AIDS Institute Updates Its Goals

In an average year, the Harvard AIDS Institute has to deal with far more than just a deadly virus.

Last fall, Institute officials made a bold statement against a U.S. immigration policy that barred people infected with the HIV virus from entering the country, by moving the VIII International AIDS Conference from its planned location in Boston to Amsterdam.

The very nature of AIDS--a disease associated with fear of and discrimination towards victims and bureaucratic frustration for researchers--has meant frequent struggles of this kind for the Institute.

Founded in 1988, the Institute has served both as an advocate for AIDS researchers and as a coordinator of efforts to study the disease in Harvard's various schools and departments.

Dr. Richard G. Marlink, who recently replaced Alan Fein as the Institute's executive director, says that its objectives lie in five different areas: biological research, clinical care and research, biostatistics and epidemiology, health policy and education and international cooperation.

Marlink, a clinical researcher and lecturer on cancer biology at the School of Public Health, says this research demonstrates the Institute's recognition "that the approach to problems in the AIDS epidemic is not one dimensional and requires knowledge of many fields."

The Conference controversy has brought many of these issues to light, and Marlink says that efforts to have the immigration ban on those who are HIV positive--which many have termed discriminatory--lifted will continue.

"There will be no future international AIDS conferences in the United States until there is no restriction," he says. "This is not a temporary issue."

"The President or future administrations will have to deal with the fact that people infected with HIV are not allowed to travel without restrictions," he says.

Now that the Institute has become a more visible leader in the field of AIDS research--in part because of the International AIDS Conference controversy--it is time, Marlink says, to bring these goals up to date and to make them more inclusive.

"Our plan is to reach out individually and collectively to those different people in AIDS research and activities at Harvard and in the Boston area, and with their help, reformulate the future mission," he says.

There is no time better than the present to reevaluate the Institute's focus, Marlink says, noting the epidemic's expansion into new populations as it enters its second decade.

Adolescents, inner-city dwellers and members of developing nations may be in more danger than most people imagine. "The epidemic is up to ten times worse in some countries as it is here," Marlink says.

An important part of reaching out to the rest of the world is the Institute's sponsorship of annual international conferences, which have in the past brought together a broad spectrum of people involved in the epidemic.

AIDS activists have bemoaned the possibility that increased travel costs would mean that local patients afflicted with the disease would not be able to attend the 1992 International AIDS Conference.

High costs for travel to such an event can be prohibitive for those with AIDS, already financially strapped-average lifetime medical costs per AIDS patient are projected at $75,000.

But Marlink says that Conference organizers are making every effort to minimize the hardship on people with HIV, including establishing a scholarship fund.

The financial plight of AIDS victims only highlights the need for support of such programs, Marlink argues. Federal funding increased only slightly this year, and taking the rate of inflation into account, actually decreased.

"We need to realize that funding for research, prevention and treatment is not a stop-gap solution," Marlink says. "The epidemic is here to stay, and it continues to worsen. Decreased funding is not going to help curb the epidemic."

Harvard's continued involvement in the Conference will also guarantee that efforts to showcase the University's AIDS--related research--all told, over $50 million-will not be hampered, Marlink says.

The Institute is now co-sponsoring the Conference along with the Dutch Foundation--AIDS Conference 1992, a group of Dutch researchers and public officials.

The international scope of the crisis caused by the U.S. immigration policy is readily apparent to Marlink, whose own work as a clinical AIDS researcher has taken him to sites ranging from New York City to Senegal.

After graduating from the University of New Mexico Medical School in 1980, Marlink first saw AIDS cases at New York City's St. Vincent Hospital. At the time, scientists had not yet identified the disease as AIDS.

His experiences there led him to clinical AIDS care, and eventually to the Harvard lab of Max E. Essex, Lasker professor of health sciences at the School of Public Health and chair of the AIDS Institute. There, Marlink and Essex began researching a new strain of HIV known as HIV-II, which also causes AIDS-like symptoms.

For this research, Marlink travels to Senegal every two to three months. Clinical studies in that country, conducted by a team of Senegalese physicians and scientists, are attempting to determine the clinical and immunological differences between the viruses.

Essex says that Marlink's research has yielded some "very exciting results," among them that HIV-II is less virulent than HIV-I. Researchers have demonstrated that HIV-II causes AIDS at ten percent the rate of HIV-I.

Marlink's work on HIV-II has ranged from the analysis of the causes of the disease to the effects of the disease on immune system responses. This broad base, Essex says, makes Marlink just the person to lead the Institute.

"I think he is uniquely qualified to bring people together on these questions because he has both clinical and research experience in both the national and international arenas," he says.

On the home front, Marlink's assessment is that Boston residents have become more aware of the disease recently, both because more aware of the disease recently, both because of grass-roots efforts and because of Magic Johnson's announcement that he is HIV-positive. But campus organizations have not been as active as they could have been, he says.

The executive director says he believes openness is key in combatting the crisis. And Harvard, because of its international reputation, can be a worldwide educator in the fight against AIDS-related discrimination.

"I think that universities in general, and Harvard specifically, would tend to deal more openly with HIV as a health issue and an issue that has its own discrimination and human rights problems," Marlink says.