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Harden: Did he already think of it as an infection rather than as a toxin or something else?
Gallin: I do not know if he knew immediately it was an infection. He knew it was a mysterious illness with all these infectious diseases associated with it. He knew immediately it was in his area of research. You will have to ask him about when he thought of it as an infection. He probably told you when he first figured it out. It was very early and I was very impressed at how quickly he recognized that this illness was going to be a disaster.
Harden: For the world, yes, indeed. Now even though you were not involved directly with the early period of AIDS research, what else do you recall about other people who might have got involved with, or commented on, the illness as it became fairly clear that it was an infection and that it had the potential to be a disaster? What kinds of things were happening within the intramural laboratories besides Dr. Fauci's work?
Gallin: You mean before I was Scientific Director?
Harden: Yes, in the early years. Is there anything else you recall?
Gallin: No one else seemed to jump on the problem right away. Not those people I was talking to anyway. They were the people on the eleventh floor of Building 10. I looked at this new disease, and it was clearly not something that I was going to place a lot of work on. I do not know if Bill Paul recognized it then. If he did, he did not seem to jump on it at all. But Tony Fauci began bringing in some patients, and it became “his thing” very quickly.
People began looking for ways to study these patients as it became obvious that there was an infectious agent involved. For example, we did a relatively early collaborative project [with Dr. Fauci] describing some abnormalities of phagocyte chemotaxis in AIDS. This chemotaxis project was started by one of my fellows at the time, [Dr.] Philip [M.] Murphy, who just got tenure last month. At the time he was a clinical associate on the floor.
We also studied some patients who were getting IL-2 [interleukin-2]. Some of Dr. Steven Rosenberg's patients who were getting IL-2 for other purposes were having serious staphylococcal infections. We knew about them because we were the infectious disease consultants for the hospital. Many patients receiving IL-2 intravenously were getting staphylococcal infections. Something was wrong. We looked at the phagocytic cell functioning and picked up an abnormality in the patients on IL-2. But many of the patients had AIDS. It was not clear whether AIDS or the IL-2 caused the phagocyte abnormality, so we had to sort that out. We found that that IL-2 can cause abnormal phagocyte functions. Steve Rosenberg said he could treat the infections and was more worried about the cancer, so he was not too concerned about the IL-2 effect. It was also true that in AIDS patients there was some measurable compromise in phagocyte function.
Harden: Do you recall the various ideas relating to the etiology of AIDS? I have asked this question of many people trying to see how ideas on causes developed.
Gallin: I think everybody thought that something like a virus was causing the disease, but no one knew what it was.
Harden: Yes, until more research revealed it. When you became Scientific Director, you inherited, by my count, something like sixteen major intramural research projects in 1983 and 1984. When you walked into your office and started reviewing the intramural program of the Institute, how did you evaluate the whole thing?
Gallin: You mean with regard to AIDS?
Harden: Yes. AIDS and AIDS versus other projects. I see this as an interesting problem for an administrator. You came on in 1985 and my memory is that it was not until 1986 or later that AIDS budgets started increasing.
Gallin: Right, that is what your charts show.
Harden: Yet, as the new Scientific Director, you had multiple responsibilities.
Gallin: In 1983 and 1984, we had not begun the computerization of the budgetary process and the monitoring of the FTEs [full-time equivalents], so tracking the budget was a much more difficult process than tracking the resources today. Before he left Dr. Sell had introduced the first IBM word processing system, but it was primitive by today's standards. As a matter of fact I thought, “There is no way I am going to do this. If tracing all this information by hand is what I have to do, I am not going to survive on the job.” It was very laborious and it was not clear to me that it was working optimally. That is the kindest way I can put it. It was very difficult to see exactly how the resources were being distributed to some of these emerging areas of scientific interest.
Laboratory chiefs had been asked to provide some information that Dr. [Richard] Krause could use to raise money for AIDS research. They compiled a wish list. But very little was actually being done in the laboratories, except in Dr. Fauci's laboratory. He was the first NIAID investigator to pursue AIDS in a major way and to pursue the pathogenesis of HIV. Mal [Dr. Malcolm] Martin was just beginning to do his work on the retrovirus, and [Dr.] Bernard Moss was pursuing his studies of vaccinia. No resources then had been added, so people were redirecting their funds. But not everybody was convinced of the severity of AIDS or whether they were going to be motivated suddenly to stop what they were doing and move into this area because they thought there was both an exciting intellectual project to pursue, as well as a crying need to pursue it.
It became apparent that there was an urgent need to apply modern computer technology to the NIAID infrastructure. In collaboration with the NIAID Executive Officer, [Mr.] Michael Goldrich, and with the support of Dr. Fauci, we developed an NIAID-wide network. We developed the first local area computer network on the NIH campus and it has been wonderful. I do not think we could have handled the incredible increase in resources that the intramural program required in the mid-1980s in any kind of efficient way without that. It was an important development. [Dr.] David Wise, Alan Graeff, and a committee of interested NIAID staff deserve the credit for its development.
Subsequently, nobody could live without this system. I refer to the communications of scientists with each other and with the administrators and so on. All NIAID components, including the Rocky Mountain Laboratories, are linked together. It is unbelievable how fast it has advanced and how much better it is getting. Plus there is the linkage to all the hardware, so that all the scientists' data is now transmitted electronically, sometimes from very remote places, a topic which we can discuss in a minute. It was very fortunate that computerization technology was available with the unfolding of the AIDS crisis.
One of the big problems that I faced was that each year, in 1986 and 1987, we had to go and present to Dr. Fauci what we thought our requirements were for HIV and what kind of increases we could handle. What was so astonishing is that we always did as well or better with financial appropriations than we had anticipated, even in our wildest fantasies. Then we had to use the resources. That was not so easy. If somebody gives you millions of dollars, it is an awesome responsibility. We were not given space nor personnel initially, just dollars. That produced quite a dilemma. I could not embarrass Dr. Fauci and say we could not spend the money. What we did and what proved to be in the long run, for reasons I can tell you later, a very fortunate thing is that we started using the contract mechanism in a major way. It is a quick way to create support services and to expand the capacity of the intramural program, without requiring new space, and without acquiring personnel, which always lag behind the budget.
We set up contracts in Frederick [Maryland], and at that time we were very fortunate in that [Dr.] Norman P. Salzman was the chief of the Laboratory of the Biology of Viruses, a very important laboratory here which trained, amongst others, Drs. Bernie Moss, Mal Martin, and Michael Bishop, who subsequently won the Nobel Prize with Dr. Harold Varmus. Norm [Salzman] was at the point in his career where he was ready to contemplate retiring from NIH, but he did not want to leave science. We were very fortunate that, through a complex series of mechanisms, he decided to step out of the intramural program and apply in a competitive way for a new contract that we were setting up to grow the HIV virus from our patient populations. Salzman moved down to Georgetown University, where he became a professor of microbiology, and he received the contract. He became a critical component of [Dr.] Cliff [Clifford] Lane's (the current Clinical Director of NIAID) and Tony Fauci's programs for cultivating clinical isolates of HIV.
At the same time we had a big contract set up at the NCI cancer facility in Frederick managed by Program Resources Inc. PRI performed clinical immunology monitoring studies of our patients. The NIAID network was tied into the PRI facility rendering data management easy. Dr. Lane worked with [Dr.] Henry Masur (Clinical Center Chief of Critical Medicine) and together they interacted with Tony Fauci. Thus, the increased use of the computer in the last eight years has been a major change in the manner of doing the business of science. Currently, virtually every NIAID scientist has his/her own personal computer, which is more powerful than the big computers used to be fifteen years ago.
Harden: I think you are the first person to point this out. We forget how recently these machines came into our lives.
Gallin: Many of the institutes do not even have them yet.
Harden: I got one of NIAID's first PC's in 1985, when I was working on my Rocky Mountain spotted fever book. I had an original PC and had to install a ten megabyte hard card. At that time it seemed like more disk space than I would ever use.
Rodrigues: Who, within the institute, had the foresight to move ahead with setting up the local area computer network?
Gallin: I was very excited about the potential of computers. Michael Goldrich, who is the NIAID Executive Officer, and Tony Fauci were willing to let us do it. I was particularly excited because I had seen on the eleventh floor of the Clinical Center the computer David [W.] Alling, who was our biostatistician, had set up. He had the first Wang computer system and had us all wired together so that we could do our statistics at our desks essentially through a machine he had in his office. We thought that was very nice and that if we could do that sort of thing in a major way it would be great.
I can still remember that when I was in college a friend of mine, who was a wizard at these sorts of things, said, “One day you are going to be able to type a paper you see on a TV screen, change it, press a button, and apply it to paper.” I said, “No, that will never happen.” My college friend was right.
What we did about computers at NIAID was different, I think, from what many of the other institutes did. Instead of hiring a contractor to set us up, we did it ourselves. We were very lucky that there were a few people in our institute who knew computers. One was Jim [Dr. James A.] Dvorak, one was Tom [Dr. Thomas M.] Chused, and there were several others. David Wise, in Mike Goldrich's group, became the leader of the program. We assembled a committee of those who wanted to become users and said, “What do you want?” Then we were very lucky, to find a very talented young fellow who made it work. That was Alan S. Graeff, a technician in [Dr.] Warren Stroeber's laboratory at the time. He was not happy with what he was doing in the laboratory, as he was really a “computer jock.” But he knew and appreciated the requirements of scientists. He came in, worked twenty-four hours a day, and made it happen.
The reason it happened was because there was the NIAID administrative/financial support from Mike Goldrich and Tony Fauci. There was a committee that spent about a year designing what they thought we needed, and they were correct on most of the things; and then there was someone to implement it. David Wise oversees the entire system while Al Graeff now runs the system for the Division of Intramural Research and has assisted other NIH components to set up their systems. AIDS resources helped to bring about the network at NIAID and indirectly at NIH. That is one example of the huge impact of AIDS on NIH.
Harden: Can you think of any other things like the computer that had an impact on NIAID's AIDS research?
Gallin: I think the effects of computerization, which I could go on and on about, ranging from e-mail to documents, had the most important managerial impact. All our personnel, procurement, technology transfer papers are now handled through the computer.
Prior to NIAID's computerization, the Clinical Center, through the then Director of the Clinical Center, Dr. Philip Gordon, and later Drs. Griff T. Ross, and Mortimer Lipsett in the 1970s to 1980s, also envisioned the importance of computerization. They brought the Medical Information System [MIS], to the Clinical Center.
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