Desperate AIDS Victims Seek a Miracle in Tijuana

When John Lounsbury came to this bustling Mexican border city recently, he was a desperate man in search of drugs. But Lounsbury wasn’t looking for a high or a quick profit. He is dying from AIDS.

The 41-year-old San Diego resident, like a growing number of other AIDS victims, came here to buy Isoprinosine and ribavirin, two drugs that some believe may be an effective treatment for acquired immune deficiency syndrome. They are available here without prescription.

The drugs were developed by two Orange County firms and are sold in Mexico and elsewhere for use against assorted viral ailments.

But the U.S. Food and Drug Administration has not approved either Isoprinosine or ribavirin because, it has stated, there is no evidence of their efficacy and both may cause potentially dangerous side effects, such as anemia and liver damage.

The two drugs are being tested experimentally in the United States in some AIDS patients, and the FDA is closely monitoring those clinical trials. But AIDS victims such as Lounsbury are unwilling to wait.

“What are we supposed to do? Wait around to die?” asked Lounsbury, his voice rising as he sat over lunch in a San Diego restaurant. On the table was a large, drug-filled pouch and a small alarm clock set to ring in time for his next round of medications.

‘Some Hope’

“At least with these treatments we have some hope,” said Lounsbury, a diagnosed AIDS patient since January, 1984.

Word of the two drugs’ potential usefulness against AIDS--and their availability in Mexico--began circulating in the gay community earlier this year, after sketchy accounts of the clinical studies emerged.

The remarkably efficient AIDS grapevine was soon filled with suggested dosages of Isoprinosine and ribavirin, generally following either the manufacturers’ recommendations or the protocol being used in the U.S. clinical trials.

Lounsbury heard about the drugs in May. “All of a sudden,” he recalled, “everybody was talking about (them).”

Just how many AIDS patients have made the trip to Mexico is unknown, but AIDS workers put the number in the hundreds, perhaps thousands.

Recently, a planeload of presumably homosexual men from San Francisco almost depleted the supply of Isoprinosine and ribavirin in Tijuana’s pharmacies, according to AIDS workers in San Diego, a popular destination because of its proximity to the border.

In San Francisco, a well-established underground supply network has sprung up, and a group known as the “Tooth Fairies” has made both drugs available at cost, according to AIDS workers and others. In other cities, the two drugs are reportedly selling on the black market for as much as 10 times their retail value.

“These people are dying, and they’re being offered absolutely no hope,” said Steven Webb, assistant to a New York physician who has traveled to Tijuana and purchased the two drugs for patients. “It’s a life-and-death situation.”

AIDS, caused by a virus, cripples the body’s immune system, leaving it susceptible to many diseases as well as infections that otherwise might be harmless. There is no known cure for AIDS.

Customers for Isoprinosine and ribavirin have included not only full-fledged AIDS patients but also those suffering from so-called AIDS-related complex, a condition that may be a precursor of AIDS. Others have included disease-free individuals who fear that they may develop the disease.

“I take calls from maybe 25 or 30 people a week, lots of them from outside the state,” said Tom Jefferson, a San Diego AIDS worker who suffers from an AIDS-related complex. He has also made the trip to Tijuana.

In a significant policy shift, the FDA and U.S. Customs officials in San Diego announced in October that they will permit Americans to bring back from Tijuana limited amounts of Isoprinosine and ribavirin--so long as the drugs are for personal use. U.S. authorities have not normally allowed the importing of drugs that lack federal approval, according to Allan J. Rappoport, U.S. Customs district director in San Diego.

The effect of that policy change--and the increasing desperation of AIDS victims--clearly can be seen in the well-stocked farmacias of Tijuana.

While Isoprinosine and ribavirin also are widely available in Europe, it is the Mexican border cities to which most American AIDS patients have come. And here in Tijuana, the process has almost become a ritual.

“We see them here all the time,” said Oscar Delgadillo, manager at the Farmacia Maxim.

“They know exactly what they want and how much. They have it written down on pieces of paper,” added Lucy Sanchez, assistant manager at Tijuana’s Le Drug Store.

Believers in Isoprinosine and ribavirin speculate that the two drugs work best in tandem because Isoprinosine is an immune-enhancing drug and ribavirin is an antiviral agent.

But some knowledgeable physicians have cautioned against their use. For instance, they fear that Isoprinosine might actually do more harm than good because the AIDS virus needs healthy cells to feed upon, and the drug--in stimulating the production of new immune cells--may actually accelerate the progress of AIDS.

In Mexico and other places, the drugs are used to counter viral ailments such as herpes, viral hepatitis and influenza. But the FDA remains unconvinced.

In the United States, meantime, a limited number of AIDS patients are participating in clinical tests involving Isoprinosine and ribavirin.

The results are being watched closely not only by AIDS victims but also by ICN Pharmaceuticals Inc., and Newport Pharmaceuticals Inc.--the Orange County manufacturers of ribavirin and Isoprinosine, respectively.

“It’s a (potential) billion-dollar market,” said Dominic Liuzzi, an ICN Pharmaceuticals vice president.

Lounsbury decided to try the drugs last summer when he felt that his condition was deteriorating and after he read up on the available information and consulted with physicians. Lounsbury, now getting by on a $524 monthly government check, has spent more than $400 on the drugs.

“I felt I had to go for it,” Lounsbury said. “We’re talking about a life-and-death situation, not a cure for the common cold.”

Lounsbury said his condition improved after taking the drugs, and that the drugs’ side effects were relatively mild.

Others Not So Lucky

But other AIDS victims have not been so lucky on either count, according to doctors and AIDS workers.

Despite the lack of scientific evidence that either Isoprinosine nor ribavirin might have some beneficial effect against AIDS, some doctors around the country have agreed to monitor patients who have chosen to take the drugs on their own.

And at least one, Dr. Barry Gingell of New York, admitted that he has made a trip to Tijuana to buy Isoprinosine and ribavirin for his AIDS patients.

“It’s creating a desperate situation,” Gingell said of the FDA’s position on the two drugs. “They’re forcing people to go over the border and play Russian roulette with their health.’

Lounsbury could not agree more.

“For somebody in my position, I would advise them to get every piece of information available, read it, and then go for it,” he said, his gaze shifting to the little clock on the lunch table.

“The worst thing that can happen by taking it,” Lounsbury said, “is you lose your life. Without it, you’re going to die anyway.”