AIDS Vaccine Nearing, Expert Says
---------------------------------
WASHINGTON - The likelihood of discovering a vaccine for HIV/AIDS
is growing, and developing nations would be among the first to
benefit from such a finding, according to vaccine pioneer Dr.
Seth Berkley.
Berkley founded the New York-based non-profit International AIDS
Vaccine Initiative (IAVI) in 1996 with the double mission of en-
suring that a vaccine gets developed as quickly as possible and
that it reaches the people who need it most, namely those in de-
veloping nations with the highest rates of infection.
"If you look at the history of vaccines, the history has been
that the vaccine is made for the north, it gets licensed, and
then 10, 15, 20 years later it trickles down to the developing
world - sometimes never," he said at a press conference yester-
day. HIV/AIDS treatments have also followed this pattern, reach-
ing North America and Europe before the developing world, he
said.
With IAVI, Berkley hopes to create a "new paradigm - simultaneous
availability of the vaccine in north and south." To that end, he
has coordinated a global initiative that focuses on all the chal-
lenges of achieving a successful vaccine, including research,
testing, manufacturing and delivery, while targeting a continent
where the disease killed 3.1 million people last year alone.
Two East African nations, Uganda and Kenya, are the sites of cur-
rent vaccine testing on humans. A third human trial is being con-
ducted in the United Kingdom.
To Berkley, the African trials are a "real success story." "A lot
of people said you can't do all these trials in a place like Af-
rica," he said. "The extraordinary thing is not only have people
rallied, but ... the quality of the lab is as good as anywhere in
the world, the quality of recruitment, the drive of the people
engaged in this."
IAVI's regional medical officer for East Africa, Chrispin Kam-
bili, said he is "very confident" that the small-scale trials
currently taking place in Uganda and Kenya will soon expand to
trials of 20,000 participants, the number he estimates a success-
ful efficacy trial will require.
Kambili, who is African, said the participation of so many Afri-
can scientists in the programs have increased the trials' "credi-
bility among people who might otherwise have misgivings about
volunteering."
"We want them to feel part of this development effort," he said.
"We want them to feel ownership of the development of an AIDS
vaccine."
The tests in Uganda and Kenya are not the first trials of a po-
tential AIDS vaccine. In February, a California-based company an-
nounced that testing of VaxGen, an antibody-eliciting compound,
found the vaccine did not successfully inoculate candidates. Af-
ter enrolling 8,000 high-risk HIV-negative volunteers and compar-
ing the rate of infection between individuals inoculated with the
vaccine and people given a placebo, researchers found no dispar-
ity in the rate of infection between the two groups.
But Berkley said the "trial itself was a success" because it gave
coordinators like Kambili a model for enrolling and keeping large
numbers of people in a trial.
The VaxGen trial also highlighted another challenge to developing
an AIDS vaccine - the problem of balancing between conducting
trials and building the infrastructure for producing and distrib-
uting a vaccine. If VaxGen had worked, Berkley said at least an-
other five years would have been needed to manufacture and dis-
tribute the drug successfully, since there was no final manufac-
turing plant, no distribution system, and no purchasing system in
place.
"That's why it's critical to plan for success before you finish
the trials," Berkley said.
But he admitted that getting manufacturers and distributors on
board without the existence of a tested vaccine would be diffi-
cult, saying that manufacturers should be given incentives to
pursue a drug that has no certain financial rewards. He suggested
pre-purchased commitments and tax incentives for manufacturers,
as well as a "pricing scheme that makes sense that you protect
the manufacturers for their primary markets in the north and have
the cheapest possible prices for the south."
With a large-scale vaccine program estimated to cost about $350
billion, Berkley also argued that governments and international
institutions must prioritize. Although that sounds like a lot of
money, he said, "compared to the 70 million infections that have
occurred and the 15,000 infections a day, its very small."
--
Dr Rana Jawad Asghar
Program Manager Child Survival, Mozambique
Provincial Coordinator Sofala Province, Mozambique
Health Alliance International, Seattle, WA, USA
http://depts.washington.edu/haiuw/
Coordinator South Asian Public Health Forum
http://www.saphf.org
mailto:jawad@alumni.washington.edu
http://www.DrJawad.com
--
To send a message to AFRO-NETS, write to: afro-nets@healthnet.org
To subscribe or unsubscribe, write to: majordomo@healthnet.org
in the body of the message type: subscribe afro-nets OR unsubscribe afro-nets
To contact a person, send a message to: afro-nets-help@healthnet.org
Information and archives: http://www.afronets.org