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Neal Nathanson, M.D., Director, Office of AIDS Research, NIH
Dr. Nathanson described his revised vision of the NIH AIDS program, emphasizing therapy and other interventions, such as microbicides, behavioral interventions, and ultimately a vaccine. This new vision emerged because, though a vast amount of information is known about the virus, the immune response, and many aspects of clinical disease, the AIDS epidemic globally is still exploding out of control.
While the number of new infections every year in the United States is fairly stable, the number of AIDS cases has dropped because of therapy. Blocking the cycle can prevent infections from developing into disease, prevent mortality, and, most important, from a public health point of view, prevent transmission.
Dr. Nathanson is reviewing the NIH AIDS portfolio and emphasizing research that would lead to better interventions globally, working under the assumption that antiviral therapy will not be a total solution. Needed are products and methods focused on specific issues, such as perinatal transmission, needle exchange, drug compliance, male-controlled preventions, particularly using condoms, female-controlled preventions, and improved safety of blood and blood products in developing countries. These kinds of priorities should mold the research agenda, he told Council.
OAR will be working with the Institutes and deal with annual research planning only in terms of broad brush strokes. He said that the planning effort that is not solely done from within the NIH. There are coordinating committees that involve extramural staff of the various institutes, dealing with five major areas of emphasis: etiology and pathogenesis, epidemiology, vaccines, therapeutics, and behavioral and social sciences. Extramural groups are also used for consultation, including three standing groups, a prevention science working group, a therapeutics working group, and also the Baltimore Committee, and the OAR advisory council. Dr. Nathanson sees an important role for OAR in helping to set priorities to insure the proper balance between major areas, for instance, vaccines, epidemiology, therapeutics, and pathogenesis. |