Presidential Advisory Council on HIV/AIDS, International Issues Subcommittee [Transcript]

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1 vaccine trials. What are your thoughts about where and who
2 those trials should be (inaudible)?
3 - MANN: Well, the question of trials in this
4 country is the first one that's usually raised, and whether
5 it is ethical to do a trial of a vaccine in another country
6 when you haven't done a trial of the vaccine here. Let's
7 think about a number of diseases that exist in the
8 developing world, like malaria. If you want to do a
9 malaria vaccine trial, would it be unethical to do it
10 abroad when you haven't done it in the United States?
11 Well, there isn't enough malaria here. Another example is
12 whooping cough, pertussis. Those trials, paid for by NIH,
13 had to be done abroad because there wasn't enough pertussis
14 here to do the trial.
15 You mentioned South Africa. The South African
16 AIDS epidemic is astounding. It's just another example of
17 how explosive epidemics can occur virtually anywhere, and
18 they have a tremendously explosive epidemic. The
19 incidence, the rates of new infection occurring in parts of
20 South Africa would make that country uniquely suited to
21 doing this. Of course, there are many obvious political
22 issues involved. But they have a high incidence of
23 infection, they have the infrastructure to be able to
24 fairly rapidly move to field trials. In Thailand there are
25 efforts, not by our government so much, but by people who
26 are working in the private sector who simply -- at times we

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