But the agency’s reservations about cure research may be softening slightly. Fauci says he hopes to spend some $60 million in the coming year. As of 2013, research networks that niaid funds will be required to include studies directed at a cure. Given Washington’s budget crisis, any increase in funding is noteworthy, and some are choosing to see it as a sign of new commitment. “Tony Fauci is definitely a believer,” says Deeks. He is? “The world has changed,” Deeks says, smiling. “In the past, no. In the future, yes.”
Fauci didn’t seem like a believer when I spoke with him. Gene therapy, he says, is “promising, but it ain’t gonna be easy.” Awakening the latent reservoir? “Nothing that’s a hot product.”
What the NIH spends on cure research “is not even close to enough,” says Frost. “It doesn’t come close to representing the genuine enthusiasm the scientific community feels about the issue—and we risk losing that enthusiasm. The science isn’t all that difficult. We’re closer than people think, and with the right financial investment, we can get there. The real question in my mind is, are we going to find the money to do it?”
Brown’s second transplant cured his leukemia, but it was much harder on him than the first. Neurological problems can be a side effect of the chemotherapy and irradiation used in ablation. In Brown’s case, his doctors suspected that the leukemia had infected his brain and ordered a biopsy. It was negative but brought new trouble. “The surgeons left air bubbles on my brain and had to perform emergency surgery to relieve the pressure,” Brown says. He temporarily lost the ability to walk and talk. Hütter says that CT scans show a scar inside Brown’s head. He cannot pinpoint exactly what happened.
Brown was in physical therapy for more than a year. His intellect is intact, but today he sometimes gropes for words. He still walks haltingly. “My public personality has changed,” he says. “I am not as outgoing as I once was—for better or worse. Part of it is that I no longer feel very attractive.”
In January, Brown moved to San Francisco. His new doctor is Deeks, who is both treating and studying him. Brown is happy to be studied. Aside from a brief stint with ACT UP when he lived in Seattle in 1989, he was never an activist. Being poked and prodded by doctors—and reporters—is his activism now. “I can help,” he says.
Brown’s neurological injuries are of no relevance to the question of how to cure AIDS, but they do serve as reminders of two things we already knew: Ablation is hell, and disease capricious. I asked Brown about living with the knowledge that something has happened to him that has happened to no one else. “I do wonder why,” he says, “but sort of in the same way that I wonder how I got leukemia in the first place. I guess I do not need to ask that question about why I got HIV.” He was twice diagnosed with a fatal disease and cured of both, only to be left impaired—possibly for life, probably by the very thing that cured him. It is not clear whether Brown is the luckiest man in the world or the unluckiest. He’s been lucky for the rest of us.