AIDS Panic at the County
By the arcane calculus of county politics, Peter Kerndt's National Institutes of Health grant caused a lot more than $1.5 million-per-annum's worth of trouble. That's why, though it promised to facilitate research to cure the world's most widespread deadly disease, the County Board of Supervisors on Tuesday officially voted the project it supported out of existence.
Kerndt's grant was to fund research that could have been a milestone on the path toward the discovery of an autoimmune-deficiency virus vaccine - the Holy Grail of modern medicine. The problem was that Kerndt apparently didn't handle his office and local politics as well as he did his research-grant proposal.
The politics are those of race and county bureaucracy. Kerndt's task was not to test a proposed vaccine, but to compile a potential pool of possible volunteer subjects for such a test, most of them people of color. Down the road, however - and here we're talking at least 10 years - like most other vaccines (influenza, polio and smallpox, for example), any AIDS vaccine would contain portions of the disease virus' components. That's how a vaccine works - by introducing the body's immune system to a nonlethal portion of a disease organism in order to teach it to develop a resistance to the entire organism.
To Supervisor Yvonne Brathwaite Burke, who doesn't seem to be very well informed on scientific matters, what this amounted to was the willful infection of inner-city African-Americans with the AIDS virus. This "atrocity" she, to put it mildly, declined to sanction. She called the subject research plan "scientific racism," aimed at inner-city "guinea pigs."
Such accusations - originating, in part, in a vividly worded confidential report produced by the Department of Health Services - from the mouth of a powerful elected official sent health officials scurrying. Rather than try to assuage Burke's rather striking misconceptions, DHS chief Mark Finucane in particular chose to point fingers. The basic cover story was that Kerndt hadn't got the DHS's approval for the research program.
This wasn't quite true, if not altogether false. According to public documents made available by Kerndt's lawyer James P. Cooper, Kerndt formally notified his superiors that he was applying for the federally funded project. Having got the funding, he also notified Shirley Fannin, the department's top official on contagious diseases, that he'd landed the $1.5 million and needed more space for his research.
Confusing the issue, however, was the fact that Kerndt had not, so far as can be determined, directly and personally informed DHS's Finucane or Finucane's immediate public-health subordinate, John Schunhoff. Further complicating accountability matters was that the study was being done with a nonprofit consortium of County-USC doctors, the Health Research Association.
But DHS' top management can't claim they had no knowledge of the fund application's success. James Haughton, Finucane's assistant for public-health programs, wrote Kerndt on October 28: "Dr. Donald C. Thomas [Finucane's second-in-command] and I wish to congratulate you on your successful application.'"
Finucane said he was investigating the possibility of whether any other county health officials had been told of the funding of the study. That information is expected to be available next week - too late for this week's deliberations.
Meanwhile, the county supervisors acted on the reverse assumption and, basically, closed out their involvement with the project. (Funds may yet accrue to the private Health Research Associates that applied for HIVNET funds along with the county, but that decision rests with the NIH.) The same board motion mandated retroactively that, whatever Finucane might yet discover to the contrary, "the county was not a knowing participant" in the research. Further inquiry was authorized to make sure no other research projects are taking place without the board's knowledge, and to make sure that all volunteers would be duly informed of the risks of medical research - a concern never seriously at issue in the HIVNET matter.
Kerndt was winding up a month of involuntary leave for his alleged missteps when the board voted, and he was not available for comment, although the doctor's future in the county medical establishment appears uncertain at best. Supporters of his DHS research, not speaking for attribution, now accuse Kerndt's superiors of scapegoating him to avoid acknowledging their own roles in sanctioning his work.
But another senior county physician, also not speaking for attribution, said that it wasn't just the county's problem. He observed that this kind of politics was all too characteristic of the emotionally polarized corpus of AIDS and HIV research over the past 16 years.
"If the research on polio myelitis had been this politicized," he said, "you'd still be seeing lots of kids in iron lungs."
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