Gates Foundation plans dumb d4T trial

[newt]

Very reasoned letter why it's dumb here:

http://www.treatmentactiongroup.org/hiv/2011/lowdose-stavudine-trial

concludes: " For the reasons outlined above, research and the resources it requires [...] should focus on increasing access to safer cost-saving alternatives to stavudine, not on seeking a comeback for a drug virtually abandoned in rich countries."

Trevor.Mundel@gatesfoundation.org might be the email address of the Foundation's President, Global Health Program

(edited for spelling)

[buginme2]

Who is conducting this trial and why?  I read the letter and no where in the letter does it state who the researcher is or why it is being done.

The Gates Foundation does not conduct any research. They give out monetary grants to researchers.  There seems to be more to this story.

[newt]

Gates is planning to fund it and it was their idea I believe. No funding, no trial.

- matt

[Tim Horn]

Who is conducting this trial and why?  I read the letter and no where in the letter does it state who the researcher is or why it is being done.

The Gates Foundation does not conduct any research. They give out monetary grants to researchers.  There seems to be more to this story.

Excellent questions. Though I have very little to base this on, I'm wondering if it has to do with keeping tenofovir out of reach therapeutically in resource-poor areas, in anticipation of its potential use for PrEP. After all, with tenofovir use therapeutically comes the risk of drug-resistant variants emerging, which could potentially decrease tenofovir-based PrEP efficacy.

Edited to add: What's really curious is that Gates, for the most part, has been primarily interested in prevention-based research. The fact that it's funding this particular treatment trial seems strange.

[Ann]

d4T? What, are they crazy? They want to study a drug KNOWN to cause PN? It's a criminal waste of money, if you ask me.

[newt]

hmmm, the restaurants of Redmond are a long way from the backstreets of Kampala, or even Washington DC.

If it is a prevention preservation strategy it's dumb. Effective combo is the best bang for buck prevention wise with ARVs and it works now (not to mention keeping people well and families functional). Saving tenofovir for modestly effective PrEP is, apart from the logistical challenges, how shall I say, like a US President borrowing one of Lady Gaga's wigs cos he want to make an impression. I know the wig dynamic might change if Mrs Clinton ever gets in, but d4T will still be a poisonous drug.

- matt