|AIDS Vaccine Advocacy Coalition Report (UNAIDS - Best Practice Digest, 2000, 3 p.)|
Extracted from 7 Years and Counting...How can we overcome obstacles to an AIDS vaccine? AIDS VACCINE ADVOCACY COALITION REPORT. MAY 2000.
The idea of finding a vaccine to prevent HIV has finally captured the attention of government leaders and affected communities. President Clinton has advocated the development of an AIDS vaccine at least six times during his two terms in office. There have been needed increases in funding at the National Institutes of Health. There are modest research programmes at the major pharmaceutical companies and among some biotech mavericks. Five thousand individuals, predominantly in the US, have volunteered to participate in the first HIV vaccine efficacy trial.
There is also progress towards a government-sponsored, large-scale human trial, and activity by governments, researchers and advocates in scores of countries. Interest and activity have grown to a point where advocates can compliment and critique multiple efforts on many fronts. Today it is possible to see how to actually get to an AIDS vaccine.
However, the AIDS Vaccine Advocacy Coalition is still impatient:
· The US Department of Defense has a directed HIV vaccine research programme. So why is it consistently underfunded?
· The President and Congress proposed important incentives. So why are these bills facing opposition or disinterest?
· Industry says it faces difficulties in dedicating resources to HIV vaccine research. So why do they seem tongue-tied when asked what incentives they need?
· NIH funding has sky-rocketed. So why are there still not enough non-human primates available for needed research?
· We are almost 20 years into the epidemic and 30 million people live with HIV. So why has there been only one Phase 3 trial of a vaccine that might prevent this disease?
The executive and legislative branches of the US government seem to lack the political will to make the more difficult policy changes that must follow the funding. Money for research is the easiest element in the equation. The other elements are partnerships with industry, incentives for private sector investment, shared objectives and consistent, concerted action.
Most encouraging to AVAC has been the awakening of developing countries to the possibility of developing or contributing to the pre-clinical development of vaccine candidates themselves. These moves towards empowerment in the face of an overwhelming disaster bode well for cooperative activity and concerted action. Nothing, perhaps, would move the vaccine development effort forward more quickly than invigorated governmental and scientific partnerships, and a sense of ownership by populations where vaccines must be tested and where they are most needed.
This year, ARVAC has three overarching recommendations.
1. Expand government programmes as rapidly as they can effectively handle expansion.
· Expand the research work at NIH that facilitates moving products from the lab to development.
· Permanently and adequately fund Department of Defense vaccine research.
· As industry becomes more involved, negotiate for trade-offs, such as reasonable pricing, before public funds are handed out.
· Conduct clinical trials more smoothly and expeditiously.
· Supplement funding beyond current and proposed increases for NIH in seven specific areas identified by AVAC. Prepare research sites in the US and other countries. Provide more and higher quality non-human primates. Develop new assays rapidly and place advance orders for new cell-sorting and other technology for analysing results from efficacy trials. Target additional resources to biotech companies through the Vaccine Design and Development Teams initiative. Prepare key communities and the public for ongoing vaccine effort. Provide adequate funds to expeditiously conduct efficacy trials in the US and abroad as soon as candidates become available. Create private-public partnerships to champion and develop orphan-vaccine concept s and support vaccine trials.
2. Pass legislation that provides incentives for private sector involvement in HIV vaccine research.
· Pass the Vaccines for the new Millennium Act introduced by US Senator John Kerry and Representative Nancy Pelosi. The Act would provide a range of important incentives for vaccine research and development.
· Establish purchase funds and other access assurances now.
3. Fund public outreach, education and communication programmes.
· Focus education and communication efforts in key communities.
· Develop and implement a strategic communications plan