Developing an AIDS vaccine that will prevent HIV from establishing infection in a healthy immune system is a daunting enough challenge. But some researchers are working on what is almost certainly an even more formidable undertaking-developing therapeutic vaccines that are intended to boost the immune response to HIV in people who are already infected.
AIDS vaccine research has long been seen as having scant overlap with treatment for people infected with HIV. But in 2003 several major AIDS vaccine trial sponsors effectively redrew the boundaries between the fields of AIDS vaccines and treatment with announcements that they would work to ensure the availability of antiretrovirals (ARVs) for volunteers who become infected through high-risk contact, such as unprotected sex, during the course of an AIDS vaccine trial.
The recent decisions by several AIDS vaccine trial sponsors to ensure access to antiretrovirals (ARVs) for trial participants who become infected with HIV come after years of debate and discussion about the ethical implications of providing-or not providing-these powerful medications to trial volunteers. Two of the central questions were: Is there an ethical obligation to provide ARVs to volunteers who become infected during the trial period through high-risk behavior?
I'm writing to say adieu from my perch at the IAVI Report. In August 2003, after three years as editor of the newsletter, I left IAVI to resume freelance writing, editing and teaching.
Mauro Schechter MD, Ph.D is one of the leading figures in the field of AIDS in Brazil, and his renown now spreads beyond his home country to the international sphere. He is Head of the AIDS Research Laboratory at the Universidade Federal do Rio de Janeiro, and was one of the first Brazilian scientists to commit to setting up a preventive AIDS vaccine clinical trial site, as well as being instrumental in setting up the first Community Advisory Board in the country.
For the better part of the 20th century, vaccine development and testing was the province of the industrialized world. Many of today's vaccines, including those against polio and measles, were licensed based on data from efficacy trials in the United States and Europe.
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