[Congressional Record (Bound Edition), Volume 152 (2006), Part 11]
[Senate]
[Pages 14435-14436]
[From the U.S. Government Publishing Office, www.gpo.gov]




                          MEDICAL BREAKTHROUGH

  Mr. FRIST. Mr. President, let me comment on one other issue before 
yielding the floor. It has to do with medicine again. It has to do with 
an issue which is very close to my heart, which I first saw in 1981 
before I ever thought about getting into politics or public policy or 
running for the Senate. I first saw this particular issue in the early 
1980s. Nobody had seen it in this country until 1981. Nobody had seen 
it before 1981, which is not that long ago, 25 years ago, but since 
that time, it killed 1 person, 3 people, 10 people, 1,000 people, 1 
million people, 5 million people, 10 million people, 20 million 
people--25 million people have died since I first saw it; that is, HIV/
AIDS, a tiny virus. You can't see it, touch it, taste it. We didn't 
have it in America. We

[[Page 14436]]

didn't know what it was, and then it hit. Now 25 years later, 25 
million people around the globe have died from that little, tiny virus. 
We don't have a cure for it yet. We don't have a vaccine for it yet, 
but we have made huge medical progress over the last 10 years.
  Two days ago, the FDA announced that they had approved the world's 
first single-pill, once-a-day HIV/AIDS treatment. The bill combines 
three FDA-approved drugs into a single dose. The impact on HIV/AIDS 
patients will be profound.
  It wasn't that long ago that patients had to take 20 pills a day and 
then 10 pills a day to control the virus, this little tiny virus, not 
to get rid of it totally but to keep it down so it doesn't have its 
ravaging impact on the human body. Some pills you have to take with 
food, some at 8 o'clock, some at 2 o'clock, some at 6 o'clock, some at 
10 o'clock. Some people say it is not that big a deal; it is 
lifesaving. It is a big deal. If you are a patient having to do it or a 
physician taking care of a patient, it is impossible to comply with 
that regimen long term. It is inconvenient, it disrupts life, and now 
it is combined into one pill.
  By the end of next week, people will be able to control the virus 
with one pill. Not everybody is going to switch to it, but it opens up 
huge opportunities.
  It is good news not just in that it simplifies the prescription 
regimen of HIV/AIDS patients, but to quote a fellow doctor who is the 
current Acting Commissioner of the FDA, Andrew von Eschenbach:

       Compliance with therapy is as important as the therapy 
     itself for a successful outcome.

  To have a successful outcome, HIV/AIDS patients have to take at least 
95 percent of their pills or the treatment doesn't take. It isn't as if 
you can take 2 or 3 of the 15 pills and it will work. You have to 
really take just about all the pills. Only one pill a day increases the 
likelihood of a patient meeting that threshold. That one pill will do 
the trick. Not only does improved compliance keep HIV/AIDS patients 
healthy, but it helps slow down that emergence and transmission of 
strains of virus that have become drug-resistant. The drugs you take 
over a period of time--the virus is smart, it is cagey, it moves 
around, and it will develop resistance to those drugs as it comes in. 
As it gets accustomed to the drugs, the virus will change.
  Scientists hail this as a medical breakthrough for good reason. 
Wednesday's announcement approving the new pill was timely. Yesterday, 
the CSIS Task Force on HIV/AIDS hosted a conference to examine the 
sustainability of United States-led efforts in combating the virus. I 
have cochaired the CSIS task force along with my colleague, Senator 
Russ Feingold. I had the opportunity, as did Senator Feingold, to 
deliver opening remarks to that conference.
  Looking back over the 25 years, as we did yesterday, I recalled the 
same story I just told: 25 million people have died on our watch, over 
my lifetime as a physician. As recently as 5 years ago, less than $1 
billion was spent by the world. If we put together all the world's 
resources, today it is more than eight times that--eight times that--in 
just 5 years.
  Today about 40 million people worldwide, including a million people 
in this country--a million Americans--are HIV positive. That means they 
have the virus in them, and it can be detected. Over half of all people 
living with HIV/AIDS or HIV in the world live in a continent I go to 
every year, and that is the continent of Africa.
  Ten years ago, in 1996, I went to Sub-Saharan Africa to Tanzania, to 
Kenya, in that whole central eastern region of Africa where I do 
medical mission work. That became an annual trip after 1996. Nothing 
quite prepares you for walking through a village in an AIDS-afflicted 
part of Africa. You see older people, and then you see very young 
people, but you don't see--there is like a big doughnut hole there--you 
don't see middle-aged people walking around. Why? Because that virus 
has ravaged traditionally the most productive part of society. They 
include teachers, police, law enforcement, wage earners, the people who 
are out moving, herding the animals, the people who are out growing the 
crops, the people who make up the strongest and most productive fabric 
of society.
  The deadly disease has left countless children as orphans. It has 
disrupted the social framework of many communities. It has challenged 
the infrastructure and stability of many nations in ways that are 
totally unprecedented and we just haven't seen in history.
  I outlined my vision at the conference yesterday for sustaining 
momentum and winning this war on HIV/AIDS, and already, with the 
successful development and approval of this single-pill therapy, we 
have seen how one piece of the vision that I put out yesterday--unity--
is reaching across differences and we can reshape our approach to HIV/
AIDS.
  The breakthrough this week was made possible because of 
collaboration, partnership, a very unusual partnership, a collaborative 
venture by two drug companies that normally are competing. So that is a 
breakthrough that may not be readily apparent, but those of us who 
follow health, the pharmaceutical industry, and public health, this is 
a huge breakthrough.
  Two drug companies set aside their competition, they set aside their 
concerns about the bottom line to work together and do what we need to 
do throughout health care, which we don't do today. As we look to 
health care 20 years from now, we have to do it, and that is put the 
patient at the center, put the patient first. That is what these two 
drug companies did yesterday.
  I commend the makers of this single-pill therapy. I hope this does 
start a new trend. I think the computer industry learned this 
collaborative effort a long time ago, and I am pleased that the 
pharmaceutical industry is catching on to it, as demonstrated today.
  I will close with that final thought because it does remind me how 
important it is to put the patient first. They did this yesterday by 
developing this pill, having the FDA to approve this particular pill. 
We need to do that throughout our health care system. We do have a 
health care system that is chaotic, in terms of its organization. It is 
not really even a system; it is more of a sector.
  If we can go back to that principle of putting the patient first, 
putting the patient in the center, we can weed out the waste and weed 
out the inefficiency and lower the cost and make a very optimistic 
future for our health care system.

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