AIDS drug trial funding could run out Jan. 31

The UH program is asking the governor for $2 million in emergency money

The Hawaii AIDS clinical trials unit is trying to keep things going despite a sudden shutdown of federal funding.

The University of Hawaii unit was one of 34 supported by the National Institutes of Health, and one of 11 notified Nov. 21 that funding is being cut off Dec. 31.

Hawaii will lose $2 million a year to treat AIDS patients with new drugs.

Dr. Cecilia Shikuma, the program director at UH, recently returned from a meeting of clinical trial principal investigators in Baltimore on Dec. 4 and said, "The mood was very angry and upset."

She said she had had dinner with the principal investigator for the Los Angeles HIV Clinic, which provides anti-retroviral drugs to about 3,000 clients, about 200 of whom participate in trials of new treatments, and he was furious.

"It was very inconsiderate of the National Institutes of Health. They had patients coming to enroll in the clinical trial the day they found out they had to shut down," she said.

Los Angeles County supervisors voted to support emergency efforts to save the clinic, Shikuma said.

Even the funded sites are getting such low-level grants that the AIDS Clinical Trials Group leaders feel they won't be able to accomplish their scientific goals, she said.

The Hawaii program received NIH approval to roll over unspent funds, which should sustain the program until Jan. 31, Shikuma said. "Beyond that, we probably will not be able to do much of anything."

Without additional support after Jan. 31, she said, "We are facing closure of our clinical program that took 15 years to build," and 15 employees will be displaced.

NIH said it would provide "tail-end" funding to the units for a transition plan, but won't know how much will be available until late this month, Shikuma said. She believes the amount will fall short of what's needed for an orderly transition.

Shikuma said the unit has had overwhelming support from Hawaii's congressional delegation and from Gov. Linda Lingle.

"At this point, I believe that politically we have done all we can," she said. "We're hopeful, but we're not really sure what to expect. We're trying to look for funds everywhere we can think of."

Even if NIH decided to reinstate funding for the program, it would take months, she said.

She said Gary Ostrander, acting dean of the John A. Burns Medical School, had suggested the unit go ahead with its grant proposals for two major projects to meet deadlines Dec. 21 and Jan. 2.

The first one "is a fairly exciting grant that we're proposing to train Vietnamese researchers in critical (AIDS ) care," she said.

"We've gotten buy-in from fairly influential entities in Southeast Asia to help us do this," she said, noting that several trips had been made to Vietnam to arrange the program. "It extends the University of Hawaii's influence into Southeast Asia in a fairly big way."

The second proposal is for a research project on neurological complications of AIDS.

"Even if we're successful in both of them, the money is not going to be here until June," Shikuma said.

She wrote to the governor asking for "emergency bridging funds." She said about $1 million annually for two years would allow the program to remain viable and provide a financial base to continue HIV patient care.

Closure of the unit would leave more than 300 patients in the clinic at Leahi Hospital and at Hilo and Kona clinics without HIV specialty care, she said.