Statement of Anthony S. Fauci, M.D., Director,
National Institute of Allergy and Infectious Diseases, on HIV
Vaccine Awareness Day, May 18, 2008
Twenty-five years ago this month, researchers reported the isolation
of the virus that causes AIDS. Since then, over 60 million people
have been infected with HIV — an estimated 2.5 million in
2007 alone — numbers that remind us that the development
of an HIV vaccine is an urgent humanitarian imperative. This year’s
HIV Vaccine Awareness Day provides us with an opportunity to renew
and strengthen our commitment here at the National Institutes of
Health (NIH) to finding a safe and effective HIV vaccine that will
slow, and hopefully one day end, the HIV⁄AIDS pandemic.
The past year was a disappointing one in the search for a safe
and effective HIV vaccine. The scientific concept tested in the
HIV vaccine study known as the STEP trial was considered to have
great promise; however, the vaccine did not have the desired beneficial
effect. Although the finding was disappointing, it was not unusual
given the nature of science and vaccine development. Historically,
it has taken decades to find effective vaccines to combat infectious
diseases. In the 89 years it took to create an effective pertussis
vaccine and the 42 years it took to develop an effective measles
vaccine, researchers experienced numerous setbacks and disappointments
before reaching success; yet they persevered. Finding a safe and
effective HIV vaccine demands an equally intense resolve.
Last year, 2.1 million people died as a result of AIDS, including
330,000 children under the age of 15. Today, 33.3 million people
are living with HIV infection. Although the problem is most severe
in sub-Saharan Africa, the United States also has been hard-hit:
more than 565,000 people in this country have died of AIDS and
an estimated 1.1 million are living with HIV infection. African-Americans
and Hispanics shoulder the greatest burden, accounting for 59 percent
of U.S. AIDS cases in 2006. In some urban areas, the HIV infection
rates rival those of Africa. Nowhere is this more shocking than
in the nation’s capital, where one in 20 Washingtonians have HIV
and one in 50 has AIDS.
Through important public health programs, such as the Ryan White
HIV/AIDS Program, the U.S. President’s Emergency Plan for AIDS
Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria,
the Bill and Melinda Gates Foundation and the Clinton Foundation,
we have made enormous strides in making life-saving treatments
accessible to HIV-infected individuals throughout the world. Despite
this heroic achievement, only a fraction of those individuals in
developing countries who need antiretroviral therapy are receiving
it. The stark reality is that for every person with HIV who is
placed on therapy, about three more individuals become newly infected
with the virus. The rate of new HIV infections far outpaces our
ability to supply a lifetime regimen of HIV medication to everyone
who needs it.
Further scale-up of lifesaving HIV treatment programs is critical.
However, treatment alone will not end the AIDS pandemic. Developing
HIV prevention strategies, including a vaccine, remains an extremely
important goal. A number of proven strategies to prevent HIV transmission
are already available, including education and behavior modification;
condom usage; medically supervised adult male circumcision; harm-reduction
approaches such as needle and syringe exchanges for injection drug
users; and antiretroviral drug regimens for HIV-infected pregnant
women to prevent mother-to-child HIV transmission of the virus.
NIAID is testing other prevention strategies, such as microbicide
gels or creams that can be applied prior to sexual intercourse
and preventive regimens of antiretroviral drugs, that we hope will
prove successful. Ideally, a vaccine that prevents HIV infection
would be a core component of our prevention program.
Recently, NIAID convened a scientific summit to examine the state
of HIV vaccine research and determine how best to move the field
forward. Based on that discussion, it became clear that although
it is important to maintain our approach to identifying promising
HIV vaccine candidates and clinically testing those candidates
when appropriate, it also is imperative that we place greater emphasis
on the basic research necessary to address the many unanswered
questions that remain about HIV. We must understand how to create
a vaccine that induces a protective immune response in people that
is more effective than the immune response that results when someone
is naturally infected with HIV.
By striking a better balance between fundamental HIV research
and vaccine development and by fostering research across scientific
disciplines, we can expand the body of knowledge needed to better
understand this complex virus and develop a safe and effective
HIV vaccine.
On HIV Vaccine Awareness Day, we applaud the thousands of volunteers,
scientists, community members and health professionals who have
been involved in HIV vaccine research and who continue to support
and participate in this extremely vital area of public health research.
We encourage all interested parties to join with us in our rededicated
battle to find an effective HIV vaccine to end the scourge of AIDS.
Dr. Fauci is director of the National Institute of Allergy and
Infectious Diseases at the National Institutes of Health in Bethesda,
Maryland.
NIAID is a component of the National Institutes of Health. NIAID
supports basic and applied research to prevent, diagnose and treat
infectious diseases such as HIV/AIDS and other sexually transmitted
infections, influenza, tuberculosis, malaria and illness from potential
agents of bioterrorism. NIAID also supports research on basic immunology,
transplantation and immune-related disorders, including autoimmune
diseases, asthma and allergies. Media inquiries can be directed
to the NIAID Office of Communications at 301-402-1663, niaidnews@niaid.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov. |