The scientific and policy challenges to the development of an AIDS vaccine are discussed in a Viewpoint in this week's edition of The Lancet. The Viewpoint, authored by Dr Seth Berkley and Dr Wayne Koff, International AIDS Vaccine Initiative, New York, USA, says: "HIV could be the most formidable adversary for vaccine development yet, because of unique scientific challenges: uniformly fatal outcome, the absence of natural immunity, the virus's genetic variability, and its ability to target the immune system."
The authors add: "Two key scientific problems -- that stem from HIV's hypervariability and its interaction with the immune system, including its propensity for immune evasion -- must be solved in the design of an effective immunogen: 1) elicitation of broadly neutralising antibodies and 2) durable control of HIV infection." The Viewpoint concludes with calls for more long-term funding for investigator-driven research, applied research, product development, and clinical testing, as well as for accelerated trials among cohorts with the highest incidence of HIV/AIDS to establish preliminary efficacy for promising AIDS vaccine candidates. The authors also call for the "recruitment of new institutions and technologies" in the search for an AIDS vaccine, and "the creation of incentives for innovation" to accelerate progress in the field.
The Lancet