GOOD INTENTIONS by Bruce Nussbaum


Email this review


At times exasperating and intemperate, at times absorbing, even moving, this attempt at government-science bashing suffers from a certain equivocation: The targets don't stay put; the bad guys change; the good guys need their wrists slapped. The focus is AIDS and all that the feds--in particular, the National Institutes of Health--have or have not done to fight the epidemic. Nussbaum, a former Business Week editor with a background in economics and international affairs, is at home in dealing with the drug companies. He targets Burroughs Wellcome as archvillain for making millions with AZT, and the FDA as accomplice before and after the fact. (He does not mention the fact that no other major company would touch AIDS drugs for years.) He attacks the principal players at the NIH--Sam Broder, Tony Fauci, Bob Gallo--for assorted ego trips, incompetence, and blindness to the feelings and fate of AiDS patients. But he reserves special spleen for the ""PI's""--the principal investigators carrying out clinical trials of anti-AIDS drugs. It's the old-boy network argument couched in words suggesting that contract research is intrinsically bad, and that the PI's have vested interests in AZT and related drugs. In contrast, his heroes are the grass-roots movements like ACT UP (AIDS Coalition to Unleash Power), the local docs treating AIDS patients, and savvy leaders like Mathilde Krim of AmFAR (American Foundation for AIDS Research), a woman who knows how to work the system inside and outside the government. For all its faults, redundancies, and often confused chronologies, Nussbaum's book puts the decade in perspective, from the do-nothing homophobic (pre-Rock Hudson) years to the current scene of reforms within the FDA and active cooperation between NIH and community docs and even with activist patient groups. Indeed, Nussbaum's earlier black-and-white depictions end up in shades of gray, with some points for Fauci and against ACT UP. Much recorded conversation, descriptions of the gay scene, and thumbnail sketches of the scientists as well as ACT UP leaders like Larry Kramer display Nussbaum's talents as a reporter--if not the best of interpreters of the biomedical world.

Pub Date: Oct. 30th, 1990
Publisher: Atlantic Monthly--dist. by PRI (P.O. Box 7001, La Vergne, TN 37086)