San Francisco Chronicle - The Voice of the West, 901 Mission Street, San Francisco, CA 94119 - Monday, July 8, 1996 - Page A1
David Perlman, Chronicle Science Editor

The news started immediately. While the city's huge conference auditorium filled with children's songs and traditional Pacific Coast Indian prayers that amplified the meeting's slogan of "One World One Hope," drug companies began disclosing indications from preliminary human trials that costly drugs approved only this year appear to be prolonging lives and reducing symptoms of disease among a fortunate few.

Scientists working with one of the new class of drugs called protease inhibitors reported yesterday that in combination with an older AIDS drug, ddC, the risk of death was reduced by 72 percent over 18 months. The results came from a trial involving 940 severely ill AIDS patients.

The drug, called saquinavir and made by Hoffmann-LaRoche Inc., has already been approved by the U.S. Food and Drug Administration. It interferes with the ability of HIV to reproduce in the human body by immobilizing the viral genetic material at a different place along the HIV gene than does ddC.

The older drug, called a nucleoside analog, is in the same class as AZT, the first drug that appeared to slow the attack of the virus. AZT later proved unable to cope with the virus' ability to mutate into resistant forms.

The Hoffmann-LaRoche drug trial was led by Dr. Jacob Lalezari of the Mount Zion Medical Center of the University of California at San Francisco.

"The results of this study clearly show the clinical benefits of giving saquinavir in combination with nucleoside analogs," he said.

Two other protease inhibitors have been approved by the FDA and at least five more are under development. Reports on trials of these drugs in combination with older compounds will be a major feature of scientific discussions at the conference this week.

HOPE FOR VACCINATION

The growing hope for vaccination against AIDS was underscored yesterday when the Rockefeller Foundation announced a multimillion-dollar AIDS vaccine initiative. It will begin with Rockefeller grants of up to $6 million to researchers and small drug companies this year. Eventually, the goal is to funnel $600 million from the World Bank, other international foundations and Third World governments for developing and testing potential vaccines.

Such preventive treatments, the experts say with growing confidence, will one day block infection by strains of HIV, the AIDS virus, that are most widespread within the typically poor nations where more than 90 percent of all AIDS and HIV cases in the world continue to strike.

But even as science news began to circulate, the major focus of yesterday's opening ceremonies was political.

It concentrated on governments that still drag their feet on the AIDS front, and on major pharmaceutical companies whose new drug combinations -- however effective in tests so far -- drive expenses for people with AIDS to $10,000-$15,000 a year. Similarly expensive are tests that monitor health by measuring the amount of the virus in the body.

To Dr. Peter Piot, director of the United Nations AIDS program, those few nations that have reduced sexual activity among teenagers are making the best progress; countries like Thailand and Uganda have distributed millions of condoms yearly. From cities to countrysides and villages, prevention programs have successfully encouraged abstinence and marital fidelity as ways to slow the deadly virus' spread.

ANGER AT ROADBLOCKS

But Piot voiced anger, too, at roadblocks to distribution of the latest medicines to those infected.

"It remains unacceptable that people living with AIDS, especially but not only in the developing world, should have to live without the essential drugs they need for their HIV-related illnesses," he said. "Most of these drugs could be made accessible . . . if governments had the right drug policies, and if doctors prescribed appropriately."

To Piot, surveying the medical priorities of the world's advanced nations, it is now time to "turn the global AIDS research agenda on its head. Nine out of 10 HIV infections occur in the developing countries, where people are desperate for a vaccine. Ignoring the research needs of 90 percent of the epidemic is not just unethical; it is irrational."

To the cheers of AIDS activists in the audience, Piot warned: "It is time to get serious about the human rights of people living with HIV and AIDS. Twenty-eight million people have already been infected. How many more will it take before the world stops blaming? Stigma is an enemy of truth and openness. How long before people with HIV everywhere are able to share the news about their infection and protect their partners?"

PROTESTS RESTRAINED

Unlike the memorable days of the Sixth International AIDS Conference in San Francisco in 1990, protests by people with AIDS were relatively restrained. No sessions have been delayed, no pickets have barred doors. But anger was palpable as hundreds of activists cheered some speakers and jeered others.

Eric Sawyer, a leader in New York's ACT-UP organization, reminded both the conference's scientific delegates as well as his activist friends that "we are a long way from a cure, even for those who can afford them," and charged that "human rights violations and genocide continue against people with AIDS -- and that's a truth!"

He was rewarded with a burst of shouted encouragement and chants of "Act up, fight back!" from hundreds of angry flag-waving people in the audience. "The greed of the drug company profiteers are killing people," Sawyer shouted as the cheers and jeers resounded.

Finally Sawyer shouted: "Greed Kills -- Access for All!" and as he repeated that charge more loudly than ever, his charge became a deafening mantra, called throughout the hall by hundreds.

There are 15,000 delegates from 125 nations at this Vancouver meeting. Most were in the hall as opening ceremonies continued into the evening. The majority remained quietly fascinated by the emotions of the first day, preparing for the serious scientific sessions that will continue through Thursday.

FREE TELEPHONE CALLS WITH CONFERENCE EXPERTS

The San Francisco AIDS Foundation will sponsor two free telephone conference calls this week to link the public directly with experts attending the 11th International Conference on AIDS in Vancouver, British Columbia.

During each 90-minute phone session from Vancouver, five physicians specializing in AIDS care will explain the most important developments reported at the meeting and answer questions from callers throughout the United States who register in advance. The free phone conferences will be held at 12:15 p.m. Pacific time tomorrow and Thursday. They are available to anyone interested in AIDS, but members of the public who want to join the phone sessions must register in advance by calling 1-800-

707-BETA.

Ronald Baker, editor of the AIDS Foundation's quarterly publication, the Bulletin of Experimental Treatments for AIDS, or BETA, will moderate the programs. Participating specialists will be Marcus Conant, Michael Saag, Kathleen Squires, Ron Mitsuyasu and Gabriel Torres.
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