Understand that uncertainty may remain a hallmark of AIDS for many years to come. In another startling turnaround, mechanisms like parallel track and accelerated approval are under attack by voices urging restricted access to new therapies and demanding long, survival-based studies before further therapies are licensed for sale. While anyone is welcome to choose such beliefs to guide his or her own therapy, many people with AIDS want the opportunity to access promising experimental therapies while they re still around to try them. If scientists or regulators continue to place emphasis on quantifying small differences between today s at-best modestly useful drugs, no one will benefit and the costs will drive industry away from AIDS drug development. Instead, such drugs should simply be available for those who choose to use them, while the profits gathered from their sale must be invested in developing a better generation of therapies and new diagnostic markers.
People refuse to stay in such studies for more than a year or two.
Care providers are unwilling to encourage patients to remain on a therapy which is failing just to provide data for these studies. Ethics demands that people be permitted to switch therapies when the existing regimen fails. We need no further studies to prove that we are not yet at this point. While the train moves ever so slowly forward, we must make sure that people with AIDS continue to have the earliest reasonable access to therapies which might help them. The fundamental right of freedom of choice, won in hard battles fought in the late 1980 s, must not be lost in a debate over the conflicting results of studies conducted on today s mediocre generation of drugs.