In The Field

AIDS: Defeatism or realism?

Since my dad covered his first AIDS conference in 1992, a lot has changed. But one thing hasn’t: we still don’t have a vaccine to prevent AIDS.

This is one of the saddest ongoing failures of science. Foundations, governments and a handful of companies have spent billions of dollars over the past 20 years trying to develop a vaccine to protect people from AIDS. But now, you hear scientists openly admitting that we may never reach this goal.

“We don’t know yet whether a peventative vaccine is possible or not,” said virologist Françoise Barré-Sinoussi of the Pasteur Institute this morning. The best we can hope for, she said, is to know by the end of this century whether or not a preventative vaccine will even be possible. Perhaps, she suggested, we will develop a therapeutic vaccine instead – one that can be given after infection, to help the patient fight the disease.

Is this defeatism, or realism? Scientists say HIV is an extremely difficult virus to combat, because it mutates quickly to evade vaccines, infects the body for life, and affects the human body in ways we are only beginning to understand. There are some who are hopeful that as we continue to learn more, we’ll finally come up with a vaccine solution.

Among these optimists are Helene Gayle, co-chair of this meeting, and a former official of the Gates Foundation, which has made major investments in the search for an AIDS vaccine. Gayle strongly disagreed with Barré-Sinoussi’s comments: “I’m fully confident we will have a vaccine,” she said, even if it’s only a therapeutic vaccine.

I wouldn’t ever argue that we should shut down an area of promising research. But as the years drag on, and the millions of dollars pile up, it’s worth asking whether, and when, this investment will finally deliver.


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