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, to determine what hampered progress toward the development of preventive HIV vaccines.
Two major themes emerged in their discussions. First, it was clear that the institutions most capable of developing such vaccines, particularly pharmaceutical companies, lacked the financial incentive to invest sufficient resources in the task. Second, although HIV was already taking a disproportionate toll on developing countries, none of the handful of vaccine candidates then under development was devised to address the epidemics and particular needs of such nations.
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.
IAVI’s first challenge was to make AIDS vaccine R&D a priority on the global public health agenda. In partnership with 70 organizations in 23 countries, IAVI launched an advocacy initiative that culminated in the Group of Eight nations issuing a “Call for Action” on HIV vaccines in 1997. The following year, IAVI produced the first Scientific Blueprint for AIDS Vaccine Development, which called for greater international collaboration to fast-track the development of multiple HIV vaccine candidates and a concerted effort to devise vaccines to prevent infection by the variants of HIV circulating in Africa and Asia.
Partnering for Success
IAVI recognized early on that to support the development of AIDS vaccines for use throughout the world, it would have to forge partnerships and bolster capacity to conduct vaccine trials at the highest technical and ethical standards in countries where the need for an AIDS vaccine is greatest. IAVI thus built a network of clinical research centers in partnership with local research institutions in sub-Saharan Africa, beginning with Kenya.
The organization supported its first clinical trial of a candidate vaccine in 2001, in collaboration with the Kenya AIDS Vaccine Initiative and the United Kingdom’s Medical Research Council. A decade later, IAVI was working with partners in 25 countries to research, design, and develop AIDS vaccine candidates.
As it sought to fill critical gaps in the field, IAVI became increasingly involved — and adept — in translational research, the conversion of basic scientific concepts into vaccine candidates fit for manufacturing and evaluation in humans. The organization launched several research consortia, including the IAVI Neutralizing Antibody Center (NAC), that drew together leading HIV researchers from around the world to address some of the major challenges of AIDS vaccine design. IAVI now is increasingly focused on devising vaccines on the basis of data generated by the NAC.
Researchers at IAVI and within the NAC have, for example, isolated numerous antibodies capable of neutralizing a wide range of HIV variants circulating worldwide and studied how many of them interact with HIV and evolve within the body. They are now using this information to devise immunogens — the active ingredients of vaccines — that might elicit similar antibodies following vaccination. Additionally, IAVI and its partners are exploring strategies for directly delivering broadly neutralizing antibodies to prevent and possibly treat HIV infection.