01 April 2008

The search for an AIDS vaccine has reached a dead end

Allan Davydov, Radio LibertyThe twenty-year search for an AIDS vaccine seemed to be heading in a dead-end direction.

Such a disappointing diagnosis of their efforts were forced to make the world's leading experts at a conference organized by the American National Institutes of Health (National Institutes of Health). Last week, scientists involved in the development of an AIDS vaccine gathered in Washington.

The conference participants were forced to finally state the unsuitability of the vaccine, which was used in two clinical trials that were discontinued last fall.

Volunteers from risk groups from the countries of North and South America, Australia and the Republic of South Africa participated in the trials. The vaccine developed and manufactured by the pharmaceutical company Merck, which had high hopes, not only showed complete inefficiency, but actually increased the risk of infection. One of the discoverers of the human immunodeficiency virus, director of the Institute of Virology in Baltimore Robert Gallow compared the failure of this series of tests with the disaster of the space shuttle Challenger in 1986, which for many years slowed down the implementation of the American space program.

I asked Mitchell Warren, Executive Director of the AIDS Vaccine Coalition, to comment on the depressing fact:

– Of course, the failure of the vaccine experiment is a huge setback in the fight against AIDS. But I still wouldn't compare it to the Challenger explosion. The shuttle disaster was unexpected, but in the scientific process, failure is always expected. In research, development and testing of a vaccine, a result with any sign is a step forward in getting an answer to the question of how to get a vaccine and end the epidemic. This is a setback, but not a crisis. In fact, we were ready for it, knowing that the creation of a vaccine is primarily associated with the improvement of the human immune system. Judging by the results of the conference, there is still no consensus on what to focus research on in the future. It is only clear that we need to focus on very narrow scientific questions, the answer to which can bring us success in developing a vaccine.

– On what positions do researchers agree with each other today?

– The so-called Washington Anti-AIDS Vaccine Summit"showed that failure will not stop anyone in finding an effective vaccine. This is the most important message of the conference. Another important point is that attention should be shifted to in-depth study of a number of fundamental scientific issues. Most researchers are convinced that the creation of an effective vaccine is still possible. After all, there are people living with the immunodeficiency virus for 7-12 years without the need for therapeutic intervention, their body itself blocks the spread of the virus. It is necessary to better understand what the body does to protect itself naturally, and how we can copy these actions of the body in the vaccine. This is the main scientific discovery to be made. It is also necessary to strengthen the monitoring of a small group of people whose representatives are regularly threatened with HIV infection, but they never get infected. Finally, we need to better understand everything related to the virus itself. Bringing all this together, we will be able to identify the most successful experimental samples of the vaccine. And this process is already underway.

– How can the experience gained from the unsuccessful vaccine trial be applied in the future?

– We should not forget that medicines failed, but not the experiment as a whole. The tests still gave us a huge amount of useful information. For example, about how the vaccine works on people exposed to it in the womb. Previously, this area was not seriously considered. It is also known that the tests were very successful in terms of organizing a set of experimental groups, maintaining their integrity and quickly obtaining answers about the health status of the participants in the experiment. This experience is critical for conducting experiments in the future.

– What options for preventing AIDS remain in the absence of a vaccine?

– Everyone wants to end the AIDS epidemic, and many would like to find a universal solution to the problem. But in reality, this can be achieved only by a combination of various measures, and not only by the use of a vaccine. And not only at the stage when taking complex antiretroviral drugs is required, but also earlier – at the stage when condoms are used, when strict control over the sterility of syringes and the lifestyle of sexual partners is carried out, when men have the opportunity to undergo circumcision at will, which almost halves the risk of HIV infection during heterosexual contacts. The combination of three components will help us overcome the AIDS epidemic: research, prevention and treatment.

According to the World Health Organization, today the AIDS epidemic has assumed the character of a pandemic. In 2007, more than 33 million AIDS patients were registered in the world, of which 2 million 100 thousand died, including 330 thousand children.

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