A Shot of Prevention

An AIDS vaccine is possible -- if we stop dragging our feet.

The ravages of AIDS are nothing new. For most of the world, the unfathomable statistics of the disease's toll -- like the 25 million people who have already succumbed to the virus, and the 4.3 million who contracted HIV last year alone -- have become all too commonplace. AIDS undermines efforts to end poverty, hunger, and illiteracy, combat major infectious diseases, and improve the living standards and health of children and mothers throughout the world. Despite promising developments during the past 25 years, including treatment and prevention programs, the virus continues to outpace the international community's response. What we don't realize is that science and industry are right now developing tools that hold the promise of ending this unprecedented plague. The world has made enormous strides in expanding AIDS treatment and care programs, yet the number of HIV infections continues to rise, especially among women, children, and marginalized groups. For each person we put on lifetime treatment, seven new people become infected. As it stands, this is not sustainable.

Scientific evidence suggests that immunologic protection -- an AIDS vaccine -- is possible. In fact, a 50- percent-effective vaccine given to just one third of adults in developing countries could cut the number of new HIV infections in the developing world by more than half within 15 years.

Although attention to AIDS vaccines has recently seen a renaissance -- there are now more than 30 trials under way in 24 countries -- we must redouble current political and financial commitments to find a vaccine that will end this epidemic. The problem is, vaccine clinical trials currently follow a standard model that is too slow and doesn't allow for a straightforward ranking and prioritization of the most promising candidates. To speed development, the best vaccines ought to be placed in a fast-track pipeline, where they can be tested head to head. Current trials of 3,000 people take a minimum of three years to obtain even interim results. Instead, six trials of 500 people each in high-risk populations comparing different vaccine candidates could be accomplished with the same resources in half the time. This simple shift would quickly weed out weaker products and could shave years off the discovery of the vaccine the world so desperately needs.

The ravages of AIDS are nothing new. For most of the world, the unfathomable statistics of the disease’s toll — like the 25 million people who have already succumbed to the virus, and the 4.3 million who contracted HIV last year alone — have become all too commonplace. AIDS undermines efforts to end poverty, hunger, and illiteracy, combat major infectious diseases, and improve the living standards and health of children and mothers throughout the world. Despite promising developments during the past 25 years, including treatment and prevention programs, the virus continues to outpace the international community’s response. What we don’t realize is that science and industry are right now developing tools that hold the promise of ending this unprecedented plague. The world has made enormous strides in expanding AIDS treatment and care programs, yet the number of HIV infections continues to rise, especially among women, children, and marginalized groups. For each person we put on lifetime treatment, seven new people become infected. As it stands, this is not sustainable.

Scientific evidence suggests that immunologic protection — an AIDS vaccine — is possible. In fact, a 50- percent-effective vaccine given to just one third of adults in developing countries could cut the number of new HIV infections in the developing world by more than half within 15 years.

Although attention to AIDS vaccines has recently seen a renaissance — there are now more than 30 trials under way in 24 countries — we must redouble current political and financial commitments to find a vaccine that will end this epidemic. The problem is, vaccine clinical trials currently follow a standard model that is too slow and doesn’t allow for a straightforward ranking and prioritization of the most promising candidates. To speed development, the best vaccines ought to be placed in a fast-track pipeline, where they can be tested head to head. Current trials of 3,000 people take a minimum of three years to obtain even interim results. Instead, six trials of 500 people each in high-risk populations comparing different vaccine candidates could be accomplished with the same resources in half the time. This simple shift would quickly weed out weaker products and could shave years off the discovery of the vaccine the world so desperately needs.

Seth Berkley is president and CEO of the Gavi vaccine alliance.

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