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prints and silhouettes with delicate lace work and intricate embroidery. It is like a game of Chess, another opportunistic infection, Then Gallo and his co-workers published four back-to-back papers about HIV (which he mistakenly thought was a human T-lymphotropic virus relative) in the 4 May 1984 issue of Science? making the case that this virus found in blood samples from AIDS patients was the cause Barré-Sinoussi and colleagues who a year earlier had identified the virus but did not have enough evidence to prove causation quickly confirmed the Gallo lab’s reports with HIV they separately had isolated from patient samples Gran Fury part of ACT UP New York made this poster in 1988 Courtesy of Mark Harrington Still a plethora of “ridiculous” theories persisted Gallo said including the assertion that HIV was created by the US government “I got some assassination letters that I’d be dead in 3 weeks and I used to have to go home with dogs and these police” Gallo said “This was not a happy time completely” He took particular exception to Peter Duesberg a retrovirologist at UC Berkeley who argued that HIV was a “pussycat” a harmless passenger virus that didn’t cause the disease One of Duesberg’s prominent supporters was Kary Mullis who won the Nobel Prize for his role in discovering the polymerase chain reaction Here’s how Gallo described a photo he showed of the two: “Our friends Kary Mullis and Peter Duesberg I hope you know I say that with intent to be malicious” Anthony Fauci an immunologist at NIH also helped change the course of the epidemic A clinician who struggled to keep his research afloat in the early years because caring for dying AIDS patients sapped so much of his time Fauci explained that in 1984 he took an offer to head the National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda in part out of frustration “I was not particularly enamored of administration but I felt that infectious disease and certainly HIV/AIDS was not going in the right direction and did not have the support I thought it should have” Fauci said “That opened my life to things I never would have been prepared for as a clinician as a scientist” Under Fauci’s leadership NIAID became the single largest funder of HIV/AIDS research in the world His own lab’s research also has helped clarify fundamental relationships between the virus and the immune system (Left) NIAID director Anthony Fauci estimates that he has testified before Congress 245 times; (Right) Fauci said he took the helm at NIAID in 1984 because he didn’t think AIDS research was heading in the right direction (Left to right) Courtesy of Anthony Fauci; Constance Brukin/ CSHL Archive Fauci showed a photo of himself testifying before a congressional hearing which he said he has done 245 times since taking the job—often about the HIV/AIDS budget and other issues related to the epidemic “I may have the all-time indoor record of testifying before Congress” Fauci said “You either get praised or you get killed You just got to know when to duck” Mark Harrington took part in a die-in staged by ACT UP as part of “Storm the NIH” in May 1990 Courtesy of Mark Harrington Harrington apologized to Lawrence Corey (r) and the other researchers if activists at times “went overboard” Constance Brukin/ CSHL Archive His job also put him in the hot seat with AIDS activists who believed the federal government for the first decade was dragging its feet in its response to the epidemic Fauci quoted a headline of an article published in The San Francisco Examiner in 1988 by Larry Kramer who founded the AIDS Coalition to Unleash Power ACT UP “I call you murderers an open letter to an incompetent idiot Dr Anthony Fauci” it read “He got my attention and I began to listen to them” Mark Harrington a leading player in ACT UP until he started his own advocacy organization Treatment Action Group in New York City was the only openly HIV-infected person to speak at the gathering “Apologies if we ever went overboard” said Harrington who after a pause added “Dr Fauci” He explained that activists condemned government health officials—and indeed staged massive theatrical protests at NIH and the US Food and Drug Administration (FDA)—because they believed the science was too shrouded in secrecy and promising drugs were approved too slowly They also insisted that affected communities should have input about the research agenda itself a battle they won inspiring many other disease advocates Harrington then told the entire gathering “I would like to thank you all and everyone who works with you from the bottom of my heart and on behalf of the world’s 37 million people that are still living with HIV and also on behalf of all those who didn’t make it because they too lived longer and had hope because of the efforts that you made” Selective memories The Who’s Who front row includes Mark Harrington Harold Varmus James Curran Anthony Fauci Michael Gottlieb and meeting co-organizers Robert Gallo John Coffin and Bruce Walker Constance Brukin/CSHL Archive When Barré-Sinoussi gave her presentation near the end of the meeting’s second session she noted that she was the first woman speaker to take the podium This drew loud applause and hoots “Things have changed over the years but still you can see that males are always the first” she said “I’m joking of course” Well yes and no The attendee list was skewed in other ways too Only a dozen participants were from outside the United States and age was the butt of as many jokes as Donald Trump “There are some young people in the audience—and by the way my definition of young is that you’re under 70” said Samuel Broder who did pivotal work at NCI on the first approved anti-HIV drug azidothymidine (AZT) Flossie Wong-Staal who worked with Gallo at NCI noted that she recently sent an email and it auto-corrected her name to “fossil” Michael Worobey an evolutionary biologist at the University of Arizona in Tucson who studies the origin of the AIDS epidemic made a point of being one of the youngsters apologizing for not having any interesting anecdotes about what he was doing in 1981 “I was 8” he said “I skinned my knee rollerskating” Most notably absent from the meeting was Montagnier who shared the Nobel with Barré-Sinoussi Gallo one of the conference organizers told me they couldn’t locate him (Montagnier has been ostracized by many of his former AIDS research colleagues for promoting several controversial ideas since his HIV discovery including the contention that water contains memory via electromagnetic DNA imprints) (Left) Beatrice Hahn cuts a retroviral cake as Robert Gallo and his NCI team look on when she leaves his lab in summer 1985; (Right) Hahn’s worked has helped elucidate how and when HIV entered humans from chimpanzees Courtesy of Beatrice Hahn Neither Gallo nor Barré-Sinoussi mentioned the blood test patent dispute or the intense competition between their teams Barré-Sinoussi did describe an evening in Paris in 1984 when they reviewed data from a study that compared the ability of both labs to detect the virus in blinded samples from AIDS patients and controls “It was so hot and strong a discussion that we decided to go to a cabaret” she said “It was a difficult period but we had a nice time all together” I asked Barré-Sinoussi why she sidestepped the controversy “For me this is a meeting of the scientific history” she said “I have no problem with Bob [Gallo]” I told her I didn’t see how you could separate the science from its historical context “It’s not interesting to me” she said “I don’t care who was first I care that there’s a solution for patients” She told me a story about a conference in France in the mid-1980s when a few people living with HIV confronted her “They said ‘Whatever you will say we will not believe you scientists because you’re more interested in fighting each other than taking care of us’” she recalled “Emotionally that was terrible for me It was so awful” Warner Greene who worked at NCI when AIDS surfaced and now is at UCSF had a most diplomatic take on how Gallo Barré-Sinoussi and others were recounting the history “It’s a wonderfully refreshing view in cordial terms of what were remarkably turbulent times” he said Rebottling the genie Marty St Clair said her company Burroughs Wellcome literally depleted the world’s supply of thymidine to make the first batches of AZT Constance Brukin/CSHL Archive Since AZT first won FDA approval in 1987 the field has brought nearly three dozen other antiretroviral drugs to market They have converted HIV infection from a death sentence to a chronic manageable disease These same drugs also can prevent viral spread from an infected mother to her baby as well as transmission between sex partners They are even taken by people who don’t have HIV to prevent infection a proven strategy called Pre-exposure prophylaxis But a cure and a vaccine remain elusive “Our challenge really is to put the genie back in the bottle” said David Baltimore one of the few old-time retrovirologists to have taken up HIV/AIDS research which he does at the California Institute of Technology in Pasadena “It is impressive to see how much can be learned in 35 years of research and how we take a challenge that’s put up by nature and apply science to it Of course it also reminds us that probably the greatest failure of modern molecular biology is that we haven’t been able to control HIV and that we’re still in the midst of an epidemic” Marty St Clair (left) helped bring AZT to market and Raymond Schinazi co-discovered 3TC The AZT/3TC combo remains a backbone of treatment today Constance Brukin/CSHL Archive Several talks at the meeting gave updates on cure research which moves forward inch by inch but Baltimore said he thought a vaccine would be a more important tool to bring the epidemic to an end His own lab has pursued the finding that some rare antibodies have unusual power to stop the virus and importantly work against a huge range of mutant strains Despite a great deal of effort into developing vaccines that can teach the body how to make these so-called broadly neutralizing antibodies progress has been slow so Baltimore’s group has taken another tack: In a technique he calls vectored immunoprophylaxis they stick genes for the antibodies into a harmless adeno-associated virus which makes the antibodies instead of relying on the body to do so Another group has already launched human trials with this approach and Baltimore’s team hopes to follow suit soon Nobelist David Baltimore (left) was one of few old-time retrovirologists to join Robert Gallo (seated) and James Curran in AIDS research Constance Brukin/CSHL Archive The quest for a more traditional vaccine has been frustrating and contentious as a debate about a vaccine trial set to launch next week in South Africa showed The $130 million trial which plans to enroll 5400 people at high risk of becoming infected by HIV is funded jointly by NIAID the Bill & Melinda Gates Foundation and the South African Medical Research Council It retests a vaccine strategy that in 2009 showed a modest 31% efficacy in a trial held in Thailand The placebo-controlled study will test a one-two punch strategy The first round uses canarypox virus to deliver several HIV genes This is followed by a vaccine that only contains HIV’s surface protein gp120 plus an immune stimulant called an adjuvant Analyses of the people protected in the Thai study found that they had higher levels of specific antibodies that can bind to the surface protein But because these binding antibodies do not prevent the virus from infecting cells in test tube experiments critics of the Thai study say that they make an unconvincing case for protection It was the adjuvant that sparked the fiercest controversy however One panelist NCI’s Genoveffa Franchini suggested the formulation might even make people more vulnerable to infection As Franchini and co-workers reported 30 May in the online issue of Nature Medicine they tested the vaccine strategy used in Thailand in rhesus macaques and found that the binding antibodies did correlate with protection But the group also conducted a head-to-head comparison of two different adjuvants used to juice up the immune response to the gp120 component of the vaccine Monkeys given the vaccine along with the “alum” adjuvant used in the Thai study were protected Not so the monkeys that received an adjuvant known as MF59 After a panel on HIV vaccine research Genoveffa Franchini (seated) mixed it up with (from left) Robert Gallo James Curran Bruce Walker and Glenda Gray Constance Brukin/CSHL Archive The South African study is using MF59 not alum “If MF59 is doing the same thing that it’s doing in the macaques then you’re going to end up having no protection and you won’t know why” Franchini said urging the designers to add an arm to the study that includes alum She suggested MF59 might even overstimulate the immune system and create more target cells for the virus to infect “There’s this oath that we take when we finish up medical school: Don’t harm” she said Lawrence Corey of the Fred Hutchinson Cancer Research Center in Seattle Washington who heads the NIH-funded network overseeing the study countered that they hadn’t ignored Franchini’s data but noted that another monkey study had different results “People of good faith will have different answers” Corey said stressing that the human experiments are the way to arrive at the real answer Ronald Desrosiers a virologist now at the University of Miami in Florida who did pioneering AIDS vaccine studies in monkeys when he used to head Harvard University’s now defunct primate research center thinks the South African study is a waste of money and flatly rejected this line of logic “Every single vaccine that’s tested in monkey can’t be tested in people” Desrosiers told me “Monkey trials let you do a rank ordering of what to test” He was so riled by this discussion that he walked out of the conference hall Through different lenses Heckler and Gallo announce “probable cause of AIDS” at a press conference in 1984 The Jim Marks Collection at the Stonewall National Museum and Archives I gave a presentation after the formal conference had ended and the auditorium doors were opened for a “public event” that included me Swedish filmmaker Staffan Hildebrand and former NIH historian Victoria Harden I spoke about the history and future of HIV/AIDS media coverage Four of my 49 slides most of which showed headlines from newspaper and magazine stories recounted the main plot points in the French/US controversy including a protracted US government probe that found Gallo guilty of scientific misconduct for misreporting a technical detail in his landmark 1984 papers and a subsequent ruling by an appeals board that dropped all charges This 18 April 1983 cover story appeared 1 month before French researchers reported in Science the isolation of a retrovirus that might be involved with AIDS I retook my seat in the front row next to Greene Gallo immediately came over asked Greene for his seat and proceeded to tongue lash me Gallo was outraged by my presentation which he thought portrayed him unfairly and discounted the fact that he helped the French group He started loudly ticking off the minutiae of the debate Gallo is hot-blooded and I have been on the receiving end of his anger before which often abates when he is reminded of the facts He and I made peace before I left but in retrospect I wish I had seen historian Harden’s talk before I gave my own I would have framed it differently Harden stressed that there is no single history of the HIV/AIDS epidemic: There are many and there will be many more There is a history written by journalists like me among them—I wish I had reminded Gallo—one who in 1993 wrote a full-throated paean in The New York Times Magazine subtitled “The Vindication of Robert Gallo” that proclaimed him a “hero” Gallo and other researchers have written memoirs There are histories written by activists relatives of people who died from AIDS and denialists who did not believe in the “HIV/AIDS hypothesis” There is the history that was told in PowerPoint presentations and barroom gabfests here at CSHL this autumn in the autumn of the careers of many pioneers whose conflicts with each other long have been eclipsed by their collective accomplishment and their continued efforts to make HIV once and for all a thing of the past And there is the history written by future historians who Harden stressed always get the last word A group shot of the meeting attendees The conference is part of a history of science series initiated by CSHL’s Ludmila Pollock who co-organized this meeting Constance Brukin/ CSHL Archive HDMI, The designer has put together a summer-friendly collection made using Merino wool in association with The Woolmark Company and Raymonds.” said neurologists at the Fortis Hospital. For all the latest Lifestyle News, The results showed that in the longer term, he did not allow and said that Gurus teachings should be remembered with folded hands and thus none should touch his feet.

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