The development of an effective HIV vaccine has been stalled for a variety of reasons, which William Heyward, MD, and his colleagues have detailed in our cover story on obstacles and progress toward the development of a preventive HIV vaccine. This article is the first in a series of reports on vaccine development to be featured in the Journal through April 1998. By that time we hope to announce the launch of our new peer-reviewed journal on HIV vaccine research.
Two of the obstacles that Heyward identifies are the lack of community acceptance of and involvement in HIV vaccine trials. Recently there have been a few new vaccine initiatives in the AIDS community that signal that long-overdue attention is beginning to be directed to this challenge. Unfortunately, there has not been any leadership in mobilizing people to participate in human vaccine trials. (The importance of implementing a human safety trial for a live-attenuated vaccine is also echoed by Ron Desrosiers in Mark Mascolini's report on the recent Keystone conference.)
Sometimes when we use the word "community," we think of people with HIV disease and the thousands of employees and volunteers at AIDS service organizations who help them. But some of the most effective AIDS advocates are the physicians who care for those affected and the researchers whose lives are dedicated to finding what we may eventually define as "the cure," and the eradication of the virus throughout the world.
Through the leadership of Charles Farthing, MD, medical director of AIDS Healthcare Foundation in Los Angeles, our association has responded to the challenge of involving the community in vaccine trials by organizing a live-attenuated HIV vaccine subcommittee. The subcommittee's mission is to implement a US live-attenuated vaccine trial in human subjects by the year 2000. Dr. Farthing will present a proposal detailing this mission at our Conference on Healthcare Resource Allocation this November in Washington, DC. One of the components of this proposal is the organization of a cadre of 1000 volunteers-physicians, researchers, and other members of the community-for this important trial.
Both José Zuniga, IAPAC's new deputy director, and I, along with Charles Farthing and several of his medical colleagues, have registered as the first volunteers for this project. As Farthing argues in his message to physicians on page 10 of this issue, it is in the highest tradition of medicine to apply the Golden Rule of medical research: The first human subject should be the doctor him- or herself.
While Charles and his colleagues may have registered for the reasons detailed above, José and I have registered because as political advocates for children, women, and men living with and at risk for HIV disease, we can only justify our advocacy if we take the same risks as physicians and researchers. Otherwise, how can we ask the White House, Congress, local and state legislators, foundations, and those who share similar responsibilities in other countries to provide the necessary funding and leadership to properly care for those affected and end this epidemic? We must lead by example. So, we hope that all of you -- physicians, researchers, AIDS advocates, and others who care about the sanctity of human life -- will join us.
Information on volunteering for the vaccine trial is found on page 10 of this issue of the Journal or on our web site at http://www.iapac.org/vaccines/vaccineform.html.
This article was provided by International Association of Physicians in AIDS Care. It is a part of the publication Journal of the International Association of Physicians in AIDS Care.