Consensus Statement on the Pricing of TMC114 /Darunavir

June 09, 2006

TMC114/darunavir will soon become Tibotec’s first licensed drug for the treatment of HIV disease. It is likely to be the first of several important anti-HIV drugs from Tibotec. To date, the HIV/AIDS community’s relations with Tibotec have been exemplary as the company has shown an exceptional willingness to invite and listen to input from people affected by HIV disease. Based on everything we know now, the licensure of TMC-114/darunavir will be a worthy addition to our anti-HIV armamentarium, especially for people who have developed resistance to the existing protease inhibitors.

This good news, however, does not exist in a vacuum. Instead, it will be played out against a background of growing national and international crises in the cost of health care. The cost of a typical anti-HIV regimen in United States has risen to $15,000 or more for initial therapy, while the cost of salvage therapy can easily reach three times that amount. This is just for cost of the drugs. These costs plus the cost of associated medical care must be supported for decades to come for every single person with HIV disease. Better drugs, like TMC114/darunavir, result in longer lives and thus even longer times on therapy. If the average duration of therapy is limited to no more than 50 years per person, the costs of HIV drugs over this period will easily exceed a trillion dollars in the US alone, not even counting future price increases. Add in a reasonable cost for the vast numbers needing therapy in developing nations and the overall cost of drug for treating HIV disease worldwide could easily equal the current US national debt. Clearly, the path we are on is not sustainable, at least not for anyone other than the pharmaceutical industry.

At a time when evidence of responsible citizenship is needed from the pharmaceutical industry, we have instead been treated to ever increasing prices with each new drug. Two recently approved protease inhibitors, Reyataz and Aptivus, leapfrogged each other in setting new pricing thresholds, quickly reaching a price nearly three times that charged for Crixivan when it offered the first real breakthrough in AIDS treatment in 1996. TMC114/darunavir is the next drug in line and all eyes will be on it the day its price is announced. Its net price must include the cost of a booster drug, Norvir from Abbott Labs, whose price was recently increased by 400% in another demonstration of reckless civic behavior by a pharmaceutical company. While Tibotec isn’t responsible for the price increases taken by others, it is responsible for the decision to use the Norvir booster. Tibotec now has two choices. It can either follow in the footsteps its predecessors, defying the needs of patients and taxpayers, or it can make a bold statement that shows that the industry will do its part to restrain the cost of healthcare. Make the wrong choice and all of the company’s efforts to maintain strong relationships with the government and the community will have been for naught. The cycle of ever increasing costs, and ever higher profits, will once again be validated. Is this the legacy that Tibotec wishes to create?

Since it was formed in 1998, the Fair Pricing Coalition has sought drug pricing that is cost neutral. We seek to avoid having each new drug push the cost of treatment upward. In the case of TMC114/darunavir, this leads to a very specific demand: we ask that the price charged for TMC114/darunavir should be less than or equal to the current price of Kaletra, which is presently the best selling protease inhibitor and the drug that TMC114/darunavir is most likely to replace in clinical practice. Since Tibotec has chosen to use a ritonavir booster to improve the bioavailability of TMC114/darunavir, the price must include its cost, just as the ritonavir booster is already included in the price of Kaletra.

We also expect substantial discounts over and above the minimum required by law for the AIDS Drug Assistance Program and other government payers. We trust that separate negotiations are underway with the appropriate representatives of those programs, but we hope to establish the baseline for those discussions with the pricing principles laid out here.

We urge the leadership of Tibotec Research, Tibotec Therapeutics, and parent companies Ortho and Johnson & Johnson to give this proposal the most serious possible consideration. We believe that the company will benefit greatly from agreeing to this request. It will establish the company both as a scientific leader and also as a civic leader. It will stand as evidence to the taxpayer and to the Congress that the pharmaceutical industry is capable of more than simply seeking the greatest possible profits without regard for the impact on society. Perhaps most importantly, it will be welcomed and appreciated by the people with HIV and the medical professionals who treat them. It will almost certainly generate positive press about a “new, more responsible attitude” by industry. And, we believe, it will encourage the fastest possible uptake of the drug into clinical practice. Tibotec is aware, no doubt, that recent Medicare Part D formulary guidance issued by the Centers for Medicaid and Medicare services, has changed the mechanism for adding newly FDA approved drugs in the six protected classes, including anti-retrovirals, as of April 17, 2006. Any drug approved by the FDA after April 17 must be approved for inclusion in the individual plan formulary by that plan's Pharmacy and Therapeutics (P & T) committee. Drugs included in a protected class will have a expedited approval time that can take up to 90 days or three months, but there is no guidance suggesting that newly approved drugs in the protected classes must automatically be added to the plan formulary. Each state will likely take price into account along with therapeutic value. Additionally the P& T committees will make decisions as to how to tier new drugs for co-payment amounts. Because of their price, most of the newer anti-retrovirals are tiered in the highest tiers making them unaffordable for many. Therefore, if Tibotec hopes to see a rapid inclusion in formularies, they must price it aggressively. How state authorities and the HIV affected public feel about the pricing of new drugs will contribute to the speed of this process. At the state level, price will almost certainly be a key consideration. Meeting the goal described here will make it possible for the activist community to support the fastest possible acceptance on the formularies.

The payers, Congress, patients and providers are greatly frustrated with the pricing practices of the pharmaceutical industry. While patients and payers are struggling year after year to raise the money needed to obtain access for a growing patient population, the pharmaceutical industry has shown virtually no restraint in its quest for profits and shareholder benefits. Its profitability ranks among the highest of all industries while the percentage of revenues devoted to research and development are at best average. The pharmaceutical industry speaks proudly of the need for a “free market economy” and the benefits of competition, but in fact it behaves more like a group of monopolies. It accepts little or no pressure on prices as a result of competition, the cornerstone of a market driven economy. In the US, the industry funds massive political lobbying to prevent government from negotiating prices for the largest national payers. Unlike other industries, in which high profits are usually the result of the consumers’ selection of outstanding products, the “buyers” of pharmaceutical products have little choice in the selection of products and product quality bears no relationship to the price charged. This coercive relationship between buyer and seller can no longer be tolerated. It must be challenged, whether through consumer protest, eventual price controls, or payer product selection, none of which are very attractive to industry. Make the right choice now and none of these approaches will be necessary.

We will follow-up this letter with continued discussions and one or more face to face meetings with Tibotec. The list of signers supporting this position will be updated weekly.

On behalf of the Fair Pricing Coalition, initial signers:

Martin Delaney, for Project Inform
Lei Chou, for Community HIV/AIDS Mobilization Project
Lanny Cross
Mark Harrington, for the Treatment Action Group
Lynda Dee, for AIDS Action Baltimore
Dennis deLeon, for the Latino Commission on AIDS
Matt Sharp, for the Test Positive Aware Network
Bob Huff, for Gay Men’s Health Crisis (GMHC)
William E. Arnold, for Title II Community National AIDS Network

ORGANIZATIONAL ENDORSERS:

A Family Affair, Patricia Kelly, Orangeburg SC
ACONDA VS COTE D'IVOIRE, Lehou Jean, ABIDJAN COTE D'IVOIRE
The Access Project, Jeff Poole, New York NY
ACT UP Austin, Heather Mitchell, Austin TX
ACT UP Philadelphia, Jose de Marco, Philadelphia PA
ACTION (AIDS Care Teams in our Neighborhoods), Laurence E. Spang, DDS, Laguna Niguel, CA
The Advocacy Project, Steve Decort, Houston TX
AED Center on AIDS & Community Health, Frank Beadle de Palomo, Senior Vice President and Director Global HIV/AIDS Programs, Washington DC
African Services Committee, Kim Nichols, New York NY
Agape Missions, Jill A. Skole, Joliet IL
AGIHAS (PWA Support group), Riga Latvia
Agua Buena Human Rights Association, Richard Stern, Director, San Jose Costa Rica
AIDS Action Baltimore, Lynda Dee, Baltimore MD
AIDS Action Project N.W., Thomas J. Cherry Ph.D., Portland OR
AIDS Affects U.$ ALL, Morgan Alexander, Ojai CA
AIDS Community Alliance, Michael Witmer, Harrisburg, PA
AIDS Foundation of Chicago, David Ernesto Munar, Associate Director, Chicago IL
AIDS InfoNet, Robert Munk, PhD, Arroyo Seco NM
AIDS Legal Referral Panel, Bill Hirsh, San Francisco CA
AIDS Like Me, Roger Zetterlund, Albuquerque NM
Aids Planning Coalition of South Central Pa, Chris Poorman, Middletown PA
AIDS Research Alliance, Martell Randolph, West Hollywood CA
AIDS Survival Project, Jeff Graham, Atlanta GA
AIDS Treatment Activists Coalition (ATAC), Kristen Lepore, Coordinator, New York NY
AIDS Treatment Data Network, Ken Fornataro, New York NY
AIDS Treatment Initiatives (ATI), Guy Pujol, Atlanta GA
AIDS Vaccine Advocacy Coalition (AVAC), Mitchell Warren, Executive Director, New York NY
AIDS/HIV Health Alternatives, Terry Grand, M.D., Ph.D., North Hollywood CA
AIDSmeds.com, Peter Staley, New York NY
Alliance For Living, Carol Jones, New London CT
Alliance of AIDS Servces Carolina, Jacquelyn Clymore, Raleigh NC
Allies Linked for the Prevention of HIV and AIDS (a.l.p.h.a.), Duane Quintana, Executive Director, Boise ID
Allianza of New Mexico, Johnny Lopez, Clovis, NM
Am Kolel, Rabbi David Shneyer, Beallsville MD
American Foundation for Regenerative Medicine, Ray Jonas, Renton WA
American Medical Student Association, Tina Wu, Reston VA
American Red Cross of the Virgin Islands, Pat Odoms, HIV/AIDS Prevention Project Director, St. Thomas VI
Asian & Pacific Islander Coalition on HIV/AIDS, Inc., Victor K. Inada, MD, Medical Director, APICHA Primary Care Clinic, New York NY
association of positive youth in nigeria, ibekwe ogochukwu, onitsha Anambra state
Athens Ohio AIDS Taskforce, Mark VanZanten, Marietta OH
Ben Gurion University Medical School for International Health, Matthew Cantor, Beer Sheva Israel
Being Alive, Daniel Pepper, Volunteer Coordinator, W. Hollywood, CA
Bethlehem House, Teresa White, Indianapolis IN
Boston University School of Dental Medicine, Stephen C. DuLong, DMD, Boston MA
Brown University, Sam Klugman, Providence RI
Buckingham Charity, Dustin O'Coilea'in, Seattle WA
BuzzCommunications, Harriet Lessy, Philadelphia PA
CALOR, Martin J. Gonzalez Rojas, Chicago IL
CALOR A Division Of Anixter Center, Joann Montes, Chicago IL
Cambridge Cares about AIDS, Elizabeth Fischer, Cambridge MA
Camino de Vida Center for HIV Services, Renee Huber-Landrum, Interim Executive Director, Las Cruces NM
Canadian Treatment Action Council (CTAC), Jean-Pierre Bélisle, Secretary of the Board, Toronto Ontario
CAVDA-Citizens AIDS Project, Howard Mirsky, Mount Prospect IL
The Center for AIDS Information & Advocacy, Thomas Gegeny, Houston TX
Center on Halsted, also NAMES Project Chicago, Modesto Valle, Chicago IL
Central City AIDS Network, Inc., Johnny Fambro, MACON GA
CHAINS, Inc., Dean F. Bilet, Fort Myers FL
Channels of Love, Susan Davis, Chattanooga TN
Chicago Department of Public Health, Englewood HIV Primary Care Clinic, Jenine L. Chiles, Psy.D., Chicago IL
Chicago HOuse and Social Service Agency, Jacqueline Miles, Chicago IL
Chicago Women's AIDS Project, Catherine Christeller, Chicago IL
Christ The King Independent Catholic Church, Fr. John R. Blackiston, Auburndale FL
Community Healthcare Network, Catherine M. Abate, New York NY
Community HIV/AIDS Mobilization Project (CHAMP), Lei Chou,
Community Service Network, Inc., Harold Hunter, Dunn NC
CorrectHELP- The Corrections HIV Education and Law Project, Cathy Olufs, West Hollywood CA
Cover, Inc., Keith A. Jackson, President and CEO, Washington DC
CPR Education & Seminars, James Thompson, San Francisco CA
CrossroadsRI, Brooke Huffman, Providence RI
CT AIDS Resource Coalition, Shawn M. Lang, Harford CT
CUNY/Brooklyn College, Irene Sosa, Associate Professor, Brooklyn NY
Dartmouth-Hitchcock Medical Center Pharmacy Department, Ann Birner, Pharm D, BCOP, Clinical Specialist, Hematology/Oncology, Lebanon NH
Denver Health and Hospital Authority, Joshua Blum MD, Medical Advisor, HIV Primary Care Clinic, Denver CO
Denver ID Consultants, Benjamin Young, MD PhD, Denver CO
Desert AIDS Project, Larry Gibson, Palm Springs CA
Dooley House, Inc., Emery Troy, Camden NJ
East Bay AIDS Center, Jeff Burack, MD; Claire Borkert, MD; Steve O'Brien, MD; Chris Hall, MD, Oakland CA
Eastern & Orthodox LGBT Christian and AIDS Mnstry, George Plagianos, New York NY
Eastern Triad HIV Consortium, Caroline Clark, Eden NC
Ebony House Inc., Lee E. Cox, Phoenix AZ
The Eric Johnson House, Inc., Laurie Litt-Robbins, Executive Director, Morristown NJ
European AIDS Treatment Group, Wim Vandevelde, 1050 Brussels Belgium
F.O.U.N.D., Robert Bonin, Los Angeles CA
FAITH Services, John Lorenzo, Hoboken NJ
Fisher Medical Communications, Inc, Len Berkstresser, MBA, Vice President, Tampa, FL
Forging Ahead for Community Empowerment & Support [FACES], formerly MTFA, Carline Numa, LMSW, New York NY
Franklin Primary Health Center, Inc., Tyloria Crenshaw, HIV Program Coordinator, Mobile AL
Full Circle Gassroots Consultants, LLC, Melina Afzal, Washington DC
Gay Asian & Pacific Islander Men of New York (GAPIMNY), Conrad Chu, New York, NY
Gay Men's Health Crisis (GMHC), Bob Huff, New York NY
George Washington University Medical Center & the Whitman Walker Clinic, Susan LeLacheur, MPH, PA-C, Washington DC
Georgia Rural Urban Summit, Larry Pellegrini, Decatur GA
GIFF, Louis Henry, Dallas TX
Grace House, Kellum Wilson, Jackson MS
Greater Baltimore Planning Council, Reginald Haden, Pikesville MD
Greater Love Tabernacle Church - HIV/AIDS Programs, Rev. Edward Burks, Director of HIV/AIDS Progarms & Social Service Programs, Boston MA
Grupo Fremont VIP, Ron Chavez, Fermont CA
Harlem United Community AIDS Center, Inc., Patrick McGovern, New York NY
Health & Disability Advocates, John coburn, Chicago IL
Health GAP (Global Access Project), Paul Davis,
Health Mentoring Services, Harold Davis, Dover AR
Hep C Advocate Network, Inc. (HepCAN), Sharon Phillips, President, Longview TX
Hepatitis C Action & Advocacy Coalition, Brian D. Klein, MA, LMSW, San Francisco CA
Hepatitis C Action & Advocacy Coalition (HAAC), James Learned, Brooklyn NY
HIFAA "Health Insurance For All Americans", G. Paul Whaley, Fulton NY
HIV Advocacy Council of OR/SW WA, John J. Cox, Portland OR
HIV Health Services Planning Council Middlesex-Somerset-Hunterdon, Robert Moore, Flemington NJ
HIV/AIDS Research Trials (H.A.R.T.) Program, Kaiser Permanente, Erika Marmolejo, Project Manager, Los Angeles CA
HIV/AIDS Services for African Americans in Alaska, Hugh Brown III, Anchorage AK
HIV/Hepatitis C Committee of California Prison Focus, Judy Greenspan, San Francisco CA
HIVictorious, Inc., Bob Bowers, Madison wi
Holy Redeemer Home Care, Caroline A. Carducci, RN, Runnemede NJ
Hope Through Health, Kevin Fiori, Jr., Medway MA
Hospital of the University of Pennsylvania, Jonathan Bazeley, M.D., Philadelphia PA
Housing Works, Robert Cordero, New York NY
Hyacinth AIDS Foundation, Matthew Franck, Public Policy Assistant, New Brunswick NJ
IFARA, Fred Schaich, portland oR
Interfaith AIDS Ministry of Greater Danbury, Silvio Soares Jr., Living Pantry Director/AIDS Educator, Danbury CT
International Community of Women Living with HIV/AIDS, Beri Hull, London, England
INTERSECT-Worldwide, Sally Fisher, New York NY
Investing In Our Youth, Inc., Sondra Jones Anderson, Quincy FL
Ivy Clinic, Arnot Ogden Medical Center, Lynn Bassler, Elmira NY
Jersey City Connections, Inc., Joanne L. Smith, Jersey City NJ
Jersey City Episcopal Community Development Corporation, Susan Milan, Director of Supportive Housing Programs, Jersey City NJ
Kaiser Permanente HIV Update Editorial Board, Rodger Brooks, San Francisco CA
Kansas Chapter of The National Action Network, James M Nordlund, Stockton KS
Latino Commission on AIDS, Dennis deLeon, New York NY
Liberation Programs, Joanne Montgomery, Bridgeport CT
Lifelong AIDS Alliance, Julene T. Weaver, Seattle WA
The LIVE Foundation, INC., Megan E. Cassano, Stamford CT
Living Hope Organization, Jude C Munaonye, Umuahia Abia State
Loudon Avenue Christian Church Faith In Action Ministry, Eva Hughes, Roanoke VA
lower east side harm reduction center, Elliot Berke, New York NY
Loyola University Stritch School of Medicine, Chris Curry, Forest Park IL
Maine HIV Advisory Committee, Jenson Steel, Portland ME
Mazzoni Center, Patti Ventura, Philadelphia PA
Men & Women in Prison Ministries/ Universal house of Refuge, Gerald Smith, Harvey IL
Messiah International Ministries, Harold M. Carter, Cleveland OH
Michigan Positive Action Coalition, Rick Otterbein, Ferndale MI
MichRx Consulting, Michelle J. Sherman, RPh FASCP, Dana Point CA
ministry of W.A.R. (Wellnes Awareness Restoration), Petra serving in the Mangum, Orange NJ
Minnesota AIDS Project, Lorraine Teel, Minneapolis MN
The Miriam Hospital, Beth A. Meyers, RPh, Providence RI
The Momentum Project, Inc., Dawn Bryan, New York NY
Morton Home Care, Cynthia Proulx, Taunton MA
Mother's Voices, Susan B. Anthony, New York NY
Mu'akhah, Incorporated, Na'imah A. Salahudin, El Sobrante CA
N.S.A.F.E. HIV/AIDS Case Management, Denise Kitson, Wilmington DE
Nassau/Suffolk Care Network, Kevin T. McHugh, Consumer Advocacy Co-Chair, Elmont NY
NATAP, Jules Levin, New York NY
National Community Research Initiative, Inc., Gary Paul Whaley, Fulton NY
National Pediatric AIDS Network, Gary Gale, Boulder CO
NBCC, Ozzie Rivera, New Brunswick NJ
NETWORTH/Positive Action, Michael Reynolds, Pleasant valley NY
New Jersey Association on Correction, James A. Hemm, Executive Director, Trenton NJ
New Mexico POZ Coalition and Planetpoz, Ingrid Kloet, Rio Rancho NM
New York AIDS Coalition, Matthew Lesieur, New York NY
New York Harm Reduction Educators,Inc., Edith Springer, Acting Executive Director, Bronx NY
Northern Colo AIDS Project - High Plains, Pam Lindenthal, Sterling CO
Northern Colorado AIDS Project, Zen Dawson, Case Manager, Fort Collins CO
Northern Illinois University, Allie Vernasco, Dekalb IL
Northern Manhattan Perinatal Parnership, Maria Guevara, New York NY
Northwestern Memorial Hospital, Kimberly Scarsi, Pharm.D., HIV Clinical and Research Pharmacist, Chicago IL
NY Presbyterian Hospital / Women & Children Care Center, Elsa Gonzalez, New York NY
Ohio AIDS Coalition, Kevin Sullivan, Columbus OH
Ohio State Medical Association, Alternate Delegate to the American Medical Association House of Delegates, Wright State University Boonshoft School of Medicine, Sunit Srivastava, Breavercreek OH
Okaloosa AIDS Support & Informational Services, Inc.(OASIS), Butch McKay, Ft. Walton Beach FL
One Earth Foundation, Inc., Tracy Carr, Decatur GA
Openarms Youth Project Inc., Tim Gillean, Tulsa OK
P.S.I. Family Services of MD/DC, Leigh B. O'Donoghue, Bethesda MD
Pacific Coast Specialty Group, Sue Reddy, MD, MD, Garden Grove CA
Pan American Concerned Citizens Action League, Inc., Rosalinda Mayo, Jersey City NJ
Partnership for Minority HIV/AIDS Prevention, Sabira Bushra, Pittsburgh PA
Pathfinder International India Representative Office, Sarah Figge, Jungpura Extension New Delhi
Perceptions for People with Disabilities, Orbit Clanton, New York NY
Perinatal Council, Sheila Tarbet, Evaluation Manager, Oakland CA
Pet Project for Pets, Inc, Felix DeBruin, Fort Lauderdale, FL
Project Inform, Martin Delaney, San Francisco CA
Project Response, Inc., Shawn Dougherty, Melbourne FL
Project THAMES*, Mike Barr, New York NY
Public Health Division, City of Portland, Martin Sabol, Portland ME
Pueblo Family Physicians, Mark C. Kezios, Phoenix AZ
PWA Coalition Tampa Bay Inc, Robert W Reynolds, President, Tampa FL
Q-LAND, Michael Linder, Portland OR
Recovery Options Inc., David Shealor, Los Angeles CA
Regional Addiction Prevention (RAP), Inc., Michael Pickering, Washington DC
The River Fund, Inc., Jaya Canterbury-Counts, M.Ed., Executive Director, Sebastian FL
Rivington House ADHCP, Deborah, LMSW Program Director LaRusso, New York NY
Rural AIDS Action Network, David E. Hanson, Lake George MN
Ryan White Title I Planning Council, New Haven/Fairfield Counties, Marie Middleton-Omorodion, Co-chair, Norwalk CT
SA HIV Health Services Planning Council, Robert Dougherty, San Antonio TX
salvagetherapies.org, Nelson Vergel, Houston TX
Save ADAP Committee of ATAC, Robert Reed, St. Louis MO
Search For A Cure, David Scondras, Cambridge MA
Shelter Resources, Inc. d.b.a. Belle Reve New Orleans, Vicki G. Weeks, New Orleans LA
Sickle Cell Disease Association of the Piedmont, Kathy M. Norcott, Program Director for HIV/AIDS Services, Greensboro NC
SMART, Inc. (Sisterhood Mobilized for AIDS/HIV Research & Treatment), Maya Iwata, LMSW, Executive Director, New York NY
South Carolina Campaign to End AIDS (SC-C2EA), Karen Bates, Columbia SC
South Texas Family AIDS Network (STFAN), Dolly Sanchez, San Antonio TX
Southern Arizona AIDS Foundation (SAAF), Anne Maley Executive Director, Tucson AZ
Southwest Community Health Center, Clunie Figaro, Infectious Disease program Coordinator, Bridgeport CT
SPECIAL AUDIENCES, Inc., Ellen Bay, Newark NJ
SPECTRUM Community Services, James Miller, Los Angeles CA
Spokane AIDS Network, Mark Garrett, Spokane WA
The Star Program, Pamela Neely, Brooklyn NY
St. Marieke Bevelanderhuis, Hannah Jansen, 1091 cc Amsterdam Netherlands
St. Philip House, Richard Baraglia, Plainville CT
State Wide Community Advisory Board Leader, Brian Datcher, Gay Men of Color Street Outreach consultan, New Haven CT
Straight From The Heart, Tracey Dannemiller, Lakeland FL
Street Works, Ron Crowder, Nashville TN
Strictly Business Dance Studio and Dance Ensemble, Jason Smith, Salt Lake City UT
Student Global AIDS Project - University of Pittsburgh, Mary Carroll, Fleetwood PA
Suncoast Resort Project, under A.S.A.P., (Aids Services Assosciation of Pinellas), Matthew Salvin, Saint Petersburg FL
Tarzana Treatment Centers, Tom Martinez, Director of HIV Services, Reseda CA
Test Positive Aware Network, Matt Sharp, Chicago IL
Thriving in SF, Dominik Mollica, member, San Francisco CA
Tibotec BVBA, Jens Van Roey, MD, Director of Global Clinical Development D. Mergaertstraat, Belgium
Title II Community National AIDS Network, William E. Arnold, Washington DC
Total Health Awareness Team, JBryan Latham, BSCP, Rockford IL
Treatment Action Group, Mark Harrington, New York NY
Triad Health Project, Melissa Moorehead, Greensboro NC
Trinity Metropolitan Community Church, Joseph McMurray, Pastor, Gainesville FL
UCSF, Paul Volberding, MD, San Francisco CA
United Communities AIDS Network, Nanci LaMusga, Client Services Manager, Olympia WA
Universal Family Connection, Inc., Marcia D. Cloutier, Chicago IL
University Medical Center Consumer Advisory Board, Dontae Crawley, Las Vegas NV
University of California, Davis, Donna DeFreitas, MD, Assistant Professor, Infectious Diseases/Internal Medicine, Sacramento CA
University of Colorado School of Medicine, Shawn D'Andrea, Denver CO
University of Washington School of Medicine, Robert D. Harrington, M.D., Associate Professor of Medicine, Seattle WA
UofL Hospital/WINGS, Mary Bishop, Louisville KY
Utah AIDS foundation, Seanna Williams MSW,CSW, Salt Lake City UT
Valley Mental Health Center, Sandy Lombardi, Ansonia CT
Vermont PWA Coalition, Kathy Kilcourse, Montpelier VT
Village Care of New York, Ilene Pendrick, New York NY
Visiting Nurse Service of New York, Donna Horton, BSN, ACRN, New York NY
VT Coalition for People of Color, Inc., Haskell Garrett, Board of Directors, Montpelier, VT
Wesley United Methodist Church, Rev. Charles M. Straight, Chicago IL
West County Health Centers, Inc. Steve Bromer, MD, Guerneville CA
West Oahu Hope For a Cure Foundation, Joseph Rattner, Executive Director, Ewa Beach HI
Western Pacific Med-Corp, Mark Hickman, CFO, Glendale CA
Whitman Walker Clinic, Christiane Geisler, RN, Clinical Investigations Unit Coordinator, Washington DC
Women Rising Project, Betty Mitchell, Austin TX
Yale University School of Public Health, Mark Kinzly, New Haven CT

INDIVIDUAL ENDORSERS:

Michelle Aldrich, San Francisco CA
Heidi Alexander, Providence RI
John L. Andrews, San Carlos CA
Boyer C. August, Hayward CA
Bill Baker, Durham, NC
Paul Beaudry, Oxford, MA
Marjorie Behnken, Jackson FL
Derek Bell, Vancouver British Columbia
Kahlo Benavidez, Las Cruces NM
Jon Benorden, Anchorage AK
Alan Bergman, oakland CA
Jeff Berry, Chicago IL
John Betters, New York NY
Jerry Biga, New York NY
Elizabeth Bowen, Chicago IL
Richard Boyle, Berkeley CA
David Brennan, Boston MA
Tim Moore/ Brian Griffith, Felton CA
Joseph C. Brister Jr., Long branch NJ
John M. Bronczyk, C.P.M., Certified Purchasing Manager, Chicago IL
Janet Burnett, Fort Lauderdale FL
Rob Camp, New York NY
Rosemary Cardwell, Silver Spring MD
Jessica Celentano, Tucson AZ
Joel S. Clough, Orlando, FL
John C. Cochrane, Akron OH
Robert L. Cohen, M.D., New York NY
Donnie Collins, Seattle WA
Sal Correa, South Gate CA
Lanny Cross, Albany NY
Vince J. Cukrov, San Simeon CA
John Cwiakala, San Francisco CA
Paul Dalton, San Fancisco CA
Paul Dalton, Houston TX
Caludia Debus, Hayward CA
Lorenzo D'Oria, Fort Lauderdale FL
George J. Dowling, St. Louis MO
Kristin Durell, Grand Rapids MI
Robert Edwards, Hampton Bays NY
Robert Ferguson, Farmington Hills, MI
Nilda Fernandez, Farmington CT
Joseph Fierro, New Windsor NY
Debra Finnegan, Hartford IL
Michael Fischer, New York NY
Kerri Fodor, New Windsor NY
Lindsay Mariko Foose, Los Angeles CA
Lynn G. Francis, Rowlett TX
Geody Frazier, Kansas City MO
Barry Freiman, Chicago IL
Sal Fuentes, Ventura CA
Tami Abondano Gaines, Wichita KS
Donald J. Garamella, Black Rock CT
Cecilia Gastón, New York NY
Fred Goldhaber, Jersey City NJ
Franklin Gonzales, Seattle WA
Robert B. Gotcher, Hallandale FL
Genia Graham, Lewiston ME
Roberta Greengold, New York NY
Mia Gregory, IDRC, Community Advisory Board, Indianapolis, IN
Raymond D. Griffin, Albuquerque NM
Richard Hahn, Albany NY
Toni Harrison, Fresno CA
Jeffrey A. Hart, Richmond CA
Paul Haugen, San Francisco CA
Lourdez Hernandez, Trenton NJ
Barry Hinkson, Portland, OR
Tracy Hough, Westchester IL
Victor Hsu, Orange CA
William Hubbard, Palm Springs CA
Ronald Hunt, Mobile AL
Robert Huntington, Hampstead MD
Janet Ivory, East Nassau NY
Hai Linh Kerrigan, Los Angeles CA
Rex Lampman, Midvale UT
Peter Lausen, Carlsbad, NM
Steve Mahkovec, Lisle IL
Jen Margo, South Egremont MA
Judy Margo, MPH, Northampton MA
Michael J. Mann, Houston, TX
Jonathan I. Martin, White river Jct. VT
Joseph R Matteo, Pompano Beach FL
Dennis McClain, Galveston TX
Paul McWilliams, Chicago IL
Yvonne Medina, Las Cruces NM
Dave Mendenhall, Portland OR
Rosetta Menifee, Buffalo NY
Salem Meyers, Gallatin TN
Sheree Miller, Seattle WA
Robbie Moody, Fort Worth, TX
Ava Morgenstern, Waltham MA
Bill Moy, Oxnard CA
Larry G. Newsome, Yosemite, CA
Gilbert Nieto, Austin TX
Derek Northcutt, Carlsbad, NM
Jeffrey L. Norton, Burbank CA
C.B. OHARE, port St. Lucie FL
Mark Pahl, Troy, NY
Sebastian Pasco, Tampa FL
Steven Pastor, Denver, CO
Fiona Pettitt, London, England
Rich Pompetti, New York NY
John C. Prather, Chicago IL
Jessica Pratt, Altamonte Springs FL
Tyrone Preston, Wichita KS
Claudia Preziosi, Bath PA
Dottie Rains, Trenton NJ
Anthony J. Raiola, Jersey City NJ
Robert Rasmussen, E Fallowfield, PA
Teresa Reed, Madison WI
Susan Rodriguez, New York NY
Yvette Rodriguez, Orlando FL
Bradley T. Rood, Bloomington IN
Doug Rose, Abingdon MD
Tom Rouland, Oakland Park FL
Matt Rowe, Brooklyn NY
Armando Saliba, San Antonio, TX
Russell Schnepf, Palm Springs, CA
Johan Schoeman, Arcadia, Pretoria, South Africa
Scott Schumacher, Palm Springs CA
Sonny Scroggins, Topeka KS
Ergeba Sheferaw, Carrboro NC
Benjamin Shepard, Brooklyn NY
Michelle Simek, West Hollywood CA
Courtney Smith, Winthrop MA
Bryan C. Cole Smith, M.Ed., Wenonah NJ
Michael Stacey, Jefferson, WI
Wendi Staib, Williamsport PA
John W. Stone, Waipahu HI
Frank Susa, New York NY
Joseph Tate, oakland CA
Peter Thomson, Koktoom Lopburi, THAILAND
Isabel Tifft, RN Tifft, RN, Santa Cruz CA
Moises Torres, North Hollywood CA
Rev. Jason P. Trace, Portland, OR
Paul J. Trickel, Erlanger KY
Maida Tryon, Silver Spring MD
Lance Tyree, Port Organge FL
Patrick Fitzgerald Walsh, Hollis NY
Dionne Warwick, Orange NJ
Kathryn M. Weiser, Mifflinburg PA
April Welchko, Austin, TX
Ryan Weston, New York NY
Bonnie Williams, Saratoga CA
B. Willis, Dumfries VA
Will Wilson, Chicago IL
Tiffany Wong, Brooklyn NY
Alberto Yanez, Miami FL
Dawn Yerger, Chicago IL
Jeffrey Young, Dallas TX
Kenneth Zink, San Francisco CA