Friday, 25 October Conference Call on AIDS Vaccine

Comments by Seth Berkley, M.D.
President's Advisory Council on HIV and AIDS Research Subcommittee
Conference Call, October 25, 1996
I am sorry to have not been able to join you at your last meeting. I thank you for allowing Dr.
Phil Russell to take my place and for inviting me to speak to you today.
I would like to make four points with you today:
1. There is an enormous need for an HIV vaccine;
2. A vaccine is scientifically possible;
3. A vaccine appropriate for use in areas where the epidemic is spreading most rapidly is
unlikely to be developed in a timely fashion in the current environment; and finally
4. This is bad public policy and a new mechanism is required to complement on-going
activities.
Need for an HIV vaccine:
I certainly do not need to remind this group of the staggering aspects of the HIV epidemic -
already over 20 million people have been infected and AIDS is now the largest killer of young
men and women in many parts of the world. But what is important to say is that despite an
active and effective global prevention campaign, approximately 5-10,000 new HIV infections are
still occurring a day, over 90% of which occur in developing countries.
The world is already spending $1.5 billion per year on HIV prevention, yet WHO has calculated
in a modeling exercise that even a 10-15 fold increase in spending in developing countries would
not halt the epidemic, but only reduce its scope. These funds are becoming more and more
scarce, which would be required indefinitely.
Why can't we succeed in controlling the epidemic with behavior change? The answer is that
sexuality is a difficult topic, behavior change is particularly hard and current efforts do riot reach
many of those at highest risk. Our conclusion is that although we need to continue and enhance
our efforts to change behaviors, we need new prevention technologies if we are to have any hope
of controlling this global pandemic.
Clearly we need female controlled microbicides, better barrier methods and diagnostics to
improve treatment and control of STDs. But what is really needed is a preventive AIDS vaccine.
The recent breakthroughs in therapeutics do not mitigate this need. Despite a very pessimistic
beginning, with no precedent for viral drug development, we have seen the unbelievable
progress, almost miraculous progress, that a targeted $1 + billion/year effort in drug development