Journal Republishes the 1996 Landmark Report That Set the Research Strategy for HIV/AIDS
Document Provided Impetus to Establish the Forum for Collaborative HIV Research
WASHINGTON, DC (August 17, 2011) - The coordinated approach to accelerating medical discovery in HIV/AIDS began 15 years ago with a White House initiative called the Keystone National Policy Dialogue on the Establishment of Studies to Optimize Medical Management
of HIV Infection. Now, the independent public-private partnership formed in response to this effort -- the Forum for Collaborative HIV Research -- is
re-releasing the landmark report that set the research strategy for scientific advancement in
HIV/AIDS, co-infection and universal HIV testing.
Published in The Annals of the Forum for Collaborative HIV Research, the August 2, 1996 report of the Keystone National
Policy Dialogue on the Establishment of Studies to Optimize Medical Management of HIV Infection reflected the possibility that biomedical
research and effective public policy can fundamentally change HIV into a chronic, manageable disease and to alter the course of the
epidemic by reducing the transmission of the virus. However, the report made plain that meeting this goal would require an
"unprecedented collaboration" among the many constituencies involved in HIV/AIDS research and therefore, called for the
establishment of the Forum for Collaborative HIV Research, which today is the foremost institution taking up the
challenges presented by the HIV epidemic to move the science of treatment, prevention and care forward.
"Fifteen years after the participants of the Keystone Dialogue Group charted the nation's course for
accelerating medical discovery on HIV/AIDS, more than 33 million people with HIV are benefitting from the significant advances that
are directly linked to the actions envisioned by this report," said Veronica Miller, Ph.D., Director of the Forum for Collaborative
HIV Research. "The tremendous progress achieved since 1996 can be directly attributed to the recognition of the 48 members of the
Keystone Group that accelerating HIV/AIDS research and public policy requires shared agreement and a unity of purpose among all
stakeholders. This is the enduring legacy of the Keystone report."
Reflecting on the impact of the Keystone report, Dr. Miller credits this policy document with defining the
nation's goals for optimizing medical management of HIV infection and changing the way clinical trials are now conducted on HIV
therapies. Moreover, by paving the way for the establishment of the Forum for Collaborative HIV Research in 1997, the report
set the stage for a number of important accomplishments in advancing the research agenda. Some of the Forum's most
important achievements to date include: identifying clinical endpoints for immune-based therapy; developing
clinical trial designs for heavily-treatment experienced patients; bridging the HIV and TB research
communities; identifying gender, racial and ethnic issues in prevention and treatment; addressing
pediatric HIV diagnosis and laboratory monitoring; and encouraging routine testing for HIV as
an important component for individual health and prevention.
But beyond accelerating the science on HIV/AIDS, the Forum also credits the Keystone report with laying the foundation for
assessing the factors affecting access to available therapies for HIV, including the duration of clinical effectiveness of specific
antiretroviral agents, costs, and quality of life measures to ensure that physicians and patients do not overuse, underuse, or
misuse available treatments, limiting their utility in achieving significant public health benefits.
"At a time when cost considerations are driving the health policy debate, it is important to realize that many of the
barriers to improved access to effective treatments were predicted 15 years ago, when the members of the Keystone Dialogue Group
cautioned about the tremendous pressure on payers and publicly funded programs to decrease coverage and payment levels for HIV
therapies," said John G. Bartlett, MD the Forum's Executive Committee Co-Chair. "Re-reading the report now should remind
policymakers that accelerating the delivery of new classes of HIV drugs is not an end in itself but must be accompanied by
an open debate about access to new therapies and more comprehensive information about the long-term effectiveness and
consequences of using these therapies in various combinations."
Looking to the future, Dr. Miller said the Keystone report provides the roadmap for improving the prevention, diagnosis, treatment and
care of people living with all chronic infections or co-infections. Accordingly, Dr. Miller reported the decision to expand the Forum's
mission to focus to advance the research agenda in TB/HIV co-infection and the hepatitis C virus (HCV). Immediate priorities for the
Forum include setting global standards for new clinical trials in HIV and for monitoring long-term drug toxicity, addressing HCV drug
resistance and setting the standard for clinical trial designs to establish efficacy for new anti-HCV compounds.
At the same time, the Forum will be working with government and foundation partners to implement research projects that
address emerging and complex scientific issues that have stalled research on HIV prevention and treatment. These initiatives include
evaluating the use of novel reproductive technology so couples with HIV can have biological children, initiating research on the
interrelationship of autoimmune disease and HIV immune reconstitution, and publishing a series of reports on antivirals that act
against HCV, pre-exposure prophylaxis to prevent HIV transmission, cardiovascular implications of HIV infection and
sustainable international pharmacovigilance.
"The Keystone report demonstrates that we can change the course of HIV in this country," Dr. Miller
explained. "Applying Keystone's consensus-driven strategic process, we now have a roadmap to advance the research agenda
in HIV and other chronic infections as never before."
The Annals of the Forum for Collaborative HIV Research is a peer-reviewed journal published by the Forum for
Collaborative HIV Research that disseminates consensus reports and proceedings, recommendations and opinions addressing current
topics in HIV/AIDS prevention, treatment and care. The 1996 Keystone Dialogue Group report is available online at:
About the Forum for Collaborative HIV Research
Now part of the University of California (UC), Berkeley School of Public Health and based in Washington, DC, the Forum was
founded in 1997 as the outgrowth of the Keystone Center's report "The Keystone National Policy Dialogue on Establishment
of Studies to Optimize Medical Management of HIV Infection," which called for an ongoing collaboration among
stakeholders to address emerging issues in HIV/AIDS and set the research strategy. Representing government,
industry, patient advocates, healthcare providers, foundations and academia, the Forum is a
public/private partnership that is guided by an Executive Committee that sets the
research agenda. The Forum organizes roundtables and issues reports on a range
of global HIV/AIDS issues, including treatment-related toxicities, immune-based
therapies, health services research, co-infections, prevention, and the transference
of research results into care. Forum recommendations have changed the ways that clinical
trials are conducted, accelerated the delivery of new classes of drugs, heightened awareness of
TB/HIV co-infection, and helped to spur national momentum toward universal testing for
HIV. http:// www.hivforum.org.
Source: Forum for Collaborative HIV Research