"AGAINST THE ODDS: The Story of AIDS Drug Development, Politics and Profits"

How AIDS activists changed the way new drugs are developed, and why the biomedical establishment may never be the same again. The fight against AIDS, say Arno (a public-policy analyst at N.Y.C.'s Montefiore Medical Center) and Feiden (a freelance journalist), has been hampered by a combination of ""indifferent leadership, cumbersome bureaucracy, and corporate greed [that] has had an impact almost as devastating as that of the AIDS virus itself."" These are strong words, but the authors back them up with a wealth of evidence. While noting with anger that the US still has no single agency responsible for developing a national strategy on AIDS, Arno and Feiden save their sharpest criticism for Burroughs Wellcome, the pharmaceutical firm that has reaped enormous profits from the drug AZT. The long-troubled Food and Drug Administration is treated more sympathetically, being described here as an underfunded, understaffed agency that has demonstrated an ability to change with the times. AIDS activists, the authors report, have brought pressure on the FDA and on other government agencies, researchers, and drug companies that has resulted in significant changes in how research on new drugs is conducted and how experimental drugs are made available. Arno and Feiden suggest that other group can learn from AIDS activists and that, in fact, a few already have. Their chronicle has a confusingly large cast of characters, but useful appendices list names and affiliations and also spell out acronyms and abbreviations. Other appendices provide a chronology of AIDS, data on how clinical trials are designed, and a summary of the current challenge to the Burroughs Wellcome patent on AZT. Inspiring documentation showing that motivated and organized patients can make a difference.