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A HINDU DOCTOR ON AIDS

If this guy can get this right, what is wrong with the CDC?
By Dr. Devananda Tandavan

Many scientists tried to implicate the African green monkey as the harbinger of a mutated natural virus that suddenly became pathogenic to man and that this was transmitted by the monkey's biting a man. It is statistically impossible for the number of cases of AIDS found in Africa today to have come from a single source such as this. The statistics prove that there was a widespread infection at the beginning of the pandemic. It has also been noted that it is genetically impossible to transfer the HIV virus from monkey to man by natural means. The simultaneous appearance of the disease in the United States, Haiti, Brazil and Central Africa was no accident.

There is monumental evidence available that the spreading of HIV was through contaminated vaccines that were used in these countries. There is no resemblance between HIV and monkey viruses; however, there is marked similarity between HIV and naturally occurring viruses in cattle, sheep and goats. None of these that are naturally found in the animals are pathogenic to man. There is irrefutable evidence that HIV is a manufactured virus, man made to be used in experiments sanctioned by the World Health Organization, National Cancer Institute and other organizations.

This man-made virus in some manner contaminated the growth media that was used for producing the smallpox and hepatitis virus from which vaccines were to be made. Infected smallpox vaccine was used to vaccinate thousands of African people and an infected hepatitis vaccine was used to infect young gay men in California, most of whom volunteered for the research project for the control of hepatitis. This is the only reason that so many gay people were infected. AIDS has been a heterosexual disease from its insidious beginning.

The gay lifestyle was ideal for the rapid spread of the fatal disease. No, the involved agencies have not admitted to their part in the pandemic, but the evidence is there and has been suppressed by all of the media except the London Times which published the smallpox/AIDS connection on May 11, 1987. If we believe the CDC's definition and the known doubling time of the disease (the time it takes for the number of people with the disease to double) of approximately one year, within twenty years the vast majority of the people in the world will be HIV infected. Unless a cure or treatment is found very soon, this HIV may well be the cause for humanity to be eradicated. Continued next month.

AIDS--Easily Transmitted: Part II

The evidence presented in part one of this series points to the disturbing conclusion that the HIV virus probably was man-made and transmitted to people through contaminated vaccines for small pox and hepatitis under the auspices of national and international health organization projects, leading to the present AIDS epidemic. A virus is a clump of genetic material (exactly the same as our normal genetic material) that must be incorporated into a human body cell before it can grow and replicate. It stimulates an immune response from our immune system, thus allowing us to use an immune testing protocol for determining its presence within the body. We were led to believe that the AIDS virus is very fragile and cannot live outside of the body for any length of time.

This is not true. According to S. L. Loskoski's report given at the Third International Conference on AIDS in Washington D.C. 1987 (NO. MP 229), "Researchers from the Centers for Disease Control in their own analysis of the viability of HIV outside the body verified that it is a tough virus which survives for several days after being dried out and placed on stainless steel strips in a desiccator jar at room temperature." We were told that it does not live within the body for any length of time before it manifests as the dreaded disease.

This is not true. The virus can lie dormant within the body's sympathetic system and nodes for as long as ten to twelve years without demonstrating any symptoms. We were told that the virus is fragile and can be easily destroyed.

This is not true. It is very hardy and difficult to destroy both in and out of the body. 70% alcohol, usually a good disinfectant, is not practically effective. High temperature, autoclaving and gas sterilization are effective for surgical instruments, but not readily available in all places. The spermicidal Nonoxynol 9, said to kill the virus, is actually so irritating to the membranes that it makes transmission easier for the virus. Furthermore, the virus entwines its genetic material around that of the human body cell. Being identical in make up, how does one separate the virus from the desirable genetic material?

The virus is primarily blood borne, and thus any exchange of blood will infect the receiver. However, the virus is also found in all of the body fluids. It is in higher concentration in the saliva than in semen. The virus is able to penetrate intact mucosal tissues through the dendritic cells. It can be transmitted through kissing, sexual contact, by contaminated blood on needles or by transfusion of contaminated blood, possibly through exchange of tears, possibly airborne by transmission through droplets of sputum and lung secretions. No studies have been done yet to determine whether or not transmission by mosquitoes or other insect bites is possible, but there is no scientific reason why this would not be a pathway. It is also possible for transmission to occur through infected food handlers. HIV and AIDS are not just sexually transmitted diseases. In fact, we do not really know how some people were infected.

AIDS--No Possible Vaccine?: Part III

In our first two articles on AIDS, we discussed the various ways that HIV may be transmitted and presented evidence suggesting the HIV virus was man-made and transmitted to people through contaminated vaccines. Indeed there are over 7,000-10,000 cases of full blown AIDS that have none of the usual risk factors for the disease. In other words, the way these people contacted the disease is totally unknown. Thus we can see that we do not know enough about its transmission. There are some unusual things about HIV; for instance, there are 9000 to the fourth power (9000 X 9000 X 9000 X 9000) possible Aids viruses.

The virus also has the ability to adapt and mutate whenever it enters a different host, whenever it is attacked by a different medication or to any change in its environment. Furthermore, it usually resides within the body's cells so is fairly well protected from direct onslaught. Since it also is entwined with the host cells genetic material, it is further protected from outside destruction. It seems to be stimulated to more rapid growth as a reaction to the normal immune response of the body; thus a vaccine may cause it to replicate faster. As soon as AZT, a drug that inhibits HIV growth, is given to the patient the virus slowly becomes immune to its action. A three drug technique has been attempted in order to try to fool the virus into not becoming adapted to drug response.

This has not shown the results to be as great as expected. Many virologists believe that a vaccine is impossible to prepare because of the number of variants and also due to the possibility that the virus would stimulate not only replication but also mutation. We have also been told that AIDS does not kill, that the patients die from acquired infections. Just what does the virus attack within our bodies? First: it attacks the T cells of the blood, these are the first line of defense for our immune system. These cells are attacked and eliminated. Yes, this does make one prone to opportunistic infections that are fatal. Secondly, the virus can produce brain rot and nerve damage. It can also produce leukemia-like conditions. These patients are very prone to tuberculosis (TB) which accounts for the rapid rise in this disease that was almost extinct in the USA.

The virus is highly resistant to our present TB drugs. We have been told that the disease cannot be transmitted by food. Recent studies show that this is not true. The dendritic cells in the mouth and intestine can easily absorb the virus that may contaminate food. This contamination is possible by the food workers as well as the health field workers and rodents and other animals. The wastes of our pets may also transmit the virus. Although the pet is unable to contract the disease, it may transmit the virus. I believe that mandatory testing for HIV carriers is necessary so that we can have some intelligent way to combat this plague. This should be amongst the food workers, health field workers, patients, teachers and anyone else that could readily transmit the virus.

AIDS--Awareness is Prevention: Part IV

Our previous three articles on AIDS focused on the nature of HIV and its transmission. We no continue by explaining some basic ways to prevent contracting AIDS and the urgent need to increase awareness of this deadly dilemma. It seems there is little that we can do to conquer the "plague of the century" but we must try. our first line of defense is to be AWARE. We must arm ourselves with as much knowledge as we can. We can not blindly accept what the health and government agencies of any nation say about it, for they have a political and monetary interest which makes them prone to be less than truthful. We must realize that the blood supplies may all contaminated in spite of testing programs-often short cuts are taken.

So if one needs elective surgery, he should furnish HIS own blood for use during or after the surgery. Become politically active to assure that meaningful laws are passed to save the uninfected. The fear of losing one's job if found HIV + should be eliminated, an alternative is needed. We must know that our dentists uses heat sterilization of his well cleaned instruments. He, as well as the patient, should be protected by glasses or other shields. WE must know that the endoscopes (instrument used to look within the body cavities) are gas sterilized. At home, the usual home disinfectants are to be used judiciously. Although chlorine does kill HIV, one must be assured that proper procedures are taken in the care of swimming pools, for indeed these are reservoirs of human secretions. There is no such things as SAFE sex, except NO sex.

Those who propose that the use of a condom makes sex safe are doing a very great disservice to our youth. HIV can be transmitted by kissing, possibly even by holding hands and other body contacts so even light petting is forbidden with you do not absolutely know is free of the HIV. We should consider that anyone who is promiscuous is probably HIV+ and therefore a health hazard. Consider that all prostitutes are HIV+. The ancient Hindu practice of brahmachariya, chastity, must be brought back as the rule again. I also believe that mandatory blood testing before marriage is essential. The great fallacy of our youth is, "That cannot happen to me!" The truth is that it can happen to you-and to you and to you and to you. And it may well happen unless we are aware every moment of the day and night of the potential threat. Condoms have 15-25% failure rate even as a preventative of pregnancy. Studies have shown that the HIV came through 33% of the condoms tested. The virus is much smaller that the natural holes in the latex condom.

This was an experiment without any motion or pressure on the condom, which I conclude is spurious-the failure rate is probably nearer 75%. Because of the political nature of AIDS, the money made by the researchers and pharmaceutical houses and the great sums that the insurance companies lose, all humanitarian aspects of the disease are forgotten. Government and news agencies fear creating panic. Yet the possibility of killing the vast majority of people and the reduction of their finances to the poverty level is REAL. The subject of AIDS is 99% political, 1% medical and 100% fatal. BE AWARE, and protect yourself.

AIDS--Develop Healthful Habits: Part V

In this fifth column on AIDS, we continue with ways to protect ourselves from this deadly disease. In order to have an healthy immune system, one that may ward off contaminants and maintain a perpetual balance of the doshas, especially at the change of seasons, we adopt the Ayurvedic Vegetarian diet. Fresh vegetables in variety will help to make the system healthy, especially when the science of taste is also used to keep the doshas balanced.. Since there is ample proof that for most of us the produce is not really fresh, we must take supplements. Especially the antioxidants and members of the B complex of vitamins which stimulate the immune system. We recommend Vitamin A (as beta carotene); Vitamin C fortified with citrus bioflavonoids; Vitamin E (d Alpha tocopheryl acid succinate) and Selineum (selinomethionine and seliniumselenate). Other nutrients can be taken upon the advice of your health practitioner.

There are also many herbs that stimulate the immune system; the advice of an experienced herbalist is suggested. Excessive use of alcohol and any use of drugs is to be discouraged. There are many scientists who believe that drug addiction, whether it be medical, recreational or so-called "nutritional" tends to weaken the immune system. The fact that most drugs are toxic at some level adds credence to this theory. Try to get all of your nutrition from natural foods and natural sources of vitamins and minerals. For example; Chywan Prash is a good source of Vitamin C. Learn to understand your doshic needs and how to satisfy them with food manipulation and the creative use of spices and condiments. It has been shown repeatedly that exercise (a brisk walk of 1/2-hour duration) helps to maintain a strong immune system and a feeling of well being.

Swimming is an excellent form of exercise, but we need to exercise caution about swimming in public pools-they must be adequately disinfected. To assure a healthy immune system we must get adequate sleep that is restful and invigorating. Since we know that stress tends to lower the efficiency of the immune system, it is wise to keep the stress level low. This may be done through meditation and a life-style that brings God and the gods into your life. Science has shown that meditation can lower blood pressure, stimulate the immune system and give a sense of well being. Living a life of joy and optimism makes both body and mind healthier. Feelings of hatred and revenge adversely affect the immune system. Although we may be tempted to fall into periods of despair, disgust and hopelessness, if we remain joyful, peaceful and loving, our health (and immune system) are at their optimum. If we are exposed, we may become infected.

The strong desire to have sex must be controlled. It would help stem the pandemic if people would return to the consideration of sex as the holy and sacred rite that it is. This past week reports were made that the hoped-for AIDS vaccines all failed their final tests-none worked. It was also reported that some of the major medical centers are now admitting that the use of dietary supplements (such as we have just mentioned) do help keep the immune system healthy. If we protect ourselves from contact with the virus and maintain a healthy immune system, we may survive this pandemic.

AIDS--Avoiding Contact: Part VI

This is the last of a six-part series in which we have been discussing the most commonly held ideas about AIDS and its professed cause, HIV. We must point out that there is a small number of scientists that do not believe that there is a causative relationship between HIV and AIDS. Although they make many good arguments, the majority opinion is that HIV is the virus that causes AIDS. The definition of AIDS has changed many times and now represents a composite of diseases that are due to immune deficiency. HIV is, supposedly, one of the deadliest causes of immune deficiency.

Illegal drugs, other toxic drugs and addictions and stressful situations also contribute to immune deficiency. Infection with this virus may occur in anyone, no matter what their color, creed, political affiliation, sexual preference or place of habitation. Then what can we do to save ourselves from this dreaded disease? The answer comes in the following categories: behavior, diet and nutrition, scrupulous rules of hygiene, exercise, transmission by blood and its products and stress reduction. Since we know that the virus is able to live on exposed surfaces both wet and dry for hours or days, it behooves us to keep our environment as clean as possible. Frequent washing of flat surfaces with household bleach (1/200 strength) is advisable. Scrupulous washing of the hands before cooking and eating is essential.

The lips must not be touched by the unwashed hands. Hand washing, preferably with sudsy detergents that do not tend to cling to the skin, should include rinsing with copious amounts of running water. Cooking utensils should also be so cleansed and air dried. Since the body fluids also carry the virus, we should frown upon and eliminate such social habits as spitting on the streets and sidewalks and urinating or defecating in public places where one may accidentally come into contact with the body wastes. Western-style toilets should only be flushed with the lid down to prevent possible airborne dissemination of contaminated water. Drinking and eating utensils should not be shared with others.

The feet should be washed thoroughly before coming into the home. Avoid touching them with the hands If one finds it necessary to administer to or nurse a patient with AIDS, he must use double latex gloves and a surgical mask. There should be caution and adherence to the rules of surgical practice, yet with no trace of fear in one's mind. Special caution should be followed when dealing with any of the patient's body fluids and daily sterilization of the utensils and surroundings are mandatory. If you need elective surgery, make arrangements to deposit your own blood with the hospital for use in case you need a transfusion.

I also recommend that you arrange with a friend or relative whom you know to be HIV negative (by testing) to be on call in case you need emergency blood. Of course, compatibility must also be tested. Wear an ID-band with this information on it or place the information with your other ID papers in your wallet. The risk is small, but why suffer if a small preparation will save you?

See more of this doctor's thoughts at:  http://www.hinduismtoday.kauai.hi.us/ashram/HimalayanAcademy/Publications/Health/Dr._T_all_columns.html

From FRONTLINE, India- Dec. 19, 1998

The quest for an AIDS cure

With no vaccine in sight and the possiblity of a total cure still remote, the only hope in the battle against AIDS has been a major finding by a team of U.S. scientists that has led to advances in multi-drug therapy.

THE Human Immunodeficiency Virus (HIV), the causative agent of Acquired Immune Deficiency Syndrome (AIDS), which has infected an estimated 30 million people around the world, is perhaps the cleverest of the micro-organisms that afflict humans. As the names of the virus and the disease imply, the infection attacks the very root of the immune system, namely the T-cell lymphocytes (white blood cells that normally confer protection). It does not so much destroy the immune system as it thrives in it. Ongoing research seems to reveal that HIV usurps the immune response for its own replication in the human host; this situation makes both prophylactic and therapeutic interventions major challenges to biomedical research.

No wonder, therefore, that 17 years after the first case of AIDS was diagnosed, the world is far from being close to a cure or a preventive vaccine for the disease. Meanwhile the infection is spreading at a phenomenal rate of 16,000 cases a day (based on 1997 figures). Last year alone about 2.3 million people died of AIDS the world over, which was probably more numerous than the number of deaths due to malaria. A more worrisome fact is that the rates of prevalence of HIV in some countries in Asia have shown increases of over 100 per cent between 1994 and 1997. Today 90 per cent of the HIV-infected population is in developing countries: the World Health Organisation (WHO) estimates that more than four million people have been infected in India. Hence, a strategy to halt the spread of HIV is of utmost importance to developing countries, particularly India.

Dr. Jose Esparza, Director of Research, United Nations Programme on HIV/AIDS (UNAIDS), who was in New Delhi recently to attend the Tenth International Congress on Immunology (ICI) says: "We believe that behavioural intervention (among high-risk groups) alone would not be sufficient to control the HIV/AIDS pandemic and that a safe, effective and affordable AIDS vaccine may be our best hope." The first HIV vaccine was developed 10 years ago and till date Phase-I trials (for safety and immunogenicity) have been conducted for nearly 25 candidate vaccines. Two of them have entered Phase-II trials (in the United States and Thailand); one of them (developed by VaxGen) has recently been cleared for Phase-III (or clinical) trials as well in the U.S. and in Thailand.

Clearly, scientists are nowhere near realising Esparza's hope. Scientists such as Dr. Fritz Melchers of the Basel Institute of Immunology believe that developing a vaccine may even be impossible because the HIV undermines the very immune system that is supposed to mount a preventive immunity. In this scenario the only succour that is available today to HIV-infected persons and AIDS patients is "anti-retroviral" drug therapy. Even here, the recommended multi-drug therapy at best prolongs the survival of patients and delays the onset of the disease in HIV-infected persons by lowering the circulating viral load in the body. But a recent finding by Dr. Anthony S. Fauci and his colleagues at the National Institute for Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH), Bethesda, U.S., may lead to a cure. However, the price of the cure will be heavy.

HIV is a retrovirus or a "slow acting" ribonucleic acid (RNA) virus, which integrates into the host cell deoxyribonucleic acid (DNA) and multiplies when the cell divides. In this form, called provirus, the infection remains lifelong. More significantly, HIV can also integrate into non-dividing cells such as nerve cells and brain cells and produce viral proteins even if it does not replicate. In HIV infection, as in other retroviral infections, the gestation period from infection to full-blown disease is long, between eight and 10 years. The virus, therefore, has ample time to infiltrate and "hide" in safe havens within the host's body before manifesting itself as and when the biological environment is conducive to that. Indeed, the time lag between infection and its detection - even in a screening of high-risk groups - would amount to a significant delay because the diagnosis is done by measuring the viral load in the blood plasma in which latent viral pools do not show up. Any effective cure, therefore, has not only to prevent the replication and expression of the virus but clear the system of the virus, from all its 'hideouts'. As regards the former, the frequent mutations of the virus and HIV's genetic variability seem to pose a major challenge. As regards the latter, the locations of these hideouts, or what are called the latent virus pools, are not known.

In a major research finding reported at the ICI, Fauci's team has identified one such hideout. The team has also found a therapeutic mechanism to flush out the virus pool from there and purge it with the help of anti-retroviral drugs. However, as Fauci cautioned, the discovery does not mean that a cure is at hand. "First we have looked at only one reservoir whereas there could be many. Furthermore, even here we have to see that the viral load does not increase in the long term when the patients are put off drug therapy. This requires a carefully planned follow-up strategy," he said. The drug regimen that has been found to work reasonably well, and is followed all over the world, is the Highly Active Anti-Retroviral Treatment (HAART), a combination of zidovudine (AZT), lamivudine (3TC) and crixivan (Indinavir).

It is basically a dual approach in the sense that it uses two types of drugs, one a reverse transcriptase (RT) inhibitor and the other a protease inhibitor, to prevent virus replication and/or viral protein expression. Reverse transcriptase is the enzyme that helps the RNA virus to convert into a DNA form and integrate itself into the host cell DNA so that it can replicate. But HIV has been found to mutate in order to evade any intervention at this stage. Protease is the enzyme which aids in the maturation of the virus before the viral proteins can be expressed. The assumption underlying the therapy is that it is extremely unlikely that a virus will mutate in the same cell and at the same time to evade both RT and protease inhibitors. Therefore, closing both the gates should work. The regimen includes two RT inhibitors and one protease inhibitor. But the therapy fails to attack the latent reservoirs.

One of the "reservoirs" of HIV is believed to be the cells known as 'Resting CD4+ T cells', which are part of the immune system. CD4+ T cells are those lymphocytes which express on their surface the protein called CD4 that binds well to HIV. Resting CD4+ T cells are those among the CD4+ T cells which have not yet seen the target - the antigenic molecules - and hence have not so far been activated to take part in the immune response. The body has a total of about a trillion lymphocytes of which 'Resting CD4+ T Cells' that harbour 'replication competent HIV' constitute tens to hundreds of millions. The important thing is that this latent pool is formed immediately after the first infection and can remain latent for as long as 15 years.

One of the clinical observations that led to Fauci's research is that in patients with active infection, any intervention to treat (or prevent) opportunistic infections such as tuberculosis was found to enhance the circulating viral load in the body. He inferred that the cytokines (or regulatory molecules) such as Interleukin-2 (IL-2) that control proliferation, differentiation and the immune response of a number of immune system cells, notably T cells, seem to drive the replication of HIV from the latently infected cells. Fauci's team found that cytokines not only regulated the replication of the latent virus pool but enhanced the expression of latently infected cells. In other words, cytokines such as IL-2 seem to clear the virus out of its hideout in resting CD4+ cells and the virus then begins to replicate and express itself. The exact mechanism by which this happens is not quite clear yet but this suggested that if HAART is adminstered to HIV/AIDS patients in combination with IL-2, the latter could tease the virus pool from its hiding and purge it with the action of HAART.

The NIAID team studied two groups of patients: 12 patients receiving only HAART and 14 patients receiving a combination of IL-2 and HAART. IL-2 was administered either subcutaneously or intravenously; the dose was between three million and 18 million international units (IUs) a day during a five-day treatment cycle, which was followed by a rest period of eight weeks before the next treatment cycle began. The viral load before the start of the experiment was less than 50 copies of HIV per millilitre of blood. The median time that the patients in the IL-2 + HAART group were receiving IL-2 was 39 months.

In six of the 14 patients (42.8 per cent), the researchers did not find any detectable replication-competent HIV in 10-20 million resting cells taken from the patients' peripheral blood. When much larger numbers of resting cells were cultured, in the range of between 200 and 300 million, three of the six did not show any detectable replication-competent virus. By contrast, in patients receiving HAART alone, replicating virus was found consistently in all the 12 patients. In the former group, a biopsy of the lymph-node tissue (the seat of the lymphocytes) also showed no detectable replication-competent HIV. When patients responded well, the interval between cycles of IL-2 was extended. The NIAID study now has patients who require only IL-2 once in several months and even some who require it only once or twice a year. One of the patients in the study has responded so well that he has received IL-2 only once in the past two years.

Fauci says: "Our new data suggest that in HAART-treated patients, IL-2 may have a role in reducing this 'reservoir' of virus, where HIV would otherwise remain sequestered from the immune system." For the first time it has been demonstrated that a "reservoir" of dormant virus can be cleared and eliminated by therapeutic means. The finding also suggests that the concept of a "therapeutic vaccine", which would be administered to HIV-infected patients in a bid to control virus multiplication, may not work because, if Fauci's finding is correct, the vaccine, by triggering cytokines, would only help viral multiplication. Perhaps such a therapeutic vaccine will also have to be administered with HAART.

More important, Fauci says that there could be other hidden reservoirs of HIV, and these may include the brain, testes, CD4+ T cells in other lymphoid organs such as the gut, and other immune system cells such as macrophages. These clearly imply a formidable obstacle to the ultimate control or eradication of HIV from an infected person's body.

However, the hope is that since IL-2 is a very general kind of cytokine that regulates the functions in even these cells to some extent, only small latent pools may be left unflushed and the immune system may be able to handle smaller latent pools.

From the perspective of medication, this finding will only push the hitherto high costs of chemotherapy to phenomenally high levels. At present the three-drug HAART costs about $18,000 (about Rs.7.65 lakhs) a year. From the point of view of a developing country such as India, this is unaffordable even to the rich. And this does not include other costs of health care and support of HIV/AIDS patients. IL-2 does not come cheap. In fact, in comparison to its market price of about $10,000 per million IUs, the cost of HAART drugs is negligible. Assuming that about one cycle (50 million IUs of IL-2) is administered every two months, the extra monthly cost of chemotherapy would be some $25,000 - clearly out of the reach of people in developing countries.

Even for developed countries this calls for a cost-effective technique and facilities for large-scale production of IL-2 in order to bring down the cost of therapy. (The fact that there are some indigenous efforts to produce AZT and IL-2 will not alter the situation greatly.)

Of course, if the finding does lead to a cure, a patient may undergo this therapy only for a short period of, say, two years. Fauci, however, does not wish to hazard a guess as to how much the modified therapy would cost if IL-2, now marketed as a biochemical for research, becomes a drug. "IL-2 is still an experimental drug with regard to its use in HIV disease. It has not been approved by the U.S. Food and Drug Adminstration (FDA) for use in HIV disease. Therefore I do not have any idea what its price would be if it were ultimately marketed for use in HIV disease."

Fauci says: "Vaccine (for prevention, and not as therapy) is the only option for developing countries. Given the viral variations in the Indian population, the sooner India gets a sound vaccine development and testing programme going, the better for it and the rest of the world." But even from the perspective of the developed world, notwithstanding the first ever Phase-III trials of a vaccine about to get under way, major scientific challenges and problems remain. Not the least is an understanding of the immune system itself.

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