The Terrence Higgins Trust was picketed by Aids patients for being too closely linked with Wellcome and its AZT, and a vociferous minority of Aids activists began a campaign, alleging it was the drug, rather than HIV, that was the cause of the disease. Preliminary results of the trial, released in a letter to the Lancet in April 1993, showed that AZT was no better than a placebo at preventing death or the onset of Aids in healthy, HIV-positive people.After three years, 92 per cent of the AZT group were still alive, compared with 93 per cent survival in the placebo group. Some patients involved in earlier trials have deliberately mixed their medication with that of friends to limit the risk of being given a useless placebo.Despite such difficulties, British and French scientists planned in 1988 what was then the largest clinical trial of AZT in both Aids patients and HIV-infected people without symptoms. The trial, called Concorde, involved 1,749 patients being followed over a three-year period. It may seem a brutal form of experimentation, but such double-blind, placebo-controlled trials are the most powerful method of determining whether a drug works in prolonging life.The problems of testing AZT in clinical trials have been made worse by suggestions that some patients taking part have deliberately tried to circumvent scientific protocols. For a short period at the end of the Eighties, it was the only ”lifeline of hope” offered to people with HIV and Aids, Mr Partridge says.That was a difficult time for medical scientists who wanted to establish proper clinical trials – when a randomly chosen group of patients taking a new drug are compared against those given placebo.

Scientists are particularly interested in ”clinical end points”, which in the case of Aids often means waiting until someone dies. ”There was a very strong demand from the patients themselves for AZT to be made available as soon as possible.”Gay pressure groups in Britain and the US lobbied hard for AZT, which was the only drug to show any signs of being able to limit the replication of HIV in an infected person. But 1986 was a time of unprecedented pressure on the medical community to come up with any Aids treatment that worked. ”The simple message then was to get drugs into bodies now,” says Nick Partridge, chief executive of the Terrence Higgins Trust, an Aids charity.

About twice as many in the placebo group had also developed Aids. However, after the trial had been stopped, as time went on, the advantages of taking AZT began to become less apparent. It subsequently emerged that AZT at best can only buy a little extra time, perhaps a year, and even then at the risk of some pretty dreadful side-effects.Most Aids researchers today feel it was a mistake to stop this 1986 trial before the true limitations of AZT could be seen. Six months into the experiment, it was clear that patients using AZT were benefiting.

Out of 145 people taking the drug, only one had died, compared with 19 deaths in the placebo group of 137 who took nothing but a sugar pill. Many newspapers, included this one, heralded it as a breakthrough.This was indeed the first real hope since 1986, when a previous clinical trial appeared to show that one drug, AZT, was better than none at all. That trial, too, had been stopped for ethical reasons, albeit after only six months.Yet it must have played on the minds of many of the scientists at the Delta results meeting that, by stopping short this latest trial, they might end up repeating a mistake made with the earlier 1986 “breakthrough”.That trial, it turned out, was ended prematurely. The news emerged earlier this week and made headlines throughout the world. In fact, death rates had been reduced by almost 40 per cent in the group taking two drugs compared with the group taking one.The Heathrow meeting happened two weeks ago yesterday.

It took the committee several days to agree on a public statement, which they wanted to make as soon as possible to tell patients and doctors of the results. The Delta trial showed that two drugs were better than one at preventing death from Aids over two to three years. They needed time to absorb the magnitude of what they were being told, and perhaps check themselves from thinking they had heard it all before. They could even be forgiven for experiencing a feeling of deja vu. It was not the first time that they were being told to stop an Aids drug trial because the results were so good – to continue would be unethical, given that some patients were deliberately being deprived of what had now become the best treatment.
Yet the results were plain to see. When the International Co-ordinating Committee of the Delta trial heard the results of the two-year follow-up of 3,000 patients from eight countries, an unusual silence descended around the table. The ships could reach the Comoros in 48 hours if Mr Chirac ordered intervention..