San Francisco Chronicle - Friday, June 27, 2003
Sabin Russell, Chronicle Medical Writer

"A well-coordinated global enterprise necessary to drive this scientific effort does not exist and must be created," according to two dozen of the world's top AIDS scientists and vaccine proponents. The proposal is published in the current issue of the journal Science.

The scientists envision the creation of six to 10 centers, with each focusing on different aspects of vaccine development. Coordination among the centers would require an unprecedented degree of cooperation, where participants would agree on which research avenues ought to be funded.

The proposal was organized by Dr. Richard Klausner, director for Global Health at the Bill and Melinda Gates Foundation in Seattle. Other authors include Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases; Dr. David Baltimore, president of the California Institute of Technology; and Dr. Peter Piot, executive director of UNAIDS, the United Nations' AIDS program.

Like the Human Genome Project, which was launched in 1990 with the audacious goal of mapping all the genes that carry the biological blueprints for a human being, the proposed Global HIV Vaccine Enterprise would draw on the work of government, university and private industry scientists, at laboratories around the globe.

"We hope this would serve as a catalyst, to get more international parties involved," Fauci said. "The critical aspect to this is the global aspect."

As the proposal points out, "no one entity actually ran the international genome project." Instead, participating scientists and those who paid for the research hammered out a continuous working relationship. The initial goal of mapping the human genome was declared completed in April, less than 13 years after the project was launched.

VIRUS OUTFOXING SCIENCE

Scientists typically work independently, often in highly competitive pursuits of common targets. But two decades into the epidemic, the human immunodeficiency virus has outfoxed all the techniques that have previously helped modern researchers create vaccines for scourges from polio to hepatitis B.

"This is borne out of frustration," said Nobel laureate Baltimore, during a telephone interview from Pasadena. "The classic approaches have not been successful, and it's not obvious that it's going to be successful. So we have two choices: to throw in the towel and decide not to do it; or to try more intensively. We're going to try more intensively."

Baltimore conceded that success was still at least 10 years away.

Since it emerged in 1981, AIDS has claimed 20 million lives worldwide. Absent a vaccine, or an effective mix of prevention and treatment programs, UNAIDS estimates that HIV will kill 70 million people by 2020. Although AIDS burns through a population slowly, its relentless capacity to kill has made it the deadliest human plague since the Black Death of the Middle Ages.

The high cost of vaccine development has proved an impediment. Because of the cost, and the high risk of failure, the authors concluded that "reliance on industry to carry the major load for discovery and development for HIV vaccines is unrealistic."

Only one vaccine has gone through the full range of testing, from test tube to large-scale clinical trials. But the long-awaited results of the trial, for a vaccine developed by VaxGen Inc. of Brisbane, were disappointing. The vaccine provided no protection to most subjects in a clinical trial involving almost 5,000 subjects, although the data showed hints of benefit among the 314 black participants.

Although drug makers such as Merck Inc. and Aventis-Pasteur are engaged in AIDS vaccine research, they were notable in their absence from the list of co- authors. The only vaccine company executive to sign-on was Dr. Don Francis, the founder and chairman of VaxGen.

"One would like to think there has been a massive competition, but it is a lot harder to get invested in an AIDS vaccine than an AIDS drug." he said.

VaxGen has invested $140 million in its candidate AIDS vaccine, building on an earlier $50 million investment by Genentech of South San Francisco.

E-mail Sabin Russell at srussell@sfchronicle.com.

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