Science, marché et compassion. L'intervention des associations de lutte contre le sida dans la circulation des nouvelles molécules

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Abstract
Science, market and compassion. How associations fighting against AIDS are involved in helping to put new molecules into circulation This article looks how associations fighting against AIDS are working to gain acceptance for a compassionate approach to patients in urgent need of therapy. Compassion means giving such patients access to biomedical innovations which have not yet been fully assessed or approved. The article shows how pressure from associations has allowed compassion to be gradually formalised within legal and administrative Systems, thus becoming a new method of making molecules available, outside of the controlled clinical trial and standard marketing circuits. It compares a series of cases in order to analyse how, within a framework of compassion, associations have shaped both the offer and the demand for molecules. Using a specific case study — ritonavir being made available before receiving authorisation to be marketed in early 1996 — it analyses the complex situations which require that the compassionate relationship with patients, medicine marketing regulations and scientific research methods ail be considered at the same time. It thus highlights the existence of different configurations used by the associations to define the relationships between science, market and compassion.