|When Will We Have a Global AIDS Vaccine?
April 28, 2008
By B. Prasai
Recently, world scientists have stated recurrent failure in finding a global AIDS vaccine despite best possible inputs. Not only have human AIDS vaccine trials failed, a serious risk is posed to the lives of some who have been tested with it. The global scientific community however is not one to despair knowing solutions do not come by easily. Moreover, vaccine trial failures have occurred previously but achieved universal success at later stages. Remember the Polio vaccine? It took scientists 47 years to develop it, 42 years for Measles, but for AIDS, an infectious disease discovered only two dozen years back, research is still on-going.
The alarming fact is, according to UNAIDS, the global AIDS epidemic has so far killed 27 million people sweeping across the global economic divide and across continents affecting men, women and children. The global estimate in 2008 is 33 million people still living with the virus, and the trend of infections continuing unabated, each new day unfurling 6,800 infections and 5,700 deaths. AIDS since it was discovered has cut a destructive path across entire continents and across all socioeconomic, racial and ethnic lines. Men, women and children have succumbed to the disease. Globally, UNAIDS estimated, in 2007 alone, 2.5 million people became infected and 2.1 million deaths occurred from AIDS. In the US, nearly 560,000 people have died of AIDS while 1.1 million infections have been noted, most of the infections concentrated in the US South. The bold and courageous bipartisan initiatives launched by President George W. Bush through the President´s Emergency Fund for AIDS Relief PEPFAR) indicate intervention areas that are hitting home in the 15 most affected and other AIDS affected economies, but still there is a need to focus more on scientific and cultural education about AIDS with this new increased funding.
The role of the AIDS vaccine was considered a serious bet to rely on until now. There was urgency in the US pharmaceutical companies to develop a vaccine that worked, and various trials earlier indicated some promise. But now, the global chorus of AIDS activists is on what they consider a lack of indifference to ameliorate the concerns of AIDS sufferers.
Mark Mulligan, James Curran, Eric Hunter, and Carlos Del Rio in an interesting commentary ´Vaccine search is vital in HIV/AIDS arsenal´ for the Journal-Constitution note, "Global access to HIV/AIDS prevention, testing and antiretroviral treatment is inadequate, and increased funding is needed. We strongly disagree … that the best way to fight AIDS is to end government funding for HIV vaccine research and to redirect those funds to prevention, testing and treatment." The authors also believe, "Despite impressive initial steps in antiretroviral rollout in developing countries — due to the U.S. President's Emergency Plan for AIDS Relief and other programs — only a fraction of those in need of treatment have received it. The number of HIV-infected persons being treated with antiretroviral drugs in less developed countries is fewer than either the number of deaths or new infections in a single year. Since therapy does not cure HIV, every new infection represents a person who ultimately must be treated for life."
Recently Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, stated that the US government was unequivocally committed to sustained HIV vaccine research based on a balance of resources devoted to HIV/AIDS research. The occasion was the National Institutes of Health Summit on HIV Vaccine Research and Development attended by various AIDS scientists, care providers and community members in Washington on March 25 which did discuss some innovative research approaches. Heads of various American scientific communities and AIDS related research organizations do agree that funding for HIV vaccine research must not be cut. If anything, it needs to be increased. For them ´persistence, sustained scientific effort and increased collaboration will drive the quest for an HIV vaccine forward —- just as they did for the polio vaccine.´ Dr. Fauci believes that priorities need to be reassessed though, while the bigger pharmaceuticals seem to be racing against time for a vaccine solution to the AIDS crises.
Officials had called the Washington conference after last September´s widely cited failure of a major vaccine trial funded by NIAID and developed by Merck. Global researchers had spent a decade and a few hundred millions dollars developing the vaccine, a deactivated version of the common cold to deliver some HIV proteins to the immune system. However in its two clinical trials, the vaccine not only failed to protect people from HIV, it actually may have made them more susceptible to infection. This baffled the researchers not knowing why it occurred. Similar to these efforts, more than two dozen major research experiments in the past decade have delivered little results because it appears the vaccines stimulate the body´s system mechanism, while the HIV virus attacks the system directly. At the same conference Professor Warner C. Greene from University of California, San Francisco, who co-chaired the meeting stated, "Despite hundreds and hundreds of millions of dollars, the reality in 2008 is that an HIV vaccine clearly remains beyond our grasp…the HIV vaccine field is clearly at a critical crossroads."
So what about the AIDS vaccine? It now seems there is need for broadened research based on prudent solution outcomes. Top scientists working on it should need not be discouraged. In fact the US has put a holistic and credible effort until now. After PEPFAR was authorized with new spending levels approved by the U.S. House on February 28, the U.S. Government has now tripled its effort in the fight against the world´s most infectious disease. This is a large bi-partisan commitment led by President George W Bush, and can be considered one of the most challenging and successful US aid dispensations in its modern history, particularly in providing relief to millions of people in the developing countries requiring wider health interventions.
America, Europe, Japan, China and India have the world´s leading scientific research community in global health. Now it is time, a consortium of these scientists get together on a routine basis and make their research results known to the media and public as well. The scientists have already dedicated hundreds of thousands of hours doing research, which is a time consuming and trial and error process. It often involves hypothesis generation, testing, refinement and retesting. Their benefits must be assessed against the global onslaught of AIDS.
Mark Mulligan, James Curran, Eric Hunter, Carlos Del Rio have stated," Vaccine development historically has taken decades, with each interim result contributing new knowledge. The recent clinical trial called the Step Study tested one candidate HIV vaccine. It was disappointing that the vaccine did not protect those who received it. But the study was successful in that it was well-executed and efficiently provided an answer, albeit not the desired one." However they believe that new and better HIV prevention interventions are clearly required. Until now, vaccines have been the most effective weapons against infectious diseases, and in the case of polio and measles, a total success. The world desperately needs a vaccine for AIDS prevention which might prove the ultimate panacea against further deaths and help reduce the global infection rates remarkably. The question is, when?
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