BOSTON, MA — When Bill Snow, now director of the Global HIV Vaccine Enterprise, first became interested in the quest for a vaccine against the AIDS virus, he had a life expectancy of less than 10 years, he said Sunday.
That was in 1989, he told the audience gathered for the opening of AIDS Vaccine 2012. He has long outlived initial predictions, but then so has the quest for an AIDS vaccine.
In the interim, three AIDS vaccine candidates progressed to clinical trials and their stories tell something of the roller coaster ride the quest that continues has been. The STEP trial of a Merck product ended in 2007 with the disheartening revelation that more participants in the product arm of the trial than the control arm had become infected with HIV. Then in 2009, the RV144 trial in Thailand revealed, through unanticipated results, that a vaccine could offer protection against HIV in humans. The one current vaccine trial, the HVTN 505 has been adapted repeatedly since its initial design to accommodate bad news and good: precautionary evidence from the Merck trial as well as for the approval of PrEP — preexposure antiretroviral treatment to prevent HIV acquisition.
The duration of the quest — the work done, the work yet to be done — is on display, is even a theme this week in Boston, with an emphasis not only on excitement from breakthroughs in the last few years, but on the work of “YECIs” — Young and Emerging Investigators, being encouraged to take up the work considered crucial to ending the AIDS epidemic with innovative approaches. The chairs of the conference, Galit Alter, 35, and Dan Barouch, 38, are “the two youngest scientific conference chairs you’ll ever meet,” one speaker said. Barouch, in turn, introduced a tribute to his mentor, Norman Letvin, a pioneer in AIDS vaccine research, who died in May, at 62. His work inspired and made possible subsequent work, said speakers who followed.
Others who opened the conference included Partners in Health cofounder Paul Farmer, Ragon Institute Director Bruce Walker, and Bill and Melinda Gates Foundation Global Health Program President Trevor Mundel.
“In some sense we’ve all been Pollyanna-ish,” Bill Snow said, at the end of his talk. He cited the growing use of the catch-phrase that an “AIDS-free generation” is on the way.
“In that optimistic environment,” he said, “we must advocate for the work, instead of the promise.”