The Twin Icons of French AIDS ResearchMichael Balter
PARIS--Ask the average French person to identify France's leading AIDS researcher, and one name is likely to come up immediately: virologist Luc Montagnier of the Pasteur Institute in Paris. Montagnier came to public attention in 1983, when he emerged as spokesperson for the group of physicians and scientists that first isolated HIV, the virus that causes the disease. And thanks in part to constant media exposure ever since, he has come to personify French AIDS research both within the country and internationally.
But ask a French AIDS researcher to name the most important figure in HIV research, and you are likely to hear a different name: virologist Jean-Paul Lévy. As director of the National Agency for AIDS Research (ANRS), the government's primary AIDS funding agency, Lévy's power to chart the course of French efforts against the disease is second to none. "If you want to do something, the only person you have to convince is Lévy," says a leading French AIDS researcher who asked not to be identified.
Yet, ironically, members of the original AIDS research team say it was Lévy's unwillingness to take the helm of AIDS research during the early days of the epidemic that paved the way for Montagnier's rise to fame. In 1982, suspecting that a retrovirus might be the cause of AIDS, immunologist Jacques Leibowitch, an early member of the group, asked Lévy and his co-workers at the Cochin Hospital in Paris--where Lévy now directs the Cochin Institute in addition to his ANRS duties--to help identify it. "I tried to involve them," Leibowitch recalls, "but they were reluctant and referred me to other groups." The team then approached Montagnier, who, together with Pasteur virologists Jean-Claude Chermann and Françoise Barré-Sinoussi, eventually succeeded in isolating HIV.
As the senior member of that pioneering team, Montagnier became its spokesperson. "Montagnier had an openness of spirit and did not have preconceived ideas" about the cause of AIDS, says Willy Rozenbaum of the Rothschild Hospital in Paris, who was one of the first physicians to treat AIDS patients in France. Immunologist Jean Claude Gluckman of the Pitié-Salpêtrière Hospital in Paris says Montagnier "played an important role" in those early days. "He agreed to work on the subject, which others refused to do."
There is another side to the coin, however. Many French AIDS researchers have come to feel that the intense media focus on Montagnier has downplayed his colleagues' roles. "To see him on television all the time is intolerable," says one former member of the team. Indeed, in a 1993 letter to Science, Gluckman attempted to set the record straight by detailing the important contributions made by other members of the group (Science, 26 March 1993, p. 1809).
Moreover, a number of researchers told Science, in recent years Montagnier's continuing media exposure has been less and less justified by his actual contributions to AIDS research. "He has come to occupy a place he doesn't deserve," says a Paris-based AIDS researcher privately. For example, several French AIDS investigators who spoke to Science cited Montagnier's long-running but unsuccessful attempts to prove that mycoplasma--a microbe that resembles bacteria but lacks a cell wall--works together with HIV to cause AIDS (Science, 18 January 1991, p. 271). Montagnier has also been criticized for associating himself with a widely publicized, but quickly discredited, claim by a group at the Pasteur Institute that a molecule called CD26 was a long-sought coreceptor for HIV (see main text). "He has lost a lot of credibility in the scientific world," says Rosenbaum.
In an interview with Science, Montagnier conceded that neither the mycoplasma nor the CD26 story has played out the way he expected. "It is now clear that some strains of HIV can produce AIDS without any cofactors," Montagnier says, although he believes that mycoplasma infection might have been an important cofactor when the virus first jumped from monkeys to humans, as has been proposed as the origin of the disease. As for CD26, he still believes that the protein "could play a role in infection, or could be yet another coreceptor." Montagnier also cites his group's ongoing work on the effect of HIV on apoptosis, or programmed cell death, of T lymphocytes as evidence that he has continued to make important contributions to AIDS research.
But whether Montagnier's high profile is still justified, he has little influence over the funding of AIDS research in France, apart from a considerable amount he has received from the AIDS telethon Sidaction for an independent research center he created at the St. Joseph Hospital in Paris. The real power, for the most part, is wielded by Lévy. About half of the ANRS's $40 million annual spending on AIDS research is reserved for special "coordinated actions," such as vaccine development and therapeutic trials, over which Lévy has considerable discretion; the remainder is awarded to investigators after peer review by scientific committees, whose members are appointed with Lévy's approval.
Some researchers complain that Lévy keeps too tight a grip on the reins of French AIDS research. "He is very authoritarian," says Gluckman, adding that the "policy of the ANRS has been to push people to have short-term results, and that kills risky research." Most ANRS grants run only 2 years, which many scientists complain is not long enough to make significant progress. "This favors unidisciplinary, academic research and does not allow a quick adaptation to new research challenges," says immunologist Brigitte Autran of the Pitié-Salpêtrière Hospital in Paris.
But Lévy disputes the contention that risky research is being stifled. "You will find very few proposals that have been refused," he argues. "The problem for the committees is to find something original. When we do find it--something truly original and not a fantasy--we support it." Lévy also argues that the system of 2-year grants encourages rather than inhibits shifts to new lines of research. "This field evolves so rapidly that it's not logical to support research for 5 years; it would be stupid. In most cases, the research is reevaluated, and if it is good, there is no problem with renewing it."
Despite the grumbling, however, most researchers who spoke to Science believe Lévy is the best person to lead French AIDS research. Says Simon Wain-Hobson, an AIDS researcher at the Pasteur Institute: "He has made mistakes, but he has probably done better than anyone else could have done."