MEXICO CITY: Leaders in the quest for a vaccine against HIV acknowledged on Monday that their mission was dogged by many problems and cautioned that any breakthrough lay years in the future.
In a workshop at the International AIDS Conference, they said the AIDS pandemic would only be
defeated by a preventative vaccine, rather than treating people who are already infected.
But they admitted there have been many setbacks in crafting such a shield, and some advocated a return to fundamentals, and said it is time to draw lessons from failure. “Vaccine science is still more of an art than a science,” said Tachi Yamada, executive director of the Bill and Melinda Gates Foundation’s Global Health Programme, a major donor to the vaccine effort.
Yamada pointed to fundamental gaps in knowledge about how the stealthy human immunodeficiency virus (HIV) subverts the immune system. Meanwhile, Yamada said funding, collaboration and cooperation urgently had to be stepped up to avoid wasted or duplicated efforts. He said the arena must be opened up to smart, revolutionary ideas, and a new generation of vaccine researchers must be groomed. “We need big investments for the future not only in the basic science of HIV prevention, but also in clinical trials for an HIV vaccine,” Yamada said.
“We have to be unafraid to fail. The road to success begins with setbacks.” Alan Bernstein, director of the Global HIV Vaccine Initiative, said the hunt was “at a critical crossroads” and any success could only be viewed as “long term.” More than 25 million lives have been claimed by AIDS and 33 million people are estimated to have HIV. A safe, effective primer of the body’s defences – the frontline antibody troops and the heavy artillery of the immune cells – remains far out of reach, however.
Out of the 50 candidates that have been evaluated among humans, only two vaccines have made it through all three phases of trials, and both were rejected as quite ineffective. In the past year, one major vaccine trial was halted after early results showed that it appeared to place volunteers at greater risk of HIV infection. Another vaccine in planning phases, involving tests among 8,500 subjects, was scrapped after a similar formula, tested in 2007, was found to be largely ineffective.
Researchers also urged governments and health communities to ramp up male circumcision to prevent HIV infection, particularly in vulnerable countries in eastern and southern Africa. Three studies were cut short in 2006 after they showed strong evidence that male circumcision could prevent HIV infection, but very little effort has been made to push for more men to go under the knife, they said.
“This is a call to action… to call for male circumcision. It’s been two years and still there is not enough money, focus to scale up effort and more needs to be done,” said Dvora Joseph, head of the HIV department at Population Services International, a US-based non-profit organisation.
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