New Report Finds Clinton's 10-Year AIDS Vaccine Goal in Jeopardy
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One year after President Clinton declared the goal of finding an AIDS vaccine within a decade -- and that he was "prepared to do all [he could] to make it happen" -- the government's AIDS vaccine research program has continued at the same unhurried pace as before with only nominal achievements and developments, and corporate commitment is at an all-time low, according to "Nine Years and Counting," a new report by the AIDS Vaccine Advocacy Coalition. The report, an independent analysis of the United States' HIV vaccine research efforts, coincides with the anniversary of President Clinton's 10-year pledge, made during a commencement speech at Morgan State University last May. In the speech, Clinton alluded to President Kennedy's pledge to land a man on the moon within the decade. "Clinton had the right idea when he reminded the nation of Kennedy's moon-landing challenge; finding an AIDS vaccine is one of the most important scientific, political and ethical dilemmas we've faced, one that requires an all-out government, grassroots and industry effort," said Sam Avrett, AVAC's executive director. "Unfortunately, Clinton is no Jack Kennedy -- his words are often more puffery than policy. We're calling his bluff."According to the report, the U.S. AIDS vaccine research program will flounder unless goals are more clearly defined. In addition, the AIDS Vaccine Research Center director position -- vacant for almost a year -- needs to have budgetary control and discretionary power and a qualified leader needs to be appointed. The report also urges that pharmaceutical companies be pressured to make substantial commitments to AIDS vaccine development -- through public/private partnerships, financial incentives and political pressure, if necessary."With 16,000 people becoming infected with HIV every single day, the consequences of inaction are dire," said Avrett. "As Clinton himself said in his State of the Union address last year: 'Every year we move up the discovery of an AIDS vaccine, we'll save millions of lives around the world.' Unfortunately, this was the last time Clinton mentioned the AIDS vaccine."While White House officials declined to comment on the specifics of the report, Todd Summers, deputy director of the White House office of National AIDS Policy, said, "AVAC has done a lot of good work and taken a hard look at what's going on ... We need time in order to achieve the president's goal."We all agree that we can't do business as usual ... We all know how important this is to ending the epidemic. It's a daunting task. There is a lot of science left to be done, a lot of trial of products, convincing the pharmaceutical industry to help coordinate efforts."Industry Commitment LackingMost in the field agree that the resources and expertise to develop vaccine products and move them through clinical trials and FDA licensing exist only in the private sector. Yet despite a growing scientific base of knowledge about HIV, no new pharmaceutical companies or biotechnology firms have entered into HIV vaccine development, and several existing HIV vaccine programs have been scaled back or canceled. In fact, Pasteur Merieux-Connaught and Merck are the only large companies that are currently involved in vaccine development at a satisfactory level, according to AVAC. "It is a failure of leadership that the world's largest vaccine manufacturer, SmithKline Beecham, with $1.2 billion in annual revenues from global vaccine sales, has essentially no active HIV vaccine development program," said AVAC member David Gold, one of the report's authors and editor of the newsletter, IAVI Report. In a previous report released in December 1996, AVAC spoke with representatives of 23 pharmaceutical and biotech companies. According to Gold, one of the most common sentiments among industry leaders was the need for "sustained political leadership by the president, vice president and the rest of the administration, and scientific leadership by the NIH. This has not yet happened," said Gold.It's Not Just the Science"Nine Years and Counting" states that contrary to what many believe, the difficulty of the science is only one obstacle; a pervasive unwillingness to assume risk, and politically meek leadership in government and industry may prove to be the more powerful deterrents to progress, according to AVAC. "An HIV vaccine is possible; the will, the money, the knowledge is there," said Avrett. The report also cites as failures the fact that no candidate HIV vaccine has moved into large-scale efficacy or Phase III study, asserting that trials of several vaccine concepts will need to begin if there is to be any chance of reaching the 10-year goal."Volunteers from high-risk areas around the U.S. are signed up and ready to participate in AIDS vaccine efficacy trials. They're just waiting for a vaccine to test," said Avrett. In fact, the report praises the efforts of the HIV NET Community Advisory Board members and community groups such as Vaccine. Other positive developments cited in the report include an innovative vaccine research grant program at NIH that has moved quickly to award new grants. Also, mounting advocacy and research efforts by a number of organizations in the U.S and abroad, including the International AIDS Vaccine Initiative (IAVI), the American Foundation for AIDS Research (AmFAR), the Joint United Nations Program on HIV/AIDS (UNAIDS), and the results-oriented research effort at the Walter Reed Army Institute of Research (WRAIR) are commended.The AIDS Vaccine Advocacy Coalition was founded in December of 1995 and its mission is to speed the development of preventive HIV vaccines by analyzing obstacles to HIV vaccine development and advocating to remove these obstacles. AVAC is committed to achieving this mission without taking resources away from basic HIV research, drug development or prevention efforts. The report was supported in large part by a grant from Until There's a Cure foundation.