July 11, 2002
BARCELONA, XIV International AIDS Conference, 11 July 2002--Two years after the widespread optimism of the International AIDS Conference in Durban, Barcelona 2002 is "a splash of cold water" and "a reality check" on how the world is doing in the fight against AIDS, said Seth F. Berkley, MD, President and CEO of the International AIDS Vaccine Initiative (IAVI).
Expectations that there would be widespread access to antiretroviral treatment in poor countries were shattered by the UNAIDS report that only 30,000 people were taking the drugs in sub-Saharan Africa.
News on the vaccine front was mixed. "We have always known that AIDS vaccine development would be a marathon, not a sprint,'' Berkley said. "We must guard against both giddy optimism and undue pessimism."
Berkley noted that results of the world's first Phase III efficacy trial for an AIDS vaccine would be known by early next year, and that a second vaccine candidate would soon be launched into Phase III trials in Thailand. "This is the only way we will get definitive answers," Berkley said, noting that IAVI hopes to speed another vaccine candidate into efficacy trials by 2004 and two more by 2007.
On the political front, Berkley noted that the government of Brazil had signed a policy development agreement with IAVI to ensure global access to an eventual AIDS vaccine, and that Canada and Ireland had increased their financial commitments to IAVI.
Berkley also said it is encouraging that some new vaccine approaches, including a multi-clade DNA-MVA vaccine and a tat vaccine, are entering the clinic. "These approaches have been long in development and it is good to see them moving forward," he said.
But Berkley said the positive news was somewhat tempered by a report of a single breakthrough infection in an already-infected patient who had appeared to be mounting a strong cellular immune response to HIV--a response similar to what current generation AIDS vaccine candidates seek to mobilize in uninfected individuals.
"We don't know what this means, particularly in an individual whose immune system was already compromised." Berkley said. "It may be an isolated case, or it may be a real problem. We shouldn't overreact. But this news underscores the IAVI philosophy that we cannot put all our eggs in one basket. It demonstrates the importance of moving multiple vaccine approaches forward in parallel, and as expeditiously as possible."
In this regard, Berkley noted that IAVI's Neutralizing Antibody Consortium, unveiled in Barcelona, would be a good complement to existing research into vaccines that stimulate cellular immunity.
"Broadly neutralizing antibodies have always been the Holy Grail in AIDS vaccine research. The Neutralizing Antibody Consortium has both the brains and the resources to get the job done," Berkley said.