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AIDS Vaccine Investment Is Paying Dividends

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For anyone interested in the future of AIDS, these are interesting times. Last week, researchers met in Paris to compare notes on their progress toward an HIV vaccine, the intervention that holds the best hope of ending, rather than just mitigating, the pandemic. Given that HIV is the most difficult virus for which a vaccine has ever been attempted, progress has been hard-won, but won nonetheless. Now the challenge -- not just for scientists but for policymakers, industry and funders -- is to sustain the momentum until an HIV vaccine is in hand. This is vital, as it is increasingly clear that the world will not fully solve the AIDS problem without a fundamental change in the status quo.

Much of the media attention around the Paris conference focused on the results of a Phase III trial in Thailand of a combination of two HIV vaccine candidates that reduced the risk of HIV infection. This is a first that provides researchers a platform from which to learn about how to design more effective candidates and prioritize them for testing. The trial sponsors, who announced the efficacy results in September, released at the conference additional data and analyses that will now be absorbed by researchers. But even without the Thai trial results, this is an exhilarating moment for science because of other promising developments animating HIV vaccine research and development, which were presented at the conference.

Many years of investment and perseverance are paying off. One cannot predict the duration of the journey to licensable HIV vaccines, but one does begin to feel that the wind has filled the sails.

In 2005, the members of the UN and the G8 resolved to provide universal access to HIV prevention, treatment and care by 2010. We are falling short on those goals. According to the latest numbers, the percentage of people in the developing world who need to be on antiretroviral drugs and are getting them increased dramatically from 33% in 2007 to 42% last year. But the gap remains enormous, and with new treatment guidelines under development for an earlier start to treatment, the gap is likely to actually increase. Additionally, for every two people who go on treatment, five become HIV infected.

The only way to ensure that everyone who needs HIV treatment and care actually gets it is to do two things simultaneously: expand access to treatment and care; and reduce the number of people becoming infected with HIV, as they too will eventually need treatment and care. Today, that figure is unacceptably high -- 7,400 people daily. Clearly, we need better ways to reduce HIV transmission.

There is no time for complacency in our efforts to stop new HIV infections. The world needs a strong HIV prevention campaign that is evidence-informed and grounded in human rights. Today, many people still do not have regular access to an effective method of HIV prevention. This is particularly true for women, who are not always able to negotiate safer sex. To ensure universal access to prevention, we need not only more HIV prevention, but new and better types of prevention. To get them, we need to invest in R&D.

For scientists to pursue the leads they now have, they need financing, which requires the commitment of governments and other funders who face economic pressures. Additional investment would help from the pharmaceutical industry, which has resources and vast experience developing vaccines but recently has tended to stay on the sidelines of HIV vaccine research. The greater engagement of young scientists and the biotech sector would be pluses. In addition, HIV vaccine clinical testing requires the support of communities from which trial volunteers are recruited, and the goodwill of regulators.

And so, we call on all these key parties to redouble their backing, commitment and investment, in order to help the researchers gathered in Paris to accelerate their efforts and exploit the momentum, so that we can close the gap between the promise of HIV vaccines and the reality.

We must do everything in our power to bring this pandemic to an end. A vaccine provides that hope.

This piece has been jointly written by Michel Sidibé, the Executive Director of the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Seth Berkley, the President and Chief Executive of the International AIDS Vaccine Initiative.