scientists, with the focus on the science itself rather than on public policy issues associated with the management or conduct of science. 32

Because data on AIDS changed so quickly, the conference report was less valuable than the conference itself, even though the steering committee did prepare a short summary with some preliminary conclusions. Much of this summary contained what to nonscientists was an impenetrable description of HIV infection. Part, however, focused on the more accessible, and very important, issue of the conduct of clinical trials. A majority of conference participants felt that tests on humans should not be done until there was evidence of "protective efficacy from animal tests." The steering committee recommended that a vaccine should proceed to clinical trials only after it had been shown to be effective in chimpanzees, macaques, or some other suitable laboratory animal, unless the vaccine's design was based "on a fundamental new understanding of relevant human immune responses that cannot be adequately modeled on animals." In all likelihood, such clinical trials lay far in the future. ''Experimental evidence has not yet justified any hope for an effective vaccine in the next few years,'' the steering committee concluded.33

Toward the 1988 Report

By the time the conference on vaccine development took place in December 1987, the AIDS Oversight Committee had begun to meet. Samuel Thier selected Theodore Cooper to head the eight-person committee. An M.D.-Ph.D. with a background in cardiovascular surgery and a major figure at the IOM for a long time, Cooper had served as director of the National Heart and Lung Institute in the late 1960s and 1970s, before becoming an Assistant Secretary for Health in the Ford administration and then the provost for health affairs at Cornell. In the fall of 1987, Cooper held the positions of vice president and vice chairman of the board of the Upjohn pharmaceutical company. Joining Cooper on the committee were David Baltimore, Howard Temin, political scientist and Rockefeller Foundation official Kenneth Prewitt, Oregon State Health Division administrator Kristine Gebbie, international health expert Donald Hopkins, AIDS health care authority Paul Volberding, and Stuart Altman, an economist with expertise in health financing. With the exception of Baltimore and Temin, who respected but often disagreed with one another, each committee member had a well-demarcated area of expertise that gave him or her a distinctive niche and enabled committee members to work effectively with one another.34



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