Perhaps more notable than who won the award is who did not: Dr. Robert C. Gallo, the University of Maryland virologist who has long been credited as a co-discoverer of the human immunodeficiency virus and whose early work led to a blood test for HIV that is believed to have saved millions of lives.
Though many in the field said they thought that a long-simmering debate over Gallo's exact role in the initial discovery had been settled and that Gallo and the French team should share credit, the Nobel committee apparently felt differently. Some scientists said yesterday that Gallo deserved to at least split medicine's highest honor.
"The people who won the prize are very deserving," said Dr. John E. Niederhuber, director of the National Cancer Institute in Bethesda, where Gallo did his AIDS research. "But it seems strange to have left Bob out."
The award was shared this year among three scientists, with half of the award going to a German virologist, Harald zur Hausen, who discovered that the human papilloma virus causes cervical cancer, and half to the two French AIDS pioneers.
"We gave the prize for the discovery of the virus. The two to whom we gave the prize, Francoise Barre-Sinoussi and Luc Montagnier, discovered the virus," Hans Joernvall of the Nobel Assembly at Sweden's Karolinska Institutet, which awards the prize, told Agence France-Presse.
Acknowledging that Gallo had "done a lot of other work" in the field, Joernvall noted that he and the two French scientists now "agree that the discovery was made in Paris."
But Montagnier, who has been a colleague and rival of Gallo's for decades, said the American researcher should have been recognized.
"It is certain that he deserved this as much as us two," Montagnier told the Associated Press in Abidjan, Ivory Coast, where he is attending an international AIDS conference.
Gallo, who runs the Institute of Human Virology at the University of Maryland Biotechnology Institute in Baltimore, told an AP reporter who woke him at home early yesterday that he was "disappointed." He later left for South Africa and could not be reached for further comment, but he released a statement congratulating the French scientists.
Colleagues said Gallo was besieged with e-mails and phone calls from scientists around the world, many complaining that an injustice had been done.
Dr. Anthony S. Fauci, director of the National Institute for Allergy and Infectious Diseases in Bethesda, said the Nobel Prize tends to be given to those who first identify a new discovery.
"I don't think it's a critique of Gallo. It's a statement about the very first observation that is made. This is how they decide," he said. "They generally make their decisions based on what they judge to be the first seminal observation as opposed to what came from that discovery. That's their judgment.
"It does not detract from the contributions that Dr. Gallo has made."
The Nobel Prize might not put to rest what at times has been a bitter scientific feud spanning two continents. And Gallo, while seen yesterday in some circles as a victim, has often been a less than sympathetic character, seen as abrasive and self-promoting.
In the early 1980s, Gallo, whose research at NCI had focused on cancer-causing retroviruses, and Montagnier, at the Pasteur Institute in Paris, were each working on isolating the AIDS virus. In 1983, Montagnier identified a virus he called LAV but was unable to prove it caused AIDS. Gallo, nearly a year later, published a paper on his virus, called HTLV-3, establishing that it caused AIDS. Gallo is credited with being the first to grow the virus in a lab, which paved the way for HIV testing and the screening of donated blood.
But a controversy erupted soon after Gallo's publication. There were allegations that Gallo's virus was actually Montagnier's and that he had improperly used it without credit to the Frenchman for first isolating the virus.
The dispute triggered investigations by the National Institutes of Health and by Congress. There was a lawsuit. It was finally settled in 1987 by a highly unusual agreement between the United States and France, with a joint announcement by President Ronald Reagan and Prime Minister Jacques Chirac.
"I was on the original committee that examined the evidence against Gallo," said Edmund Tramont, who now directs the NIAID's division of AIDS. "We examined all the data and came to the unequivocal conclusion that he did all the work on his own. And that what he discovered and what he wrote, that HIV is a retrovirus that infects T-cells, that it was the cause of AIDS was unequivocal.
"He had in his lab previous work that was necessary to isolate the virus and others followed in his footsteps and duplicated what he had done."
Gallo and Montagnier have published joint papers sharing credit for discovering HIV. And as far back as 1986, they also shared the prestigious Lasker Award. The citation given then outlined why they were honored: Montagnier was praised for his role in detecting the virus later identified as causing AIDS and Gallo for determining HIV was the cause of AIDS.
Dr. Bernard Poiesz, who worked in Gallo's lab from 1978 through 1981, said yesterday that because the first discovery was the Frenchman's, the Nobel should be too.
"This is all built upon many, many people's work over the years," Poiesz said. "But if you restrict it to the word discovery, then that award goes to the French."
Dr. Samuel Broder, the NCI's director from 1989 to 1995, worked closely with Gallo. Yesterday, he called him "a brilliant revolutionary investigator" whose work with HIV led to the discovery of lifesaving drugs that significantly shrunk the AIDS death rate, which rose sharply through the early 1990s until new drug therapies came on the market in the middle part of the decade.
"What you have to ask yourself is what would have happened if Gallo were not around - those curves would have shot right up," said Broder, who is now the chief medical officer for Celera Genomics in Rockville. "Symbolically, Gallo is in the room whenever any AIDS patient is getting retrovirus therapy. Those facts speak for themselves."
But Broder stopped short of saying whether he thought Gallo deserved the ultimate prize for his work.
"In terms of how you assign accolades and who gets to become a Nobel laureate, that's not for me to say," he said. "The larger issue is, Bob Gallo and his group transformed medicine in the totality of their work in human retrovirus. Their discoveries are responsible in a dramatic shift in the death rate in this country on HIV; without them, it would not have happened."
Many in the field of AIDS research said it was about time that the discoverers of the AIDS virus were recognized with a Nobel Prize. Some said they suspect it took all these years because of the debate among the players in what one called "the major new discovery of our lifetime."
"There had to be something holding it up," said Dr. John Bartlett, a professor of infectious diseases at the Johns Hopkins University School of Medicine. "I always assumed it was the controversy that made the Nobel Prize group uncomfortable in coming down one way."
Poiesz said he thinks previous controversy over Gallo's role in the HIV discovery might have hurt his chances at being named a Nobel laureate.
"I don't think that cast a favorable light on things," he said. "I think that created concern on a lot of people's minds about whether the French were given the appropriate credit for the discovery."
Rules state that only three people can share the prize, which is worth $1.4 million and will be awarded in December in Sweden.
"It's unfortunate they could only give the award to three people," Fauci said. "If they were able to give it to four people, one could make a very strong argument that Bob Gallo would be in that group."
Timeline of AIDS discoveries
1981: U.S. Centers for Disease Control report finding a rare pneumonia in young gay men.
1982: Disease previously called "gay cancer" is named AIDS (acquired immune deficiency syndrome) by CDC scientists.
1983: Dr. Luc Montagnier and his team at the Pasteur Institute in Paris report discovery of virus they call LAV.
1984: U.S. health secretary announces that Dr. Robert C. Gallo has discovered the probable cause of AIDS, a virus the American scientist's team calls HTLV-3.
1986: HIV, human immunodeficiency virus, is adopted as the name for LAV and HTLV-3.
1987: AZT becomes available to treat people with HIV.
Source: News accounts