Breakthroughs Blog: Vaccines

In this guest post, Margaret McGlynn, president & CEO of the International AIDS Vaccine Initiative (IAVI), writes about a new partnership between IAVI and the Indian government. The post originally appeared on the US Agency for International Development’s (USAID) Impact blog. When you’re dealing with a global public health crisis, having an international presence isn’t just advisable—it is imperative. This applies as much to the development of new tools to prevent disease as it does to treatment. An AIDS vaccine candidate, for example, must be tested in the people who will eventually use it and against the strains of HIV it is devised to protect them from. That’s why (IAVI), in partnership with USAID, has worked diligently over the past several years to establish itself as a truly global nonprofit partner. Using donor funds, IAVI has created an enviable network of research centers in sub-Saharan Africa dedicated to assessing novel AIDS vaccine candidates in clinical trials and conducting supporting epidemiological studies on HIV. These partnerships have made meaningful contributions to the research capacity of many developing countries—a capability that is now helping local researchers tackle other diseases. IAVI and its partners are now applying that same model to support the design of a new generation of AIDS vaccine candidates. Today, IAVI and the Translational Health Sciences and Technology Institute (THSTI), an autonomous institute of the Indian government’s Department of Biotechnology (DBT), launched an HIV Vaccine Design Program near New Delhi. The program is dedicated to the large-scale generation and preclinical evaluation of immunogens, the active ingredients of vaccines. It will focus on devising immunogens capable of eliciting antibodies that can prevent infection by a broad range of the circulating genetic variants of HIV. That challenge, known to researchers as the neutralizing antibody problem, has long stymied progress toward an AIDS vaccine. But recent discoveries of antibodies capable of blocking a number of HIV variants have provided researchers with clues to the design of potentially powerful new vaccine candidates. The HIV Vaccine Design Program will use these insights to develop new methods to generate large numbers of potential HIV immunogens and rapidly assess their potential for use in candidate vaccines. Much of the work will take place in a laboratory housed within THSTI that is being built and staffed with support from IAVI, DBT, and THSTI. The program’s location is no accident. Over the past decade, IAVI has enjoyed a productive partnership for the clinical evaluation of candidate AIDS vaccines with key medical research institutions of the Indian government. Indian scientists have also actively participated in an international consortium of HIV laboratories supported by IAVI to advance HIV vaccine research. The government of India, meanwhile, is in the early phase of its “Decade of Innovation,” a policy that seeks to harness a growing roster of home-grown biotechnology companies, the nation’s deep pool of scientific talent, and global research partnerships to boost innovation in a variety of high-tech fields. The HIV Vaccine Design Program provides an opportunity to engage an emerging economy in the global quest to develop a vaccine against HIV. For India, it creates an opportunity to address a crisis of significant relevance to Indians. As importantly, it seeds the kinds of collaborations that often foster scientific and technical innovation and generate ideas that might be applied to address other diseases that have long hampered development.

On the second day of the XIX International AIDS Conference, the need for a host of new tools to prevent and treat HIV and AIDS has already made it to the forefront of the agenda. Of particular note has been the resounding call for a vaccine to prevent HIV, with leading policymakers, scientists, and advocates saying that the world will never reach the end of AIDS without this powerful tool. In a session that focused on improving the effectiveness and efficacy in the HIV and AIDS response, Senator Lindsey Graham (R-SC) said that a vaccine is desperately needed to help make a sizable dent in the pandemic. Graham’s call for a vaccine was echoed by Bill Gates from the Bill & Melinda Gates Foundation. The “ultimate tool” in the fight against HIV and AIDS “will be a vaccine,” Gates said, adding that the US government has been the largest supporter of efforts to develop and vaccine “by far.” He also said that microbicide gels and rings will be powerful prevention products. Without a number of these new tools, the world cannot “talk seriously about moving toward the end” of the pandemic. “We will get these tools, but only if we stay the course.” Later in the afternoon, National Institutes of Health (NIH) Director Francis Collins and Jon Cohen from Science magazine chaired a panel that looked at what lies ahead in HIV and AIDS science. Gary Nabel, director of the NIH’s Vaccine Research Center, said “we’ve never been in a more exciting position” in the search for an HIV and AIDS vaccine. He added that recent discoveries related to broadly neutralizing antibodies over the past two years have made HIV vaccine research “like a phoenix rising from the ashes.” When sharing their hopes for the status of HIV and AIDS research, several panelists also stressed the urgent need to develop new HIV prevention and treatment options. Nabel said that by 2020, he expects researchers will be “in the midst of efficacy trials for an HIV vaccine candidate.” Robert Siliciano of the Johns Hopkins University School of Medicine stressed that by 2020, scientists will be leading clinical trials for new drugs that attack HIV reservoirs. And Dawn Averitt-Bridge of the Well Project said that by 2020, she hopes the world has effective microbicides to prevent HIV, a functional cure for the disease, and that “research makes it into the lives of the people and families we all care so much about.” Cohen ended the session with a call for young people to become the “next generation of scientists” leading HIV and AIDS research. “I’m looking to the young people, because that’s where the revolution is going to happen.” Kim Lufkin is the GHTC’s communications officer.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The US Food and Drug Administration has approved the first over-the-counter, self-administered HIV test. Developed by OraSure Technologies, the test is 92 percent accurate and will cost less than $20. A recent article in IRIN News highlights the serious need for new antibiotic drugs worldwide, and discusses the potential of public-private partnerships to boost antibiotic discoveries. The United Nations (UN) is urging countries to impose various innovative financing mechanisms in an effort to raise money to offset cutbacks in development aid. The UN hopes that coordinated taxes on carbon emissions, air traffic, currency transactions, and other taxes could raise more than $400 billion a year. Global Health Initiative (GHI) leaders announced last week that the GHI office will be phased out at the State Department. According to GHI Executive Director Lois Quam, the GHI office will be replaced by the State Department’s new Office of Global Health Diplomacy.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The Associated Press reports that “[o]ne in 10 cases of tuberculosis in China cannot be treated by the most commonly-used drugs,” due to drug-resistant strands of the epidemic. Because of this, there is an even greater need for newer or improved health technologies. Researchers at the fifth annual World Science Festival discuss the need for universal vaccines as “new diseases…continue to emerge.” Pharmaceutical company Sanofi could potentially find out in the fall of this year whether or not they can move forward in developing the most advanced vaccine to prevent dengue. Secretary of State Hillary Clinton announced a new public-private partnership initiative between the US and Norway to improve maternal health, including a partnership with drug maker Merck & Co.