AEGiS-WSJ: Top AIDS Researchers Propose Global Network for Finding Cure

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Top AIDS Researchers Propose Global Network for Finding Cure

Wall Street Journal - June 26, 2003
Marilyn Chase, Staff Reporter of The Wall Street Journal

Two dozen AIDS researchers and public-health officials, citing the lack of any preventive vaccine two decades into the AIDS pandemic, are calling for the creation of a global HIV vaccine enterprise, saying that it is "unrealistic" to expect private industry to shoulder the burden alone.

The policy statement, published in Thursday's edition of the journal Science, was signed by top officials of the U.S. Centers for Disease Control and Prevention; the AIDS divisions of the United Nations and the World Health Organization; the U.S. National Institutes of Health; an array of international research institutions; the Bill and Melinda Gates Foundation; and two Nobel laureates.

"A well-coordinated global enterprise necessary to drive this scientific effort does not exist and must be created," the authors said, adding that "reliance on industry to carry the major load for discovery and development for HIV vaccines in unrealistic."

Currently, there are 42 million people world-wide living with AIDS, including 2002 casualties of five million new infections and three million deaths, according to the WHO. If AIDS proceeds at its current pace without a vaccine, scientists said they expect 45 million new infections by 2010 and nearly 70 million deaths by 2020.

Researchers so far have failed to come up with an effective vaccine. In 2001 and 2002, only seven new-vaccine candidates entered clinical trials.

Only one product, VaxGen Inc.'s gp120 vaccine, progressed to the pivotal Phase III studies of effectiveness, but overall it didn't work because it didn't succeed at blocking viral infection overall.

Vaccine development is saddled with high costs ranging from $200 million to $600 million, high risk of failure and uncertain markets in developing countries, which are hardest hit.

People close to discussions said it is expected that the Gates Foundation will provide a major portion of a budget that could run from several hundred million to $1 billion. The Gates Foundation hasn't yet committed any funding to the project, but plans to convene the group of authors in the next few months to discuss budgeting needs, said Joe Cerrell, a spokesman for the Gates Foundation, whose assets of $24 billion make it the largest private U.S. foundation.

What is needed is an "integrated global clinical trial system" to make sure all promising vaccine models are pursued, successes and failures instantly reported and efforts not duplicated, said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases.

"It doesn't mean the free market system has failed," Dr. Fauci added. "We don't want to take individual creativity away from anybody." But he said the resources of a giant consortium could provide critical mass, conceptual leads, and strategic data sharing "that would spur companies to get even more involved than they are."

'Big Science' Effort

"In some ways, this is a 'big science' effort like the human-genome project," said Gary J. Nabel, director of the Vaccine Research Center at NIH in Bethesda, Md.

People have discussed the possibility of a "Manhattan Project" approach to AIDS since the birth of the pandemic two decades ago. "The difference," said VaxGen Inc. President Donald Francis, "is that this is going to happen." The new element is "catalytic" funding by the Gates Foundation, and the drive of its creator, Microsoft Corp. founder Bill Gates, to develop a product.

"Government is good at directing the research pathway, and [Mr. Gates] is good at driving the product pathway," Dr. Francis said. Moreover, he said the huge health gap between the developed and the developing world could be bridged by licensing a huge private foundation like Gates to purchase and distribute vaccine overseas.

Intellectual-property rights and patent positions have hobbled distribution of cutting-edge AIDS drugs to the Third World, and such issues are likely to pose a high hurdle in vaccine development as well.

However, Dr. Francis said, "I think it can be worked out.

Separately, the U.N. said global AIDS funding of $4.7 billion from all sources to fight the epidemic this year in low- and middle-income countries is less than half the $10.5 billion a year needed by 2005 for a "barebones" package of prevention and treatment in areas of greatest need.

--David Bank contributed to this article.

Write to Marilyn Chase at marilyn.chase@wsj.com

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