By Kambiz Shekdar, Ph.D.
In a crowded 2020 presidential race, taking the lead on curing AIDS may offer candidates an opportunity to differentiate themselves and resonate with voters across multiple key demographics. More than 1.1 million LGBT, African-American, Latino and female Americans are living with HIV/AIDS today. Where does each candidate stand on curing AIDS?
Last month, CNN hosted a presidential town hall focused on LGBT issues. With the highest viewership of any such LGBT-focused event, the town hall provided an unprecedented opportunity to learn more. However, only a single question about curing AIDS was asked during the entire four-hour event, and that question, coming at the end of the night at 11:30pm EST, was directed only to one candidate, Tom Steyer.
An excerpt of CNN’s transcript containing Steyer’s response reads:
STEYER: What we should be doing in a case like trying to come up with solutions to AIDS, with cures for AIDS, is going directly to the best scientists and funding them as much as necessary, as much as conceivably effective to make sure that we solve this problem.
In order to give all the other candidates a chance to state their position, if any, on curing AIDS in full, I emailed my own set of questions to all the campaigns (see http://westviewnews.org/2019/10/conquering-aids-in-the-lgbt-presidential-town-hall-top-10-questions-regarding-curing-aids/). Bernie Sanders, Marianne Williamson, Beto O’Rourke and Pete Buttigieg’s campaigns all responded. Their complete response and a summary follows.
Bernie Sanders and Marianne Williamson used the opportunity to introduce curing AIDS as a new pillar of their comprehensive approach to address AIDS. Both campaigns provided specific responses to each of my questions, including these and other significant highlights:
SANDERS: Bernie believes that we can and we must end the AIDS epidemic in the United States and abroad, and we can lead the world by developing a cure for AIDS. Bernie will invest significant federal resources and convene experts, advocates, scientists, and researchers to ensure this goal is met. The United States has before come together to achieve things once thought impossible. What we need is a grassroots political movement that will stand up to the greed of the pharmaceutical industry and take the steps necessary to ensure we end the AIDS epidemic by 2025 and ensure no person in America dies because they cannot afford medication or health care. Bernie is proud to say he will, alongside a political movement, rise to this challenge.
WILLIAMSON: Yes, I will marshal our might to cure AIDS. We will bring together private research and government efforts to work together for a cure with the focus and support that the Manhattan Project received.
I would support a variety of methods to cure AIDS including funding for and support of cellular therapies. We need to look at all means curing the disease.
In addition, rather than responding to each specific question, Beto O’Rourke’s campaign provided a statement. The following is an excerpt attributed to Beto’s campaign spokesperson:
O’ROURKE: An O’Rourke Administration will fully support research efforts by NIH and other federal agencies in the United States and throughout the world with resources needed to keep innovating and making progress towards ending the HIV epidemic.
On the other hand, while Pete Buttigieg’s campaign also got back to us, his campaign provided several links including to Pete’s coming out story, a press article and his LGBT agenda. However, none of these includes any further detail beyond general support for research, similar to Elizabeth Warren’s previously stated position (see Elizabeth Warren and Pete Buttigieg campaign statements at https://www.aidsunited.org/Elections-Center/Candidate-Surveys.aspx).
A cure for AIDS has been proven possible yet it remains a struggle to raise the funds needed to make it a reality. AIDS won’t cure itself; what is needed is presidential leadership.
An exclusive focus on treatment and prevention (PrEP) alone must be expanded to include support for cellular science and curative therapies. Special interests and conflicts of interest must be rooted out (see http://westviewnews.org/2019/09/wild-west-ad-culture-on-facebook-targets-youth/).
My great thanks to Bernie and Marianne for their leadership on curing AIDS and to Beto, Tom, Pete and Elizabeth for adding “cure” to the national discussion on AIDS. I look forward to sharing any additional follow-ups that we may receive from any campaign.
Kambiz Shekdar, Ph.D.
The author is a biologist, a biotech inventor, a gay man and the President of Research Foundation to Cure AIDS. Visit FreeFromAIDS.org to help accelerate a cure for AIDS.
Complete responses from Bernie Sanders and Marianne Williamson to “Top 10 Questions Regarding Curing AIDS”
- If elected president, will your administration offer each of the more than 1.1 million Americans living with HIV/AIDS today any reason to hope for a cure in their lifetimes?
SANDERS: Bernie believes we can and must end the epidemic of HIV and AIDS in the United States and abroad. As President, Bernie will fight for those living with and affected by HIV and AIDS to receive the health care — including prevention and treatment — they need as a right.
He will also end the price gouging of life saving drugs like PrEP. He has introduced legislation to spur the research and development needed for HIV and AIDS treatments and prevention based on the needs of the population to replace our system where the market is manipulated to keep out all competition. Bernie has long stood up against discrimination and remains committed to ending the stigma the HIV/AIDS community are unjustly subject to.
This will not be an administration where HIV/AIDS is swept under the rug. He will appoint people living with HIV/AIDS, community representatives, and public health experts to the HIV/AIDS Task Force to develop specific recommendations on how to successfully meet the varying needs of the communities living with and affected by HIV/AIDS.
WILLIAMSON: Yes. We have made great progress and I support fully funding continued research on HIV/AIDS to produce a cure.
2. Pharmaceutical manufacturers of AIDS medications have saved countless lives; they have also reaped billions in profits. What in your view is Big Pharma’s corporate social responsibility, if any, to share the costs of developing and implementing a cure?
SANDERS: If Big Pharma does not end their greed, we will end it for them.
To lower costs for HIV/AIDS drugs everywhere, Bernie will fight to reform the existing patent laws written by and for the pharmaceutical industry to boost their profits and keep medicine so expensive in the United States. The status quo of government-sanctioned monopolies driving prices up must end.
Additionally, Bernie has a plan to establish a multibillion-dollar “Prize Fund” to spur the development of new HIV/AIDS treatments. This prize fund system would replace our country’s broken system where new treatments are only developed if they are profitable.
Essentially, a company bringing a truly innovative HIV/AIDS treatment to market would receive a cash prize instead of patent protection; the treatment would then be placed in the public domain, allowing generic versions to come onto the market immediately after FDA approval. This ensures companies are still compensated for their research and development, while keeping drug prices affordable for all patients. We have seen absolutely incredible advancements in HIV/AIDS treatment over the last thirty years, but the disease can only be managed if patients can afford their medications.
Bernie will provide universal access to life-saving medicines for HIV/AIDS as soon as they are approved for sale through the Prize Fund and Medicare for All. And it will also be much cheaper than the current system, reducing the costs of the drugs to employers, taxpayers and patients by billions of dollars per year.
WILLIAMSON: Big Pharma produces drugs often based on research paid by the US taxpayer, yet sometimes charges Americans 3-15 times the amount charged in other countries for the same medicine. This is outrageous. I would work to overturn the bill that prohibits the US government from negotiating drug prices, and negotiate lower prices. And I would invoke the “march-in rights” in the Dole-Bayh law that allows the government to revoke exclusive patent rights if a pharmaceutical is either not making the drug available or charging too much, and award the patent to another company that will produce the medicine at lower cost.
3. When America set its sights on winning, American ingenuity, talent and resources have achieved near impossible goals including landing a man on the moon. As president, will you marshal our might in a new “Manhattan Project” to cure AIDS?
SANDERS: Yes. We now have all of the tools we need to end AIDS deaths and HIV transmission and develop a cure for AIDS. Now, we need the political will to do it.
We must set a national goal of ending the HIV epidemic in the U.S. by the year 2025 so that HIV is no longer a public health threat to any community in the U.S. and that people with HIV are able to live long, healthy lives. We will invest substantial federal resources in science, research, and development to cure AIDS.
WILLIAMSON: Yes, I will marshal our might to cure AIDS. We will bring together private research and government efforts to work together for a cure with the focus and support that the Manhattan Project received.
4. Curing AIDS is as much about making room for new ideas and teams as it is about the science and technology. How will you carve out space for cellular therapies in an arena dominated by AIDS medications alone?
SANDERS: Bernie believes we must continue to innovate and lead the world in cutting edge research and development. Bernie has a plan that would establish a multibillion-dollar prize fund to spur the development of new treatments. In addition, Bernie strongly supports increased funding for the NIH, including to further research into promising cellular therapies for this and other diseases. Bernie also believe that a comprehensive health research agenda should include not just the necessary financial support for disease-specific research, but must also consider our long-term investments in science education and how we can broadly support the next generation of scientists tackling some of the greatest medical challenges of our time. Ultimately, curing AIDS will take more than investing in discovery. When there is promising research, every effort should be made to expand safe and affordable access to those treatments as soon as possible. A treatment that no one can afford will not save lives.
WILLIAMSON: I would support a variety of methods to cure AIDS including funding for and support of cellular therapies. We need to look at all means curing the disease.
5. An AIDS cure will offer limited national value if it is only affordable by the wealthiest 1 percent of Americans. How will you ensure that tomorrow’s breakthrough therapies will reach all Americans regardless of ability to pay?
SANDERS: One of the great moral issues of our day is that people with HIV and AIDS are suffering and, in some cases, dying in America because they can’t afford to pay the outrageous prices being charged for the medicine they need to live.
It is indefensible that even with insurance and rebates, a person with HIV must spend thousands of dollars per year just on prescription drugs — often leaving them unable to afford decent housing or other necessities — all while profiteering companies continue to jack up the price of these treatments overnight, simply because they can.
Instead of focusing on public health and the public good, drug companies are focused on padding the pockets of their shareholders and top executives. That has got to change.
In the richest nation in the world, we must not tolerate a health care system that offers the best care to the rich, while leaving everyone else to fend for themselves. We must do everything possible to end the greed of the pharmaceutical companies and get people the medicine they need at a price they can afford.
Bernie will guarantee health care as a human right through his Medicare for All program which will ensure that no one has to pay more than $200 per year out of pocket for medication.
WILLIAMSON: As mentioned above, Big Pharma produces drugs often based on research paid by the US taxpayer, yet sometimes charges Americans 3-15 times the amount charged in other countries for the same medicine. This is outrageous. I would work to overturn the bill that prohibits the US government from negotiating drug prices, and negotiate lower prices. And I would invoke the “march-in rights” in the Dole-Bayh law that allows the government to revoke exclusive patent rights if a pharmaceutical is either not making the drug available or charging too much, and award the patent to another company that will produce the medicine at lower cost.
6. By considering parameters for global implementation at the outset, the United States can help ensure that cellular therapies are developed such that they may be implemented from Park Avenue to the Sudan. How could you envision working with the international community to bring about a global cure for AIDS?
SANDERS: Bernie believes America has a responsibility to lead the international community in solving the health crises we have seen arise globally and establish efficient emergency systems for future epidemics. Taking steps back and cutting funding for critical programs like PEPFAR and the Global Fund are an abdication of American leadership and an international disgrace.
The bad news is that nationally we have not seen an improvement in the nearly 40,000 avoidable HIV infections that are taking place each and every year. Tragically, in some regions of the country, the epidemic has gotten even worse. And globally we are not doing better. It was estimated globally in 2017, 1.8 million individuals became newly infected with HIV and nearly 25 percent of people living with HIV are not aware and lack testing services. In the year 2019, we have got to do much better than that.
We must join the international community in committing to make large changes in our country to ensure the HIV epidemic and other epidemics are treated with urgency and adequate resources are allocated to end them.
WILLIAMSON: While I would prefer that the United States lead the research for a global cure on AIDS, we need to work with other countries and every international agency to pursue and investigate every possible cure no matter where the research originates.
7. Gilead Sciences, Inc., a major manufacturer of AIDS medications, is known to pay hundreds of millions of dollars to AIDS and LGBT organizations that go on to advertise its drugs on social media. What is your view of the need for transparency and accountability when it comes to the marketing of prescription drugs?
SANDERS: The United States is one of two countries in the world that allows direct-to-consumer advertising of prescription drugs. Bernie has long supported measures to increase transparency and public accountability for advertising and marketing of prescription drugs. When Bernie is President, he will end the greed of the pharmaceutical industry and ensure all Americans, regardless of income, are able to afford the life-saving medication they need.
WILLIAMSON: We need to exercise the utmost in honesty and transparency about each AIDS medication. At the same time, we don’t want to hinder the spread of effective drugs and we need to use social media as one part of a multi-pronged attack to stop the spread of AIDS.
8. Heavy use of the new AIDS prophylactic drug Truvada® / PrEP manufactured by Gilead Sciences, Inc. has dropped HIV infection rates but opened the door to drug-resistant HIV/AIDS. How will you prevent the new paradigm in which people require ever-newer, stronger, more expensive and more obligatory pharmaceuticals, just to have sex?
SANDERS: The government, using taxpayer funding, developed and patented the research that led to the use of the drug Truvada for PrEP in preventing HIV transmission. That drug is now being sold by the pharmaceutical giant Gilead for as much as $2,000 a month and generated $3 billion in sales for Gilead last year. This is unacceptable. Tens of thousands of individuals with HIV and AIDS are still uninsured or cannot afford their treatment. Bernie is the author of legislation that would give the federal government power to authorize generic versions of medicines if drug companies refuse to stop charging Americans higher prices than they do in other industrialized countries. And if needed, he will direct federal agencies to use Bayh-Dole march-in rights to produce these medications at reasonable cost.
We will remain on the cutting edge of innovation by funding research and instituting the Prize Fund for groundbreaking treatments. And In a Bernie Sanders administration, no one will pay more than $200 per year for prescription drugs, including PrEP once we pass Medicare for All to guarantee health care as a human right.
WILLIAMSON: First, we will reintroduce education efforts and safe sex practices that successfully reduced the spread of AIDS in the past. Then, we will work with Big Pharma to make sure that they work on developing new products that work on drug resistant HIV/AIDS are affordable to all.
9. Even with the best medical care, doctors and insurance policies, people living with HIV/AIDS continue to suffer from side-effects, immune systems that do not fully bounce back and AIDS-related dementia. Until there is a cure, how will you help people living with HIV/AIDS achieve optimal health outcomes?
SANDERS: Bernie believes it is a national disgrace that we are the only major industrialized country not to guarantee health care to all people, especially to those living with and affected by HIV. In order to ensure all people have access to affordable comprehensive health care, the United States must join every other major country on Earth and guarantee health care to all people as a right, not a privilege, through a Medicare-for-all program.
Under Medicare for All there will be no premiums, no deductibles, no co-pays and no surprise bills. Out of pocket spending on prescription drugs will be capped at $200 per year.
And he will ensure that every community has the providers and health care infrastructure needed to address this epidemic. He secured $11 billion for Community Health Centers in the Affordable Care Act, which serve 28 million patients a year in underserved communities. He also secured funding for the National Health Service Corps in the Affordable Care Act to bring more health care providers to underserved communities. As president, he will expand Community Health Centers and the National Health Service Corps so that more underserved communities can get the health care they need.
Finally, he understands that many factors outside of health care – such as housing, nutrition, access to transportation, income inequality, and more – impact an individual’s ability to get healthy and stay healthy. His entire platform is aimed at reducing all types of inequality and ending discrimination which will, in turn, help improve health outcomes for communities disproportionately impacted by HIV/AIDS.
WILLIAMSON: Today, in certain communities, there are upswings of the disease as education and ways of prevention are not discussed enough in public. Education and medical research for a cure will be central to a Williamson Administration, as well as making sure that drugs are available and affordable. Availability is a problem in many states. While the increase in the number of new cases has slowed, the new cases are disproportionately occurring in Black and Brown communities. As I said in a statement last June marking Stonewall, the Williamson administration would invest in stopping the spread of HIV/AIDS in all communities. Further, I will make sure that people living with HIV/AIDS will be fully supported in their lives to help achieve health outcomes by making sure that government works with non-governmental organizations (NGOs). I proudly co-founded Project Angel Food, a non-profit that has delivered more than 12 million meals to ill and dying homebound patients since 1989. The group was created to help people suffering from malnutrition and the many other ravages of HIV/AIDS and they have since expanded their service to any person battling critical illness.
10. President George W. Bush is credited with averting a global AIDS calamity via his administration’s plan, President’s Emergency Plan for AIDS Relief (PEPFAR). President Trump pledged to end the U.S. AIDS epidemic by 2030. Are you excited, ready, willing and able to rise to the opportunity and challenge of being the president to cure AIDS?
SANDERS: Yes. Bernie believes that we can and we must end the AIDS epidemic in the United States and abroad, and we can lead the world by developing a cure for AIDS. Bernie will invest significant federal resources and convene experts, advocates, scientists, and researchers to ensure this goal is met. The United States has before come together to achieve things once thought impossible. What we need is a grassroots political movement that will stand up to the greed of the pharmaceutical industry and take the steps necessary to ensure we end the AIDS epidemic by 2025 and ensure no person in America dies because they cannot afford medication or health care. Bernie is proud to say he will, alongside a political movement, rise to this challenge.
WILLIAMSON: Absolutely. I began working with AIDS patients before there was any hope of a cure or even any drugs to help treat the symptoms. Being able to help mobilize forces of the private and public medical research in order to find a cure for AIDS is a top priority and one of the most important things that I could do as President.
CNN transcript of Q&A with Tom Steyer during CNN’s LGBT presidential town hall:
CNN LGBT TOWN HALL QUESTION: AIDS is the gift that keeps on giving. Big pharmaceutical companies and the insurance industries profit. Truvada and similar prophylactic treatments are not a cure for AIDS. Pharmaceutical companies profit irrationally. There is no incentive for them to develop a cure because they continue to profit from people that have HIV for the rest of their lives. As president, how would you finance the science of developing a cure so that we can scale back the avarice of the pharmaceutical industry?
STEYER: James, that is right at the heart of our broken government, that question. We have a group of corporations led, really, by the drug companies who’ve bought our government. If you look at how we’re being treated under law by those companies, it is somewhere between infuriating and scary.
They charge us more than they charge any other people in the whole world, sometimes 10 times more for the same drugs. And in this case, they’re actually working to preserve long-term extremely valuable monopolies for themselves.
The way that we can go after that is by directing science through universities, through research to solve the problem. So if you look at what Mr. Trump has done, he has cut research funding across the board in every one of his different budgets. I think that’s the exact wrong thing to do.
What we should be doing in a case like trying to come up with solutions to AIDS, with cures for AIDS, is going directly to the best scientists and funding them as much as necessary, as much as conceivably effective to make sure that we solve this problem.
But it’s much bigger than that. These companies have bought the government. They are controlling what’s going on in the government. They charge us what they want. We can’t go to Canada to buy much — the same drug much cheaper. And in fact, the government is prevented legally from negotiating with them. What’s going on here is we’re going to have to break ultimately the power of these corporations to own our government and to control what happens to us.
Statement from O’Rourke campaign spokesperson:
RFTCA: AIDS is the gift that keeps on giving to pharmaceutical companies – treatment and prevention are not cures – How will you fund the science that is needed to cure AIDS?
O’ROURKE: An O’Rourke Administration will fully support research efforts by NIH and other federal agencies in the United States and throughout the world with resources needed to keep innovating and making progress towards ending the HIV epidemic. As President, Beto will continue to support programs like the Ryan White HIV/AIDS program that provides care for uninsured individuals with HIV while also working towards the promise of universal, guaranteed, high-quality health care. He will also tackle price gouging by drug companies so critical and effective treatments like PrEP are accessible and affordable to all.