POLITICS JOINS SCIENTISTS AT AIDS MEETING

The drawn-out controversy in the U.S over the alleged distortion of
scientific evidence by neo-conservatives and the religious right is
thundering down on the International AIDS Conference here next month.

More than a hundred U.S. activists will come to Toronto for the
six-day meeting, organized into a "strike force" to counter
presentations where ideology, prejudice or opinion are warping the
scientific evidence about prevention, a leading AIDS campaigner told
the Star this week.

"We're prepared to combat situations at the conference where more
ideological positions are taken," said Judy Auerbach, an official
with the Foundation for AIDS Research in Washington.

The Aug. 13-18 meeting, expected to draw as many as 26,000
participants, is the 16th edition of the premier event in the
HIV/AIDS field, put on every two years by the International AIDS
Society. Past meetings have featured both major scientific advances
and heated political clashes.

Clashes are again expected in Toronto over ideological flashpoints
such as the Bush White House insistence on giving a high profile to
sexual abstinence in government HIV prevention programs, despite low
success rates.

In apparent response to such opposition, the Bush administration --
despite its wide-ranging, multi-billion-dollar commitment to fight
HIV/AIDS -- at first restricted conference attendance to just 50
scientists or policy-makers from the two U.S. government agencies
mostly responsible for AIDS research, the National Institutes of
Health and the Centers for Disease Control. That's a fifth the
numbers sent to previous such conferences overseas.

NIH officials said they had negotiated another 18 places, bringing
their total to 43. A CDC spokesman wouldn't provide details about numbers.

"The conference is at the crossroads of science and politics. It will
suffer because of this quota," said co-chair Mark Wainberg, a McGill
University professor and top Canadian AIDS researcher.

Despite the Bush restrictions, conference officials estimate as many
as 2,000 participants will come from the U.S.

"Our conference will be extremely strong from both the scientific and
community standpoints, but would have been even stronger still if not
for the policy being enforced by the U.S. government," Wainberg wrote
in an email.

The quota means numerous well-known scientists from CDC and NIH won't
be coming, Wainberg said. Some didn't even bother to submit
presentation proposals because they saw so little chance of getting
travel approval.

Many of those given the green light to take part are bureaucrats from
the two agencies rather than the leading scientists "who would have
loved to attend," the conference co-chair said.

Scientists stress the importance of major conferences for networking
and informal information-sharing.

The White House contends the quota was imposed several years ago as
part of a wider move to rein in the soaring costs of attending
international meetings. But Wainberg says many NIH and CDC scientists
have told him privately that politics is the real motivation "without
question."

"One reason Toronto was chosen as a venue was that people could come
from the U.S. without much expense. We thought we were doing the U.S.
government a huge favour," said Wainberg.

Several scientists noted that the quota approach guarantees tight
control on which government researchers attend and also the message
they present.

The conflict is just one skirmish in a larger war that erupted soon
after George Bush took office 5 1/2 years ago over interference with
scientific research in politically sensitive areas such as endangered
species, climate change, sexually transmitted diseases, evolution
versus intelligent design, and stem cell research.

The larger struggle continued this week as Bush cited "moral" reasons
Wednesday in vetoing a bill from the U.S. Senate to allow the NIH to
fund medical research that used surplus embryonic stem cells from
fertility clinics.

And on Thursday a leading science advocacy group released its third
survey where U.S. government researchers complained of political
interference with scientific findings.

Nearly a fifth of the almost 1,000 scientists who answered the
confidential survey said they had been asked -- for non-scientific
reasons -- to change or delete technical information or conclusions
in scientific documents at the Food and Drug Administration.

The FDA is the federal agency which guarantees the safety of food and
drugs through testing and regulation. The Union of Concerned
Scientists sent the survey to the FDA's 6,000 scientists.

"These aren't isolated incidents. It's something that's happening
across government on a regular basis," said Francesca Grifo, the
union's director of the scientific integrity program.

Also happening on a regular basis is controversy over U.S. government
policies at international AIDS conferences. Advocacy groups didn't
have a unified front at previous meetings in Bangkok and Barcelona.
So this time more than three dozen U.S. and international groups
created the ad hoc "strike force," called the Caucus for
Evidence-Based Prevention. The three key partners are the Foundation
for AIDS Research, Population Action International and the Sexuality
and Education Council of the U.S.

The groups are pushing for HIV and AIDS strategies based solely on
scientific evidence, defined as "rigorously designed, implemented and
evaluated studies and programs."

"Too often, for ideological and political reasons, strategies with no
proven efficacy have been promoted instead of those that are known to
work," says a caucus briefing memo.

Auerbach, the foundation's vice-president for public policy and
program development, said the caucus expects to field about 100
members at Toronto. Planned activities include a daily newspaper
emphasizing presentations about HIV prevention, and smaller working
groups concentrating on specific topics such as youth or new
prevention technologies.

"We're going to make the public in Toronto aware that there's a lot
more going on in preventing AIDS than abstinence and being faithful,
which are the answers most promoted by the U.S. government," Auerbach said.

But Auerbach and others also acknowledge that the Bush administration
deserves credit for making major investments in HIV/AIDS research,
prevention and treatment both domestically and abroad. The U.S.
government currently spends $17 billion helping the estimated one
million Americans with HIV/AIDS.

From $840 million (U.S.) in the 2001-02 fiscal year, government
spending on HIV/AIDS outside the U.S. rose to $3.2 billion in the
current fiscal year. For 2007-08, the Bush administration has asked
Congress to approve more than $4 billion. Included in that spending
is the President's Emergency Plan for AIDS Relief.

Unveiled in 2003 and projected to cost $15 billion over five years,
it's the largest international health crusade ever with projects in
more than 120 countries.

Activist complaints of ideological distortion centre on the 7 per
cent of the plan's spending earmarked for abstinence and "be
faithful" programs in 15 so-called focus countries. That amounts to
one-third of total spending on prevention, which is 22 per cent of
the overall budget.

Wainberg praised the relief plan as "the largest program that's
getting AIDS antiviral drugs into the hands of people who otherwise
would not have had access to them."

Yet by limiting official participation in Toronto, the U.S.
squandered a chance to ensure the world knows how much good it's
doing. "It's an opportunity that they've blown," Wainberg said.

That's just one example of the bigger picture which global health
expert Dr. Peter Singer argues shouldn't be eclipsed by skirmishes at
the AIDS convention next month. Even Prime Minister Stephen Harper's
shunning of the Toronto gathering is simply small-p politics and not
truly significant.

"This is less about whether the PM shows up at a conference or not
and more about what should be Canada's international signature in
addressing the global challenge of HIV/AIDS," said Singer, a U of T
professor of medicine and senior scientist at the McLaughlin Centre
for Molecular Medicine.

He said Canada needs a robust foreign policy strategy that applies
its strengths in science, technology and innovation to tackling
HIV/AIDS. Canada's contributions to the international AIDS effort
since 2000 have topped $800 million.

"The millions affected in Africa would be much more interested in
what Canada is doing about HIV vaccines than about the small-p
politics at the conference," said Singer.

Yet examples gathered by the Union of Concerned Scientists show that
interference by the Bush administration can be extremely political.

As recently as May, panellists for a CDC-sponsored conference on
sexually transmitted diseases were switched at the last minute after
a conservative congressman complained that abstinence-only education
wasn't well represented.

But the substitute pro-abstinence panellists didn't go through the
customary scientific peer review process as had those initially chosen.

Alan Bernstein, head of the Canadian Institutes for Health Research,
said respecting peer review is paramount to the credibility of any
scientific agency.

Speaking generally and not about the May conference, Bernstein said
there is nothing improper with governments setting priorities for
scientific and health research. "But the decision as to what
researchers actually get to spend that money on should only be based
on peer review. That's the line in the sand."