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Reviving The HIV Vaccine Hunt

Any vaccine should be accompanied with counseling and continued emphasis on preventative actions.
by Rosalie Westenskow
UPI Correspondent
Washington (UPI) Jul 24, 2007
A renewed emphasis on the critical but elusive HIV/AIDS vaccine is needed, along with more funding, to mitigate the disease's rampant spread in developing countries, health experts said Monday. "Any serious discussion about AIDS must include the Holy Grail -- the potential for a vaccine," U.S. Rep. Tom Lantos, D-Calif., said at a panel discussion in Washington hosted by the online journal Health Affairs, a peer-reviewed, health policy journal published by the non-profit organization Project HOPE.

"The devastation of this virus goes far beyond those who suffer directly from it," he added. "It has caused massive upheaval to political, social and cultural structures, including the most important: the family."

While the United States has been working to fund prevention and treatment programs, much more needs to be done, Lantos said.

The AIDS pandemic in the developing world garners particular attention because of its wildfire spread over the past two decades, especially in sub-Saharan Africa, where 2.8 million, or almost half of the world's infected, live. The virus has claimed 30 million lives but has impacted millions more, Lantos noted.

An AIDS vaccine plays a crucial role in the battle because prevention programs alone cannot put a significant dent in the rate of infection, said Robert Hecht, who co-authored a study, "The Impact of an AIDS Vaccine in Developing Countries," published in the July/August issue of Health Affairs.

"Even with an increase in the adoption of current prevention methods, without a vaccine, we will still see millions of new infections every year," said Hecht, who is senior vice president of policy at the International AIDS Vaccine Initiative, a non-profit group pushing for an AIDS vaccine. "At best, our model suggests there will continue to be 4 million people infected annually. This would hardly put a dent in this terrible epidemic."

Significant progress has been made in recent years toward developing a vaccine. Currently, approximately 25,000 volunteers are participating in more than 30 AIDS vaccine trials around the world. Two of these trials are nearing fruition, and the scope of their protection should be known within the next two years, Hecht said.

"If one of these vaccines shows some modest level of benefit, we would consider this a tremendous victory and could move into large-scale production in the next decade," he said.

Because of the difficulty of combating HIV, Hecht said the first vaccine to be approved for use may only be partially effective.

Yet even a partly protective vaccine could have positive results, he added. If a third of the adult population received a vaccine that kept only 50 percent of those exposed to the virus from developing it, 17 million new HIV infections could be averted between 2015 and 2030, according to the Health Affairs study.

Although some have raised concerns that a partially effective vaccine would be counterproductive by encouraging risky behavior without guaranteeing protection, scientists who participated in the study downplayed that possibility.

"Clearly, there is a mathematical possibility that if people adopt worse behaviors than they already had because of the availability of the vaccine, it ends up making things worse," said John Stover, who also contributed to the AIDS vaccine study. "But we don't think that that's likely to happen."

Any vaccine should be accompanied with counseling and continued emphasis on preventative actions, said Stover, the president of Futures Institute, an organization that conducts health policy analysis.

The study's authors said they gained confidence from the behaviors of those participating in AIDS vaccine trials, including one in Thailand that resulted in negligible changes in the sexual behavior of participants over a four- or five-year period.

Global health has gained increasing importance in Congress over the past decade, as spending has increased from $1 billion a year in 1997 to $6 billion in 2007. Part of this growth results from an increased awareness of how quickly infectious diseases can spread in the era of globalization, said Nicole Bates, director of government relations for the Global Health Council, a membership organization that promotes world health initiatives.

"Particularly for communicable disease, it doesn't matter where it starts," Bates told United Press International. "It's in our interest to be able to respond to healthcare threats."

To that end, President Bush recently requested that Congress reauthorize the president's Emergency Plan for AIDS Relief and double the program's five-year budget from $15 billion to $30 billion. PEPFAR, created in 2003, aims to provide anti-retroviral treatments to 2 million HIV-infected people, prevent 7 million new infections and coordinate supportive care for 10 million others affected by the disease.

The AIDS scourge in developing countries also underscores the striking disparity of healthcare access between high- and low-income countries, health experts say. While only 2 percent of world health spending takes place in poor countries, 56 percent of those infected with diseases reside in these regions.

Source: United Press International

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