Tom Paulson raised a very valid point on his Humanosphere blog entry this morning: for as significant and exciting as the progress toward an HIV vaccine, which was discussed during the AIDS Vaccine 2010 conference this week in Atlanta, strikingly little media attention has been given to it. Despite the fact that the entire meeting was held inside the CNN center, CNN has not covered the event at all, and even the local newspaper, the Atlanta Journal-Constitution, was not present at the press conference. As Mr. Paulson so aptly put it, “unlike many AIDS meetings, there’s been lots of enthusiasm and excitement here because…there’s actually been some significant progress in the search for an AIDS vaccine. But, really, who cares?”
An HIV vaccine would be an ideal solution to a disease that has defied all manner of interventions polarized public health and political responses. 33.2 million people around the world were HIV-positive in 2008; 2.7 million are infected every year, and two million die annually from HIV- and AIDS- related deaths.1 The statistics are familiar to virtually all global health professionals, but effective strategies to control the epidemic are hard to come by, and the debate over infection control has become hopelessly infected by ideological bickering. In 2008, for example, Pope Benedict provoked the wrath of sexual and public health advocates when he stated that condoms make the HIV problem worse during his first visit to Africa. In response, Rebecca Hodes, head of policy, communication and research for the Treatment Action Campaign in South Africa, said that his “opposition to condoms conveys that religious dogma is more important to him than the lives of Africans.”2 Even when Edward Green from the Harvard School of Public Health pointed out that the empirical evidence supported the Pope, he said that “[w]e liberals who work in the fields of global HIV/AIDS and family planning take terrible professional risks if we side with the pope on a divisive topic such as this.”3
So if an effective HIV vaccine could solve the problem and end all of the ideological squabbling, why has it been largely ignored? Paulson points out that there is a significant paucity of funding which may be due to different priorities in the global health agenda or the economic downturn; public apathy also affects political support, which in turn influences funding (or lack thereof). But perhaps it goes beyond that – after so many years of failure and disappointment, it looks like most people have largely given up on the prospect of an HIV vaccine. When the US HHS Secretary Margaret Heckler announced in 1984 that the virus that caused AIDS had been isolated, she said, “We hope to have a vaccine ready for testing in about two years.”4 Researchers worked to develop that promised vaccine for decades and were met with persistent failure. After all, the first clinical trial with even modestly promising results did not come until last year in Thailand, 25 years later – and Dr. Nelson Michael, who lead the study, said that they “weren’t prepared for success,” and they had not even made enough vaccine for follow-up studies. If the researchers behind these vaccine candidates have so little faith in their work, what message does that send to the scientific and public health communities?
At the conference, leaders in the effort to develop an HIV vaccine discussed the need for a more aggressive approach to vaccine development and more funding for further research and trials. While these are valid concerns, more effort should be put into restoring the faith of the public health community (and the public) in the possibility of having an effective vaccine. In light of the public health victories that have been won through vaccines for diseases such as smallpox and polio, isn’t it worth getting excited about?