A lot of mediocre ideas get substantial funding. Every now and then, someone on the inside writes a tell-all book. A lack of desire to do good, or to support those whose research is to do good, whether or not their methods of inquiry lie outside the fashions and trends of the moment. A good treatment that has little m0ney-making potential may never be brought to market. Areas of research that aren't potential moneymakers, seldom get enough funding or attention.
Substance carries little clout, credential and prestige are only badges.
Public perception, gained through radical programs devised by groups such as Visual AIDS, Gran Fury, and Act Up, forced the issue on the medical establishment and has had unexpectedly positive results.