Back in 1984, federal health officials, flush with excitement
over discovery of the virus that causes AIDS, famously predicted
that they would have a vaccine ready for market within three
years. Now, after almost a quarter-century of toil and struggle,
the effort has crashed in failure. No one yet knows whether a
vaccine to prevent the disease will ever be possible.
David Baltimore, a Nobel-winning biologist, sounded a note of
despair in an address to the American Association for the
Advancement of Science in February. He noted that the virus has
evolved in a way that makes it virtually impossible to attack by
priming the immune system, the usual goal of a vaccine. Repeated
efforts have failed, he said, leaving "no hopeful route to
success." The best hope, he said, may lie in the biological
equivalent of a "Hail Mary" pass - a wholly new approach that
would combine gene therapy, stem cells and immunologic therapy to
thwart the disease.
At a conference at the National Institutes of Health last
Tuesday, AIDS experts assessed how to proceed after the failure
of the most promising vaccine candidate in two large clinical
trials last year. Early results showed that those who received
the vaccine may actually have been more likely to become infected
with the virus than those who did not.
At least one organization that treats AIDS patients has called
for giving up on a vaccine and shifting the money to testing,
treatment and prevention. That is too defeatist. Federal health
officials are rightly determined to increase financing for basic
laboratory research, curtail big clinical trials of existing
vaccine candidates, and funnel money to researchers with novel
ideas. There is little doubt that a vaccine would be the most
effective and cheapest way to shrink the AIDS epidemic.