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A Vaccine is Essential to Eliminating AIDS

Jeannette Kagame / Seth Berkley

As participants gather in Mexico City for the biennial International AIDS Conference, global attention will turn to the HIV/AIDS pandemic. If previous conferences are any gauge, the attention will be fleeting, soon to be replaced on the pages of the world's press.

The world has become accustomed and hardened to hearing the figures. At the end of last year, approximately 33 million people were living with HIV - a figure equivalent to the total population of Canada. In sub-Saharan Africa, more than 60 percent of people living with HIV are women. For them, poverty, economic dependence, and lack of power to negotiate health and sexual matters fuel the pandemic's growth.

While improvements in access to antiretroviral therapy mean that more HIV-infected people in the developing world are getting the benefit of these life-prolonging drugs, the great majority - two-thirds of all infected - still are not. And for every two people put on treatment, there are five new infections. Furthermore, even for those lucky enough to have access to a lifetime of HIV treatment, antiretrovirals are not cures. Sadly, AIDS remains a pandemic that is out of control.

So is there any hope of eliminating this dreadful disease?

Yes, in fact, there is. In the short-term, governments must continue to scale up the use of the tools presently at our disposal. These include the use of prevention methods like abstinence and faithfulness campaigns, condoms, and male circumcision. But our battle so far against AIDS tells us these methods alone will not suffice. Particularly for the long-term, we need a more powerful weapon - a weapon that will be equally useful to women and girls as for men and boys.

What we need is an AIDS vaccine.

Although clues suggest that a vaccine is possible, developing a vaccine against AIDS is arguably the greatest scientific challenge of our time. HIV is the toughest virus vaccine designers have faced. But we have faith in science. Although a promising AIDS vaccine candidate that was tested in Africa and the Americas just failed, one cannot consider the trial itself a failure - nor even a disappointment. From a scientific perspective, apparent failures nevertheless provide previously unknown critical information and are the key stepping stones in the road to a successful result. Therefore the more we learn about HIV, the more likely we are to identify and then effectively utilize the chinks in its armor.

Just as AIDS is a global disease, so the search for a vaccine need be a global effort. Researchers around the world are engaged in work ranging from basic explorations of how HIV works to field testing of experimental vaccines in human trials.

Africa, the epicenter of the epidemic, is at the forefront of much of this science. Since 1999, 25 AIDS vaccine trials have been conducted in eight countries in Africa. African investigators today are working hard to engage an ever-increasing number of the continent's scientists, as they strive to answer some of the hardest questions facing AIDS vaccine design.

In their work - and in the parallel efforts of scientists across the globe - there is great promise: the potential for progress that will put us on the path toward an effective, preventive vaccine. A vaccine which, when it is finally found, will be suitable and affordable for all who need it - both in Africa and other parts of the developing world, as well as the developed world. We should be clear: This path is almost certainly long. Developing a vaccine will require patience and perseverance. But we must make the investment for a future payoff now.

Jeannette Kagame is first lady of Rwanda and the high representative for the African AIDS Vaccine Program. Dr. Seth Berkley is president and CEO of the International AIDS Vaccine Initiative.

© Copyright 2008 The Boston Globe

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