And the Band Played On

  Bill Kraus was devastated by the criticism. He had spent the past decade doing little else than promoting gay rights. Now he was chastised as a “traitor” for his efforts to ensure the biological survival of gay men. He felt that a homosexual McCarthyism had descended on the gay community. You could be homosexual and be homophobic, by the logic of this McCarthyism, just as McCarthy had denounced American citizens as “un-American.” McCarthy felt he could proscribe all the political views a true American should have; the Bay Area Reporter and its like-minded gay leaders now felt they could order all homosexuals to think exactly as they did or be branded unhomosexual traitors. With such logic, the heroes had become the bathhouse owners, who had assured doctors at the AIDS Clinic that bathhouses were fine because “we both make money off” the people who were killing themselves there.

  What disturbed Bill Kraus more than the charges themselves was the fact that there was no one in the gay community who would censure this verbal terrorism. Not one gay politico, writer, or thinker would step forward and say, simply, “This is madness.” Insanity triumphed because sane people were silent. Bill felt abandoned and isolated. Publicly, of course, Bill put the best face on his reaction and feigned to be honored at making a list of such esteemed personages. Privately, he complained to his friend Catherine Cusic: “Those bastards. If I get it, it’s because of them.”

  On the morning of April 9, Dr. Silverman announced a decision that further complicated the bathhouse issue. Flanked by twenty-two gay physicians and community leaders, the health director announced that rather than close the baths, he would propose regulations to ban high-risk sexual activity.

  “What we are doing today is taking steps, with the support of many community members, to eliminate bathhouses, bookstores, and sex clubs as places of sexual encounters between individuals, places where multiple sex takes place,” he said. “We want these places to continue to operate, to be places for social gatherings, for exercise, for a number of things. They just won’t serve the purpose that they have served in the past. What we’re trying to do is not have sex between individuals.”

  Silverman’s move had the effect of satisfying no one. Bathhouse supporters were angry that anything was being done to impede bathhouse sex, so Silverman was denounced in the gay community as a homophobe. People who wanted the facilities shut down were dissatisfied by the fact they would remain open, and months of political dilly-dallying clearly lay ahead. Mayor Feinstein was said to be livid at the decision. With this announcement, however, the political heat was off the issue, because Larry Littlejohn said he would not pursue his ballot measure, which had in effect asked for the same restrictions that Silverman had announced.

  Nationally, gay leaders turned rabid on the issue. On the afternoon Silverman announced the restrictions, New York Native publisher Charles Ortleb left a message with Jim Curran’s secretary, asking, “Now that you’ve succeeded in closing down the baths, are you preparing the boxcars for relocation?”

  The Native’s next cover story, “I Left My Towel in San Francisco,” obscured a story Ortleb had unearthed in an interview with James Mason, CDC director. Buried in the Native was the first report anywhere from a government official stating flatly that the cause of AIDS had been discovered. The virus, Mason said, was called LAV and had been discovered by the French.

  NATIONAL CANCER INSTITUTE, BETHESDA

  The same day Dr. Silverman announced his bathhouse sex ban, a doctor from the National Cancer Institute went to Building 31 on the NIH campus and picked up a bottle that had been carefully packed in a double-sealed plastic bag. He drove the bottle to the “P3 containment facility” at the Frederick Cancer Research Facility in suburban Maryland. The bottle contained 100 million particles of HTLV-III. The center, which once housed the nation’s biological warfare research, was beginning to gear up to produce the 750 gallons of virus that would be needed each month for blood assays to test every unit of blood used in transfusions. Although one branch of the U.S. Public Health Service, the Food and Drug Administration, continued to maintain that the threat of transfusion AIDS was so minimal that it did not need regulatory action, another PHS branch, the NCI, had made the blood test its top AIDS priority.

  Evidence supporting HTLV-III as the cause of AIDS mounted. Since 1981, Drs. Bob Biggar and James Goedert from the NCI’s Environmental Epidemiology Branch had been collecting blood from gay men in Washington and New York as part of a prospective study on AIDS in this high-risk population. As various theories for different AIDS agents emerged in the following years, the blood was tested for a host of agents, including African Swine Fever virus, parvo viruses, and even interferon levels. By the time HTLV-III tests were available to Biggar in April, there was only enough blood from each study subject to conduct this one last blood test. Fortunately, his tests showed that HTLV-III was not another bum lead.

  In San Francisco, an AIDS researcher inadvertently speeded the timetable for the HTLV-III announcement with an offhand remark to a radio interviewer. Like just about everyone in AIDS research, Dr. Donald Abrams, AIDS Clinic assistant director, knew of the breakthrough. He alluded to the discovery of “the AIDS agent” during a radio interview with the local CBS affiliate on Sunday afternoon, April 15.

  “Is that a scoop?” the reporter asked.

  Abrams immediately regretted mentioning it. It broke all rules of scientific courtesy to announce somebody else’s discovery. The reporter, however, seemed innocuous enough in her Snoopy sweatshirt. She probably didn’t understand the significance of what he had said, Abrams thought.

  “This is just for the local audience,” she assured him, for airing in “the next week or so.”

  “What’s an agent?” she asked casually. “Is that a virus?”

  “An agent is anything that causes a disease,” Abrams said. “But in fact, this is a virus.”

  Abrams didn’t think much more of the interview until he got a phone call from a cousin in New Jersey the next morning.

  “Mazeltov,” he said. “Everybody heard you on the radio this morning when you announced the discovery of the AIDS virus.”

  When more newspapers and networks started calling, Abrams declined to comment. CBS upped the ante, however, when a reporter demanded that he either retract his statements or reveal the researchers.

  That afternoon, Don Francis got a call from the CBS News bureau in Paris.

  “What is this?” the reporter asked. “Gallo says be has the cause of AIDS.”

  The San Francisco Chronicle was going with its own story on HTLV-III the next morning, and a number of other newspapers were calling to demand a press conference on the “new virus.”

  In England, also, the news was about to break because a few weeks earlier a BBC correspondent had persuaded Bob Gallo’s secretary to give him copies of Gallo’s Science articles, promising not to air the information until July. He then released the reports to New Scientist, which quickly ran with the HTLV-III news. When the journal contacted Jean-Claude Chermann for a comment, the Pasteur Institute researcher called Don Francis in a rage.

  “If Gallo violates our agreement, I’ll kill him,” Chermann said.

  The National Cancer Institute scheduled a press conference to make the announcement, but Secretary Heckler was on the West Coast and could not attend. The press conference was ordered delayed until Monday, April 23.

  Days before the announcement, Don Berreth, CDC public affairs chief, got a draft of the NCI’s press release. Their announcement made no mention of LAV or the Pasteur Institute. Although Assistant Secretary for Health Edward Brandt now had preprints of the papers to be published in Science, neither he nor the NCI had shared them with the CDC. James Mason, Jim Curran, and Don Francis put through a conference call to Brandt, pleading with him to delay the announcement until it could be orchestrated with the French. Francis explained that HTLV-III and LAV were the same virus, that this was not an American discovery.

  By coincidence, The New York Times science writer, Lawrence Al
tman, had been at the CDC in Atlanta a week earlier. Mason had told Altman then that the Pasteur Institute’s work with LAV was “highly significant” and that it looked “like they have the AIDS virus.” Late in the afternoon on Friday, April 20, Altman called Mason. He had heard of the hubbub surrounding the impending HTLV-III announcement and wanted to put Mason’s earlier comments in the Sunday Times. Mason knew that it would look as though he were upstaging Heckler’s announcement and asked Altman not to print the story.

  “Anything you say I say will get me in trouble,” Mason said.

  April 20

  SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH

  By that Friday afternoon, Dr. Selma Dritz had heard of the imminent HTLV-III press conference. The news brought a natural end to the phase of the epidemic that had involved people like herself, Dritz thought. It seemed appropriate that this was her last day of work. With the cause of the disease found and the routes of transmission established, the focus of the next phase of AIDS research would shift to the lab, where scientists could develop the vaccine and treatments. Selma Dritz’s legacy was written into the notebooks she had carefully kept since the first day she had heard of the mysterious case of Kaposi’s sarcoma in Ken Home. Dritz felt a serenity with her retirement. She had done her share of the world’s work, she felt, and she had done a good job.

  At her retirement dinner, somebody recalled a talk he had heard Dritz give in 1980 at UCSF about venereal diseases in gay men. In the talk, Dritz had warned that “too much was being transmitted” and there would be “hell to pay” if any new infectious agent made it into this population. The statement showed uncanny prescience, the colleague noted. Selma Dritz didn’t remember.

  45

  POLITICAL SCIENCE

  April 23, 1984

  HUBERT H. HUMPHREY BUILDING, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES, WASHINGTON, D.C.

  Bob Gallo was weary and nervous when he arrived in the office of Health and Human Services Secretary Margaret Heckler. He had come straight from the airport, having flown all night from Italy, where he had delivered the closing remarks at a human retrovirus conference. Only yesterday had he learned that his presence was required this morning at a press conference in which Heckler would announce the discovery of HTLV-III. Gallo was stunned to hear that the previous day’s New York Times carried a page-one story in which Dr. James Mason from the Centers for Disease Control gave credit to the Pasteur Institute for isolating the AIDS agent. Knowing that the Times writer who broke the story, Dr. Lawrence Altman, was a former CDC staffer, Gallo figured the leak was a salvo meant to upstage his research at the NCI. And Gallo had no doubt that Don Francis, who was collaborating with the Pasteur, was the man behind the Times story.

  Indeed, James Mason, who had flown to Washington for the press conference, was made aware in no uncertain terms by HHS officials that his comments in the New York daily were not appreciated. Before the press conference, a shouting match had broken out between Bob Gallo and one of Heckler’s top aides when the HHS staffer had the temerity to scold Gallo, NCI Director Vincent Devita, and NIH Director James Wyngaarden about the leak. After the hollering subsided, the scientists briefed Heckler and walked down to the massive auditorium in the Hubert H. Humphrey Building.

  Gallo had never seen so many reporters, lights, and cameras. He quickly realized that the announcement would be a major international news story and that the French scientists would be furious with him. Heckler opened the press conference with a six-page statement that had both a nationalistic and political tenor.

  “Today we add another miracle to the long honor roll of American medicine and science,” she declared. “Today’s discovery represents the triumph of science over a dreaded disease. Those who have disparaged this scientific search—those who have said we weren’t doing enough—have not understood how sound, solid, significant medical research proceeds. From the first day that AIDS was identified in 1981, HHS scientists and their medical allies have never stopped searching for the answers to the AIDS mystery. Without a day of procrastination, the resources of the Public Health Service have been effectively mobilized.”

  The doctors who accompanied Heckler to the podium blanched visibly when she proclaimed that a blood test would be available within six months and a vaccine would be ready for testing within two years. None of the doctors with Heckler on the stage believed this claim, and nobody could determine where she had conceived such deadlines, which they knew would never be met.

  Because of the CDC’s prodding, Heckler had added a nod to the efforts of the Pasteur Institute. Heckler went out of her way, however, to enumerate why the NCI research was particularly “crucial.” She noted, accurately, that Gallo alone had figured out how to reproduce the virus in large quantities, a feat that continued to elude the French. Only this ability made the mass production of a blood test kit possible. Somehow, however, Heckler also managed to deduce that the Pasteur Institute’s research “has in part been working in collaboration with the National Cancer Institute.” With further studies, Heckler added, scientists expected that LAV and HTLV-III “will prove to be the same.”

  After the years of frustration, the announcement of the HTLV-III discovery deserved elation, Don Francis thought as he watched the live Cable News Network coverage of the Heckler press conference in the CDC’s television studio with other members of the AIDS Activities Office. Instead, he felt burdened by the conflicts he saw ahead. The French were being cheated of their recognition and the U.S. government had taken a sleazy path, claiming credit for something that had been done by others a year before. Francis was embarrassed by a government more concerned with election-year politics than with honesty. Moreover, he could see that suspicion would play a greater, not a lesser role in the coming AIDS research. Competition often made for good science, Francis knew, lending an edge of excitement to research. Dishonesty, however, muddied the field, taking the fun out of science and retarding future cooperation.

  The New York Times echoed the concern in an editorial shortly after the announcement. “What’s going on?” the piece asked. “Since even certain discovery of the guilty virus will not produce a vaccine for at least two years, and even better blood screening cannot occur for months, what you are hearing is not yet a public benefit but a private competition—for fame, prizes, new research funds…. Some kind of progress is surely being made. The commotion indicates a fierce—and premature—fight for credit between scientists and bureaucratic sponsors of research. Certainly no one deserves the Nobel Peace Prize.”

  In Paris, the Pasteur scientists were aghast at the short shrift their work was given. Willy Rozenbaum considered Heckler’s performance no more than a political stump speech. “Elect us and we give you antibody test in six months,” he mimicked bitterly. “Elect us and we give you vaccine in two years.”

  Three days later, Luc Montagnier revealed his own suspicions when he told UPI, “I don’t say Gallo took our virus. He worked independently.”

  Officials at the National Cancer Institute had no reluctance about taking center stage in the discovery of the AIDS agent. The French would never have been able to find their LAV without Gallo’s earlier work. It was Gallo’s own comments about a possible connection between HTLV and AIDS that led the French to even look for a human retrovirus in the first place. They thought the Pasteur and NCI did not deserve equal credit because the NCI clearly had done more extensive and definitive work on the virus. Beyond perfecting the means for its mass production, Gallo had cultured many more isolates and perfected a more sensitive blood test. Complaints from the Pasteur and the CDC were sour grapes, they thought.

  How timely was the discovery of the long-sought AIDS virus? Partisans of the scientific establishment and the Reagan administration pointed out that the mystery of the AIDS epidemic was solved much faster than for any comparable disease. This is an accurate observation. Such analysis, however, ignores the fact that AIDS did not emerge in the days of Antonie van Leeuwenhoek or Louis Pasteur.
Rather than compare the research on AIDS to disease research in earlier eras, it is more to the point to look at the chronology of the actual AIDS research.

  As it turned out, the AIDS virus was not a particularly difficult virus to find. The French took all of three weeks to discover LAV and had published their first paper on it within four months. This early publication lacked the certainty of a definitive discovery, but the French had enough evidence to assert they had found the cause of AIDS by the summer of 1983, seven or eight months into the research process.

  Nor was the NCI research marked by great longevity. Gallo’s announcement of forty-eight isolates of HTLV-III came just twelve days past the first anniversary of the April 11, 1983, NCI meeting in which the researcher swore he would “nail down” the cause of AIDS. Meanwhile, at the University of California in San Francisco, it took Dr. Jay Levy about eight months to gather twenty isolates of a virus he called AIDS-associated retrovirus, or ARV, which he too believed to be identical to LAV. Levy’s research was hampered by lack of resources and did not begin in earnest until after the arrival of his long-sought flow hood and the release of UC research funds impounded the previous autumn. On the date of the HTLV-III press conference, Levy also was on the verge of announcing his discovery.

  Therefore, by April 1984, isolates of the AIDS virus had been made at the Pasteur, NCI, CDC, and UCSF, all of which were discovered after substantially less than a year of research.

  What delayed the NCI, therefore, was not the difficulty in finding the virus but their reluctance to even look. Most CDC researchers privately believed that if the NCI had begun serious laboratory efforts in 1981, the virus could have been detected by 1982, before it had made its vast penetration into American life. Although all the scientists who made the viral isolations certainly deserved applause, the discovery of the AIDS agent ultimately was not a contest for accolades but a race against time. Once again, time, the true adversary, had won.