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Hannaway: I think many people see that. The knowledge of immunology has been enhanced by this research in so many ways. The other thing that I think that some people see, in the larger picture of medicine as a whole, is that people thought that the primary focus of disease research would be on chronic diseases at the end of the twentieth century. Yet here you have an infectious disease, and this changed the perception across the board of what diseases to work on and what the concentration in research was going to be. It does not mean that the chronic diseases have gone away, but you also have renewed interest in infectious diseases.
Yarchoan: We also helped make AIDS a chronic disease.
Hannaway: Yes, that is true.
Harden: But also, in one sense, there has been a sideways shift, because both infectious and chronic diseases are now studied via molecular techniques, so there is not much division anymore in the way you approach understanding it all.
Yarchoan: I think that Drs. [Harold] Varmus and [Richard] Klausner support the notion that there are a number of critical medical problems, and in addition to attacking them directly, we should focus on basic science with an eye to those problems. As you get to the more basic levels, the amount of crossfertilization that you get increases substantially. I feel the distinctions between the fields are not really so important, unless you are talking about truly applied research, and even out of that you can learn a lot of basic information if it is done well.
Harden: Is there anything else that would like to say?
Yarchoan: Just that ddI was yet another drug that was developed here, and that was also very satisfying because it induced greater immunologic changes than ddC and it was a drug that we really saw through from the very beginning, from the laboratory concept, through its preclinical development, through the Phase 1 testing. The NIH holds the patent on this drug. Then we worked with Bristol Myers, to whom it was licensed. Again, it was one of the drugs used in combination therapy that I talked about. It was very, very satisfying that ddI is probably, of the single nucleosides, the most active and, for reasons that still are not clear, works for the longest period of time. It is also, I believe, the cheapest on a patient-year basis, and thus it is more affordable for patients in Third World countries.
I am also grateful that NIH gave me the opportunity to do research on AIDS. NIH deserves the credit for putting the tools in my hands and the collaborators within reach to work together on it. And finally, this was the effort of a number of very dedicated people.
Harden: Thank you very much for the interview.
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