AIDS Vaccine Testing Goes Overseas

A quick overview of the  history and difficulty of developing an AIDS vaccine...

CHONBURI, Thailand -- Inside a ramshackle Buddhist temple here on
the country's southeastern coast, curious villagers gathered last fall
as part of the United States' biggest gamble yet on stopping the AIDS
pandemic.

The informational meeting was almost like a game show
as attractive young hosts revved up the crowd, working up to the big
question, boomed out over loudspeakers: Would the audience be willing
to volunteer to test an experimental HIV vaccine?

The villagers
hesitated. No one moved for a full 60 seconds. Then, tentatively, they
approached the three stands set up at the front, marked "Join," "Not
Join" and "Unsure."

For the past three years, such gatherings
have been held all over Thailand, exhorting young adults to take part
in the largest, most expensive, most resource-intensive AIDS vaccine
trial ever. Funded by the National Institutes of Health, it ultimately
will involve 16,000 people and last 3 1/2 years.

But as the trial
moves forward, at a cost of more than $120 million, some researchers
are raising questions about its validity. They disparage its science,
question its ethics and doubt its efficacy.

One of the chief
dissenters is Robert C. Gallo, who helped discover the human
immunodeficiency virus. He scoffs at the notion that the trial will be
successful. "I thought we'd learn more if we had extract of maple leaf
in the vaccine," he said derisively.

(..)

Despite years of effort, investment in the billions of dollars, and
dozens of small tests in people around the world, there's still no
scientific proof that a vaccine is even possible. HIV is a diabolical
virus that disables the very immune responses a vaccine needs to
trigger in order to work.

And yet the need is so urgent that
scientists have gone forward with preliminary human tests of many
vaccines on the basis of data they acknowledge is weak. The one in
Thailand is the largest.

(..)

The U.S. government last year spent 22 percent of its $3 billion
AIDS research budget on vaccines and other preventive drugs, compared
with less than 8 percent a decade ago. (Most of the rest is devoted to
developing treatments or a cure for those already infected.) Meanwhile,
the Bill & Melinda Gates Foundation this year designated up to $360
million for AIDS vaccine research, and Congress is encouraging more
research with bills that would provide liability protection and tax
benefits for drug companies.

But the science is daunting and
subjects hard to come by. Scientists have been forced to travel to
remote corners of the world to find communities where the infection
rate is high enough to show results in a reasonable amount of time.