In 1994, little more than a decade after HIV was identified as the cause of AIDS, the Rockefeller Foundation convened a meeting of 24 authorities on the disease in Bellagio, Italy. Their goal: to determine what hampered progress toward the development of preventive HIV vaccines.
Two major themes emerged in their discussions. First, the institutions most capable of developing HIV vaccines, particularly pharmaceutical companies, lacked the financial incentive to invest sufficient resources in the task. Second, none of the handful of vaccine candidates then under development was devised to address the epidemics and particular needs of developing countries, where the HIV/AIDS burden was and is greatest.
The International AIDS Vaccine Initiative (IAVI) was conceived at the meeting as a vehicle to address these issues. Launched in 1996 as a nonprofit, public-private, product development partnership (PDP), IAVI immediately began taking steps to address each of these problems. Operating as a PDP allows IAVI to harness the experience and expertise of vaccine manufacturers and other for-profit entities but remain unhindered by the commercial imperatives that discourage private investment in high-risk endeavors, such as HIV vaccine research and development.
Since our founding, we’ve made fundamental contributions to understanding the epidemiology, transmission, virology, and immunology of HIV. This work played a key role in facilitating the design of promising HIV vaccine candidates, as well as the discovery of broadly neutralizing antibodies that are now being advanced as promising approaches for HIV prevention. While we don’t yet have a vaccine, HIV vaccine research that began over two decades ago in Africa has returned to the continent in the form of experimental medicine trials — this time using mRNA — led by local investigators.
Despite significant progress, many of the big questions faced early on by HIV vaccine developers persist — and not just for HIV. Our report from IAVI’s 25th anniversary summit held jointly with the Rockefeller Foundation reveals the challenging work ahead to make pandemic preparedness vaccines affordable and globally accessible. We’re hopeful that the scientific foundation IAVI and our partners have built in the last decades will yield new solutions for tuberculosis, COVID-19, Lassa fever, Ebola Sudan, antimicrobial resistance, and Marburg virus disease.