Mr. Stroger Goes to Halsted
When Cook County Board President Todd Stroger took the stage at the Center on Halsted in Chicago on Tuesday, August 25, he faced an audience of around 200 individuals who were already irritated, if not downright angry, that he had kept them waiting for 45 minutes to start the community meeting his office had arranged. The audience included a variety of stakeholders in the HIV/AIDS community—leaders from several AIDS service organizations, doctors, advocates and people living with HIV, members of the media, including TV and radio crews from Fox and WBBM, and at least one GeoVax investor. The community had come together hoping to clarify the controversy surrounding a proposal that Stroger orchestrated from GeoVax, a company who wished to conduct a Phase 1 safety trial of their therapeutic vaccine candidate at the Ruth M. Rothstein CORE Center in Chicago.
Since the story broke on August 5, there has been a storm of accusations, inaccurate information, rumors and suspicion that has spilled over from the HIV/AIDS community to minority communities on the South and West sides. The CORE Center has chosen not to conduct the study after review of the proposed protocol by a variety of experts.
According to publicity, Mr. Stroger felt the CORE Center’s decision was a rather arbitrary, baseless action that would deny the economically disadvantaged people of color served at the CORE Center what he said is the thing they need most – hope for a cure for AIDS. Mr. Stroger took his cause to the Sweet Holy Spirit church on the South side, inflaming the African American congregation and creating a wave of negative publicity for the CORE Center that not only threatens their ability to serve their patients, but which could also heighten the level of distrust in the community, potentially leading to negative effects on other studies at the CORE Center, as well as the ongoing Phase 2a trial of GeoVax’s preventative vaccine in Atlanta.
At Tuesday’s meeting, Dr. Toyin Adeyemi, M.D., Attending Physican, Infectious Diseases, of Cook County Hospital and the CORE Center, gave a clear and detailed explanation of the medical reasons for CORE’s decision. She explained that every trial proposed is vetted by the Institutional Review Board and CORE’s Clinical Trials Group, both of which, along with outside experts from the HIV Vaccine Trial Network and the National Institutes of Health, decided that, based on the protocol information they had on the proposed trial, the potential benefit of the study did not justify the risk to the 10 HIV-positive patients who would be required to interrupt their successful antiretroviral therapy in order to participate in the study.
Mr. Stroger listened patiently to Dr. Adeyemi’s explanation and then said, “That is the kind of answer I expected when they sent me a letter.” He went on to say that he feels he deserves such an answer and “when I don’t get it, it’s demeaning to the office, forget about Todd Stroger, it’s demeaning to the office and it makes things more difficult to deal with the outside world.”
When asked to comment, Dr Adeyemi stated over the phone on Wednesday, “At a meeting called by Mr. Stroger, it was great to hear the opinions and support of the greater HIV/AIDS community. I think we made our point that this trial would not be appropriate for our patients at this time and we hope it convinced Mr. Stroger to come out in support of the decision not to proceed with the trial.” She also expressed hope that the support shown at the meeting would overcome the backlash of negative publicity aimed at the CORE Center.
The level of Mr. Stroger’s knowledge about the trial, the protocol, the risks involved, and even the purpose and phase of the trial under consideration seemed so low that it truly did make it difficult for him to deal with the crowd he faced. As was noted by one audience member, Mr. Stroger seemed to be misinformed, or at least under-informed. There was confusion about the difference between the proposed Phase 1 safety trial of GeoVax’s therapeutic vaccine versus the Phase 2a trial of its preventative vaccine, being studied in HIV-negative people; there was misinformation about proof that the vaccines work (the preventative trial is also still studying safety, not efficacy) or had potential to provide a cure; misleading information about the CORE Center “pulling out” of an established agreement; and there seemed to be no consideration of what a 12-week interruption in antiretroviral medications could do to an HIV-positive person.
In an exclusive interview with Positively Aware after the meeting, Stroger was asked if the meeting was what he’d expected. He replied, “No. I knew people wanted to talk about GeoVax, but I didn’t know what their angle was on it.” He was then asked what he thought was the most important or impactful thing he’d learned from the two-hour meeting. In the midst of the impassioned speeches by HIV/AIDS community leaders; information provided by the CORE Center docs; urgings from HIV survivors; and pleas for more careful thought from CORE Center staff members and other agency leaders, President Stroger said, “The most important thing, for me, was that better communication has to occur between me and [Core Center Director] Dr. Weinstein.”
Through it all, Mr. Stroger correctly stated that he has no control over what happens next. The CORE Center has made its decision and GeoVax must conduct its trial elsewhere. But, as several people pointed out during the meeting, there have been a few valuable “educational moments” throughout this controversy when Mr. Stroger could have used his voice, his “bully pulpit,” to address the horrific infection rates in communities of color; to encourage people to use condoms and get tested; to stress the point that if you do test positive, your best hope is to take your antiretroviral drugs. As a politician, not a medical expert, perhaps that would have been a better use of his time and certainly more appreciated by the GLBT and HIV communities. Questions remain about why this issue was so important to him. As one audience member pointed out, he has not come to the forefront of the fight against HIV before now, though he does claim to have worked on the issue in collaboration with Illinois State Representative Connie Howard. At one point during the meeting, he did say that he’d known and lost people with HIV/AIDS and perhaps that was part of his motivation. Mr. Stroger did confirm that he will run for re-election and he cited the accomplishments of his last three years in office – bringing the budget from deficit to neutral; maintaining the health care system (though he didn’t say if there were plans to re-fund or re-open the 16 of 26 community health clinics he cut before raising the county sales tax); keeping the public safety system intact; and the money his departing CFO (his cousin, Donna Dunnings, fired over a hiring scandal) found in the county coffers to contribute to the problem of homeless youth in the Lakeview neighborhood.
It cannot be an easy job. When asked if he had higher political aspirations, he laughed and said, “Oh, no. This is a big enough job.” He admitted that he was not tired of it, just tired, that it had added years to his life. Perhaps he will use that as a frame of reference and take away from his encounter with the active, engaged HIV/AIDS community of Cook County some appreciation of the energy it takes to live with HIV and to continue the fight against it. As for the community, it was an opportunity to remember what we learned from early HIV activists. Our greatest power lies in the combined energy of our awareness and our willingness to speak out.—Sue Saltmarsh
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