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ENDING AIDS: The Story Continues
By Mitchell Warren, Executive Director, AIDS Vaccine Advocacy Coalition

A safe, effective and globally accessible vaccine is the best hope to bring the devastating AIDS pandemic under control. Vaccines have saved more lives and resources than virtually any other public health intervention. They have eradicated smallpox, have nearly eradicated polio and have greatly diminished the human suffering caused by many other diseases.

For many years, scientists, policy makers and advocates have recognized that an accessible preventive vaccine against AIDS could have a profound positive impact on global public health, but it has taken longer to find an AIDS vaccine than initially expected.

Traditional methods of making vaccines are thought too risky to be used in designing AIDS vaccines and so new technology must be developed and tested. HIV presents numerous scientific challenges to vaccine designers. Economic disincentives and scientific unknowns translated into limited industry involvement in AIDS vaccine research until relatively recently.

While there remain hurdles in the search for an AIDS vaccine, there are still many reasons to be optimistic that an AIDS vaccine can be developed. Today there are over 30 AIDS vaccine products in human clinical trials or in later stages of pre-clinical development. Over the coming years scientists will learn more about the promise of these current AIDS vaccine candidates and continue working to develop better vaccines. (For a review of the current state of the AIDS vaccine field that includes a list of the vaccine candidates currently being tested around the world, go to http://www.avac.org/pdf/reports/2005_Chapter1.pdf.) PDF requires free Acrobat Reader.

Ending AIDS: The Search for a Vaccine follows several important people and organizations working to develop a safe and effective AIDS vaccine.

— Don Francis is a public health pioneer, who led the development team of the first vaccine candidate to undergo Phase III efficacy trials. Unfortunately, the "VaxGen" trials produced disappointing results by failing to protect the overall study populations from infection. But Francis and some of his colleagues recently created Global Solutions for Infectious Diseases to expand the development of vaccines for the prevention of infectious diseases afflicting less developed countries. (www.gsid.org/)

— Omu Anzala and colleagues at the Kenya AIDS Vaccine Initiative (www.kaviuon.org) worked with international partners to develop and test the first vaccine candidate based on the most common type of HIV circulating in Kenya. Although this vaccine candidate did not work in initial trials, KAVI continues to collaborate with international partners to develop and test other vaccines.

— Ron Desrosiers continues to play a leading role in AIDS vaccine research at the Harvard Medical School and the New England Primate Research Center. He continues to advocate for accelerated efforts to answer the unsolved scientific questions that stand in the way of developing a vaccine. (www.hms.harvard.edu/nerprc/)

— Seth Berkley and the International AIDS Vaccine Initiative (IAVI) are now testing a variety of vaccine candidates, preparing a number of clinical trial sites in Africa and India, and developing a variety of policy and advocacy initiatives to accelerate the field. (www.iavi.org)

— Peggy Johnston directs the Vaccine and Prevention Research Program at the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the National Institutes of Health (NIH). NIAID funds several important efforts to develop and test AIDS vaccines:

     • The HIV Vaccine Trial Network (HVTN): An international collaboration of scientists that conducts all phases of clinical trials, from evaluating experimental vaccines for safety and the ability to stimulate immune responses, to testing vaccine efficacy. The HVTN is now implementing two major trials of different adenovirus vector-based vaccine candidates. (www.hvtn.org)

     • Vaccine Research Center (VRC) was established in 1997 to facilitate research in vaccine development. In October 2005, the VRC's lead vaccine candidate entered Phase II trials in sites around the world. (vrc.nih.gov/VRC)

     • The Center for HIV/AIDS Vaccine Immunology (CHAVI) was established in July 2005 as a "virtual consortium" of universities and academic medical centers led by Duke University Medical Center Professor Barton Haynes. The center's goal will be to solve major problems in HIV vaccine development and design with over $300 million over the next seven years. (www.chavi.org)

— The Global HIV Vaccine Enterprise is now under development to promote innovation and collaboration in the field. The Enterprise is an alliance of independent organizations around the world, including the Bill & Melinda Gates Foundation NIH, IAVI, CHAVI, and many others featured in Ending AIDS, that hopes to increase the resources and the collaboration in the AIDS vaccine field. (www.hivvaccineenterprise.org)


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