2 AIDS experts resign over journal editorial

CONTROVERSY: They leave the board after the publication likens Third World
AIDS studies to the Tuskegee experiment.

BOSTON Two top AIDS experts have resigned from the New England Journal of
Medicine's board to protest an editorial that likened AIDS studies in the
Third World to the notorious Tuskegee experiment.

Dr. David Ho, head of the Aaron Diamond AIDS Research Center in New York
City, and Dr. Catherine M. Wilfert, a pediatric said as board members they
should have been consulted about the editorial before it was published last
month.

The editorial criticized several studies, mostly in Africa, that are
intended to see if brief, inexpensive doses of the drug AZT will keep
HIVinfected mothers from passing the virus to their babies. Some of the
women are receiving dummy pills instead of AZT.

Dr. Marcia Angell, the journal's executive editor, said in the editorial
that the studies are unethical. She likened them to the Tuskegee study in
which poor black men in the South with syphilis were left untreated even
after penicillin became available.

The editorial upset many AIDS researchers, including Ho and Wilfert, who
believe the African studies are the only practical way to prove that a
simple approach works better than nothing. Wilfert and others worried that
the influential journal's criticism could bring the studies to a halt.

In an opinion piece in the Sept. 29 issue of Time magazine, Ho called the
Tuskegee comparison "inflammatory and unfair." He said it "could make a
desperate situation even worse."

Dr. Jerome P. Kassirer, the journal's editor in chief, fired off an angry
Email to Ho, criticizing him for not talking to the journal before writing
in Time.

Kassirer said Wednesday that Ho wrote back offering to resign. "I sat on it
for a couple of days and then decided to accept his resignation," Kassirer
said.

Wilfert said she submitted her resignation to take effect after the
editorial board's annual meeting in December. "There should be discussion
about the role of the editorial board."

She said the journal's decision to present just one side of the controversy
was a policy issue that should have been brought to the 25member board.

"I resigned because of the way in which it was handled," Wilfert said.

Kassirer said the board members, among some of the most prominent
physicians in research, are asked for advice on policy questions but never
on the journal's content.

"I regret this happened," Kassirer said. "On the other hand, we can't be
hamstrung by trying to have decisions made by committee."