by Bruce Nussbaum
This book’s subtitle, How Big Business and the Medical Establishment Are Corrupting the Fight Against AIDS, both clarifies and over-simplifies the points it makes.
Yes, this is a meticulously researched chronicle of what the federal government, its drug-developing agencies and the big pharmaceutical companies have done (and not done) to find anti-AIDS drugs, but it is also much more. Clearly the work of a seasoned reporter (Nussbaum is a senior writer at Business Week), Good Intentions develops characters, plots and subplots as carefully and with as much detail as the best novel. Nussbaum’s book is at least as much about the power plays, arrogance, fear and greed that motivate its players as about the details of AIDS research itself.
Any in-depth study of the decade-long epidemic will necessarily overlap with other books on the subject, notably Randy Shilts’s And the Band Played On. Yet while Nussbaum occasionally uses the same sources and explores the same topics, his focus is more clearly on such people as Dr. David Barry, the “puppet master” of the giant drug company Burroughs Wellcome, producer of the only approved anti-AIDS virus drug, AZT; Sam Broder, the zealous scientist who, Nussbaum says, colluded with Burroughs Wellcome to “wrap his career around AZT”; and Dr. Joseph Sonnabend, one of the first community physicians to experiment with AIDS treatments.
The resulting drama of how these and other AIDS activists have interacted provides fascinating glimpses into the big business that is medicine in this country.
There are flaws in Good Intentions. Some passages about drugs are too technical; the bureaucratic twists and turns can be difficult to follow. Occasionally the chronology gets confusing. But for those who wonder why the billions spent by the finest scientists have yielded only one “mediocre” AIDS drug in 10 years—and for anyone concerned with the way bureaucracies can impede the very processes they’re supposed to facilitate—Good Intentions is a must read. (Atlantic Monthly, $22.95)