Seattle is home to the world’s largest HIV vaccine research network and, as a scientitic meeting here this week indicated, they’re quite comfortable with not knowing where they’re heading.
“We actually don’t know what the agenda is,” said Dr. Jim Kublin, executive director of the HIV Vaccine Trials Network (HVTN) based at Seattle’s Fred Hutchinson Cancer Research Center.
That drew a lot of laughs from the audience, since Kublin’s lecture title for the day was ‘Scientific Agenda, the Next Seven Years.’
“That’s the way science is,” Kublin told me after his talk. “Good science is based on uncertainty, on having an open mind and dealing with the unknown.”
But what makes it easier to laugh about not knowing where you’re going, he added, is that researchers today have a lot more tantalizing clues – beginning with the ground-breaking Thai vaccine trial known to this bunch as RV 144.
“We now know that a vaccine against HIV is truly possible,” Kublin said. “Before RV 144, there was enormous skepticism that a vaccine against HIV was even possible.”
And there was a lot of skepticism about the Thai trial RV 144, including among the Seattle gang at HVTN.
Kublin acknowledged that they had counted themselves as among the skeptics and were as surprised as anyone when the much-maligned combo vaccine tested in Thailand actually showed some level of protection against HIV infection. It was only about 30 percent, but it was the first vaccine ever to do this — meaning something in the immune system had responded.
“That’s pretty exciting, but now comes the hard work of trying to figure out what,” Kublin said.
Here’s some background on the Thai trial, which I reported on extensively a few years ago — on a freelance contract for the AIDS Vaccine Advocacy Coalition, AVAC — when the results first came out. I was asked to do it as an independent journalist, not as a representative of AVAC, because of some of the more controversial and political aspects of the project.
The Thai government and the AIDS vaccine research community learned a lot from the RV 144 trial, both about expecting the unexpected and about the critical importance of gaining and retaining public support for these studies.
New trials, including one to be launched by HVTN in South Africa focused on a modified version of the RV 144 vaccine, are underway as are a number of laboratory and clinical research projects aimed at finding HIV’s weak spots. Compared to only a few years ago, the HIV vaccine research community is no longer acting like they are attendants at a wake.
The evidence indicates an AIDS vaccine is possible. It is also likely the only chance of ever bringing the pandemic to an end.
But scientists now have a different concern. The skepticism may be gone, Kublin said, but many of the donors and aid agencies that once supported HIV vaccine research have drifted away in search of more certain, short-term success stories.
Many funders, he said, seem to be taking more of an industrial or commercial approach by demanding specific goals and milestones.
“That’s not good for science,” Kublin said. “For science to make progress, you have to embrace uncertainty. Many donors don’t like that and that’s a problem for us.”