IAVI Report Vol. 2, no. 2

Ratihalingaswami Interview continued from page 9
Madras, using four different types of vaccines
against leprosy. It is a vast, community-based
study. And one of these vaccines comes
from outside India.
IAVI REPORT: Will a vaccine tested in India
have to be tested first in the industrialized
country where it was developed?
RAMALINGASWAMI: Yes, I think-so.
If a vaccine developed in an industrialized
country has shown some positive effect in
different trials, there won't be much of a
problem in testing it in developing countries.
But if vaccines have not yet shown a clear
effect, different standards will be used. India
has taken the stand that no vaccine
developed in the industrialized countries
can be tested in India without having first
been tested in the population of the
originating country
But there could always be exceptions to
that rule. For instance, if a product
developed outside shows real promise, I
would expect India to take an enlightened

view and allow trials as long as the potential
side effects are clear.The problem can be

somewhat mitigated by
creating expanded
partnerships between We havi
groups like the World
Health Organization, IAVI the pi
and developing countries
to evaluate these ethical India's
issues and move promising lies in c
vaccines forward.
IAVI REPORT: Has there HIV vacc
been any reaction to U.S.
President Bill Clinton's call
for development of an AIDS vaccine within
ten years?
RAMALINGASWAMI: I have not seen it
highlighted in newspapers. In fact, there is
very little public discussion about HIV
vaccines. Stories that are printed are all hairraising reports about the huge numbers of
new infections in India.
Indian papers are now covering stories

e.t(
'bi
sel

about the benefits of triple drug therapy. But
people are hopeless and feel that these
drugs will never be
available in India.
o educate IAVI REPORT: Are you
concerned that if and
when an effective HIV
finterest vaccine is developed, parts
of the world that need it
nducting the most will have
difficulty getting it?
ie studies. RAMALINGASWAMI:
This is a very good
question. It is entirely
possible. Because the vaccines in the
childhood immunization program are
low-cost and often subsidized, we have
a mind-set that all vaccines are low cost.
But now, molecular biology and genetic
engineering are becoming crucial to the
development of modern vaccines. And
these new vaccines may be very expensive.
Therefore, developing and industrialized
countries must begin working together so
that pricing is kept in mind from the very
beginning.There are ways in which highpriced drugs and vaccines can be sold to
Third World countries at reasonable prices.
Differential pricing systems, in terms of low
income and high-income countries, and
support from international organizations
are both very-important. We need totaki
steps from the beginning to make sure that
what happened with HIV therapies does
not happen with a vaccine.

IAVI REPORT: Finally, could you tell us
how you ended up getting involved in AIDS
vaccine research?
RAMALINGASWAMI: I am a pathologist
and my interest has been in infectious
diseases and immunity. When I became
the head of the All India Institute of Medical
Sciences, and later of the Indian Council of
Medical Research, my interests widened.
I first read reports about AIDS in the
United States in the early '80s and as the
disease spread here,.1 got more deeply
involved in research, advocacy and program
development. I now focus a great deal of
my time on AIDS, working with
government agencies to stimulate and
encourage research efforts. *