“The world’s first vaccine against dengue fever, being developed by French drugmaker Sanofi SA, protected against three of the virus’s four strains in a keenly awaited clinical trial in Thailand,” the company announced on Wednesday, Reuters reports (Hirschler/Regan, 7/25). “The vaccine actually generated antibody responses against all four strains of the virus, but for some reason, one strain was still able to infect children who received the vaccine, the company said, and scientists are now trying to figure out why,” the Los Angeles Times’ “Science Now” blog reports, adding, “Meanwhile, a much larger trial involving 31,000 adults and children is now under way in 10 countries in Asia and Latin America” (Maugh, 7/26). Reuters notes, “Other drug companies are also working on dengue vaccines but Sanofi’s product is several years ahead” (7/25).
“What stands out in my mind from this week’s presentations [at the XIX International AIDS Conference (AIDS 2012)] is that [HIV] interventions previously proved to work in controlled clinical trials are now — over and over again — proving effective outside the research setting, in the real world, in poor and rich communities alike. The pieces are coming together,” Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, writes in a Washington Post opinion piece. He discusses several of the interventions, including the scale up of antiretroviral therapy (ART), treatment as prevention, voluntary medical male circumcision, and pre-exposure prophylaxis (PrEP). “Ending the HIV pandemic is an enormous and multifaceted challenge, but we know it is possible,” Fauci writes, adding that it will require “commitment” and “investments.” He continues, “We must enhance what works and eliminate what does not, overcome legal and political barriers, and remove the stigma associated with HIV.” Fauci concludes, “The global community has a historic opportunity based on solid scientific evidence to end the AIDS pandemic, opening the door to an AIDS-free generation” (7/26).
In this post in the Center for Global Health Policy’s “Science Speaks” blog, IAVI President and CEO Margaret McGlynn, AVAC Executive Director Mitchell Warren and UNAIDS Executive Director Michel Sidibe highlight the release of a report from the HIV Vaccine & Microbicides Resource Tracking Working Group, which “documents 2011 research investments in preventive and therapeutic HIV vaccines, cure research, microbicide development, pre-exposure prophylaxis (PrEP) and operations research to support implementation of such evidence-based interventions as the prevention of vertical transmission, voluntary medical male circumcision and the use of antiretroviral therapies for HIV prevention” (Barton, 7/23). In related news, in a post in USAID’s “Impact” blog, McGlynn writes about recent advances that have “fueled optimism and lent a new momentum to the field of HIV vaccine” research and development (R&D) (7/24).
Though “a massive 24-year global effort to eradicate [polio] forever is now within striking distance of its goal, … there is still a very real danger that the entire campaign could come undone,” Jay Winsten, associate dean at the Harvard School of Public Health, and Emily Serazin, a principal in the Washington, D.C. office of the Boston Consulting Group, write in a Wall Street Journal opinion piece. The campaign to eradicate the disease faces geopolitical challenges, “[b]ut the biggest danger faced by the campaign is a dramatic funding shortfall of $945 million — almost half the amount originally budgeted for 2012-13,” they write. “The challenges faced by the polio campaign are emblematic of problems that affect worldwide efforts to conquer vaccine-preventable diseases such as measles and whooping cough,” Winsten and Serazin state and note that a Global Vaccine Action Plan was recently compiled by a huge collaborative effort and endorsed by the World Health Assembly. “With sufficient funding and political will, the massive health and economic benefits of vaccines are indeed attainable,” they conclude (7/24).
Speakers at Tuesday’s plenary session at the XIX International AIDS Conference in Washington, D.C. highlighted the challenges that lie ahead in the response to HIV/AIDS and discussed potential solutions, ABC News reports (Duwell, 7/25). Bernhard Schwartlander, director for evidence, strategy and results at UNAIDS, “highlighted the many new possibilities for collaboration, activism, and financing for the AIDS response as economic growth is rapidly changing the global order,” UNAIDS reports in a feature story (7/24). “A lot of very clever and dedicated people are working very hard in making sure that services are delivered more efficiently, and … more people receive HIV services with the same amount of money,” he said at the session, PlusNews writes (7/25). According to UNAIDS, Schwartlander “outlined a number of innovative financing methods … such as the financial transaction tax; front-loading investments for health through bonds; or utilizing fines paid by pharmaceutical companies for anti-competitive practices for health assistance” (7/24).
Bill Gates Stresses Importance Of Investment In Both HIV Treatment And Research For Vaccines, Microbicides
In a symposium session on Monday at the XIX International AIDS Conference in Washington, D.C., politicians and public health experts joined Bill & Melinda Gates Foundation Co-Chair Bill Gates for a discussion about improving effectiveness and efficiency in the HIV/AIDS response, the Washington Post reports (Brown/Botelho, 7/23). “Gates … reiterated the importance for nations and donors to support research, but also expressed support for ongoing treatment initiatives in the meantime,” according to Agence France-Presse. “No one should think that we have got the tools yet. We will get the tools but only if we stay the course in terms of the scientific investments,” Gates said, AFP notes (Sheridan, 7/23). The Washington Post adds that “[t]he main one lacking is a vaccine, but also important and missing are woman-controlled means to prevent infection, such as a vaginal microbicide” (7/23).
In a statement on Saturday, the World Health Organization and UNICEF said “a local community worker who helped an anti-polio campaign in Pakistan has been shot and killed in Karachi — days after two of its staff were injured in a shooting in the city,” the Associated Press reports (7/21). According to the WHO/UNICEF joint statement, Muhammad Ishaq was killed in the Gadap town area on Friday evening” (7/21). “The United Nations condemned the killing … on Friday,” the U.N. News Centre writes, noting, “Mr. Ishaq had worked with the national polio eradication effort as a Union Council Polio Worker for several months, helping to plan and implement vaccination campaigns to protect vulnerable children against the disease” (7/22).
The XIX International AIDS Conference opened in Washington, D.C., on Sunday and “is expected to draw 25,000 people, including politicians, scientists and activists, as well as some of the estimated 34 million people living with HIV who will tell their stories,” Agence France-Presse reports (Sheridan, 7/22). “Researchers, doctors and patients attending the world’s largest AIDS conference are urging the world’s governments not to cut back on the fight against the epidemic when it is at a turning point,” the Associated Press writes, adding, “There is no cure or vaccine yet, but scientists say they have the tools to finally stem the spread of this intractable virus — largely by using treatment not just to save patients but to make them less infectious, too” (Neergaard, 7/22). “New breakthroughs in research will be announced, as will new efforts by governments and organizations to reduce the spread of HIV, to treat those who have it, and to work, eventually, toward a vaccine and a cure,” the Seattle Times writes (Tate, 7/22). According to the Washington Post’s “Blog Post,” three remaining challenges to be addressed at the conference include: “More research into treatment and prevention, and more ways to deliver treatments”; reaching marginalized populations, such as men who have sex with men and sex workers; and “[i]ncreasing funding for PEPFAR and other anti-AIDS programs” (Khazan, 7/20).
Scientists Plan To Announce Research Strategy Aimed At Pursuing HIV/AIDS Cure, Wall Street Journal Reports
On July 19, ahead of the XIX International AIDS Conference in Washington, D.C., “prominent AIDS scientists plan to announce the first comprehensive research strategy aimed at pursuing new leads and addressing hurdles to a cure” for HIV/AIDS, the Wall Street Journal reports. “The announcement of the initiative will be followed by a two-day symposium on cure research,” the newspaper continues, noting, “Recent research has offered a glimpse of paths to a cure. That promise, together with breakthroughs in preventing transmission of the disease, is spurring optimism that the epidemic, which kills about 1.7 million people a year, can eventually be brought under control.” The newspaper highlights several cases and studies on prevention and treatment (McKay/Winslow, 7/18). The Associated Press/Washington Post features a video examining some of the research (Bradley, 7/19).
The goal of an “AIDS-free generation” “requires an ambitious implementation-science agenda that improves efficiency and effectiveness and incorporates strategies for overcoming the stigma and discrimination that continue to limit the uptake and utilization of [treatment, prevention and care] services,” AIDS 2012 Co-Chair Diane Havlir of the University of California-San Francisco School of Medicine and Chris Beyrer of the Johns Hopkins Center for AIDS Research write in a New England Journal of Medicine opinion piece. They note that “[r]esearch efforts on HIV vaccines will also probably be key, and the field has been reinvigorated” by recent study results. “A combination approach to prevention that includes HIV treatment can generate tremendous gains in the short term by curtailing new HIV infections, but ending the AIDS epidemic will probably require a vaccine, a cure, or both,” they write.