AIDS Vaccine 04 opened on Monday 30 August 2004 in Lausanne, Switzerland, a city which never loses an opportunity to remind the visitor of its status as the “Capitale Olympique”. The most relevant Olympic event is probably the competition to host the Games in 2012, since the arrival of an effective HIV vaccine is at least equally distant.
It can also be hard, at times, to distinguish solid constructions from the kind of plans which will never leave the drawing board.
That said, there is clearly a great deal of constructive effort in the field and a sense of engagement to be maintained for however long it takes. As the world struggles to face the implications of widespread access to antiretroviral treatment, so it is obvious that a range of better methods of HIV prevention are essential, if only to make such commitments sustainable.
Co-chair Professor Giuseppe Pantaleo of the University Hospital in Lausanne opened the conference with a call for more transparency, cooperation and coordination between the different organisations involved in HIV vaccine development. He proudly announced that “global commitment” had been adopted as the theme for the meeting. He was pleased to welcome more than 700 participants from more than 50 countries. 92 people had been supported by scholarships and travel grants to attend, mainly from countries in Africa, Asia and the Americas, which are increasingly in the frontline of clinical AIDS vaccine research.
Dr Tony Fauci, Director of the US Federal Government’s National Institute of Allergy and Infectious Diseases, reviewed progress on funding AIDS vaccine research and was able to argue that his own institution - with an AIDS vaccine research budget set at US $410 million for FY 2005 - probably accounts for around half of the entire global expenditure. While he acknowledged that issues around global access may need to be addressed well before a vaccine arrives, he insisted that the most important issues limiting progress remain scientific ones.
Dr Fauci gave his full backing to the “Global HIV Vaccine Enterprise” for which he and others had called in 2003 and which has since been endorsed by the leaders of the G8 group of leading industrial countries, among others. He stressed that this is not a formal organisation but rather a shared science-based strategy subscribed to by a number of agencies, governmental and non-governmental, which would maintain their independence from each other. It was not limited to present participants and he hoped it would encourage more governments and others to see how they could add to the global effort.
The US government would itself be adding to its existing efforts with a call to establish an additional AIDS vaccine and immunology research centre, outside of the NIH, for which proposals are shortly to be invited.
The EuroVac project, and the EuroVacc Foundation (registered in Lausanne) to which it has given rise, has now entered into an agreement for a shared clinical project with the US government-funded HIV Vaccine Trials Network, set to begin in 2005.
The International AIDS Vaccine Initiative is likely, unless there are radically improved clinical trial results within the next year, to stop further development of its leading project, a prime-boost vaccine designed at Oxford University with support from the Medical Research Council and now in clinical trials in the UK, Kenya and other African countries. Unfortunately, this now seems to be no better than Aventis Pasteur's canarypox vaccines at producing cellular immune responses to HIV in people, despite promising initial results in animals. However, IAVI will be pressing ahead to develop potential vaccine trial sites which may later decide to adopt any suitable vaccine to be tested, no matter who has designed and produced it. Although, of course, IAVI is working hard to bring forwards alternative vaccine candidates of its own. IAVI also stresses that the poor results seen with the Oxford vaccine combination may not rule out the possibility of much better results with other similar vaccines, including two based on the same vector (Modified Vaccinia Ankara or MVA) which it is sponsoring itself.
Of the 312 abstracts, some do give rise to a “déjà vu” sensation when compared to presentations at the recent International Conference on AIDS in Bangkok. Nonetheless, there is new data to be presented and this series of meetings has clearly established itself as an important forum to discuss difficult and unresolved issues. The meeting continues until Wednesday and further reports will appear here.