AIDS vaccine

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Seattle’s Julie McElrath leading in the search for an effective AIDS vaccine | 

WHO

Map of the AIDS pandemic

Thirty years ago, Julie McElrath was a medical resident in Charleston, South Carolina, seeing young patients with rare illnesses, unusual forms of pneumonia or cancer, typically only seen in the elderly with weakened immune systems.

“We were trying to care for these people but we didn’t know what they had,” McElrath said. What they had was AIDS. The epidemic had emerged.

Three decades later, McElrath is one of the world’s leading scientists searching for what many believe is the best, perhaps only, hope of ending the pandemic. A vaccine.

“I do think a vaccine is what we will ultimately need,” she said. Recent studies that have shown that treatment can prevent spreading the infection to others is tremendous news, she said, but the logistics and expense of making that happen are daunting.

HIV Trials Network, Fred Hutchinson

Julie McElrath

Today, in her Seattle lab, the HIV Trials Network operated by the Fred Hutchinson Cancer Research Center, she and her colleagues will open precious vials containing white blood cells collected from thousands of Thai research volunteers.

Not that long ago, many had given up on ever finding a vaccine against HIV.

Then, in late 2009, the Thai Prime-Boost vaccine trial (technically known as RV 144) stunned the skeptics, well, okay, almost everybody, by demonstrating that a vaccine could prevent infection. It wasn’t enough protection, but it was protection.

“It gave us hope that this was possible,” McElrath said. Continue reading

HIV Vaccine Awareness Day | 

by hitthatswitch, Flickr

It’s HIV Vaccine Awareness Day.

So you should, at the very least, be aware that for the first time in decades there’s optimism in the field of HIV vaccine research. We appear to be making progress.

I attended a big AIDS vaccine research meeting in Atlanta last fall, at which there was almost a kind of giddiness among scientists who for decades had been frustrated time after time, making little progress. A clinical trial in Thailand, run by the U.S. military in collaboration with Thai scientists, showed for the first time that a vaccine could prevent infection.

Yet the public, I bemoaned at the time, was barely paying any attention .

“This is an exciting time in HIV prevention research,” said Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition.

Most of the public attention is on advances in treatment, Warren said, though last week scientists showed that treatment is prevention by documenting (again) that getting HIV-infected on drugs helps prevent the spread of HIV — a finding that some say is a “gamechanger” in the global fight against HIV.

“At the same time, it is important that the progress in the search for an AIDS vaccine not be over-looked,” Warren said.

Gates Fdn’s Bertozzi: Three things make this World AIDS Day different | 

It’s World AIDS Day, a day we’ve been marking for decades. Millions of people are still dying of AIDS every year, two people still getting infected every day for every person put on treatment.

But this year, it’s different.

Gates Foundation

Stefano Bertozzi

“It’s night and day, at least when it comes to prevention,” said Dr. Stefano Bertozzi, director of HIV and tuberculosis programs at the Bill & Melinda Gates Foundation. “The landscape has shifted dramatically.”

Progess has been made in reducing the rate of new HIV infections through education, safe sex campaigns and the like. The world community has succeeded in getting more people on life-saving treatments. But the pandemic continues worldwide, with numbers (33 million infected, nearly 2 million dying every year) that are daunting if not mind-numbing. Continue reading

Paying attention to progress on an AIDS vaccine | 

Seattle is home to the world’s largest network of AIDS vaccine researchers, the HIV Trials Network, and home to one of the world’s leading funding sources for AIDS vaccine research, the Bill & Melinda Gates Foundation.

That’s why I’ve been in Atlanta all week.

Many, if not most, of the world’s experts on HIV/AIDS vaccine research have gathered here for the AIDS Vaccine 2010 conference. Something like 1,000 scientists from around the world attended.

And, unlike many AIDS meetings, there’s been lots of enthusiasm and excitement here because — after decades of frustration and failure — there’s actually been some significant progress in the search for an AIDS vaccine.

But, really, who cares? Continue reading

A new game, if not new game plan, for an AIDS vaccine | 

HIV, AIDS virus

I’m not sure most people really understand just how crucial it is that we find a vaccine to prevent HIV/AIDS — or that it now seems more possible than ever before.

It’s a totally new ball game, on both fronts.

A huge study in Thailand, reported almost exactly a year ago, showed for the first time a vaccine can prevent HIV infection. And scientists have identified immune system cells (called neutralizing antibodies) that in the lab appear highly effective at killing the AIDS virus.

At the same time, the AIDS pandemic is continuing to spread worldwide and the international community is recoiling at the anticipated expense (tens of $billions) of making good on its promise to get everyone on life-saving treatment. More than 30 million people are HIV-infected and only one-third of those who need treatment now get it.

And so, here in Atlanta at a meeting of the Global HIV Vaccine Enterprise, convened and largely sponsored by the Gates Foundation, the experts have issued a new game plan aimed at “accelerating the search” for an effective vaccine against HIV.

So far as I can tell, the new plan focuses on coordinating the scientific research agenda, sharing data and making the best of the most promising avenues of exploration — about the same as was the original agenda in 2003 when the Global HIV Vaccine Enterprise project was launched.

What’s different is the Thai vaccine trial and the findings on the neutralizing antibodies. We’ve been hearing more about both of these at this meeting. I’ll try to summarize what’s new on these fronts later.

Oh, and the Gates Foundation agenda for HIV vaccine research. That looks different to a lot of folks here, and not all of them are too happy about it.

Nobody’s saying much on the record yet, but I’ll report back on what I can get later.

Tom Paulson

2010 AIDS Vaccine meeting, Atlanta

HIV Vaccine Summit: A world without AIDS | 

Los Alamos National Laboratory

HIV, the virus

I’m in Atlanta this week for a meeting, starting today, aimed at ridding the world of AIDS — the Global HIV Vaccine Enterprise.

A vaccine is really the only way.

After many years of frustration and even despair of ever finding an HIV vaccine, there have been some  significant, positive steps forward in the past year:

These are good signs, indicating an effective HIV vaccine is indeed possible. But we’re probably still a long way off getting one, and not just because of the scientific challenges.

As always, one of the biggest barriers is money.

We (the world community, all of us in the Humanosphere) spend less than a billion dollars a year on HIV vaccine research — as compared to the $30 billion or so we spend treating people and dealing with the still-spreading AIDS pandemic.

“And we’re not keeping up,” said Catherine Hankins of the Joint United Nations Program on HIV/AIDS (UNAIDS). “For every two people we put on treatment, another five people are still being newly infected.”

Alan Bernstein, executive director of the Global HIV Vaccine Enterprise, said there is new momentum and optimism about finding an effective vaccine against AIDS.

“But at the same time, funding for research has dropped,” Bernstein said. He noted that the U.S. government (NIH) and the Bill & Melinda Gates Foundation today are responsible for perhaps 80 percent of the world’s funding for HIV vaccine research.

That has to change, Bernstein said, if we are to speed up the search for the only real chance the world has of beating AIDS. More and more people are still getting infected, he said, and the cost of treating them is ballooning, creating a global moral and financial crisis.

“We’re on a treadmill and the pace is picking up,” Bernstein said. Business as usual will no longer be enough to even remain in place, he said. And true progress will require much more investment in the scientific quest for a vaccine.

AIDS: It’s the Vaccine, Stupid | 

Vaccine

hitthatswitch / Flickr

In 1992, James Carville coined the phrase “It’s the economy, stupid!” to focus the Clintonites in their successful  bid to gain the presidency and, in so doing, created a monster snowclone (a customizable, formulaic cliché).

When it comes to HIV/AIDS, it’s clear that no single approach – or snowclone – can beat the pandemic. It will be a combination of treatment and prevention strategies that turns the tide. But many say success against HIV/AIDS will ultimately hinge on whether or not we get a vaccine. Continue reading

Thailand AIDS Vaccine Lesson: Public Support Matters | 

Earlier this year, I went to Thailand to report on a historic AIDS vaccine study known as the Thai Prime-Boost study (its technical name is RV144).

I was asked by the AIDS Vaccine Advocacy Coalition to offer a journalistic take on the project, the world’s largest HIV vaccine study to date and the only one to show some level of effectiveness.

You can read my report here and the full AVAC report here.

It was a controversial research project, for a variety of reasons. And it almost fell apart – not because of the science but from a failure to appreciate that we can’t develop vaccines without public support and understanding. It takes a lot of people to test a vaccine. Continue reading