On March 31, 1987, the White House made a major announcement. President Ronald Reagan and French prime minister Jacques Chirac confirmed an agreement to end what The New York Times described as a “bitter dispute” between France and the United States over who had discovered the human immunodeficiency virus (HIV). According to the terms of this new-found understanding, the financial rights to the patented HIV screening blood tests were to be shared on both sides of the Atlantic. A large amount of this money was invested in a new research organization, the French and American AIDS Foundation.
The two men involved in this scientific and political controversy were Professor Luc Montagnier, who passed away last February, and Professor Robert Gallo. Or rather, two teams from two institutions: the Institut Pasteur in Paris and the National Cancer Institute, which reports to the National Institutes of Health in Bethesda, Maryland. “The French and the Americans initially cooperated with each other,” says Yves Pommier. This French researcher has worked at the NIH since 1981, and actively contributed to the fight against AIDS. “Working together to find the agent responsible for these illnesses was very exciting. The French had well-isolated samples, while Robert Gallo had decisive experience in retroviruses and was backed by the resources of the U.S. research sector. A relationship of scientific exchanges and shared material – true collaboration – soon developed. But things turned sour when each party wanted to take all the credit. Financial interests then came into play, and the quarrel went beyond the researchers themselves.”
The announcement by the White House did not put an end to the controversy. It was not until 1994 that a new financial agreement was concluded between France and the United States. However, that wasn’t even the most important aspect. Harold Varmus, the director of the NIH, admitted the same year that the blood screening test patented by Robert Gallo was designed using the virus discovered by Luc Montagnier’s teams at the Institut Pasteur.
The Warning Signs of a Pandemic
To understand this antiviral investigation conducted under the growing pressure of countless deaths, we must go back to 1981. Back to the facts, much like in Anthony Passeron’s novel Les Enfants endormis, published in France last August. In every other chapter, the author uses cross-cuts, in the cinematic sense of the term, to tell the story of his uncle Désiré, who died from an AIDS-related illness in 1987, and the progress of research into the virus responsible for the pandemic. Adopting a sharp style without writing clinically, he describes how AIDS destroyed families in the rural areas around Nice, far from the gay and artistic worlds of major international cities. Closer to André Techiné’s movie The Witnesses (2007) than to Tony Kushner’s play Angels in America (1991), Les Enfants endormis is reminiscent of Indignation by Philip Roth (2008) in its way of connecting family tragedy with the course of history.
The world changed after a simple report was published by the Centers for Disease Control and Prevention on June 5, 1981. Doctor Willy Rozenbaum, at the Claude-Bernard Hospital in Paris, received the following information: Five homosexual American patients were suffering from pneumocystis pneumonia. This was an incredibly rare infection, and its reappearance was incomprehensible. One of Dr. Rozenbaum’s patients, a young gay flight attendant, came to see him the same day, with the same symptoms. Jacques Leibowitch, an immunologist at Raymond-Poincaré Hospital in Garches, west of Paris, was also shocked to see reports of Kaposi’s sarcoma, a rare skin cancer, and pneumocystis in France and the United States. With a small group of doctors, including virologist Françoise Brun-Vézinet, they alerted the health authorities, who refused to listen.
In early 1982, Libération spoke with Willy Rozenbaum and became the first French newspaper to write about the “mysterious malady of American homosexuals.” A small number of doctors soon launched the Groupe Français de Travail sur le Sida (the French AIDS Working Group). This new generation of politicized researchers in their forties wanted to focus on a stigmatizing syndrome that mostly affected gay people, prostitutes, drug addicts, and hemophiliacs. The scientists believed that a retrovirus could be what was causing these cancers and pneumopathies. They contacted American specialist Robert Gallo, who had previously identified the first human retrovirus, HTLV-1 (human T-cell leukemia virus), linked to leukemia and lymphoma.
Cutting-Edge French Research
Meanwhile, the Institut Pasteur had developed efficient techniques for isolating viruses. In December 1982, Willy Rozenbaum, Françoise Brun-Vézinet, and Pasteur researchers Jean-Claude Chermann, Françoise Barré-Sinoussi, and Luc Montagnier devised a strategy for targeting whatever was destroying the patients’ immune systems. On January 3, 1983, Rozenbaum took a tissue sample and sent it by taxi to the Institut Pasteur. “In this modest convoy, kept in an ice box and carried through the chaotic traffic of the French capital,” writes Anthony Passeron, “was perhaps the culprit behind one of the deadliest epidemics of the end of the century.”
“Given the size of France and its former colonies, cases of AIDS appeared in very different regions that were or had once been French,” says Yves Pommier. “The Institut Pasteur had people there, and the highly organized research system made it extremely effective. The French had a head start, which was good. The Americans wanted to see if they reached the same conclusions; it was therefore logical to collaborate.” French samples were regularly sent to Robert Gallo at the NIH for analysis. The renowned American researcher cooperated gladly with unknown French doctors. He invited Luc Montagnier to his home and his laboratory. The two stood on the same stages and shared their findings as a team.
In May 1983, the U.S. journal Science announced a French breakthrough: Barré-Sinoussi, Chermann, and Montagnier had successfully identified a virus, which they named LAV (lymphadenopathy associated virus). The Institut Pasteur was not yet able to prove the connection between the new, deadly virus and AIDS, but the finding dealt a major blow to Robert Gallo’s prestige and ego.
American Researchers at an Impasse
“The American professor refused to consider that the virus responsible for AIDS could be truly different from HTLV, the first human retrovirus, which he had discovered in 1981,” writes Anthony Passeron. “What Robert Gallo did not yet know was that the patient on whom he had based all his findings was doubly infected – by HTLV, yes […], but also by the AIDS virus. This sad twist of fate trapped the scientist in a research rut – and kept a large swath of the international community there with him.”
For a long time, Robert Gallo was convinced that the French doctors had been clumsy and accidentally contaminated their samples. He persisted and published a series of articles in Science, announcing the discovery of a retrovirus called HTLV-3B. One of the photographs illustrating his research, based on the samples from Paris, was an image of the LAV taken the previous year under the microscopes of the Institut Pasteur! Two weeks earlier, in April 1984, Margaret Heckler, the United States Secretary of Health and Human Services, wrongly declared that America had identified the virus responsible for AIDS.
The dispute broke out in 1985. The Institut Pasteur, with the support of the French government, patented its screening test and sued its American competitor for patenting its own screening test developed by Abbott Laboratories. The French claimed that they deserved credit for identifying the virus, that LAV and HTLV-3B were the same thing, and that they should therefore receive more than half of the financial rights to these tests worldwide. The reply from the American legal team was scathing: “Pasteur’s claim that the two viruses were the same is akin to saying that ‘because John Wilkes Booth and Abraham Lincoln were both people, they were identical.’”
In 1994, the U.S. government finally admitted that HTLV-3B and LAV were the same virus, which was renamed HIV. In his report, the inspector for the United States Department of Health and Human Services brushed aside the defense put forward by Robert Gallo’s team: “The claim that 3B was contaminated by LAV comes into question since there appears to be no evidence there ever was a 3B to be contaminated.” In the name of research, the American scientist agreed to bury the hatchet: “It is now time for this episode to be permanently closed,” he said. “Pasteur scientists and I should focus all our energies on seeking a cure for AIDS.”
An Eventually Joint Effort
The failures, hopes, and therapeutic false leads stacked up for several long years, including HPA-23, cyclosporine, the HIV 87 trial, and AZT. The different approaches saw patients’ disease states alleviate before worsening, but the researchers remained determined. At the NIH, Dr. Anthony Fauci revolutionized clinical trials by widening access to experimental treatments. This was followed by a tritherapy experiment carried out in France by Jacques Leibowitch and in the United States. “It is hard to believe,” writes Anthony Passeron. “And yet, the results from the first tests are clear: Despite the intensity of the treatment, all patients have shown a spectacular drop in viral load. Finally.”
Yves Pommier discovered the first HIV integrase inhibitors, which block the multiplication of the virus, in 1993. Treatments were majorly adjusted as a result. In 2008, Françoise Barré-Sinoussi and Luc Montagnier received the Nobel Prize for Medicine for their discovery of the AIDS retrovirus in 1983. This award was seen by some as too little, too late, and failed to acknowledge the contribution of many French and American scientists. “I don’t understand why Robert Gallo was penalized,” says Yves Pommier. “Perhaps he gave the impression of having cheated the system in other fields. However, in scientific terms, his contribution is clear. The Nobel could also have been given to other French researchers alongside Montagnier – he was the lab director. Historically speaking, this Nobel is something of a failure…”
Thanks to antiretroviral treatment, people can now have HIV without developing AIDS, while also presenting less infection risk to their partners. The virus and what we have learned about it have been back under the microscope since the Covid-19 crisis, which rebooted the old rivalry between France and the United States. “Competition is always a good thing,” says Yves Pommier. “Without it, humans don’t have the same energy. We just have to respect the rules and play fairly.”