Why this matters: It is no accident that upwards of 97.8% of current drug development efforts and other clinical research for HIV/AIDS focus exclusively on bringing to market the same type of therapies over and over again—entry and integrase inhibitors among them. For the most part, development of these antiviral medicines involves small research costs and yields huge profit margins. [And for people living with HIV -- especially those with advanced, oftentimes drug resistant virus, commonly referred to as "failing" on currently available therapies, it is instead the pampered Key Opinion Leaders ('KOLs') who are resistant: resistant to new ideas, resistant to therapeutic approaches inimical to the craven hunger of Big Pharma, resistant to reforming a corrupt, self-serving system of flattery, bribes & kick-backs. It is not you who are failing; it is a system and a usurious clinical myopia that is failing you. A little creative engagement -- thinking outside the cushy Big Pharma box -- could very likely keep you alive, lead to improved health, and maybe even help you to evolve to a place in your HIV treatment where you can actually do better on fewer drugs. But this is unlikely to happen under the current system of leadership and incentives.] Although there are a few antiretroviral drugs in development aimed at new viral targets, a treatment model based solely on maximal viral suppression guarantees that HIV-infected persons will need to take these powerful and expensive medicines nonstop for life. The generous and widespread drug company contributions to AIDS researchers, academic institutions, governmental clinical trials networks, patient advocacy and education organizations also see to it that the profits-before-public-health agenda of Big Pharma proceeds largely unexamined. Since 1996, newly licensed AIDS drugs have been nothing but knock off variants of already existing drugs: the ubiquitous "me-toos." For the most part, they are not substantively different from the older, better characterized medicines except that they garner new patent protection and can therefore command a higher price. And all this recent hoopla over the integrase inhibitors simply evokes a sense of déjà vu all over again. Been there, done that. We heard it about the NNRTIs. Heard it about the proteases. More recently, folks were all agog over he CCR-5 antagonists. (And look how quickly their fate was sealed.) It's all a scheme to keep us on that antiretroviral hamster wheel, with each 'revolutionary' advance grabbing a bigger share of the formulary budget. It's not about helping patients, it's about assuring steady profit growth for Big Pharma. After all, there's no money to be made in a cure. Because the world of AIDS research is dominated by a small clique of powerful individuals (mostly old white men), all of whom serve behind-the-scenes as private consultants and advisors to the pharmaceutical industry, less pharma intensive approaches to treating this disease are seldom given a fair chance or a prominent place in academic discussions. Less drug intensive approaches, such as cycles on and off antiretroviral therapy or induction-maintenance strategies, would cost the pharmaceutical industry billions of dollars in lost sales and are skillfully marginalized. (Check out reports by the market research firms IMS Health and DataMonitor -- although the reports typically go for $12,000+ a pop -- for detailed analysis.) Similarly, exciting new discoveries about how the human body might "learn" to control the infection on its own, given the proper conditions, are also starved for funding, dismissed in all but 1-2 medical journals controlled by this AIDS cabal, and passed over by scientific program committees for the major AIDS conferences in favor of the marketing oriented presentations underwritten (and oftentimes ghost written) by the large pharmaceutical companies and their public relations and “med ed” surrogates. While it is possible that some of these treatment biases stem from an aggressive, oncologically-based ideology on the part of members of this AIDS plutocracy, the sheer scale of the financial ties with the pharmaceutical industry for all but a tiny minority of these key AIDS opinion leaders and committee heads is worrisome if not alarming. This website, along with folks at the Center for Science in the Public Interest and the newly formed THAMES• Project (Transparency in HIV Authorship, Medical Education and Scientific Investigation), believes that these serious conflicts of interest need to be made public -- and eventually reined in. Shillfactor.net and shillfactor.org are uniquely dedicated to bringing these issues to light. The Center for Science in the Public Interest and the THAMES• Project will continue to focus on making such transparency mandatory, standardizing reporting requirements across all major medical journals, conferences and CME programs, and eventually requiring quantification of dollar amounts and number of hours spent consulting for or colluding with the marketing departments of the large pharmaceutical companies. Any comments or suggestions on behalf of the concerned public are always welcome. Project THAMES* Transparency in HIV Authorship, Medical Education and Scientific Investigation 148 West 23rd Street Suite 10H New York, NY 10011