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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?

A gathering of the world’s leading AIDS scientists
Tom Paulson

The folks at this meeting clearly cared, but if media coverage is any indication not many others do.

Something like 5,500 people still die every day from AIDS. Most agree that finding a vaccine is our only real chance of stopping the pandemic. But most of us seldom give much thought to what it will take to find one.

There’s a problem with assuming that scientists will just do what they do without our attention and support. Public apathy affects political support for a cause, and often funding priorities.

The photo above is from one of several press conferences I attended along with a few other journalists, most of whom came here under sponsorship of the National Press Foundation. This journalism program is done in collaboration (I mean that in the best possible way) with the Global HIV Vaccine Enterprise, which runs the meeting, and is funded by the Gates Foundation. It’s all aimed at trying to get coverage for this cause.

On the left up there in the photo is Dr. Nelson Michael, a U.S. Army scientist and one of the leaders of the world’s largest AIDS vaccine trial — done in Thailand — that for the first time showed that HIV infection can be prevented with a vaccine. This was a major surprise when they announced it last year.

Michael spoke at the conference about ongoing studies aimed at finding out what exactly elicited the immune response, and how they are making plans to improve upon the “modest” effect of the vaccine. One challenge in following up on the Thai trial is that there is not enough of the vaccine to do more studies.

“We weren’t prepared for success,” said Michael. After decades of failed experimental vaccines, he said industry didn’t make enough vaccines to do follow-up studies.

Pictured in the middle is Dr. Larry Corey, principal investigator of the HIV Trials Network and the incoming director of the Fred Hutchinson Cancer Research Center. As a leader in HIV vaccine trials, Corey said his primary goal is to convince his colleagues to pursue new methods to speed up such trials.

“At the rate we’ve been going, we are making one (vaccine) innovation, or gaining one insight, about every seven years,” he said. “We need a new strategy.”

Cancer therapies are often tested using an approach called “adaptive clinical trial design” that Corey explained speeds up the evaluation process by incorporating more checkpoints, more aggressive monitoring and the flexibility to change direction. This needs to be adopted for HIV vaccine studies, he said.

“We’re still throwing long passes into the end zone rather than moving the ball incrementally down the field,” Corey said. Except for the “pleasant surprise” of the Thai trial, he said, we’ve had to wait years to find out at the end of a long study that we’ve been throwing them in the wrong direction.

Also at the press conference (and to the far right in the photo) was Dr. Salim Abdool Karim. Karim is the South African medical researcher who stunned the world this summer when he announced the successful test of a microbicide gel — a vaginal gel with an anti-HIV drug — in preventing HIV infection in women.

After two decades of failure in the search for a microbicide, Karim and his team showed that this gel containing a small amount of a common and cheap anti-HIV drug cut a woman’s risk of HIV infection from an average of 39 percent to nearly 60 percent (in those who used it most regularly).

But again, success led to a new problem — lack of funding to move forward with further microbicide studies. Some blame “shifting priorities” in the global health agenda away from AIDS. Others blame the economy.

That’s why we should worry about public apathy and media inattention to the search for an AIDS vaccine. Worldwide, funding for HIV vaccine research already has dropped — even as we have seen significant progress and renewed optimism that a vaccine against HIV is possible.

The pandemic is continuing to spread and to devastate poor communities in Africa and elsewhere people cannot afford treatment. Donors have been flat-lining their funding or even reducing assistance funding for AIDS programs, even as the numbers of those in need continue to climb.

A vaccine is the only way out of this mess, yet there seems little public interest in this story. Even the local newspaper, the Atlanta Journal-Constitution, didn’t show up to cover this meeting in their backyard.

Heck, the whole AIDS meeting was held inside the CNN Center (which looks like a huge shopping mall). But not a peep on CNN all week about this extraordinary global gathering of scientific talent.

I guess the search for an AIDS vaccine just doesn’t capture the public’s attention as much as a good scandal about some pathological religious leader or a newly discovered ‘habitable’ planet only 20 light-years away.

But I have a hard time imagining what things will be like for us, how habitable our own planet will be just 20 years away, if we don’t find a vaccine that can prevent the spread of HIV.


About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at] or follow him on Twitter @tompaulson.