The AIDS Vaccine Quest
“My fellow Americans, if the 21st century is to be the century of biology, let us make an AIDS vaccine its first great triumph…And let us also pledge to redouble our vigilance to make sure that the knowledge of the 21st century serves our most enduring human values.”
– President Bill Clinton, Commencement Address, Morgan State University, Baltimore, Md., May 18, 1997
Today is HIV Vaccine Awareness Day, marking the 18th anniversary of that speech and the launch of a major AIDS vaccine development program. No one expected the solution to arise easily. But the quest for a vaccine that can outwit the quick-change artist known as HIV has turned out to be even more challenging than expected. There is, however, good reason to be hopeful.
When then-President Clinton delivered this speech he reminded the audience that the 20th Century gave the world atomic energy, genetic engineering, the transistor and, toward its end, Dolly the lamb, the Hubble telescope, and protease inhibitors. He asked us to imagine the next century “full of promise, molded by science, shaped by technology, powered by knowledge.”
Although an AIDS vaccine is still not within reach, there is great progress in understanding the virus and figuring out how to design a vaccine capable of keeping it at bay. Among other advances, discovery of hundreds of antibodies that can decimate multiple strains of HIV, so-called broadly neutralizing antibodies (bNAbs), has electrified the field. This century also saw the first vaccine candidate to provide any protection against HIV in clinical trials with the results of the RV144 trial in Thailand.
A just-released video, created by the International AIDS Vaccine Initiative (IAVI) and other partners worldwide to mark HIV Vaccine Awareness Day, vividly captures the optimistic mood among researchers today. “The only reason we’re spending 90 percent of our time trying to make an HIV vaccine is because I believe we can do it,” Bill Schief, associate professor of immunology and member of the IAVI Neutralizing Antibody Center at The Scripps Research Institute, says in the video.
John Mascola, director of the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases (NIAID), senses a momentum that is propelling progress: “There’s really been a critical explosion of knowledge in the last five years. It’s just a matter of perseverance and keeping the science going forward.” Max Crispin of the University of Oxford also senses the field advancing. “Ten years ago, I would have said there are five huge hurdles that could each be insurmountable. But now, there’s one or two.”
The latest VAX—“Fighting the Good Fight”— marks HIV Vaccine Awareness Day with a special issue examining the motivations and work of five leading female researchers from the US, Australia, and Africa. These researchers include: Linda-Gail Bekker, the president-elect of the International AIDS Society; Ambassador-at-large and Colonel Deborah Birx, the U.S. Global AIDS Coordinator in charge of the President’s Emergency Plan for AIDS Relief (PEPFAR); Sharon Lewin, director of the Doherty Institute for Infection and Immunity in Melbourne, Australia; Nelly Mugo, a principal research scientist at the Kenya Medical Research Institute; and Galit Alter, principal investigator at the Boston-based Massachusetts Institute of Technology, and Harvard University.
Bekker faced down a period of AIDS denialism in South Africa in the 1990’s. She had to fight this view because she knew it was costing lives. The tide was turned, she said, by an unusual coalition of academic researchers and activists that “took on the government, providing incontrovertible evidence” about the efficacy of antiretrovirals. Birx oversaw the launch of the RV144 vaccine trial in Thailand. “I like to believe I am always a skeptic about data and pushing the envelope to understand things in a deeper way,” Birx told VAX.
Creativity, courage, and cooperation are values expressed by these female researchers and all of the field’s leaders. Guided by science and strengthened by such virtues, researchers working tirelessly to develop an AIDS vaccine will be well aligned with the other aspect of President Clinton’s vision: that the knowledge we gain be used “to serve our most enduring human values.”
Groups worldwide will support and participate in HIV Vaccine Awareness Day events today across Africa, India, Europe, and North America.
- Kitta MacPherson is a writer for VAX and IAVI Report in New York and an award-winning science journalist