The article incorrectly said that the National Institutes of Health is spending $497 million on AIDS vaccine research this year. That amount was spent in the last fiscal year by NIH's National Institute of Allergy and Infectious Diseases. The entire NIH spent $597 million on AIDS vaccine research in the last fiscal year and is spending an estimated $593 million this year.
AIDS Vaccine Testing at Crossroads
Wednesday, March 26, 2008
The leaders of the federal government's effort to develop an AIDS vaccine said yesterday that more of their budget needs to be spent on basic lab research and less on testing the current crop of vaccines, none of which has proved useful in human trials.
The declaration made at a "summit meeting" is tantamount to an admission that almost no progress has been made in the search for an AIDS vaccine in the past 25 years and that something close to new start is necessary.
The conference, held at the National Institutes of Health in Bethesda, was called after a much-touted vaccine tested in half a dozen countries not only failed to benefit people who received it but also may have actually increased their chance of becoming infected with HIV, the virus that causes AIDS.
"We need to turn the knob toward [basic scientific] discovery -- nobody should be unclear about that," said Anthony S. Fauci, head of the National Institute of Allergy and Infectious Diseases.
One of the co-chairmen of the meeting, Warner C. Greene of the University of California at San Francisco, was more definitive in his assessment. "There is no question the AIDS vaccine enterprise is in need of a major mid-course correction," he told the gathering of about 300 scientists, who came from as far away as South Africa and Kenya for the one-day meeting.
Carl W. Dieffenbach, the head of the NIH's Division of AIDS, acknowledged that "this summit does mark a change in our approach."
The meeting was called after two studies testing the same vaccine were stopped in September. The vaccine, made by the pharmaceutical giant Merck, used a crippled version of a common respiratory virus, called adenovirus type 5, to deliver a selection of HIV proteins to the immune system in the hope of inducing protection.
The studies were stopped when early results suggested that people receiving the vaccine were more likely to become infected with HIV than people receiving placebo injections. The reason is unknown and the subject of intensive scientific study.
NIH is spending $497 million on AIDS vaccine research this year, with about $476 million going to researchers outside its campus. About 47 percent of the money funds basic research and 38 percent funds testing "candidate vaccines" in humans. Fauci said the ratio needs to be tipped more steeply in favor of basic research.
Although researchers have tested numerous AIDS vaccines on small groups of volunteers, only three vaccines have gone to large clinical trials with thousands of volunteers.
Earlier this decade, one product, called AIDSVAX, was found to be ineffective. The Merck vaccine, which showed promising results in monkeys, may have been harmful. A third vaccine, being tested in an experiment nearing completion in Thailand, is given little hope of working by most researchers, 21 of whom wrote a letter to the journal Science several years ago saying that the study should not even begin.
The search for an AIDS vaccine has proved difficult for several reasons.