The following is a blog post by Jose Esparza, Deputy Director of HIV Vaccines at the Bill and Melinda Gates Foundation. Writing from the AIDS Vaccine Conference in Bangkok, Thailand, Dr. Esparza discusses recent scientific developments in the creation of an AIDS vaccine, and what we can expect to see in the future. The post was originally published on Impatient Optimists.
This week, more than 800 scientists and policymakers will gather from around the world in Bangkok, Thailand, for AIDS Vaccine 2011. It’s a fitting venue for the world’s premier HIV vaccine conference. Thailand, after all, was home to the largest AIDS vaccine study every conducted (RV144) and the first one to demonstrate limited effectiveness.
As an MD and PhD virologist, I’ve devoted most of my career to developing an AIDS vaccine. It has been a roller coaster ride, with moments of great excitement followed by deep disappointment. Today, however, I’ve never been more optimistic about the prospect for developing a safe, effective and accessible vaccine to prevent AIDS.
My optimism is based on two recent scientific developments, both of which we expect to learn more about in Bangkok.
First, two years after the Thai vaccine trial demonstrated 31 percent efficacy, scientists will present data that for the first time explains why some people were protected, and why some people weren’t. By knowing what biological characteristics are associated with protection, we will be able to develop better vaccines.
Second, at this conference we will feature a number of presentations looking at newly discovered HIV antibodies that neutralize many different strains of the virus. These “broadly neutralizing” antibodies have long been likened to the “holy grail” of AIDS vaccine research. Today, they are firmly within reach.
And these are just two examples of the recent scientific bonanza.
Encouragingly, the new optimism for AIDS vaccine development comes amid a renaissance in HIV prevention research.
In the past several years, we have learned that circumcising men can reduce female-to-male HIV transmission by more than 60 percent. New prevention tools have shown promise in clinical trials; these include microbicide gels, a pill to prevent HIV infection, and the use of treatment as prevention.
All of this will help to control — but not to end — the epidemic, especially in resource-poor countries. For that, a vaccine remains our best hope. That’s why AIDS vaccine development remains a priority of the foundation. We are in this for the long haul and have always known that developing an AIDS vaccine would be a marathon, not a sprint.
In this respect, as an amateur historian, I am encouraged by the parallels to the quest for a polio vaccine. The polio virus was first discovered in 1909, but it took 45 years – and much trial and error – until Jonas Salk developed his vaccine. Salk needed two things to succeed: the science had to be right, and the funding and political will had to be there. In Salk’s case, much of the funding came from the March of Dimes, the inspired volunteer organization created by polio survivor Franklin Delano Roosevelt and his longtime associate Basil O’Connor.
Today, 28 years after HIV was first isolated in 1983, the science is slowly coming together. As the French mathematician Henri Poincaré observed: “Science is facts. Just as houses are made of stones, so is science made of facts. But a pile of stones is not a house, and a collection of facts is not necessarily science.”
In AIDS vaccine research today, we can see much more than a pile of stones. In Bangkok, the metaphorical house Poincaré so eloquently described will begin to come into view. But, like Salk, we also will need funding and political will to finish the job.
Long after we leave Bangkok, history will judge whether we rose to the occasion.