Tuesday, US government officials and top scientists met near Washington to discuss the future of AIDS vaccine research. The meeting was called following the failure last September of a promising vaccine candidate in human trials.
The outcome of the meeting showed that while vaccine research will continue, more emphasis will now be placed on basic science.
Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition, attended the meeting at the National Institutes of Health. He spoke to VOA English to Africa Service reporter Joe De Capua about the call for more basic science.
“I’m not sure there was big news. I wouldn’t characterize it as a major overhaul. I think what we saw yesterday at the summit and we frankly have seen for the last six months since the Merck vaccine result is a proper course correction. Historically, when I look at AIDS and AIDS vaccine research, people kind of look for these pendulum shifts. And we did have a very big setback in a large human clinical trial. But to think that the pendulum should just swing away from human trials and over to basic science, I think, misunderstands what the discussion was yesterday,” he says.
The main issue, he says, is “discovery – identifying and answering really important scientific questions and product development. And what we did see was rightly a sense that we have less than ideal vaccine candidates. And to develop those candidates we need to go into discovery efforts. And discovery of science can be done both certainly in the laboratory as well as in the clinic with human trials. We need to develop better vaccine candidates and to do that we need to answer some really important scientific questions. So, it’s just kind of a re-balancing.”
Some questions, for example, are how the immune system really works and why some people are able to control HIV, the AIDS virus, without the help of anti-retroviral drugs.
Asked what basic science is, Warren says, “Particularly, when we think about the development of a vaccine, basic science is the idea of identifying critical scientific questions and answering them. And it may lead to a product, whether it’s a vaccine or a new drug, but it may not. But it’s going to answer a question…. Vaccine development eventually is going to take that basic scientific answer hopefully and develop a product. That’s again part of the process for the last 20 odd years in AIDS vaccines and part of the process for vaccine development for centuries.”
Warren expects competition for funding in the scientific community over research. But Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who called the summit, is quoted as saying, “Under no circumstances will we stop AIDS vaccine research. Not only will we not cut it, wherever possible we will increase it.
Warren says, “It was possibly the most important thing that was said yesterday. There are obviously people looking at this from the outside, who would say in the face of failure of the AIDS vaccine we should stop vaccines and focus on treatment. Or stop that and focus on prevention. We should be focusing on clean water. You name your issue. We obviously need to do it all. What Tony Fauci said yesterday was an emphatic endorsement of the fact we cannot treat our way out of this epidemic. We cannot prevent our way out of this epidemic. And we can’t research our way out of the epidemic. None of those three strands alone can do it. It’s got to be the creative, disciplined, strategic integration of those three things.”
Another reaction to the call for more basic science in AIDS research comes from Richard Burzynski, head of the International Council of AIDS Service organizations (ICASO). He says, “I think we’re all disappointed after 2007, when we recognized following the Merck trial that we’re on the wrong path. And I think this brings into question all the vaccine trials. And the call to go back to some basic science, to go back to some issues related to HIV, I think are required. If we’re not making headway, if the path we’re on and the path that most research is on for the vaccine trials is not producing the results, I think we have to go back to the drawing board. And I think this is a really disappointing time for everyone. We were looking forward to having some trials showing some efficacy. We’re not finding that.”
What does it mean for the many NGOs represented by ICASO? Burzynski says, “It means we’ve got to step up our efforts in HIV prevention. There’s no doubt about it that prevention in some instances is working. But we’re recognizing now for the first time and I think in a way that is more widespread that there are concentrated epidemics in certain specific populations and key populations. And it’s here we probably want to concentrate more of our efforts, put more of our resources, and really step up the kind of programming that is required. And I think this is going to mean a much, much more different advocacy effort. We have to look at harm reduction more carefully…. We have to look at condoms and lubricants for populations that normally do not get any of this information, do not get any of these products or are often left out of national AIDS programs. And we’re going to have to step up our efforts on prevention on all groups and all populations. And this is something that is really difficult to do in many countries.”