HIV vaccine leaders call for global effort

Researchers call for worldwide push to beat killer virus.
27 June 2003

TOM CLARKE

Just one candidate vaccine got to advanced testing - and failed. © GettyImages

HIV researchers have warned that a fresh approach is needed if a safe and effective vaccine against the virus is to be developed soon¹.

If the AIDS pandemic continues to spread at its current rate, there will be 45 million new infections by 2010 and nearly 70 million deaths from the disease. But given the pace of current vaccine-development efforts, it could be 20 years before a vaccine is available.

By highlighting the lack of progress, HIV experts hope to prompt their colleagues - and more importantly the charities and governments that fund them - into action. A philosophy similar to the one that led to the sequencing of the human genome is needed, they argue.

"There's still 5 million people a year getting infected [with HIV] every year," says Helene Gayle, director of HIV-vaccine development at the Bill and Melinda Gates Foundation in Seattle, Washington, which funds infectious disease research. "It's time to get out of this business-as-usual mode," she says. Gayle wrote the report together with leaders of all of the major HIV vaccine efforts.

It was only last year that the first candidate HIV vaccine made it to advanced-stage clinical trials in humans. The trial ended in failure. Only seven other candidate vaccines have entered early-stage trials in the past year.

Progress has been slow because HIV is a formidable enemy. It infects the very cells that are designed to kill viruses, and mutates with breathtaking speed. Normal strategies of vaccine development - using weakened or killed viruses, for example - don't work.

The way to win the battle is to have as many scientists as possible working on different facets of the problem, the report argues. The huge scale and cost of the effort mean that it must be a global collaboration.

To that end, the report calls for:

• At least six to ten more vaccine-development centres worldwide. Some can be virtual centres - providing leadership and funds to researchers in several labs across the world.
• Scientists to organize themselves in breaking down the vaccine-development problem to ensure that their efforts are invested efficiently.
• Donors who fund vaccine research to join with vaccine manufacturers to ensure that the infrastructure exists to produce trial vaccines rapidly.
• A clinical-trial system that will allow candidate vaccines to be tested internationally in a safe and ethical way. The United States and the European Union intend to carry out clinical trials in Africa.
• More money to pay for the vaccine effort - around US$1 billion per year.

Ultimately, the initiative needs coordination, says Gayle. She argues that the multicentre organization of the Human Genome Project (HGP) is perhaps the best model for the future of HIV-vaccine development.

The HGP's scientists spontaneously divided up the enormity of the human genome into workable chunks. "No one entity actually ran that project," says Gayle.

"I thoroughly agree with what they are saying," says Frances Gotch, who studies HIV at Imperial College in London, UK, and in Uganda. "Right now, HIV-vaccine researchers are not singing from the same hymn sheet."

But there was financial incentive and coordinated funding for projects like the HGP, Gotch points out. Whether similar funding will materialize for HIV - essentially a disease of the poor - remains to be seen, she says.

1. Klausner, B. et al. The need for a Global HIV Vaccine Initiative Science. Science, 300, (2003). |Homepage|