Blood, Sweat and Ego

SCIENCE FICTIONS: A Scientific Mystery, Massive Cover-Up, and the Dark Legacy of Robert Gallo, by John Crewdson. Little, Brown: 672 pp., $27.95.

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In the history of science, as in other fields, there have certainly been scandals and controversial figures: researchers who planted archeological finds made from clay, fudged their statistics or painted spots on lab animals to prove something about genetics that wasn’t true. But what if they falsify research on diseases when lives are hanging in the balance?

That’s an offense of another order, especially when it concerns a disease as cruel as AIDS, according to John Crewdson’s “Science Fictions.” HIV, the virus that causes AIDS, has spread worldwide to 50 million people and killed 20 million so far, most of them young adults and children. The scale of the global AIDS epidemic was becoming clearly known in the 1980s and early 1990s when the events in Crewdson’s book were unfolding. The story of the U.S. National Cancer Institute’s Robert Gallo and his relentless insistence that he was the first to discover HIV and the first to develop a blood test for it--in the face of powerful evidence to the contrary--is gruesome, indeed harrowing, for suggesting what happens when scientists succumb to ego and greed in the race for discovery.

Few in the scientific community can forget Gallo’s April 1984 announcement that his lab had discovered that AIDS was caused by a retrovirus called HTLV-III. The discovery led to the development of a blood test to protect the blood supply and help doctors make diagnoses and begin work on vaccines. This was a triumphant moment for American scientific research, by far the best-funded and most active in the world.

But across the Atlantic, this book relates, all was not well. Months before Gallo’s announcement, a group of French scientists at the Pasteur Institute in Paris had sent a sample of their own candidate AIDS virus, which they called LAV, to Gallo’s lab. Eventually the French began to suspect that Gallo’s lab workers had contaminated their cell cultures with LAV and had then rediscovered it and claimed it as their own. Perhaps, at first, Gallo and his colleagues deceived themselves into believing that they had discovered this virus independently of the French. But AIDS viruses from different people are different in subtle but detectable ways, and by 1991, it became clear that the French were right: LAV and HTLV-III were the same virus and had come from the same patient. The credit for the discovery should have gone to the French.

Crewdson describes how Gallo maintained that, though his technicians might have used the French virus by mistake, his own lab was the first to grow the virus in significant quantities and to develop a blood test that showed that this new virus was the most likely cause of AIDS. The French might have isolated the virus first, he suggested, but the Americans made it useful: It was an argument akin to saying that the Germans had demonstrated that nuclear fission was theoretically possible but that Americans made the first bombs and reactors, or that English mathematician Alan Turing may have described the principle of a computer but that a real operating system was developed by Americans.

That is how the credit for the AIDS blood test was apportioned in 1994, when the head of the NIH announced that royalties for the test would be split 50-50 between the French and the Americans. But in “Science Fictions,” we learn that, for Crewdson, the matter didn’t end there. He has spent the last eight years sifting the evidence and has come up with some startling conclusions: Gallo wasn’t the first to grow the virus in significant quantities nor was he the first to make a blood test that showed the virus was the most likely cause of AIDS. In fact, Gallo’s blood test, although based on the French virus, wasn’t nearly as good as another test developed by the French. Even though the French had applied for a patent more than a year before Gallo did, Gallo’s test was patented first and was the first one on the U.S. market, where it was used to screen the blood supply.

Though the American test could identify most infected batches of blood, it also had a high false-positive rate that meant many safe batches of blood were thrown away at great cost to the blood banks. When Abbott Laboratories, the company that made the test, tried to improve it, the result was a test that failed to detect all infected bags of blood, and some slipped through the screening process with tragic results. Meanwhile, the U.S. government, which held Gallo’s patent, was raking in millions of dollars a year, and Gallo and Mikulas Popovic, his postdoctoral assistant, were taking home handsome royalties. The French sued, but U.S. government patent lawyers kept them tied up in technicalities for years, costing both parties an enormous amount of money.

Crewdson’s squalid tale of grasping self-interest in the face of a devastating epidemic is told through court documents, reports from internal NIH and congressional investigative committees and interviews. The enormous amount of evidence which the author has gathered in favor of the French seems convincing. A Pulitzer Prize-winning journalist, Crewdson reveals how Gallo was able to suppress the results of others, including the French scientists, through his influence over scientific journals and meetings. Then, the U.S. government tried too hard to defend him and disparage the French.

By Crewdson’s account, Gallo may well be a rascal, but still, 10 years seems a long time to devote oneself to one wayward scientist. (Today, Gallo heads the Institute of Human Virology in Maryland, an independent research facility that receives money from public and private sources.) It is chilling to contemplate that, according to the book, some people may have died because the more accurate French test was kept off the market. The French test eventually entered the market, and U.S. manufacturers managed to improve their own test, and by now many lives have been saved by AIDS blood tests. The discovery of the cause of AIDS will leave a mark on the world forever and matters far more than the men and women who made it.

He doesn’t say so, but investigating the unholy alliance between scientists, government and industry in America was clearly part of Crewdson’s motivation. But not all scientists behave as Gallo does in Crewdson’s account, and focusing so much attention on this case risks overly demonizing the scientific establishment in general, which some journalists see as a secretive coven of amoral, even destructive geniuses.

However, “Science Fictions” dramatizes far more important issues in contemporary science that others have recently been raising, but which Crewdson himself does not explore. Despite the billions of dollars spent on medical research every year in the United States, the returns have been relatively poor lately, and “Science Fictions” does shed considerable light on the way science works in America and the larger dilemma it may be facing.

Medical historian James Le Fanu has argued that the golden age of medical research began in the 1930s with the discovery of antibiotics and ended roughly in the 1970s with the invention of in-vitro fertilization. The intervening years saw the development of treatments for mental illnesses and childhood cancer, new surgical techniques and many other innovations. Since then, the rate of innovation has slowed while government and industry science budgets have soared. The number of new chemical entities filed by the U.S. patent office is about half what it was 40 years ago, and many patents today are merely for “copycat” versions of existing drugs. Le Fanu blames molecular biology, which he sees as a technical distraction from the serious business of studying disease.

But there are other possible explanations for the relatively slow pace of medical innovation today. Like so many other things in this world, science has become bureaucratized. The people closest to the work itself often aren’t the ones making the decisions. “Science Fictions” describes how Popovic originally wanted to give the French credit for their findings and their help. But Gallo, according to Crewdson, had problems with Popovic’s scientific paper and took out almost all the references to the French virus. Postdocs like Popovic do most of the research in the world’s labs, but they are in a very precarious position.

According to science journalist Daniel Greenberg, in the early 1980s, leading U.S. scientists warned the government that by 1990, there would be a shortage of scientists in the country, and this could threaten America’s position in the world. They reminded U.S. politicians that the Soviets had a vigorous scientific research program, devoted mainly to military applications. So the U.S. government provided universities with money to expand their science doctoral programs. In the end, established scientists got more cheap labor, but the scientist shortage never materialized. Now, most new PhDs move on to low-paying postdoctoral positions in other people’s labs. If, after a few years, they fail to make a major discovery (and many do fail), they move on to other postdoc jobs. This may well have been running through Popovic’s mind when, according to “Science Fictions,” his powerful boss urged him not to give the French any credit. In the end, when the various government committees investigated the AIDS virus incident, Popovic, not Gallo, took most of the blame.

These days, the atmosphere in America’s labs is increasingly tense and competitive, sometimes in an unhealthy, unproductive way. The glut of underemployed postdocs explains part of this phenomenon. So does the Bayh-Dole Act of 1980, which allowed scientists at federally funded labs to profit, personally, from patented discoveries. As predicted, this led to closer ties between industry and academic research. But no one predicted that it would deal such a blow to the spirit of cooperation among scientists.

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From ‘Science Fictions’

Popovic flew to Utah on March 18, 1984, a Sunday. The following Friday, he got a message to call Gallo at once. When Popovic found a phone, he learned that Gallo had major problems with his manuscript, especially Popovic’s description of his experiments with LAV....

The manuscript Popovic saw when he walked into the lab on Monday afternoon bore little resemblance to the one he had left behind. Entire sentences, even whole paragraphs, had been excised, replaced with Gallo’s scrawled additions. Crossed out altogether was the paragraph in which Popovic acknowledged the Pasteur’s discovery of LAV and explained that the French virus was “described here” as HTLV-3.

“I just don’t believe it,” Gallo had written in the margin. “You are absolutely incredible.” Also gone was Popovic’s description of his use of LAV as a “reference virus” in his search for a permissive T-cell line. Next to that strikeout, Gallo had scribbled “Mika you are crazy.”

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Helen Epstein taught biochemistry at the medical school at Makerere University in Uganda and has written about public health for the New York Review of Books, the TLS and other publications.