HIV vaccines: resolved that more fundamental research on vaccine development is required prior to the implementation of phase III trials of HIV vaccines.
Int Conf AIDS 1996 Jul 7-12; 11:214 (abstract no. Tu.10) Mbidde E; Uganda Cancer Institute, Kampala, Uganda. Fax: 256-41-532-282. E-mail: e.k.mbidde@mukla.gn.apc.or.
By the YR 2000 approximately 40M people would havebeenHIV-infected with 90% of them from developing countries despite the availability and use of what are considered to be effective interventions against HIV/AIDS. These projections raise two important questions: 1) why are current interventions not so effective in those societies severely affected by the epidemic? 2) shouldn't efficacy trials of HIV preventive vaccines be accelerated for the benefit of those societies? Ignorance, illiteracy, customs, attitudes and lack of both human and financial resources worsened by the HIV/AIDS epidemic are the major factors responsible for the limited success observed. Subunit and live vector based HIV vaccines have been shown in man to be safe and immunogenic but protective in animals. Given the differences between man and other animals regarding the pathogenesis of HIV, is it not appropriate that we learn more about these vaccines in the species for which they are developed? Even low efficacy HIV vaccines could have tremendous positive impact in those areas that are worst hit if used alongside known effective interventions. History clearly documents the utility of an empiric approach in vaccine R&D. Why are we so timid in using this approach against this "plague" of the 20th century? By using intermediate size efficacy trials we can quickly get information that could be used in re-directing R&D in HIV vaccines thus bringing us yet closer to our goal of HIV preventive vaccines.
Keywords: AEGIS, AIDS Vaccines, Clinical Trials, Foundations, HIV, HIV Infections, Acquired Immunodeficiency Syndrome, Research, Developing Countries, Forecasting, Ethics, Human, Male, economics, ICA11
