The Bay Area Reporter - June 18, 1999
Bob Roehr

It is part of the commitment the president made in May 1997, in a speech at Morgan State University, to develop that vaccine within 10 years. An estimated 16,000 people worldwide become infected with HIV every day. The only way to control the epidemic is with a preventative vaccine.

"We are a long way from winning this battle" against AIDS, said Donna Shalala, secretary of Health and Human Services. She hoped that this building "will be the Cape Canaveral of vaccine research."

She noted that the expansion of NIH research under the Clinton administration "may be the legacy that has the longest and most sustained impact on this country and the world."

Unspoken by Shalala was that over the years, Clinton has offered only modest increases for NIH in his budget proposals. The Republican controlled Congress has appropriated substantially greater amounts than the president has requested.

HIV "has become the leading infectious killer in the world," the president said, it infects one in every 100 people. He called the ceremony "a hopeful moment in America" struggling to conquer HIV. "I am confident that this is the place where miracles will happen."

He recounted the day, nearly 50 years ago, of the discovery of the polio vaccine, and subsequent development of vaccines against 20 other scourges. "The triumph of vaccines over infectious disease is one of the great achievements of a remarkable 20th century."

The speakers devoted most of their time to praising Dale and Betty Bumpers. The pair preceded Clinton in the Governor's Mansion in Little Rock, Arkansas. Dale later served in the U.S. Senate.

As first lady of the state, Betty Bumpers championed childhood immunization. Clinton said that whenever she appeared at a school, "the kids would start to cry. They knew that when she came in, somebody was going to have to get a shot." She later allied with presidential wife Rosalynn Carter to spread the program nationwide. Dale Bumpers pushed for funding for childhood immunization in the Senate.

AIDS advocates were disappointed that the event was entirely celebratory, that the president did not take the opportunity to advance his commitment to fighting HIV.

"The president is patting himself on the back, but we say that not enough is happening," said Jay Blotcher, spokesman for the AIDS Vaccine Advocacy Coalition (AVAC).

Steve Wakefield, president of AVAC, believes that private industry also must make a commitment to developing a vaccine. That has not happened. He believes the government needs to offer tax credits to stimulate industry participation.

"When the president has wanted something in the past, the White House has held a conference on it," Wakefield said. The subjects have ranged from racism, to classroom violence, to aging. But that has not happened with an AIDS vaccine. He said, "The sense of urgency is missing here."

Vaccine Research Center

The Vaccine Research Center was without a permanent director for nearly two years ago after its creation. Several leading candidates are believed to have declined interest in the position because of its unique and somewhat vague lines of authority within the institute dominated NIH.

On March 11 of this year, Secretary Shalala announced that Dr. Gary Nabel would head up the center. He began a month later but will split time between NIH and his lab at the University of Michigan, Ann Arbor until the VRC building becomes fully operational, probably in August 2000.

Nabel has been a leader in developing gene therapy as an anti-cancer agent and in preventing infection from the deadly Ebola virus. He chaired the AIDS Research Advisory Committee of the National Institute of Allergies and Infectious Diseases (NIAID) in 1996-97.

Nabel is a 1975 magna cum laude graduate of Harvard University, where he remained for his graduate and medical study. He is a prot g of David Baltimore, Ph.D., who is now president of the California Institute of Technology and chairs the NIH AIDS Vaccine Research Committee.

AIDS vaccine setback

Many researchers interpreted an article, in the June 2 edition of the New England Journal of Medicine (NEJM), as a setback for at least one approach in developing an effective AIDS vaccine to prevent infection.

The article was on further developments in Australia. That nation began screening blood for HIV in 1985. Prior to that six surviving patients had become infected with what was later identified as a weakened mutant strain of the virus. The donor and five transfusion recipients have been followed closely.

They had not exhibited symptoms of infection, leading researchers to hope that an attenuated or weakened form of the virus might provoke an immune response from the body. That would be the basis for creating a protective vaccine.

But now, three of the six are developing signs of immunological damage. A viral load has become detectable and their CD4 counts are beginning to decline. It indicates that a weakened virus, while slower, is still deadly.

This "provides another cautionary note with respect to the use of live attenuated HIV strains as vaccines. If large populations of uninfected persons were given this virus, there would almost certainly be unacceptable risks," said an accompanying editorial in the NEJM, written by Nabel and Kathleen L. Collins, MD, Ph.D., of the University of Michigan Medical Center.

HIV vaccines currently in clinical trials in the U.S. and overseas do not use live attenuated virus, they use a killed portion of the virus' outer shell to stimulate an immune response. There is little concern that these vaccines could lead to active HIV infection. But for that very reason, many question how effective they may be in stimulating an appropriate immune response strong enough to prevent infection.

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