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The Honolulu Advertiser
Posted on: Thursday, December 28, 2006

AIDS clinic gets late reprieve

By Christie Wilson
Advertiser Neighbor Island Editor

The Hawai'i AIDS Clinical Trials Unit, which conducts research and provides front-line care to hundreds of HIV/AIDS patients, has gotten a temporary reprieve from a federal funding cut that would have forced it to close at year's end.

The National Institutes of Health has agreed to provide $640,000 in "bridge" funding to allow the unit to operate awhile longer, said program director Dr. Cecilia Shikuma.

Combined with leftover money from this year, the unit should be able to function for another six months, she said.

In the meantime, Shikuma and supporters are making the rounds at the Legislature in advance of next month's session to drum up backing for state funding.

"We're keeping our spirits up here," she said. "We're confident that with the layers of support we've been receiving, we will not shut down."

Shikuma's optimistic tone is decidedly different from concerns she expressed in November, when the unit was told by officials with the NIH's National Institute of Allergy and Infectious Diseases (NIAID) that it would lose $1.6 million in funding as part of a move to shut down about a dozen units that are part of a network of sites involved in pharmaceutical trials of HIV/AIDS drugs.

The decision was seen as a devastating blow to the healthcare community, as the unit is the only research program in the state dedicated exclusively to HIV/AIDS and its experts have become an invaluable resource to physicians and patients.

The unit operates within the University of Hawai'i's John A. Burns School of Medicine.

The university already submitted its proposed budget for fiscal year 2007-2008, so it was too late to include an appropriation for the AIDS unit, Shikuma said. Instead, she is talking with lawmakers about drafting a separate bill seeking financial support that could be integrated into the UH budget.


State Sen. David Ige, D-16th (Pearl City, Waimalu, 'Aiea Heights), said yesterday he believes the clinical trials unit is a worthy cause, but not only because of the direct care it provides to patients.

"Also important is the notion of participating in clinical trials so that our residents have access to cutting-edge kinds of treatment and drugs that you wouldn't be able to get otherwise," he said.

Ige, chairman of the Senate Health Committee, said it is still early in the budget process, and he is talking with UH officials to see where the AIDS unit "stacks up as a priority." While acknowledging there is always competition for funding, the senator said he will encourage his colleagues to support "this important program."

Jon Berliner of Gregory House, which runs housing programs for people with HIV/AIDS, has been accompanying Shikuma on her legislative visits. He said there are myriad benefits to keeping the clinical trials unit open.

"It's not just in cost-savings and care for people, but for UH and the medical school in training new physicians. There is a real shortage of experienced physicians, especially on the Neighbor Islands, who understand and know HIV, and the treatment changes so quickly," he said.

As former executive director of the Maui AIDS Foundation, Berliner said he knows many people who were helped by the clinical trials unit.

"(The unit) was for many people their last hope of treatment due to failing on all other approved treatments," he said.


On a different front, Shikuma said she has enlisted the support of Gov. Linda Lingle and Hawai'i's congressional delegation to lobby the NIAID to reconsider the funding withdrawal. She has not been formally notified in writing of the institute's decision, "so nothing is set in stone." Shikuma said she does not expect to hear any news on the appeal until after the holidays.

Officials at the NIAID said funding decisions for its various clinical trials units had not been finalized and they would not discuss such matters until the process is done. Shikuma suspects the Hawai'i unit was chosen for elimination because of the relatively small number of AIDS cases in the state.

At the end of 2005, there were 1,305 known AIDS cases here and at least 1,542 deaths from AIDS-related causes since 1983. There is no reporting system for HIV cases.

Shikuma said that despite its relatively small caseload, the local site has provided 34 percent of the entire number of HIV patients of Asian and Pacific island descent enrolled in national HIV/AIDS drug trials.

Since it was established 15 years ago, the Hawai'i AIDS Clinical Trials Unit has participated in 275 drug studies involving a total of 1,000 patients.

Aside from research and drug studies, the Hawai'i unit operates the Clint Spencer Clinic at Le'ahi Hospital that treats 300 to 350 patients, and Shikuma and her staff travel to the Big Island to see patients who might not otherwise be able to find or afford doctors.

Reach Christie Wilson at cwilson@honoluluadvertiser.com.