An experimental HIV vaccine developed by scientists at Scripps Research and the nonprofit vaccine research organization IAVI has reached an important milestone by eliciting antibodies that can neutralize a wide variety of HIV strains.

The tests, in rabbits, showed that these “broadly neutralizing” antibodies, or bnAbs, targeted at least two critical sites on the virus. Researchers widely assume that a vaccine must elicit bnAbs to multiple sites on HIV if it is to provide robust protection against this ever-changing virus.

The promising results, which appear in Immunity, suggest that researchers are one step closer to developing an effective HIV vaccine—a major goal of medical science ever since the virus was identified in 1983.

“It’s an initial proof of principle but an important one, and we’re now working to optimize this vaccine design,” says the study’s senior author Richard Wyatt, Ph.D., a professor in the Department of Immunology and Microbiology at Scripps Research.

According to UNAIDS, about 35 million people worldwide have died of the immunodeficiency syndrome, AIDS, which is caused by HIV infection. About 38 million others are now living with HIV infection. Antiviral drugs can keep HIV-infected people alive and reduce their ability to transmit the virus to others, but these drugs do not clear the infection and must be taken indefinitely. Researchers have long recognized that a preventive vaccine, available at a low cost to uninfected people, will be needed to eliminate HIV as a major public health threat.

HIV’s rapid mutation rate and other mechanisms for evading immune attack have made it an extremely difficult target for vaccine designers. But the test conducted by Wyatt and his team confirms that vaccination can elicit the kinds of antibodies that are needed to provide broad protection against HIV. These bnAbs, as vaccine experts call them, can neutralize multiple HIV strains because they bind to critical sites on the virus that do not vary much from strain to strain. People who are infected with HIV sometimes produce bnAbs as part of their antibody response, but infrequently and usually after infection has been long established. The chief challenge for HIV vaccine designers has been to find ways to stimulate the immune system—in most or all individuals—into making bnAbs that hit multiple vulnerable sites on the virus, in order to protect against a high proportion of HIV strains.

At the heart of the vaccine design by Wyatt and colleagues is a virus-mimicking protein based on HIV’s “Env” protein. Normally, multiple copies of bush-like Env proteins are spread out on the surface of each spherical HIV particle. Each Env protein contains a molecular mechanism that allows it to bind to a receptor on immune cells known as CD4, and use that receptor as a portal to break into the cell. The researchers engineered a version of Env that models the essential structures on the real Env while being stable enough to use as a vaccine. To present it in a way that would resemble a real HIV virus particle, they created virus-sized synthetic spheres of fat-related molecules, “liposomes,” which are studded densely with the engineered Env proteins.

On a natural HIV Env protein, thickets of sugar-related molecules called glycans normally help shield the all-important CD4 binding site from immune attack. As an initial “priming” immunization, the researchers used versions of Env in which this glycan shield around the CD4 binding site had been partly removed.

“The idea was to better expose this site and thereby stimulate a broad antibody reaction to it at the start,” Wyatt says.

Subsequent booster immunizations over 48 weeks used Env proteins with restored glycans, to select for antibodies that target the CD4 binding site but can also get through this shield. The Env proteins in the booster shots also were mixes based on different strains of HIV, to generally promote antibody responses against Env structures that do not vary among these strains.

The team inoculated 12 rabbits following their vaccine strategy and compared the results with a control group that received only a single, glycan-shielded version of Env. They found that their vaccine strategy had a much better response, with five of the rabbits developing antibodies that could neutralize multiple HIV isolates.

The researchers analyzed the antibodies of the rabbit that had responded most strongly, and identified two distinct types of bnAb. One, which they called E70, blocks the CD4 binding site as expected, though in an unusual way—partly by grabbing one of the shielding glycans. The other, 1C2, hits a different but well known vulnerable spot on Env, at the interface between two key segments of the complex protein. The binding of antibody 1C2 apparently destabilizes Env so that it can no longer mediate HIV’s entry into host cells. That antibody also turned out to have an unusual breadth of neutralization, blocking 87 percent of a panel of 208 distinct HIV isolates.

The finding is an important demonstration that vaccination against HIV, if done in the right way, can achieve the goal of inducing bnAbs to multiple sites on the virus, Wyatt says.

The team of scientists are continuing to test and improve their vaccine strategy in small animal models and hope eventually to test it in monkeys and then humans.

The post Experimental HIV vaccine successfully elicits broadly neutralizing antibodies to the virus appeared first on MyMedicPlus.

Do a quick scroll through Instagram, and chances are you’ll see a slew of wellness and fitness personalities touting the benefits of collagen peptide powder and adding it to their smoothies.

So what exactly is collagen and why are some people clamoring for it?

“Collagen is a structural protein made up of amino acids that’s found naturally in the connective tissue of our bodies, such as our skin, hair, muscles, bones and even blood vessels,” Keri Gans, registered dietitian nutritionist and author of The Small Change Diet, tells Yahoo Lifestyle. “It is essentially the ‘glue’ that holds our body together, enables us to move and find stability.”

Adds Joshua Zeichner, MD, director of cosmetic and clinical research in Mount Sinai Hospital’s department of dermatology, “Collagen is the main protein in our skin that provides structure and support.”

And it’s that structure and support that plays a role in keeping skin looking smooth, firm, and wrinkle-free. But collagen production slows down as we age, which is why many people are turning to consuming collagen peptides (also known as hydrolyzed collagen) in the hopes that the supplements will reverse or at least stave off skin aging.

“The hope for ingestible collagen is that it helps strengthen our skin to improve the appearance of fine lines and wrinkles, as well as enhance skin texture,” Zeichner tells Yahoo Lifestyle.

But does consuming collagen powder actually do anything? Possibly.

“The true benefit of ingestible collagen is unclear,” says Zeichner. “Since collagen is a large molecule, it is broken down by our gut into smaller pieces. The smaller pieces and individual amino acids may serve as building blocks for new collagen production. I look at ingestible collagen similar to the way I look at eating a high-protein meal.”

Adds Gans: “Many individuals believe the numerous health claims in regards to collagen. There are claims that it can reduce constipation, improve gut health, improve sleep, decrease anxiety, reduce joint pain, eliminate food cravings and has anti-aging properties.”

What are the benefits?

Although more research is needed, there are some studies that have looked into collagen supplements’ potential benefits — particularly for easing joint pain. “Some preliminary research suggests collagen supplements may help reduce knee pain among people with osteoarthritis, and help reduce joint deterioration in athletes,” says Gans.

While it’s no fountain of youth, there is some good news for people who are consuming collagen hoping to improve their skin and hair. “One small study revealed collagen supplements improved skin elasticity, but didn’t do any more than a placebo to improve skin moisture and evaporation,” says Gans. A 2019 review of several studies showed that collagen supplements increase skin elasticity and hydration.

It may also help with brittle, fragile nails. A small 2017 study in the Journal of Cosmetic Dermatology found that consuming collagen peptides daily for 24 weeks helped prevent nail breakage, increase nail growth, and improved the appearance of brittle nails.

How safe is it?

Collagen supplements are considered safe for the most part — as Zeichner puts it: “The only harm is to your pocketbook, as many of the collagen powders are pricey.” However, it’s important to read up on the source of the supplement’s main ingredient. The collagen found in supplements is typically sourced from cow (bovine) hides, as well as chicken cartilage, but in some cases they can be made from fish or eggs, which can be dangerous for people with those food allergies.

“As with any supplement, one should read the label closely to make sure it doesn’t include any allergens that they are sensitive to,” suggests Gans. “Also, if on any medications a person should discuss with their doctor or a registered dietitian before implementing in their daily diet.”

If you’re interested in trying collagen peptides powder, your best bet is to stick with a well-known brand, such as Vital Proteins. As Gans points out: “Like all supplements, collagen is not closely regulated by the Food and Drug Administration — therefore, one should choose nationally-recognized brands or store brands from a retailer they trust. Consumers can also look for a seal from a third-party certifier, such as NSF International, UL or USP.” You may also want to start with unflavored collagen peptide powder, which you can add to smoothies, as well as hot and cold beverages like coffee, without altering the flavor.

The post People are drinking collagen powder for its anti-aging benefits but how safe is it? appeared first on MyMedicPlus.

Fans of TV presenter and fitness guru Davina McCall will know she’s a huge advocate of self-love – a quick scroll through her Instagram feed will give you enough positive mantras and empowering selfies to get you through even the toughest of days. True to form, 51-year-old Davina has been spreading the message of loving yourself at every age in our new issue.

Speaking about ageing on her Good Housekeeping cover shoot, Davina shared that she’s totally embraced the process.

Davina McCall

“I feel better about it now than I ever have. You get to a point where you realise you can’t do anything about it, so why worry?” she said.

“My boobs are going down, my bum is going down and admittedly, I went through a stage where every time I looked in the mirror I’d think ‘What would I look like if I had something done?’ But I’ve decided that changing and ageing is okay.”

Davina McCall
RACHELL SMITH/ GH
While she’s only at the start of her 50s, Davina revealed she’s loving the decade so far.

“My 50s are a banger of a decade! Every age has a different set of hurdles to get over, but I’ve calmed down a bit and I’m feeling a lot more at peace with myself,” she said.

“It’s a kind of self-acceptance, warts and all. We talk about that a lot in recovery. Once you stop trying to be perfect, it’s such a relief,” she added.

Davina McCall
RACHELL SMITH/ GH
Advertisement – Continue Reading Below

Entering a new decade of life isn’t all Davina’s had to get to grips with of late, in 2017 she announced her split from husband of 17 years Matthew Robertson.

The mum of three spoke to us about solo parenting and getting used to her ‘new normal’.

“Matthew is quite hands on, so I have support from him. We share the school runs in the morning, which is really nice. I won’t deny it feels quite full on when I’m on my own though.

“Now that Tilly’s nearly 16, I can go out and leave her and Chester at home for the evening, which has made quite a difference. I’m finding my new normal,” she said.

The post Davina McCall on ageing and why her 50s are a “banger of a decade” appeared first on MyMedicPlus.

Normal blood pressure is vital to life. Without the pressure that forces our blood to flow around the circulatory system, no oxygen or nutrients would be delivered through our arteries to the tissues and organs.
However, blood pressure can become dangerously high, and it can also get too low.

In this article, we will discuss what blood pressure is, how it is measured, and what the measurements mean for our health.

What is blood pressure?
A garden hose
Without a pump or water tank, no water will flow. Hose pipe properties also affect water pressure. Similar principles apply for blood flow.
Blood pressure is the force that moves blood through our circulatory system.

It is an important force because oxygen and nutrients would not be pushed around our circulatory system to nourish tissues and organs without blood pressure.

Blood pressure is also vital because it delivers white blood cells and antibodies for immunity, and hormones such as insulin.

Just as important as providing oxygen and nutrients, the fresh blood that gets delivered is able to pick up the toxic waste products of metabolism, including the carbon dioxide we exhale with every breath, and the toxins we clear through our liver and kidneys.

Blood itself carries a number of other properties, including its temperature. It also carries one of our defenses against tissue damage, the clotting platelets that prevent blood loss following injury.

But what exactly is it that causes blood to exert a pressure in our arteries? Part of the answer is simple – the heart creates blood pressure by forcing out blood when it contracts with every heartbeat. Blood pressure, however, cannot be created solely by the pumping heart.

Function
Our circulation is similar to a highly sophisticated form of plumbing – blood has ‘flow’ and arteries are ‘pipes.’ A basic law of physics gives rise to our blood flow, and this law also applies in a garden hose pipe.

Blood flows through our body because of a difference in pressure.

Our blood pressure is highest at the start of its journey from our heart – when it enters the aorta – and it is lowest at the end of its journey along progressively smaller branches of arteries. That pressure difference is what causes blood to flow around our bodies.

Arteries affect blood pressure in a similar way to the physical properties of a garden hose pipe affecting water pressure. Constricting the pipe increases pressure at the point of constriction.

Without the elastic nature of the artery walls, for example, the pressure of the blood would fall away more quickly as it is pumped from the heart.

While the heart creates the maximum pressure, the properties of the arteries are just as important to maintaining it and allowing blood to flow throughout the body.

The condition of the arteries affects blood pressure and flow, and narrowing of the arteries can eventually block the supply altogether, leading to dangerous conditions including stroke and heart attack.

Measurement
Lady having her blood pressure checked by a doctor
When the pressure from the arm cuff stops the pulse briefly, it gives the top figure of arterial blood pressure that we are familiar with from medical dramas – for example, “140 over 90”
The device used to measure blood pressure is a sphygmomanometer, it consists of a rubber armband – the cuff that is inflated by hand or machine pump.

Once the cuff is inflated enough to stop the pulse, a reading is taken, either electronically or on an analogue dial.

The reading is expressed in terms of the pressure it takes to move mercury round a tube against gravity. This is the reason for pressure being measured using the unit millimeters of mercury, abbreviated to mm Hg.

Readings
A stethoscope identifies the precise point when the pulse sound returns and the pressure of the cuff is slowly released. Using the stethoscope enables the person measuring the blood pressure to listen out for two specific points.

Blood pressure readings consist of two figures – the systolic pressure first and the diastolic pressure second. The reading is given as, for example, 140 over 90 mm Hg.

The systolic pressure is the higher figure caused by the heart’s contraction, while the diastolic number is the lower pressure in the arteries, during the brief ‘resting’ period between heartbeats.

Ranges
The National Institutes of Health cite normal blood pressure to be below 120 mm Hg systolic and 80 mm Hg diastolic.

However, blood pressure changes naturally, a fact that cardiologists explored while writing about blood-pressure variability in Nature in March 2013:

“Blood pressure is characterized by marked short-term fluctuations occurring within a 24-hour period (beat-to-beat, minute-to-minute, hour-to-hour, and day-to-night changes) and also by long-term fluctuations occurring over more prolonged periods of time (days, weeks, months, seasons, and even years).”

The guidelines state that for blood pressures above a figure of 115/75 mm Hg, every rise of 20/10 mm Hg doubles the risk of cardiovascular disease.

The overall guidelines for high blood pressure received an update in November 2017. They allow for earlier intervention.

Since 2017, the American Heart Association (AHA) has advised that people with high blood pressure should receive treatment at 130/80 mm Hg rather than 140/90 mm Hg.

They also removed the “prehypertension” category between 120-139/80-89 mm Hg. A blood pressure reading of 140/90 mm Hg now qualifies as stage II hypertension and not stage I, as it used to be.

This category now forms two separate ranges:

elevated blood pressure, from 120-129/less than 80 mm Hg
stage I hypertension, from 130-139/80-89 mm Hg
In these new guidelines, the AHA also advises that doctors should only prescribe medication in cases of a previous heart attack or stroke, or in the presence of risk factors for these conditions, such as age, a diabetes mellitus diagnosis, or chronic kidney disease.

Treatment at the earlier stages should instead come mainly through lifestyle changes.

Tips
The guidelines for doctors list the following measures patients can take to help keep a healthy blood pressure:

Keep a healthy body weight.
Eat a diet rich in fruits, vegetables, and low-fat dairy products.
Cut down on sodium, or salt, in the diet.
Take regular aerobic exercise, such as brisk walking, for at least 30 minutes a day, most days of the week.
Moderate alcohol intake. Men should drink fewer than two alcoholic beverages a day for men. Women and men with a lower body weight should consume a maximum of one alcohol drink a day.

The post What is a normal blood pressure? appeared first on MyMedicPlus.

On June 25, veteran lobbyist Tom Sheridan published his first book, Helping the Good Do Better: How a White Hat Lobbyist Advocates for Social Change, an unvarnished view of the lessons learned by partnering with unusual political allies—from rock stars to Republicans—to enact meaningful reform like the Ryan White CARE Act of 1990, which is featured in the excerpt below. For more stories from the likes of Bono, Ted Kennedy, and Tom, check out the website here.”

APRIL 24, 1990. The world had just watched a boy die, one of the most impassioned advocates of his generation. Ryan White had just died of AIDS, and I was in the midst of a desperate battle to pass a bill that would provide care to others who were suffering from the disease. I had invited Ryan’s mother, Jeanne, to Washington to help me gather support for the bill, and we hit the halls of Capitol Hill.

We needed to add 14 senators as co-sponsors in order to get to the needed number of 60 so that Senator Jesse Helms, the homophobic arch-right-wing senior senator from North Carolina, wouldn’t be able to filibuster. One of our main targets for the day was Senator Joe Biden. When he came out of the Senate chamber he looked hurried, clearly in no mood for chitchat. But I ran up and quickly got in a word. Ryan White’s mother had just flown in the night before. She was standing right behind me, and she wanted to speak to him. He stopped in his tracks and immediately took her hand. This act of intimacy took Jeanne and me both by surprise. Joe Biden is, in many ways, the quintessential charismatic politician, yet he, too, has suffered a great loss. In 1972—as he prepared to be sworn in as a senator—Biden’s wife and daughter were killed in a car accident on the way home from picking out the family Christmas tree. His two sons barely survived, and Biden nursed them back to full recovery as a single father.

As I stood nearby, I heard Jeanne start her request for Biden’s support. He stopped her midsentence. “You don’t need to tell me the pain of losing a child,” he told her. “I have been there, and there is nothing more painful a parent can experience.” They both started to cry. Hell, even I started to cry. The world around us came to a complete stop. Senators came in and out, staff bustled around, but a protective bubble seemed to envelop us. Something magical was happening.

By the end of his deeply personal conversation with Jeanne, I knew that the power of Biden’s and Jeanne’s shared passion, grief, and hope would be an unstoppable force if it could be harnessed on behalf of all the parents and families who had lost someone to AIDS. There is a strange peace and deep authenticity that comes with such pain—as if there is little else in the world that can hurt so much and, thus, nothing in the world left to fear.

Grief is a powerful force, and it animated the AIDS movement. If turned inward, grief can destroy lives and create further suffering. If turned outward, however, it can heal the deepest wounds, bring together fierce enemies, and birth what some might call miracles. Perhaps that is why the height of the AIDS epidemic, which is where this story begins, was at once so tragic and so miraculous. AIDS brought fear, shame, anger, and division to this country as it arbitrarily stole friends, family members, and colleagues. Yet, AIDS created a shared suffering. It cut across race, creed, socioeconomic status, and sexual orientation and introduced a degree of compassion and humility that few could have predicted. In this sense, AIDS was the great leveler of our time. Our response—as individuals and as a country—was a test of our common humanity. This excerpt tells the story of how we fared in that test, what we learned, and how these lessons may help us address the challenges ahead.

“AIDS in the ’80s was a wholly different disease than the one we know today.”
In 1984, a 13-year-old hemophiliac contracted a mystifying illness from a contaminated blood treatment. Ryan White was, like most people diagnosed with AIDS, given six months or less to live—it was a death sentence. Back in his hometown in Indiana, he tried to return to school but faced enormous opposition: beyond taunts, threats, and abuse, parents and teachers organized and rallied to prevent him from attending school. At the time, there were fewer than 150 cases of pediatric AIDS in the country and being diagnosed with the disease carried an enormous social stigma. But Ryan was undeterred. He and his family fought back against the school. As Ryan’s case gained attention, celebrities like Elton John, Michael Jackson, and Phil Donahue took up support of his legal battle. Along the way Ryan White became a national celebrity and advocate for AIDS education and research. AIDS in the ’80s was a wholly different disease than the one we know today; it was not chronically managed, widely understood, or accepted. It was lethal, highly stigmatized, and characterized by a national mood of crisis, desperation, anger, and scornful discrimination.

If we had had the luxury of time, I could have spent more of it debating options and crafting compromises, but a ticking clock in 1989 was a death sentence for so many. We had made our decisions, and now it was time to get down to work.

Thankfully, we had a heavy hitter on our team: Senator Ted Kennedy had emerged as a leading AIDS advocate. In May 1987, he introduced the AIDS Federal Policy Act (S. 1220), which sought to provide funding for testing, counseling, research, and patient access to experimental drugs. It passed the Senate, but similar House bills that year didn’t fare as well. Despite herculean efforts by many tireless people, at that moment we couldn’t see much progress. Yet these early defeats taught us to do our homework and forced us to rework the content and language of the bills, in order to be better prepared for next time.

Ever so slowly, we could sense something start to shift: A small number of legislators—like Representative Nancy Pelosi (D-CA), Representative Henry Waxman (D-CA), Representative Barbara Boxer (D-CA), Representative Ted Weiss (D-NY ), and Senator Alan Cranston (D-CA), whose districts were facing major public health disasters, were becoming more powerful advocates. But there was a bigger reason why 1988 was a tipping point when momentum behind the AIDS crisis quickly gathered speed: the epidemic had become much more widespread. Sadly, it was only after the death toll mounted that more and more family members and friends joined us in demanding a more effective and compassionate response to the AIDS crisis. It was during this time that AIDS began to touch my life personally; my partner, Vince, had an ex-boyfriend who suddenly became ill, an alumnus from our Mondale campaign team died, and another dear friend, unable to even tell us he had AIDS, stayed with us as he got sicker and sicker.

As painful as these deaths were, the stories of desperation and anger of hundreds of thousands of Americans (not just gay men) who were being affected by this epidemic created a powerful chorus. Stories were voiced by more and more people, at an increasing volume. These were the voices that needed to be heard on Capitol Hill. These were the people who would finally silence Helms. And so, for the next two years, we went to work on giving them the biggest amplifier we could find—it was time to truly do battle.

As 1989 dawned, National Organizations Responding to AIDS (NORA) refined its efforts to focus on three measurable goals. First, win appropriations for AIDS research. Second, pass civil rights legislation under the Americans with Disabilities Act. And third, expedite the FDA’s process for approving experimental AIDS drugs.

RELATED IN U.S. NEWS

Bruce Vilanch: ‘Stonewall Was the First Shot Across the Bow’

Lord Michael Cashman: LGBT Rights Will Always Need Defending

Michael Benjamin Washington: We Need a Human Rights Movement
That year also marked the beginning of a new Congress (the 101st) and a new administration under President George H. W. Bush. In December 1988, the NORA leadership arrived early to a large conference room in the transition team’s offices in D.C. The doors finally swung open, and in walked the president-elect. We were shocked—we had not expected to see him in person; we had prepared to meet with some of his staff. We gathered ourselves and made our pitch. He listened intently and then pledged to “do better on this issue.” The bizarre moment seemed to offer a glimmer of hope toward opening a dialogue.

But contrary to his pledge to do better, Bush allotted no new money for AIDS in his proposed fiscal year 1990 budget. This was largely a continuation of Reagan’s policy of avoiding AIDS, but it also perpetuated the previous eight years of slashing and burning the domestic budget. The budget and appropriations process in this kind of environment was going to be brutal. All the AIDS bills in the world wouldn’t mean anything if they never got funded.

“Prevention was a trickier matter because it meant talking about condoms and homosexuality and drug abuse.”
There was also growing concern by other health groups that we (the AIDS lobby) were going to take some of their funding— especially at the NIH.

We soon started to realize that we couldn’t just keep funding research. We had to get out of the “white coats and stethoscope” mode—which was the only safe place to be politically—and start helping the organizations trying to care for people with AIDS. The practical measure of successful public policy is always public benefit, and that was singularly missing from the AIDS policy debate up until that moment. Thus, we began a conversation with a small group of AIDS policy experts. One of the first recommendations from these discussions was that we take on entitlement reform—that is, we should make Medicare and Medicaid more accessible for AIDS patients so they would not have to wait 24 months to be considered “disabled” to qualify for Medicare or to spend down all their money to poverty levels to qualify for Medicaid.

Prevention was a trickier matter because it meant talking about condoms and homosexuality and drug abuse. Any attempt at a serious and meaningful prevention strategy was sure to bring Helms and company to the party. We knew an all-out confrontation over AIDS prevention was unlikely to be winnable. Practicalities are not always easy to embrace, especially when shelving a critical element of your public health strategy will result in more people infected with HIV. But, in the final analysis, care offered our best and possibly only chance to win.

Part of the process we used to reach this conclusion was a strategic meeting with key members of Congress and their senior staff. When I would discuss the matter with Orrin Hatch, he told me frankly that he couldn’t support us on most of the prevention issues but that he “did care about how these people [AIDS patients] were treated—especially in their final days.” This sort of “care for sinner without condoning the sin” philosophy was fairly typical of Christian conservatives, who were at their apex of power at the time.

I started to realize that we could win over these pragmatic and more compassionate conservatives like Orrin Hatch (as well as the fiscal conservatives who hated entitlement programs) if we could create a cost-effective model that relied on early intervention and outpatient/community/home-based care, one that could act as a bridge from work to disability. If we could get conservatives to come to our side strictly on the merits of public health and fiscal arguments, then this could really be the next frontier for a major AIDS bill. However, first we had to know what was really needed in terms of care on the front lines.

In February 1990, Kennedy, Hatch, and 26 other co-sponsors introduced S.2240, the Comprehensive AIDS Resources Emergency (CARE) Act of 1990. Elizabeth Taylor joined Kennedy and Hatch for a widely covered introductory hearing and press conference to announce the bill and promote its swift passage.

The next day, we sent out an action alert to the NORA coalition, requesting letters in support of CARE. It seems so antiquated now, but back then it was cutting-edge stuff: in a few hours we could inform organizations and individuals around the nation that an important action was getting ready to happen (mostly thanks to our knowledge of votes in committee or on the floor). Once our action alerts hit the fax machines, massive phone trees, and phone banks were deployed to help fill up phone lines and message pads with our support or opposition. When NORA got big that meant one action alert would go to 120 organizations who would then fax the alert to their field and they would begin the phone or letter campaign. At our best we could put a few hundred calls or letters in a congressional office within 48 hours. It was considered revolutionary back then.

All during March and April, letters poured in from AIDS service organizations all around the country. Efforts like this in other issue areas would have cost millions of dollars and taken years to create, so in this sense, the structure of the coalition worked brilliantly.

In early April 1990, the battle over AIDS funding had reached its zenith in the Senate. We were poised for CARE’s markup hearing before the Senate Committee on Labor, Health, and Welfare. Despite Kennedy and Hatch as co-sponsors, the long-term prospects didn’t look good. Even though we hadn’t yet realized it, we needed help. We needed a superstar. And we found him in Ryan White.

It was Senator Hatch who suggested the bill be named in honor of Ryan. At this point, Ryan was dying. A week earlier, Ryan had been admitted to the Riley Hospital for Children in Indianapolis with a severe respiratory infection. He had to be placed on a ventilator and sedated.

While we immediately agreed that this was a noble idea, I remember worrying that we might offend Jeanne by using the public’s sympathy for her son to gain political traction. I suggested that Senator Kennedy call Jeanne to ask her permission. I had no idea how she would react. Here she was, this young single mother from small-town Indiana, whose family had been thrust into the national spotlight just five years earlier. Now she was at her son’s deathbed about to be interrupted by a relative stranger (albeit one of the most powerful politicians in the country) six hundred miles away in Washington who wanted to use her dying son’s name to help win a fierce political battle over AIDS policy.

Senator Kennedy and Senator Hatch each spoke with Jeanne briefly and explained the situation. “Well, I’m not sure what to say,” I remember her saying. “I mean, I guess that would be great. Ryan would be honored—we would be honored. That would be terrific. Can you do that? Will this really help?” Secretly, I wondered if Jeanne truly understood the enormous act of generosity she was committing and the legacy that Ryan’s name would bear. But Senator Kennedy hung up with a satisfied smile. “Let’s get to work,” he said as he stood up abruptly and headed toward the committee room. He strode in, called the committee to order, and without hesitation, they renamed the bill for Ryan and put the final touches on the most important AIDS legislation ever considered by the U.S. Congress.

It wasn’t until we were ready to bring the bill to the full Senate the following week that we ran into problems. Senators Jesse Helms, Gordon Humphrey, and Malcolm Wallop and a handful of other Republicans said they would immediately block it from going to the floor, and George Mitchell, then Senate majority leader, acquiesced, saying he “just didn’t know” if he could find time in the Senate calendar to withstand a filibuster.

In the ’90s, filibusters were rarely used, and they were considered an extreme tactic in legislative negotiation. Those 72 hours represented precious time, which would not be squandered for a losing cause. The clock was ticking: we had to pass the bill in the Senate, get it through the House, and then get it through a conference committee by September in order to get it signed before the federal budget was completed for the year. We might well get the entire Congress to agree on a huge new AIDS program—only to miss the budget negotiation and therefore lose out on funding.

I went to Senator Bob Dole’s office—he was then Republican minority leader—and met with his chief of staff, Sheila Burke, to see what could be done. Sheila had been a nurse and understood the severity and human toll of the AIDS crisis. She was also in charge of the very delicate task of protecting the rights of Republicans as the minority party. Though she was harshly criticized for it—even years later—Sheila helped us figure out how to isolate Helms and his colleagues so we could get the majority of Republicans to go along with Ryan White. Sheila assured me that we had to prove that we could mobilize a super majority (60 senators) to break any attempt at a filibuster by Helms. As it stood, we had barely 40 co-sponsors, and the list was largely Democratic. I buried my head in my hands and sighed. I had a queasy feeling that good might not prevail this time.

The post How a Dying Ryan White United Washington on the AIDS Crisis appeared first on MyMedicPlus.