The Long Push For a Vaccine

Aaron Diamond AIDS Study Targets HIV in China, South Asia and Africa

“There’s something killing the virus,” she said, adding quickly that the reason remains a mystery.

But there are clues, and researchers such as Dr. John Moore at Cornell, have taken this work to the lab stage. IAVI has put resources into this effort as well.

“Ten years ago people didn’t use the words AIDS and vaccine in the same sentence,” said IAVI’s Adasiewicz. “There was nothing going on.”

The reasons have a lot to do with the profit motive. A successful AIDS vaccine is not going to be a terribly profitable product. It’s a medicine that ideally each person at risk will use once, and the measure of complete success will be that the virus is eliminated and nobody will need to use it at all.

So HIV/AIDS vaccine research even now gets only one percent of the world’s spending on health product research and development, approximately $650 million out of a total of about $70 billion. But AIDS is now the leading cause of death in Africa, and the fourth worldwide, less than 25 years after its emergence. The top three killers worldwide—heart disease, strokes and lower respiratory infections—typically afflict the old. AIDS kills the young and otherwise healthy.

Non-profit groups, chiefly IAVI, are starting to take over much of the work. Merck’s top researcher, Emilio Emini, moved over to IAVI in January 2004.

One of IAVI’s top priorities is to establish a uniform standard worldwide to judge the potential effectiveness of vaccine candidates, so that not-too-promising candidates don’t get tested in place of really good ones, simply because the group behind that candidate can afford it. That’s a tall order in a complex research environment that mixes public, non-profit and private funding.

Will there ever be a successful AIDS vaccine?

Most researchers remain convinced that the solution exists, but that verifiable success is at least several years away.

“We’re going to have to be very lucky,” Schlesinger said. “But Pasteur said that chance favors the prepared mind.

“Look at Salk and polio. Years and years of work went by. They thought there was never going to be a vaccine. And then it worked.”

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