As HIV vaccine conference opens, experts appeal for sustained commitment to global fight against disease

Oct 20 2009

Experts, gathered for the start of a four-day conference on HIV vaccines in Paris, called upon donors to maintain their funding support for the fight against HIV/AIDS despite the global economy, Agence France-Presse reports. "The financial crisis is of course affecting, and clearly affecting, the capacity of donors to fund international programs on AIDS," Michel Kazatchkine, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, said. Kazatchkine noted that 2010 would be a "key year when it comes to funding global health and funding AIDS prevention, treatment and AIDS science," adding, "The risk is ... that we lose the momentum, that we lose the trust and that we lose the hope that we have generated in an unprecedented movement in global health in the last eight years" (Ingham, 10/19).

"I'm very concerned that AIDS is slipping off the agenda in many countries of the world due to a combination of financial and economic crises," said Peter Piot of the Institute for Global Health at Imperial College London and a former UNAIDS head, Reuters reports (Lyn, 10/19). Although four million people are now on antiretroviral treatment, an increase of 36 percent in just one year, "we can't treat our way out of this epidemic," Piot said, according to Health-e/allAfrica.com. "For every person who gets antiretroviral treatment, there are two to three others who get infected. We have to invest in prevention, including vaccine research. AIDS is a long-term problem and we need a long-term approach."

The news service reports that Piot also addressed U.S. PEPFAR funding. "The big test will come next year when the Senate votes on the next PEPFAR budget," Piot said, adding, "[President] Obama has already said that the aid money should not just go into AIDS, but also into maternal and child health. I am not sure what is going to happen. I think the people already on [ARV] treatment are fairly well protected, but will there be money to enroll more people on ARVs? Will there be money for HIV prevention?" (Cullinan, 10/20).

Times Live reports that in 2007, funding for HIV vaccines dropped 10 percent globally. "Dr. Alan Bernstein, the executive director of the Global HIV Vaccine Enterprise, said the speed with which a successful HIV vaccine is developed would be influenced by the funding available. 'Today, more than ever, I am confident an HIV vaccine will be developed. How quickly depends on the money and ideas,'" he said (Keeton, 10/19).

Full Results From Thailand AIDS Vaccine Trial Released

Also during the AIDS vaccine conference Tuesday, researchers presented a full analysis of the results from an experimental HIV vaccine tested in Thailand, the Los Angeles Times reports (Maugh, 10/20).

The full results of the study, published online Tuesday in the New England Journal of Medicine, "include two additional analyses that merely suggest the vaccine is beneficial, rather than providing definitive proof," the Associated Press reports. Though one analysis found "[n]ew infections occurred in 51 of the 8,197 given vaccine and in 74 of the 8,198 who received dummy shot" - a "31 percent lower risk of infection for the vaccine group," a "smaller analysis of just the 12,452 participants who received all six shots exactly on schedule, [revealed] there were 86 infections — 36 in the vaccine group and 50 in those given dummy shots" (Marchione, 10/20).

"This is a weak signal, but a signal that has enough relevance that we need to pursue it," Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, Bloomberg reports.

The more detailed analysis of the AIDS vaccine trial also showed the vaccine appeared to provide the most protection during the first year following the vaccine. "The trial raises more questions than it answers," Alan Bernstein of the Global HIV Vaccine Enterprise, said. "The initial protective effect after the first year looked like it was 60 percent and it dropped off with time. The most important thing with vaccines is memory. Your body remembers it's vaccinated so when you encounter the real bug you are prepared. We need to explore what's going on there and extend that benefit" (Bennett/Cortez, 10/20).

"The results [of the trial] also hint that the vaccine may be more effective in the general population than in those at higher risk of infection, such as gay men and intravenous drug users," the U.K. Press Association reports. "It was the first time an AIDS vaccine was tested mostly in heterosexuals at average risk, and doctors have long known that how a person is exposed to HIV affects the odds of becoming infected," according to the news service (10/20).

"The findings raise a number of questions that have important implications for future directions in vaccine research," Raphael Dolin, of Beth Israel Deaconess Medical Center in Boston, wrote in a New England Journal of Medicine editorial. "The answers to these and related questions will require the application of a balanced and coordinated research approach to the complex and difficult problem of the development of an HIV vaccine" (10/20).