Financial constraints under the fiscal year 2006 budget proposed by President Bush might require NIH to stop some ongoing AIDS vaccine research and other projects that cannot meet predetermined intermediate markers, Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said on Monday at a press conference at the American Association for the Advancement of Science, Reuters reports. Bush's FY 2006 budget calls for a $163 million, or 0.5%, increase in NIH's current $28.8 billion budget, according to Fauci, who added that between 1997 and 2003, NIH's overall budget doubled. "Our belt is being tightened for us," Fauci said, adding that AIDS vaccine trials will have to meet certain "milestones" to continue to receive funding. However, some research might be "stopped partway through to concentrate on more promising research," according to Reuters. "Through the years, HIV/AIDS (research funding) has usually done at least as well as and usually better than other diseases," Fauci said, adding, "However, as we now approach '06, '07, '08 and '09, it has become clear that not only will there be a less than 2% increase in the NIH budget, that the previous largess that was associated with all research, particularly HIV, is now not going to be a reality for the future." Fauci said that NIH will have to work more closely with private industry and not-for-profit groups, such as the International AIDS Vaccine Initiative, to get "the most bang for the buck." Of the approximately $600 million being spent worldwide to develop an AIDS vaccine, $520 million is provided by NIH, about $60 million comes through the U.S. Department of Defense and groups such as IAVI contribute the remainder, according to Reuters.

Current Trials
Fauci said there are currently about 30 ongoing HIV/AIDS vaccine trials being conducted with human participants, none of which is "very close to having a vaccine that would prevent infection," Reuters reports. Although other vaccines cause the body to produce antibodies to prevent infection, current AIDS vaccine candidates aim to produce a cellular response where CD4+ T cells recognize and attack infected cells (Fox, Reuters, 2/21). Some scientists are "approaching a critical crossroads" where they must determine if a cellular approach alone will be effective, according to IAVI President Seth Berkley, the AP/Yahoo! News reports. "If cellular immunity turns out to be quite positive, we've got a series of candidate vaccines," Berkley said, adding, "If it turns out that cellular immunity is not very useful ... it's a much longer time period" to an effective vaccine (Neergaard, AP/Yahoo! News, 2/22). Although nearly all health experts agree that a vaccine is the "only way" to stop the HIV/AIDS pandemic, some vaccine research will have to be "cu[t] back," Fauci said, Reuters reports (Reuters, 2/21).

A kaisernetwork.org HealthCast of the session at which Fauci and Berkley spoke is available online.

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