In the early 1980s, many scientists believed that the era of infectious diseases was over. Modern medicine had tamed threats such as polio and tuberculosis with vaccines and antibiotics.
Then came the advent of AIDS in 1981, which effectively changed that notion and the overall approach to disease research forever.
Victoria Harden, director of the Office of the National Institutes of Health (NIH) History, explored AIDS research at the Baltimore-based NIH in this year's J. Harvey Young History Lecture, held on Monday, Dec. 1--also World AIDS Day.
The lecture was a homecoming of sorts for Harden ('66C, '83G), who studied under the lecture's namesake as an undergraduate and later as a graduate student. Young sat on the front row in the Rita Anne Rollins Room in the Rollins School of Public Health as his former pupil chronicled the vast topic of AIDS research at the NIH.
Harden, who is the first NIH historian, designed her discussion around a large-scale website chronicling the organization's AIDS research. Found at http://aidshistory.nih.gov/home.html, the site is home to an ongoing project collecting various historical items, including oral transcripts from key AIDS researchers, images (from charts and graphs to public service announcements), original press releases and publication articles.
As soon as she reached the podium, Harden told the audience she wanted to specifically focus on a narrow but "critically important" segment of AIDS history: how the NIH responded to the initial threat of AIDS.
Today, the NIH often works in tandem with the CDC and the Food and Drug Administra-tion (FDA) when researching diseases in all aspects, from drug testing to education. Prior AIDS, this was not the case, Harden said.
"In 1981, the boundary lines between these three agencies were pretty clear," she said, explaining that the NIH covered medical research, the CDC was responsible for disease epidemiology and the FDA regulated food and drug issues. "But the advent of AIDS introduced strife into the system. AIDS just didn't fit neatly into any of the existing structure."
One of the biggest problems facing early AIDS research (in addition to the complex manifestation of the disease) was obtaining research funding, Harden said. She compared the NIH grant system to a "vast ship, laboriously constructed over many years." The existing grant system was launched in 1946 and was lengthy, taking about eight to nine months per request. Until AIDS, there was no need to ramp-up large-scale funding for a new disease, she said.
"The threat simply was not expected--and it was especially not expected that the NIH would need to respond quickly. That was the CDC's role," Harden said. "After AIDS was identified in 1981, the ship was nudged to turn its path slightly as the holders of [the grants] could come to agreement and shift their interest to AIDS."
Shifting research interest toward AIDS required only the agreement of the laboratory's chief scientist and the NIH scientific director, Harden said.
This allowed for teams of researchers--with interests in cancer, immunology, blood sciences and drug development--among the many branches of the NIH, CDC and FDA to quickly form collaborations early in the AIDS crisis.
AIDS has changed the way clinical trials are run, skewed research priorities, introduced new research models and laid the foundation for the future research of emerging diseases and epidemiological issues, such as approaches to the current bioterrorism threats, Harden said.
Throughout the rest of her lecture, she elaborated on research strides and tied them together to the overall social impact AIDS has had worldwide, a daunting task in and of itself.
As she concluded, with a photo of the famous AIDS Memorial Quilt behind her, Harden delivered one key lesson learned from the disease.
"I want to remind you--on this World AIDS Day--that AIDS is a disease that affects human lives; it's not just an abstract, scientific problem," she said.