AIDS vaccine research slow, under-funded

In places like Zimbabwe and Uganda, among the countries first hit by the virus, infection rates are starting to fall as the children who grew up under the threat reach maturity and show they have more sense than many of their elders when it comes to changing lifestyles or taking precautions.

Unfortunately, two-thirds of these people living with HIV live in Sub-Saharan Africa, the poorest region in the world.

Most of these Africans live in Southern and East Africa. It is that imbalance that has led to many of the problems and to what can only be termed a scandalous international Aids industry.

The problem is obvious. A dozen of the poorest countries in the world have to cope with over half the people living with HIV. Clearly they need help, and to an extent they are getting it. But the help is still very patchy and inadequate with only a few of the myriad of organisations and programmes set up to help people living with HIV, or those affected by the pandemic, largely orphans of parents who died of Aids-related illnesses, carrying most of the burden.

There is a double scandal.

Hundreds of thousands of people around the world now earn their living, and often a very good living, in the “Aids industry”. Scores of conferences are held in pleasant locations every year with millions of US dollars spent on air fares, hotels, conference facilities and the like. Somehow, we doubt that much good comes of these conferences, meetings and fancy travel.

A glance at those attending, and brought to, the present 16th International Aids Conference in Toronto will show what we mean.

Even in the countries hardest hit there are many who “run programmes” that seem to exist solely to provide an office, luxury vehicle and decent salary to the administrators with very little left over to provide services, drugs, food or school fees to the poor person living with HIV or seriously affected by the pandemic.

We strongly believe that if all involved in the Aids industry followed the example of the best, allocating less than 5 percent of income to “administration” and more than 95 percent to doing real effective work, then several million more Africans would have access to life-saving drugs and millions more orphans could be helped by those dedicated church groups and the like who are doing so much good on a shoestring.

The second scandal is the emphasis on research for better and better drugs and drug regimes to control the infection in a person living with HIV. Some stunning scientific work has been done in this area, and the result has been that a person living in an advanced Western economy no longer has to worry about dying too early from HIV-related illnesses. The pharmaceutical companies that funded and directed this research have made good profits and, it must be admitted, have allowed prices to fall fast expanding their markets dramatically. But it took pressure from India and South Africa, and their threats to break patent laws, to force much of that fall.

But the research into a vaccine has been slow, scandalously under-funded, and largely ignored by the big drug companies and major funders like the US government. In fact, Bill Gates has probably done more than any single government to keep those dedicated vaccine researchers plodding. And although he is the richest man in the world, there are obvious limits. There are pharmaceutical companies whose assets dwarf even Microsoft.

A cheap effective vaccine would be a boon to billions in the developing world and could well wipe out HIV, just as decent cheap vaccines eradicated smallpox, have almost eradicated polio and have done so much to remove the threats of measles and other killers from the lives of most of the world’s children. Profits would be low and the weird laws and anti-vaccine culture of the US and parts of Europe, where most pharmaceutical research is done, make research problematic. And the fast-mutating virus is not the easiest to control through a vaccine.

It is a fact of life that it makes better economic sense for a pharmaceutical company to find new expensive drugs to control HIV in rich Americans than to find a cheap vaccine for poor Africans.

But, again, we believe that if a modest percentage of what is now spent on international conferences and the like was pumped into promising lines of vaccine research, there would be results. Even a vaccine that was only 75 percent effective could be good enough to contain the disease and save millions of lives.

It is difficult to believe that if a quarter the population of the US, or France or Britain or Japan was living with HIV the present sidelining of vaccine research would be allowed to continue.

We hope that SADC leaders and heath ministers, who represent around half the world’s people living with HIV, will redouble pressure for better programmes, more effective programmes and for proper vaccine research. They also need to ensure that they set a good example in their own backyards, and ensure that those sections of the “Aids industry” they can control actually deliver. HIV can be conquered. It just needs an intensification of present programmes, more money and a greater focus on those at risk and those living with HIV to ensure that present and future funds are better spent.

August 2006
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