While researchers around the world are trying to develop a vaccine for AIDS, money problems require new collaborations to carry out research, disease experts said Monday.
Of the roughly $600 million to $700 million being spent on AIDS vaccine research internationally last year, the U.S. government’s contribution was $582 million, with all but $60 million coming from the National Institutes of Health.
After seeing its budget double in the past decade, NIH is being forced to get by on less. The institute’s entire budget is set to grow by just half a percent under the president’s budget plan, although spending on AIDS vaccine research will continue to grow at a slightly higher pace for the next few years, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.
“Against this backdrop of fiscal constraint, it is clear that new cross-sector collaborations involving government, industry, academia, philanthropies and others are needed to make the best use of available resources,” Fauci said. “The previous largesse is not going to be the reality for the next several years at least, so the whole issue of research entitlements is being challenged.”
Seth Berkley, president of the International AIDS Vaccine Initiative, had a similar message.
“Given the magnitude of the AIDS epidemic and the complexity of the virus, the world must continue to galvanize resources to develop new prevention technologies, most importantly a vaccine,” he told a seminar at the American Association for the Advancement of Science’ annual meeting. “An effective AIDS vaccine is our best hope to stop the spread of HIV. No other single product in health research would have as profound an impact.”
All the vaccine trials under way thus far involve strategies that coax immune cells to attack cells that have been infected with HIV, experts said. While this approach could match or exceed today’s anti-HIV drugs in extending life and reducing spread of the disease, it would not guard against new infections or address the ability of HIV to hide inside the genetic structures of cells.
A second avenue, which would muster a broad response from antibodies against all strains of HIV, is more difficult, but if successful, could actually keep people free of HIV.
Fauci and Berkley said that, ultimately, the ideal vaccine would be some combination of approaches that could treat people already infected and protect people from the array of rapidly mutating HIV strains around the globe.
“There are multiple candidates in the pipeline moving at various speeds, a horserace of candidates, and there may be more than one successful vaccine,” Fauci said. “We should be so lucky.”
According to the United Nations Program on AIDS, 39 million people worldwide are infected with the human immunodeficiency virus, with an estimated 4.9 million newly infected last year.
Although 800,000 people are living with HIV in the United States, the vast majority of people carrying the virus live in the developing world where prevention measures and anti-retroviral drugs are in short supply.
The fact that the epidemic primarily affects poorer nations has drawn limited participation by major vaccine companies into research and development, leaving the field almost exclusively to government and foundations.
While NIH officials won’t cut off promising work, more attention will be paid to what milestones are reached, and experiments that seem to have reached a dead end are less likely to be continued. At the same time, projects that bring other sponsors, like pharmaceutical companies, into an effort earlier may be viewed with more favor, Fauci said.
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