Since the first cases of AIDS were identified in 1981, more than 20-million people have died from the disease. And it’s estimated as many as 40-million people are currently infected with HIV, the AIDS virus. Despite the growing availability of anti-retroviral drugs to prolong lives, the statistics underscore the need for a vaccine to prevent further infections. But, an effective vaccine has been elusive. To help explain why, the AIDS Vaccine Advocacy Coalition, or AVAC, has published the AIDS Vaccine Handbook.
AVAC Executive Director Mitchell Warren says it’s important for people to understand, in simple terms, the complexity of the quest for a vaccine.
He says, "The why is very easy to do, why the need for an AIDS vaccine and that’s pretty straight-forward. The challenge is to ensure that people from all sorts of different communities – whether in the scientific world or policymakers, community organizations, grassroots communities, the media – there really is a need to raise what we like to think of as research and vaccine literacy."
Mr. Warren says the AIDS Vaccine Handbook is an attempt to bridge the communication gap between laymen and the scientific community.
"One the one hand, we’re trying to translate what is very complex scientific thinking and very complex clinical trial issues to people who are not scientists by training, so the lay audiences. But at the same time, we see this handbook, as well as our role as an organization generally, as one that seeks to translate what are very complex community perspectives back into the scientific field. So, it’s really a bit of two-way translation that we see both the organization, and particularly the AIDS Vaccine Handbook, serving that role," he says.
One question that’s frequently asked is when will an AIDS vaccine be discovered? The estimate of 5 to 10 years is often given, but many scientists say they just don’t know.
"HIV continues to mutate and change and we see that in other pathogens as well. But HIV is an incredibly smart virus and it mutates as the body tries to fight it off. So, trying to challenge it with a vaccine is not necessarily easy," he says.
Not only does it mutate, it’s just different depending where in the world you are.
"There are many sub-types of HIV. So, there are sub-types that circulate in different parts of the world. And the sub-type that circulates mostly in the US and Europe is the sub-type B. And the sub-type in East Africa is largely sub-type A and the largest sub-type of the virus is sub-type C that circulates mainly in southern Africa, India and China. And we don’t necessarily know if sub-type matters, but because to create vaccines based on pieces of the virus there’s a lot of work to try to match a vaccine candidate with virus type or sub-type," he says.
The head of the AIDS Vaccine Advocacy Coalition says scientists don’t know whether one vaccine will work for all sub-types, or whether individual vaccines will have to be developed.
"There’s also a challenge in the stigma associated with HIV and AIDS. And this is not directly related to the science of a vaccine, but in terms of doing clinical trials getting people to enroll is quite complicated because people need to be tested. We need to know their status so they can be in the trial. There’s still so much stigma still attached to being HIV positive both in the US and internationally that people are often quite concerned about knowing their status. And it’s somewhat of an inhibition to getting people into trials," he says.
Mr. Warren says from 2000 to 2004, spending on AIDS vaccine research doubled. Currently about 700 million dollars is being spent annually. However, he says spending should be increased to more than one billion dollars per year.
Nevertheless, he says there is some encouraging news. Over the past year, there’s been an effort to create the Global HIV/AIDS Vaccine Enterprise. The effort, led by the Bill and Melinda Gates Foundation, aims to bring together US and international AIDS vaccine researchers on a “unified scientific agenda.” In other words, getting all the researchers to agree on priorities and how money is spent.
If you’d like see or obtain a copy of the AIDS Vaccine Handbook just go to the AIDS Vaccine Advocacy Coalition website, at www.avac.org/handbook.