World needs to commit more resources to treat people infected with HIV

Leaders of the International AIDS Vaccine Initiative (IAVI) have stressed that as the world commits more resources to treat people infected with HIV, it must also intensify efforts to develop a vaccine to prevent new infections and stop the continuing spread of the virus.

Dr. Seth Berkley, MD, President and CEO of IAVI, and Dr. Wayne Koff, IAVI’s Senior Vice President and Chief of Vaccine Research, briefed reporters at the United Nations in Geneva, following a major conference in Lausanne where scientists discussed preliminary data on candidate vaccines entering clinical trials.

Treatment programs, such as the World Health Organization’s 3x5 Initiative, are helping people with HIV live longer, restoring hope to communities decimated by AIDS deaths. However, treatment does not stop new infections, which are occurring at the rate of 14,000 each day. Some of the most alarming trends in new infections are in Asia and Eastern Europe, and among young women.

“The global response to AIDS must include both compassion for those who are infected and a heightened commitment to protect those who are not,” Dr. Berkley said.

HIV was identified more than 20 years ago. It is only in recent years that significant progress has begun to be made toward a vaccine. In particular, scientists have learned a great deal about the structure of the virus, how infection occurs and how the immune system tries but fails to defend itself. This dynamic is at the heart of the science of how a vaccine needs to work.

Yet the questions that have been answered are outnumbered by those that have not. For most vaccines for other diseases, scientists have been guided by studying people who became infected and then recovered; in the case of AIDS, there is no one known to have recovered from infection. In addition, HIV is a moving target, constantly mutating its shape to evade detection.

“Given what we know about HIV today, we are advancing promising candidates into development and clinical trials. At the same time, basic research questions still must be solved,” Dr. Koff said.

Currently, more than 30 AIDS vaccine candidates are in clinical trials in 19 countries, including five IAVI-sponsored candidates in eight countries. At this stage, experts view the current crop of candidates as a first generation attempt. They expect that an effective vaccine is likely to be developed after more is understood about HIV and the immune system, and new generations of candidates are developed and tested.

IAVI is calling on the vaccine field—including pharmaceutical and biotechnology companies, and public sector research agencies—to work more aggressively and cooperatively to advance progress. This will require substantial new funding; of the US$70 billion spent each year globally on health product R&D, less than 1% is dedicated to an AIDS vaccine.

Recognizing the toll that AIDS has already exacted, and the magnitude of what is yet to come, the world must push a preventive vaccine to the top of international health and humanitarian agendas.