This peculiar illusion of collaboration

Been off the air for the last couple of weeks, due to a lengthy visit to Perth in Australia, partly to attend the 20th Conference of the Australasian Society of HIV Medicine (ASHM). Many of the science sessions were well over my head; my colleague Tim Mackay commented that listening and watching the slides of some of these sessions was like attending a symphony concert: you don't understand it, but it sounds good.

Quote of the week: "There's more of the virus in us than us in us".

There were a surprisingly large number of sessions reporting the results of collaborative research between the big academic institutes in Australia with research organizations around the Asia-Pacific region, including in Malaysia, Cambodia and of course Thailand, where Australia cooperates with Holland in the HIV-NAT (Netherlands-Australia-Thailand) consortium. But nothing from Indonesia.

Or at least almost nothing. Only a very curious report from 2006 on side effects from first-line therapy, with participation from Malaysia and Pokdisus AIDS, the clinic operated by the Cipto Hospital in Jakarta together with the University of Indonesia Faculty of Medicine. This reported that, in the Jakarta arm, almost all of the patients were taking d4T (a really nasty drug, at least for anything over around six months). But the 'official' policy in Indonesia (unlike in Africa - luckily!) is to use AZT as the drug of first choice, with d4T reserved for cases of anaemia caused by AZT. So why were they all taking d4T?

I collared the speaker (Kate Cherry) about this, but she confirmed that this was what she was told, and that she was informed that AZT was difficult to obtain in Indonesia! Very curious!

To get back to the point. As far as I know there is no real clinical research being done around AIDS in Indonesia, certainly nothing similar to the other countries I mentioned. There are no doubt many challenges (though more than Cambodia?), but one is no doubt that the Minister of Health will not allow any samples to be sent overseas. Great if Indonesia had microbiology labs and equipment to do all the research. But it doesn't and collaboration would surely be a win-win situation, including for the patients. Oh well...

Babé