HIV/AIDS Vaccine More Than Decade Away, Bill Gates Says; Funding Development of Vaccine Main Goal of Gates Foundation

An HIV/AIDS vaccine is "not around the corner" and will take at least a decade more to develop, Microsoft founder Bill Gates said during a recent trip to Britain, where he received an honorary knighthood, the Wall Street Journal reports. Although other prominent figures have predicted that an HIV/AIDS vaccine might be developed sooner, Gates said, "I'll eat my hat" if a vaccine is developed in the next 10 years, according to the Journal. Developing an HIV/AIDS vaccine has been one of the "most difficult endeavors of modern medicine," and most vaccine tests have "flopped," according to the Journal. HIV continually mutates during its lifecycle in the human body, and there are different strains of the virus, making vaccine development complicated, according to the Journal. "In the natural course of HIV infection, the virus wins 99% of the time, showing that specific immunity in an infected person is unable to completely clear the virus," Dr. David Ho, scientific director of the Aaron Diamond AIDS Research Center in New York, wrote in an article published in the January edition of the journal PLoS, according to the Journal. However, "the pace of vaccine research has accelerated," the Journal reports (Naik, Wall Street Journal, 3/3). Currently, there are about 30 ongoing HIV/AIDS vaccine trials being conducted with human participants, but none of the vaccine candidates is close to being able to prevent infection, Anthony Fauci, director of the NIH National Institute of Allergy and Infectious Diseases, said recently. Although other vaccines cause the body to produce antibodies to prevent infection, current AIDS vaccine candidates aim to produce a cellular response in which immune system cells recognize and attack infected cells (Kaiser Daily HIV/AIDS Report, 2/22).

Gates Foundation Main Mission
Funding the development of an HIV/AIDS vaccine is the "overriding goal" of the Bill & Melinda Gates Foundation, Gates said, according to the Journal (Wall Street Journal, 3/3). The foundation last month pledged as much as $360 million over five years to support an array of innovations aimed at progressing the development of an HIV vaccine (Kaiser Daily HIV/AIDS Report, 2/17). The foundation also has pledged approximately $126 million for HIV/AIDS vaccine research (Wall Street Journal, 3/3). In addition, the foundation is a driving force behind the Global HIV/AIDS Vaccine Enterprise, an alliance of independent organizations that hope to speed HIV vaccine development. The enterprise was formed in June 2004 by leaders from the Group of Eight industrialized nations at a summit on Sea Island, Ga. (Kaiser Daily HIV/AIDS Report, 2/17). However, Gates said that the "best hope" for limiting the spread of HIV/AIDS over the next 10 years would be the development of a microbicide, according to the Journal (Wall Street Journal, 3/3). Microbicides include a range of products -- such as gels, films, sponges and other products -- that could help prevent the sexual transmission of HIV and other STDs (Kaiser Daily HIV/AIDS Report, 1/3).

Jumpstarting Vaccine Research
Although vaccines for HIV/AIDS and malaria would be the "holy grail" for anyone at risk of contracting the diseases, vaccines could be a "poisoned chalice" for the pharmaceutical company that discovers and produces them because the company would be "under heavy pressure" to sell the vaccines at a loss in developing countries, the Financial Times reports. "One representative from the pharmaceutical industry told us that, in some ways, actually discovering a vaccine for AIDS was their biggest nightmare," Owen Barder, a senior program associate for the public health program at the Center for Global Development, said. However, the G8 hopes to counteract this "glaring failure of the market" by providing incentives to companies to produce the vaccines and establishing the Global HIV/AIDS Vaccine Enterprise, according to the Times. There are plans being developed for G8 countries to agree to an advance purchase of any HIV/AIDS or malaria vaccine, the Times reports. In addition, donor countries might offer funds to drug companies that would provide an incentive to invest in vaccine development. Another consideration might be to allow pharmaceutical companies to extend their patents on existing medications in exchange for providing new vaccines at low or no cost, according to the Times.

Reaction
"When you don't have a market, you are not going to have much investment in these developing-world diseases," Gates said. Barder said he believes a fund of $3 billion for each disease would be enough to encourage vaccine research and development. However, some critics wonder whether incentives are needed at all, saying that they already exist, according to the Times. Michael Sinclair, a senior vice president of the Kaiser Family Foundation, said that the problem with advance purchase plans "is that they mortgage resources into the future that are needed now." But Jeffrey Kemprecos, director of public affairs for Europe and Africa at Merck, said that the industry is responding to the increased pressure. "Signals are very important to the private sector," he said, adding, "We all need to take a look at how to turbo-charge the research already being done on tropical disease" (Beattie, Financial Times, 3/3).

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