WASHINGTON, May 18 (IPS) - An influential group of AIDS
activists is challenging the US administration to take the lead
in the push for an HIV vaccine.
"The Bush administration must take ownership of the HIV vaccine
challenge and provide global public leadership toward
developing and delivering an HIV vaccine," says the US-based
AIDS Vaccine Advocacy Coalition in an assessment of the state
of vaccine research released Friday.
Titled 'Six Years and Counting: Can a Shifting Landscape
Accelerate an AIDS Vaccine?' the report also calls on the US
Congress to speed up passage of legislation to boost research
incentives.
HIV has infected more than 50 million people to date and AIDS
has killed more than 17 million, surpassing tuberculosis and
malaria as the leading infectious cause of death in the
developing world, researchers say.
President George W. Bush has not announced his position on tax
incentives to develop vaccines against HIV, nor has he
committed his administration to the 2007 deadline set by former
President Bill Clinton.
In May 1997, Clinton conceded to pressure from the coalition
and other groups by making the development of an HIV vaccine a
national priority and setting 2007 as the deadline for
achieving this goal.
Last week, the United States became the first country to commit
to a proposed global fund to fight HIV/AIDS by pledging 200
million dollars. To mount an effective challenge to HIV and
other infections, the United Nations estimates that the fund
will require between seven billion and 10 billion dollars
annually.
Overshadowed by the need for treatment and care of those
already infected with HIV, the search for a vaccine has been
slow, cautious and, critics say, often caught up in
bureaucratic red tape.
"What we need is a new level of political and scientific
leadership and it's important that the US lead the way in the
establishment of a global fund" specifically to finance vaccine
research, says Rose McCullough, the coalition's executive
director.
Last year, Congress almost took action on the proposed
'Vaccines for the New Millennium Act', which would have covered
HIV, tuberculosis and malaria vaccines, but the legislation was
lost to year-end political gridlock.
It has been re-introduced this year and, if enacted, would
provide tax credits for research and development, clinical
trials, and delivery of priority vaccines. It would
specifically encourage researchers to engage in neglected areas
such as malaria and HIV and promote delivery to low-income
countries.
Despite activists' sense of urgency, only one vaccine -
AIDSVAX, currently being tested by the US-based company VaxGen
- is expected to reach the final stages of clinical trials by
2003.
Susan Buchbinder, research director at the University of
California-San Francisco Department of Public Health, says that
if AIDSVAX proves effective in at least 30 percent of test
cases, it may be approved for use in some countries.
However, distribution may be held up by technicalities such as
building manufacturing plants - which can take up to five years
to complete.
"We have stated publicly for some time that we will not be able
to meet worldwide demand from day one," says Lance Ignon of
VaxGen. "This is not going to be like the introduction of any
other medical product."
McCullough says it is vital to have more than one drug in
advanced development to raise the chances of success.
AIDSVAX trials are being conducted primarily on HIV subtypes
most prevalent in North and South American, Europe, the
Caribbean, Australia, Southeast Asia, and the western Pacific
Rim.
No trials on the disease subtype that affects sub-Saharan
Africa, India, and China have reached the advanced stages of
development - even though this subtype is responsible for more
than 70 percent of the estimated 36 million current HIV
infections worldwide.
Several Western countries have scaled back or abandoned their
HIV vaccine programmes. These include Britain, Canada and the
Netherlands, leaving the French and US governments as the
leading public-sector developers of a vaccine. The US
government has yet to endorse tiered pricing, which analysts
say will be vital if drugs are to be affordable for poor
countries.
"There is talk, but little concrete action, on the principal
issues that will determine the accessibility of HIV vaccines,"
says the coalition report. Steve Wakefield, of the
government-financed HIV Vaccine Trials Network, says it takes
between 10 and 20 years for new drugs developed in the West to
reach people in poor countries.
Wakefield points to the Hepatitis B vaccine, which was licensed
in the early 1980s, and the Haemophilus influenza b (Hib)
vaccine, licensed in the late 1980s, as examples. They are
still unavailable in many poor countries, "at the cost of
hundreds of thousands of lives", he says. "We cannot afford to
allow that to happen in the area of HIV/AIDS."
(END/IPS/WD/NA/HE/gm/aa/01)