HIV/AIDS vaccine within reach

An affordable and effective HIV vaccine could be developed within seven to 10 years if rich and poor countries cooperated on research and infrastructure, according to South African researchers.

In this week's issue of the British Medical Journal, scientists from the Medical Research Council of South Africa reported that successful vaccine development depended on "a complex interplay of politics, science, institutions and their organisation, and public-private partnerships".

Rich and poor countries were obliged to cooperate, as wealthy countries had the expertise and experience but lacked sufficient numbers of patients to conduct clinical trials. Poor countries were, however, fertile ground for such trials, the researchers said.

"Any trial must take into account the history of exploitation and abuse of vulnerable people in clinical trials," the report noted. Clinical trials had the potential to introduce unequal power relations between researchers and trial participants, particularly when the participants were from developing countries, it added.

The weak research infrastructure and regulatory bodies in poor countries allowed rich countries to exert more control over the trials and over intellectual property rights, the researchers said.

The current scientific knowledge base remained inadequate, as it had failed to explain the "correlates of protection against HIV". Animal models for investigating candidate vaccines were another problem, as their applicability to the development of a human HIV vaccine was questionable.

"Vaccines have never been as commercially successful as other medical treatments, so entering the field of HIV vaccine development is a risk for companies," the report said.

Even when a vaccine had been developed, there was no guarantee that it would be used appropriately, as there were no rules and guidelines for access and distribution. The researchers suggested that the rules for distributing a vaccine should break with the current unequal access to antiretroviral drugs.

"HIV vaccines must be given firstly to the poorest and most vulnerable people in our global society," the report said.