Speeding Help on AIDS

The Food and Drug Administration has acted wisely in accelerating the distribution of an experimental drug helpful in controlling one of the opportunistic infections associated with AIDS. The step almost certainly will reduce the need for hospital care, and could extend the lives of these patients.

Under the action, aerosol pentamidine will be made available to those with AIDS and to those without the symptoms of AIDS who have the human immunodeficiency virus that causes AIDS and who also have markedly reduced T-4 white-blood-cell counts. As many as 100,000 persons could be affected. Tests have shown that the treatment greatly reduces both the onset and the recurrence of pneumocystis carinii pneumonia--the most common life-threatening infection afflicting those with the virus. There are at least 1,000 new cases of the pneumonia each month.

The FDA is implementing the distribution under its treatment investigational new drug application program, instituted in 1987, which permits the widespread availability of some drugs before formal FDA approval. Field work in this case justified the FDA action. It is consistent with the commendably cautious approach that the FDA has been following, resisting pressure for the hurried release of experimental drugs. That policy already has kept from the market at least one drug, initially promising, that proved toxic. Of course, the effectiveness of this step by the FDA will now depend on the willingness of insurers, including Medicare and Medicaid, to pay for it.

There remain concerns about the adequacy of funds for the federal drug-testing programs--a complex and costly, although necessary, process. Proposals for accelerating the process were included last year in the report of the Presidential Commission on the Human Immunodeficiency Virus Epidemic, but they have not been implemented. They deserve priority consideration in the new federal budget.