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HIV Vaccine Awareness Day May 18, 2009

Statement of Anthony S. Fauci, M.D., Director, National Institute of Allergy and Infectious Diseases, National Institutes of Health

May 18, 2009

On this 12th annual HIV Vaccine Awareness Day, we reaffirm our commitment to the research needed to develop a safe and effective HIV vaccine.

People continue to become infected with HIV at an alarming rate. An estimated 2.7 million new HIV infections occurred worldwide in 2007 alone. Here in the United States, about 56,000 new HIV infections occur annually -- a figure that has remained fairly consistent for more than a decade. Although antiretroviral medicines have enabled individuals infected with HIV to live longer, healthier lives, no one with HIV has ever been truly cured of the infection, and people with HIV continue to die of AIDS-related diseases in unacceptably high numbers in rich and poor countries alike.

Historically, vaccines have eliminated or greatly reduced the burden of many viral diseases, including smallpox, polio, measles, and yellow fever. HIV, however, presents unique and significant scientific obstacles that have made vaccine development particularly daunting. Most importantly, people are unable to mount an effective immune system response that clears HIV infection. This is likely because of the ability of HIV to rapidly invade and hide in host cells, and elude detection by normal immune system responses; its extraordinary capacity to mutate and evolve; and its destruction or disabling of critical immune system cells. While extremely rare, some individuals do develop antibodies that effectively neutralize HIV, but investigational vaccines so far have not induced these antibodies in a large number of people.

Recognizing these challenges and working to build upon disappointing clinical trial outcomes, NIAID in 2008 hosted a scientific summit where we committed to placing a greater emphasis on the fundamental research needed to unlock the mysteries of the human immune system and HIV infection. Since that time, we have launched several basic research-focused initiatives and studies that are beginning to produce interesting insights that may help us design future HIV vaccines. At the same time, we continue to test promising vaccine candidates in clinical trials when scientifically appropriate.

Although vaccines will continue to play a prominent role in NIAID's broad and multifaceted HIV prevention research agenda, other new prevention approaches are in advanced testing. These include microbicide gels or creams that can be applied prior to sexual intercourse, and pre-exposure prophylaxis -- the use of antiretroviral medicines in people who are not infected with HIV but who are at high risk for infection. Another important prevention concept is universal, voluntary HIV testing and treatment for those who test positive. One recent model suggests that such a test-and-treat program could reduce HIV infection rates by 95 percent within 10 years. NIAID is evaluating critical research questions that underpin the validity of this voluntary approach.

Our hope is that the development of an HIV vaccine and other advances in HIV prevention research will become part of a comprehensive HIV prevention toolkit that will markedly decrease new infections, even as we continue to expand our efforts to find a cure for HIV/AIDS.

Finally, today we specifically wish to thank the thousands of volunteers, scientists, community members and health professionals who have participated in HIV vaccine research and who continue to support and participate in this extremely important research effort. With your help and continued dedication, we will win the fight against HIV.

Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.

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This article was provided by National Institute of Allergy and Infectious Diseases. Visit NIAID's website to find out more about their activities and publications.
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