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Malaysia-AIDS: Researchers close to AIDS vaccine but warnings of "staggering" Asian toll

Agence France-Presse - October 26, 1999

KUALA LUMPUR, Oct 26 (AFP) - Researchers are "on the verge" of making an HIV vaccine, a scientist told an international AIDS conference Tuesday, as another speaker gave "staggering figures" for the epidemic's impact on Asia.

"I think that we are on the verge of making an HIV vaccine...we have all the components and we just need to find the most potent ones and put them together," US researcher Margaret Liu told the 5th International Congress on AIDS in Asia and the Pacific.

"I think we do have all the tools and that now we just need to be as aggressive as possible about moving these ahead.

"We have entities that are very near to the stage that we need them for making a successful vaccine."

Liu, of Chiron Corp., said a number of laboratories including hers were working on ways to deliver genes into cells without having to use a live virus.

In a paper issued before her speech she said gene-based vaccines now being developed "may provide the critical element necessary to make vaccines against diseases such as HIV for which earlier vaccine approaches have failed."

Unlike killed-virus vaccines, she said, DNA vaccines induced not only antibodies but immune responses in cells.

Live viruses could also induce immune responses but may also cause disease. DNA vaccines may thus be safer as well as easier to manufacture and stable at room temperature.

"Both these traits would greatly facilitate development and distribution of vaccines throughout the world," her paper said.

Using a gene-based vaccine, she told the conference, "it's possible that we could make an HIV vaccine that does not prevent infection but prevents either disease or the progression of disease."

Liu also said researchers were working on delivering a vaccine through the nose to treat large numbers of people quickly.

Julian Bilous, director of communicable disease prevention and control for the Western Pacific region of the World Health Organisation (WHO), told the congress that by next year there would be five to ten million HIV-infected Asians.

In 2000 Asia would experience half a million new cases of infection, including about 300,000 in India and 50,000 in Thailand and Myanmar.

"These are staggering figures as you all know," he told delegates. More than 3,000 people are attending the congress.

Bilous said the major emphasis was still on prevention -- "fighting the fire where it's occurring." Asian governments must make decisions based on priorities and national capacities.

"For example Cambodia will experience 10,000 AIDS deaths in the year 2000. This will overwhelm the capacity of the health services."

Bilous said only 8,000 hospital beds were available in the whole country, which had an estimated 200,000 people infected with HIV.

He said international organisations were making cheaper bulk purchases of drugs to cut costs for cash-strapped nations but the capacity of each country's health service and the attitude of its health workers were the most important issues.

Other options to cut costs were parallel importing, under which drugs sold in a third country more cheaply than in a local market can be re-imported at the lower price.

Bilous said an agreement reached in 1994 during negotiations on the founding of the World Trade Organisation also allowed for compulsory licensing -- the production and sale of drugs without the agreement of the patent holder -- "to achieve important puiblic health interests."

He said the World Health Assembly this year urged nations to explore their options under trade agreements to safeguard access to essential drugs.

The WHO was also consulting the world intellectual property organisation on "ways to ensure intellectual property laws have a supportive role in making HIV-related drugs affordable and accessible."

But Bilous said compulsory licensing of life-saving drugs "will not solve all problems." Poorer countries needed pharmaceutical industries and sustainable financing as well as a health system which could deliver the drugs.

However, he predicted financing mechanisms were likely to be available in the next decade for most countries to procure HIV-related drugs.

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