Why we still don’t have a cure for AIDS — a novel explanation

If someone discovered a cure for AIDS, would the pharmaceutical industry be able to – or even want to — develop it?

That’s one of the questions explored in Through These Veins, the first novel by Anne Marie Ruff, a veteran journalist who has covered AIDS, medical research, biodiversity and other international issues for many publications.

It’s perhaps also a question worth asking in reality this week as international leaders have been meeting at the United Nations and throughout New York City to debate, among other things, how best to fight disease in poor countries.

HIV infection is today, in rich countries at least, no longer a death sentence but rather a manageable, chronic disease almost like diabetes thanks to the development of effective anti-HIV drugs.

That’s obviously of life-saving benefit to millions of people infected with HIV who can get these drugs.

It’s also one of the great success stories for what some might call the “medical-industrial-complex.” At the risk of sounding a bit crass, people with HIV, like people with other chronic diseases, have to keep buying these products in order to stay alive.

Is there just as much market incentive for a drug company to spend hundreds of millions of dollars to find a cure for AIDS? Ruff doesn’t think so.

“I would challenge you to show me a pharmaceutical company that can afford to undertake the very expensive, risky, and long-term research necessary to develop a cure for HIV/AIDS, or almost any other disease for that matter,” she told me. “The sales model simply will not support the effort.”

(Maybe not for drug companies. But I should note that there are medical scientists at the Fred Hutchinson Research Center exploring a gene-modification approach to curing HIV infection.)

Ruff says she isn’t necessarily criticizing the drug industry (though one fictional company, Klaus Pharmaceuticals, is certainly the bad guy in her novel). Drug makers are simply responding to market forces, she says, and are legally required to their shareholders to pursue the most lucrative business strategy.

Unfortunately, she says, the money is in treating and not curing. And the scientific community, Ruff adds, tends to follow the money also.

Telling that story is one reason why she wrote Through These Veins. After years spent reporting on these issues – including a stint covering AIDS in Thailand – Ruff said she grew frustrated with the limits of trying to describe a complex situation within the limits of a news reports.

Another motive for writing Through These Veins was to help readers gain an appreciation of how important natural resources and biodiversity are to our planet’s health and our own physical well-being.

The books opens in Ethiopia, where an innovative pharmacist and his talented daughter Zahara discover that a concoction made from the red-veined leaves of a local plant and a tree fungus is effective at ridding HIV entirely from infected members of their community.

A charismatic Italian scientist who collects plants with potential therapeutic value (based on a real charismatic Italian scientist Ruff met who does much the same thing) visits the Ethiopian village and learns of this.

Someone gets killed, romantic interests flare and subside, a medical researcher gets excited, which excites a drug maker and Zahara eventually goes to the U.S. where all hell breaks loose.

I can’t say any more. I don’t want to give away Ruff’s plot and dramatic conclusion.

I just think it’s a fascinating first novel that raises, in an entertaining and fact-based way, some questions about the unhealthy influence of the marketplace on how we fight disease – and how we don’t.

Note: All profits from the book go to Campaign for Access to Essential Medicines of Médecins Sans Frontières/Doctors Without Borders and the Institute of Biodiversity Conservation in Ethiopia.

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About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.