One of the central issues surrounding the fight against AIDS has always been if, how, or to what degree the pharmaceutical industry is pulling the strings of the medical community, AIDS organizations, and even the medical journals that depend on its advertising.

A classic ethical conundrum in our capitalist society is how to regard the flow of funds and its potential impact of the flow of information - why do corporations place their money where they do? When does a gift become a bribe? These questions have recently arisen in the world of AIDS politics due to reports that Burroughs Wellcome Co. has contributed large sums of money to key AIDS organizations. There is nothing inherently sinister about that, one might argue, since it's plausible that Wellcome just wants to improve its karma. You know, do the right thing. But knowing that there is a blazing controversy surrounding AZT - regarding its terrible toxicity, whether or not it does much good, the validity of clinical studies, and pricing - and since the AIDS groups in question present themselves as objective and impartial, this news does give one a pause.

In fact, for years, Burroughs Wellcome has been giving money to a great number of AIDS organizations, large and small. A Chicago-based AIDS organization, Test Positive Aware Network, just received $350,000 from Burroughs Wellcome, which amounts to half of its budget. The group said it used the money to pay for its newsletter. Project Inform, a leading AIDS organization and information service, got $150,000 from Wellcome to upgrade its computer system. Treatment Action Group (TAG), an offshoot of ACT UP, received $10,000,and ACT UP Golden Gate received $2,000. Says TAG founder Peter Staley, "It's hard to find an AIDS organization that hasn't taken money from Burroughs Wellcome."

Responding to the question of whether the Wellcome money may influence his organization's policies, Project Inform Executive Director Martin Delaney says, "In no case do any of these groups report to Burroughs Wellcome. It is entirely appropriate that we seek funding from the companies that have profited from this epidemic."

Delaney stresses, "We've criticized the price of AZT, and the validity of some studies. If Burroughs Wellcome does something stupid and irresponsible, we're going to be out here as loudly and strongly as we were in the past."

Burroughs Wellcome spokesman Kathy Bartlett insists, "We are not influencing information. We are doing this to create a broader distribution of information."

Since 1987, Wellcome has contributed more than $5 million to national and community-based organizations that provide HIV-related services and programs. Wellcome aggressively promotes AZT for early treatment of HIV infection. A Wellcome press release attributes its donations to the company's "strong commitment to improving health care and a tradition of philanthropy." I'm all for philanthropy, but this worries me. I'm not saying that Burroughs Wellcome is a company driven by evil people, but on what basis are we to assume that gargantuan pharmaceutical companies are able of such benevolent, altruistic aims as philanthropy? My concern is that profit-driven companies, much like the government, don't have feelings. Individuals do. The main objective of a company is to grow and to be profitable, and for this, it needs the cooperation, not the resistance, of a certain population. Voilà. It's not evil, as such - it's just business. It is, after all, selling a product.

Some of the groups receiving Wellcome money put out newsletters in which AZT is discussed, almost invariably uncritically. Would they hold the same uncritical stance on AZT if there were no financial connections to Wellcome? In all fairness, quite possibly. Will they be able to be perfectly objective about the AZT controversy in the future, particularly if they develop a financial dependency on Wellcome funding? Possibly, but as the British would say: not bloody likely.

One of the most problematic developments in the Wellcome funding debate involves the AIDS activist group ACT UP. ACT UP has, in the past, been fiercely critical of Burroughs Wellcome and other large pharmaceutical companies, charging that they exploit people with AIDS through exorbitant pricing, among other things. Another complaint is that Wellcome, by virtue of its wealth and power, has clogged up federal research trials with its drugs, to the exclusion of other potentially lifesaving treatments. Although ACT UP has not taken significant sums of money directly from Wellcome, it has launched a drive to get pharmaceutical companies to donate to community-based research organizations. On June 30, a press conference was held at which it was announced that Wellcome had donated $1 million to AmFAR (American Foundation for AIDS Research) as a result of ACT UP's negotiations.

"The members of ACT UP were very devided on this," says Vic Hernandez, a member of the group. "I personally am very concerned about this. Look at where the money is going. AmFAR has a very conservative approach to AIDS treatment and to questions about HIV and AIDS."

The deal was negotiated by former ACT UP Treatment and Data committee member Staley, a prominent activist who was one of a group that invaded the Wellcome complex and chained themselves to a radiator to protest the price of AZT in 1989.

This year, Staley created TAG, which was designed to be leaner, meaner, and more efficient at targeting treatment issues than the unwieldy ACT UP. Eventually, Staley worked his way onto the board of directors of AmFAR. It was as a member of all three groups that Staley - using ACT UP's reputation for political tenacity, TAG's stable relationship with Burroughs Wellcome, and AmFAR's mainstream appeal - managed to bring former adversaries ACT UP and Wellcome together.

At the June 30 press conference, Staley, representing ACT UP, said, "ACT UP New York is pleased to announce the successful launching of its campaign to solicit funds from the pharmaceutical industry for the Community-Based Clinical Trials Network (CBCTN). Burroughs Wellcome Co. has agreed to provide $1 million as a leadership grant this year, with the possibility of renewals pending reviews of the progress of the clinical trial program."

Staley said that ACT UP had contacted 50 pharmaceutical companies asking them to donate funds, with the goal of raising $5 million this year. The majority of ACT UP members voted in favor of the fundraising campaign and see the move as a step in the right direction - with drug companies putting funds back into the community. Others are concerned and feel that Staley used ACT UP's name without really respecting that the move might compromise - or at least appear to compromise, the group's ideological stance. The controversy is raging: Is this a step forward, toward a "common goal," or is it an unwitting and potential devastating sellout for the activist community? Staley defends charges of attaching ACT UP's name to what some call "dirty money" by saying at a press conference, "A million dollars for AIDS research is a million dollars for AIDS research.

"We are at war and must use desperate measures," he told the Village Voice. "If I have to take money from the devil to save my life and the lives of my friends, I'll do it."

Staley is convinced that this move will in no way compromise the activist community's integrity, and that both ACT UP and TAG will remain as critical of Burroughs Wellcome as they have been in the past. Others are more skeptical.

"I don't like this deal at all," says Bill Dobbs, a longtime member of ACT UP, "because it blurs the lines, and it will ultimately prevent ACT UP from doing what it does best, which is to be a watchdog. Staley can do whatever he wants with TAG, but the fact is he used ACT UP as a club to beat the drug companies with because they're afraid of ACT UP. I find it absurd that ACT UP should wind up assisting Burroughs Wellcome public-relation efforts, and that's exactly what this is for them." Staley declined to comment.

To ACT UP members like Dobbs, who take ACT UP's democratic ideology very seriously, Staley, for all his good efforts, appears maddeningly oblivious to the fundamental principles of the group. Staley and his ilk have brought a kind of "whatever works" methodology to AIDS activism. And they get results, but the question is, at which cost?

While the majority of ACT UP voted in favor of the move, Dobbs contends that many were not fully aware of what they were voting about. "I don't think most of us knew just what Staley was getting ACT UP into here. When it did become clear, it was too late."

With 16,000 AIDS organizations - in this country alone - competing for funds, Staley seems to have pulled a miraculous stunt. What may or may not happen to ACT UP's integrity as a political organization remains to be seen. It's the age-old dilemma - if you have an urgent cause at hand, do the ends justify the means? Says Dobbs, "People ask me, would you rather this money not be spent at all? To which I respond, why do we have to be put in these situations in the first place?"

Does he believe that the Burroughs Wellcome funds will influence the discourse of AZT? "When you're saying money around, one way or another you acquire influence," he says. "They also make the people who are taking the money dependent on them and that creates another kind of fear. Not only are you taking this money, but you might lose it. The bureaucracies are going to expand because of this money. And they're going to have to scramble if they do something Burroughs Wellcome doesn't like."*

Additional research by Staci Bonner