OCT 11990 wna

DUKE UNIVERSITY MEDICAL CENTER

Department of Pediatrics
Division of Infectious Diseases

September 20, 1990

June E. Osborn, M.D.

Dean

The University of Michigan

109 South Observatory Street
Ann Arbor, Michigan 48109-2029

Dear June:

Thank you for your response to my letter of August 31. I
assumed that you had not yet had a chance to receive my letter
and certainly felt that our meeting at the Institute of Medicine
was friendly and we were both busy at that time. The comments in
the letter are certainly not personal ones but were meant to
provoke some thought in particular directions on the part of the
Commission.

The Commission does have the opportunity to help move the
response to the epidemic forward. However, I feel very deeply
that part of our country's ability to respond is dependent on
provision of health care for the disenfranchised. If we do not
acknowledge the problems but rather blame the clinical trial
system we will not be able to progress. Drug rehabilitation and
care for the impoverished requires funds and a particular
commitment on the part of our government. One would wish it had
happened long ago. It would also help with immunization
delivery.

The clinical trial system can be criticized. Individual
units may functicn less well than others but will be forced to
compete for their funds with all units. It is possible that poor
function will result in the failure of an ACTU to obtain
continuation support. This process is well underway and I think
it is important to appreciate that there is self-criticism taking
place within the framework of the clinical trial system.

It is extremely important to acknowledge some of the
positive contributions of the clinical trial system if funding is
to continue. Again, please listen to the perspective of the ACTU
leadership. -

Sad ~*~ MH BUYlean,

Box 2951 ¢ Durham, North Carolina 27710 ¢ Telephone (919) 684-6610, 684-3570

VW eect

 
You have done and are continuing to do an enormously
important job. I appreciate your taking my comments seriously
and sharing them with the Commission.

Sincerely,

, J
4

YW

Catherine) M. Wilfert, M.D.
Professor of Pediatrics
and Microbiology