understanding. If an event or a phenomenon is not well understood, no amount of resources including money can be guaranteed to bring a desired application.
Not infrequently, one hears calls for a Manhattan-Project-type initiative to accomplish this, that or the other, for example, to find a cure for cancer. The Manhattan Project was for building an atomic bomb. Only academic specialists appear to know that the Project came about only because the knowledge and understanding were already at hand to know that such a bomb was feasible in principle: it was known that nuclear fission of uranium occurs and that it releases energy far outstripping anything produced by chemical reactions. The Project started because scientists told policy makers that it was feasible. Inventing the atomic bomb was essentially an engineering project rather than a scientific one. Could the fissionable material (a relatively rare isotope of uranium) be isolated from raw uranium in sufficient quantity? Or could an alternative fissionable material, plutonium, be prepared in sufficient quantity in a nuclear reactor? How could the bomb be designed to explode only when and where desired, rather than as soon as the “critical mass” of fissionable material was assembled?
Innumerable technical problems had to be solved to attain the final goal, and some of those did involve the gaining of new scientific understanding; but the point remains that the Project was known to be in principle possible before it was begun; the pertinent laws of Nature were sufficiently understood. That cannot be said for several desired goals that have been hyped by researchers as well as by politicians and pundits. President Nixon declared a war on cancer more than 4 decades ago, and it has gotten nowhere, just as the (relatively few) honest and informed scientists had predicted: Because we still do not know how cancer starts or what it really is in terms of biological mechanisms.
Also much hyped since the human genome was decoded has been the desirable (as most people believe) goal of “gene therapy”: to replace known “bad” genes with good ones. Several decades of trials and errors have killed a number of human guinea pigs but have had none of the promised successes: Because we do not yet understand the workings of the human genome well enough. “Genes” are not immutable entities in their everyday operation; elaborate signaling mechanisms and feedbacks govern “gene” actions. (For an accessible description, see Gil Ast, “The alternative genome”, Scientific American, April 2005, pp. 58-65.)
Moreover, we do not know how to get “good” genes into the right place in the genome.
Those are just a few reasons why it was silly (some might say thoughtless or even criminal) to jump into human trials of “gene therapy”.
Now I read of another such pie-in-the-sky initiative: To provide more resources for “cure research” on HIV/AIDS:
“Congressman Henry Waxman Meets on Cure for HIV [26 February 2013]
(Sent by AHF on behalf of the campaign for a Cure for HIV)
LOS ANGELES — On January 31st, 2013, a team comprised of leading cure scientists and AIDS support group leaders met with Congressman Henry Waxman . . . to address a cure for HIV and the problem of inadequate funding” [emphases added].
I was dumbfounded by “cure scientists” and “inadequate funding”.
The implication is unavoidable, that the Campaign for a Cure for HIV believes that there are presently researchers on HIV/AIDS whose ambition does not include finding a cure. What then are they doing? Quite a lot else, evidently, since “the National Institutes of Health (NIH) allocates a mere 3% of its 3 billion dollar HIV research budget to cure research” — according to “Gerald Gerash, . . . a longtime gay rights advocate whose recent passion has turned toward a cure for HIV/AIDS”.
The absurdity should be apparent if just a few moments are devoted to thought. Unlimited fame, glory, wealth awaits anyone who comes up with a “cure” for HIV. No researcher is unaware of that. They will follow any inspiration that offers a hope for that, and they would be given grant funds without stint to pursue that hope — so long as their peers agree that the hope seems reasonable and the method feasible. But the current proposals fail the test of plausibility rather obviously and badly.
What “cure research” means here was explained by the (grant-seeking) scientists present at the meeting with Waxman:
“Drs. Mitsuyasu and Cannon . . . discussed their ongoing, extraordinary and promising efforts in the area of anti-HIV gene and stem cell therapy . . . . Inspired by ‘the Berlin patient’ . . . who was cured of HIV by the use of blood stem cells from a person who was born with T-cells lacking CCR5, they hope to duplicate his result in a safe way for people with HIV. Their novel approaches are at the forefront of AIDS cure research, one already at the early stage of human testing” [emphases added].
As already remarked, gene therapy has gotten nowhere. Stem cell therapy has not yet gotten even that far. The “human testing” cannot possibly be at the level of actually trying out the “cure” as such (or at least it shouldn’t be); it will just be early preliminaries — otherwise the call would not be for research funds but for resources to provide the cure to all “HIV-positive” people.
As for inadequate funding . . . . What has been provided for HIV/AIDS research is enormously in excess of what has been devoted to the ailments that most people suffer from and eventually die of, for instance cardiovascular disease, COPD (chronic obstructive pulmonary disease), diabetes (Open Letter to my Representatives in Congress).
As to “cure research”, I had evidently missed an earlier (26 July 2012) Media Release by the International AIDS Society on the occasion of their XIXth International Conference:
“Last week the Inaugural Global Scientific Strategy Towards an HIV Cure was launched amid renewed optimism from the world’s leading HIV/AIDS scientists that the future prospects for finding an HIV cure are increasing. . . . Towards an HIV Cure identifies seven important priority areas for basic, translational and clinical research and maps out a path for future research collaboration and funding opportunities” [emphasis added].
If further comment seems needed, see “The Research Trough — where lack of progress brings more grants”;
“From Dawn to Decadence: The Three Ages of Modern Science”;
“80% unemployment?! The research system is broken”;
“Dishonesty and dysfunction in science”.
As a general rule, it is good to bear in mind that just because words can be put together doesn’t mean that a feasible reality is being described. “Gene therapy”, “cure research”, “stem cell therapy” and many more are just words and wishes. They are perfectly suited to science fiction but not (at present; yet?) to science policy.