Because the issue is so complex, publicattention often turns to the one place wheretangible results are expected--clinical testing.It's through clinical testing that victims of AIDScan directly--and quickly--benefit from whatscientists are digging up in the labs, and it'sthrough clinical testing that the scientificcommunity learns whether new discoveries reallywork.

Just ask Jerome E. Groopman, who co-directs theInstitute's Center for Clinical Research. He'llexplain how his center is doing some of the mostexciting work around on fighting the AIDS virus.

Right now, the Center's researchers areinvolved in several projects. Many of them arestill conducting extensive tests on AZT, thehighly touted drug that has been shown tochemically block the AIDS virus from replicating.Other researchers at the Center are working on anew generation of drugs, which work directly onthe virus' gene structure, Groopman says.

But the Center garners almost as much attentionfor its other role--providing experimentaltreatment to current AIDS victims. That fallsunder the domain of Professor of Medicine MartinS. Hirsch, the Center's other co-director, whooversees the AIDS Clinical Testing Unit (ACTU),which is one of only 47 such government-fundedunits across the country.

The ACTU conducts clinical trials on HIV, aswell as some of the diseases that result from abroken-down immune system, to determine howpatients with AIDS can best be treated. Hirschsays although researchers are much closer tofinding a vaccine than they thought they would bea year ago, there is still a long way to go.

"I don't think we're there yet, and it willprobably be about five to 10 years before we havea safe and available vaccine," he says.

Frustration With Research

In recent years, however, frustration with theslow pace of research has translated intofrustration with the ACTU, and the way itdispenses treatment. At times, activists havecriticized Harvard for not devoting sufficientresources to the care and treatment of peoplecurrently infected with HIV.

On several occasions, ACTUP stageddemonstrations to pressure the ACTU into makingAIDS treatments more available to those who mostdesperately need it. Of particular concern are theACTU's requirements for clinicaltesting--activists claim that in an attempt toobtain a "proper" scientific sample, the ACTUexcludes many AIDS victims from eligibility.

In response, Hirsch says he convened acommunity advisory board for the ACTU last spring,in an effort to bring clinical researcherstogether with representatives from the community,minority groups and AIDS activists.

Last August, that advisory board recommendedseveral changes in the clinical testingprocess--among them, making treatment moreaccessible to women, children and minorities--saysRochelle L. Rollins, spokesperson for the Blackcommunity on the ACTU advisory board. Rollins, whois director of research at the Multicultural AIDSCoalition, says the board has also suggested theACTU make more appointments during non-work hours,recruit a more multilingual staff and providechild care for women taking part in the trials.

Harvard officials say they are working on suchrecommendations, but activists like Immel, whorepresents ACTUP on the community advisory board,say they feel Harvard is still out of touch withthe needs of those infected with HIV. He describesthe ACTU's criteria for drug trials as "reallyanal" and too restrictive.

"They're not in touch with the people who havethe disease. They treat them as subjects, not aspeople," Immel says.

Immel also says Harvard does not try enough newdrugs, instead relying on older ones that havealready proven unsuccessful but are nonethelesssupported by the pharmaceutical companies thatproduce them and fund research.

But Harvard clinical researchers say they arewill aware of the community's needs, and arereceptive to the advice of the advisory board.