Avid Bioservices Inc (CDMO)

[jazzbeerman]

Alan Bernstein re: Mexico City conf -



Statement from Alan Bernstein,
Executive Director of the Global HIV Vaccine Enterprise,
following the XVII International AIDS Conference:

http://www.hivvaccineenterprise.org/_dwn/news/2008_mexicocity_closing_statement.pdf


The AIDS 2008 conference, which ended last week, brought renewed focus to HIV prevention
efforts. This represents a dramatic shift, as increased access to treatment has dominated the
HIV/AIDS agenda for much of the past 20 years. While it is essential that treatment reach all
those who need it, it is clear that effective prevention is the only way to end the HIV pandemic.
The anti‐retroviral (ARV) drugs developed over the past two decades have been spectacularly
successful at keeping HIV in check – far beyond what anyone optimistically could have hoped
for. Yet despite these powerful new drugs and expanded access through programs like PEPFAR,
new infections continue to outpace the availability of treatment. There are still five new
infections for every two people who gain access to ARVs. ARVs, used in combinations to limit
resistance, can control HIV in most individuals, but they are not a long‐term solution to the HIV
pandemic. As Anthony Fauci, Director of the US National Institute of Allergy and Infectious
Diseases (NIAID), said during the conference, even these powerful drugs have never truly cured
anyone of HIV/AIDS – in the sense that they no longer require continued therapy.

When a person infected with HIV stops using ARVs, a latent reservoir of the virus, probably in
the gut, becomes activated. People living with HIV are therefore dependent on life‐long
combination therapy. Given that there are still almost 3 million new cases of HIV each year, the
cost of universal access to ARVs is astronomically high and will continue to grow unless new
infections fall. As Mark Harrington, Executive Director of the Treatment Action Group, stressed
in his conference presentation, "We must seek a cure and a vaccine."

Mark and other conference speakers (myself included) emphasized the need for a
comprehensive prevention strategy that includes short, medium and long term goals, and that
emphasizes both a cure and a vaccine. In the short term, we need to expand access to therapy,
which we know works to save lives. In the medium term, the world must intensify efforts to
develop and use social and biological interventions (such as condoms, behavior change and
circumcision), microbicides and other HIV prevention methods. ARVs themselves may offer
some hope in this regard: AIDS 2008 saw considerable discussion and some data on the concept
of Pre‐Exposure Prophylaxis (PrEP), including data from the BC Centre for Excellence in
HIV/AIDS in Vancouver that suggests that aggressive treatment prior to exposure may
significantly reduce the probability of viral transmission. While “Treatment as Prevention” holds
promise, further study is needed.

In the long term, the best way to stop HIV is with an effective, preventative vaccine. Finding an
HIV vaccine is the greatest scientific challenge of our time, and the effort will not be easy. But
history has shown that an effective vaccine is the best way to prevent the spread of a virus.
With a vaccine as our long‐term goal, we must ensure continued scientific momentum. We
should work to renew the current generation of distinguished scientists by attracting and
nurturing the next generation of HIV vaccine researchers. Young scientists from across the
globe will bring the creativity and energy required to surmount HIV's unique challenges. They
will also bring knowledge of the cutting edge technologies that are revolutionizing other areas
of biomedical research.

During AIDS 2008, in partnership with many other organizations, the Enterprise sponsored an
exciting Satellite Symposium entitled "New Minds, New Ideas: Attracting the Next Generation
of Investigators to HIV Vaccine Research." Panelists included José Esparza from the Bill &
Melinda Gates Foundation, Peggy Johnston from NIAID, Giuseppe Pantaleo from Centre
Hospitalier Universitaire Vaudois, and two distinguished young investigators: Dan Barouch from
Beth Deaconess Medical Center and Thumbi Ndung’u from the University of KwaZulu Natal. The
discussion was extremely stimulating and constructive, and resulted in a number of good ideas
and programs that the Enterprise will expand on in the coming months.

Later in the meeting, I chaired a panel discussion with four young prize‐winning investigators
working on different aspects of HIV/AIDS, including vaccine research. In both these sessions, I
was astounded by the skills and passion of the field’s young investigators – they are bright,
energetic, articulate and full of great ideas about how to move the field forward.

Today’s HIV vaccine scientists must be sure to mentor these young researchers and encourage
new investigators to enter the field. Their success will be our success. At the same time, young
scientists themselves must come together and form a coherent vision of the future of vaccine
research.

I believe strongly that it the responsibility of all Enterprise members – researchers young and
old, funders, host institutions, governments and advocates – to provide the opportunities,
environment and resources to foster creative ideas and advance the HIV vaccine field. This
effort must also cut across sectors. During AIDS 2008, Richard Horton, Editor of Lancet, noted
the decline in the number of scientists and science sessions at this year's meeting. He expressed
a concern that I share: that we are creating two solitudes, with social scientists and activists on
one side, and biomedical researchers on the other. This is not healthy for the field.

Coming out of this meeting, it essential that we ensure meaningful dialogue with the global
activist community, and that all of us agree that an effective HIV vaccine is an integral part of
any long‐term, comprehensive HIV prevention strategy. At the same time, the conference
reinforced my conviction that, with dedication and global collaboration, we will get a vaccine –
and that it is the new minds and new ideas that will get us there. AIDS 2008 provided new
impetus to global efforts to prevent the spread of HIV. It is up to all of us now to live up to its
promise.


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