“The Blue Sheet”

APR 10 '97 11:03AM AAAS SCIENCE MAGAZINE

P.2/2

April 9, 1997

"The Blue Sheat"

that we have a commitment that we shall develop a
vaccine."
"I don't think it would be appropriate to say that
we're going to have it in five years or in seven years or
in ten years," Fauci maintained. "I think the finm commitment is enough."
AIDS Vaccine Research Committee Chair David
Baltimore, MIT, also stated: "I don't think it is possible
to put a date on when a vaccine should be ready....I
think there are too many uncertainties. It may be seen as
depressing, particularly in the less developed world."
The subcommittee also suggested that the position
of a full-time White House AIDS vaccine coordinator
should be established to direct the national vaccine
effort. Many of the invited participants disagreed with
the draft recommendation.
"I personally don't think that a full-time AIDS
coordinator in the White House is required because I
believe that now that vaccine feasibility is becoming
more apparent, natural collaborations and alliances, if
they are necessary to accomplish this task, will occur,"
Sadoff stated.
Fauci Opposes AIDS Vaccine Development Coordinator
Fauci concurred that such a coordinator is not
necessary. "We need a commitment from the
Administration," he stated, "and I believe we have a
commitment from the Administration. I don't believe
that another layer of someone coordinating is something
that we need.'"
Margaret Johnston, International AIDS Vaccine
Initiative, asserted that "we already have too many
advisors, advisory committees, and coordinators.
Delegate down or delegate out. Empower the individuals, organizations or agencies with sufficient resources
and authority and hold their feet to the fire to produce."
Another of the subcommittee draft recommendations
stated that the Vice President should "convene a publicprivate HIVIAIDS vaccine council, composed of senior
representatives to aid in focusing efforts in a coordinated and comprehensive manner."
"My sense is...that perhaps what the government
needs to do is put the private sector on notice that it's
willing to help, but really let the private sector get itself
together and decide how best the government can help,"
Johnston commented.
"I'm not sure the companies...will be completely
frank in making their assessment at the table with the
Vice President," she stated. "Perhaps the first step should

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be to let them prioritize themselves, and then come and
let the government know what [industry] can do."
However, she noted that if "such a consortium gets
formed, then the goals of that consortium need to be
very clearly defined. And I would suggest that the goal
be to attract more investment and more resources into
the private sector side of this equation."
NIAID HELPS PLAN HHS ADULT IMMUNIZATION REPORT;
INFLUENZA, HEPATITIS 8 AND PNEUMONIA ADDRESSED
An action plan on ways to enhance adult immunization for vaccine-preventable diseases will be delivered
to HHS Secretary Donna Shalala in May by a working
group consisting of representatives of 15 federal agencies. Bruce Gellin, a medical officer at the National
Institute of Allergy and Infectious Diseases, serves on
the group for NIH.
The plan, to be published in a peer reviewed journal, will focus on three vaccine-preventable diseases:
influenza, hepatitis B and pneumococcal disease. It will
implement recommendations made by the National
Vaccine Advisory Committee (NVAC) in 1994.
On April 17, the HHS working group, chaired by
the department's Acting Assistant Secretary Jo Ivey
Boufford, will meet to discuss a draft action plan based
on the NVAC recommendations. In addition, the group
will review comments submitted by outside experts and
advocacy groups, such as the National Coalition for
Adult Immunization,
Although Boufford will leave HHS to become dean
of the New York University Graduate School of Public
Service in June, she is expected to remain chair of the
working group until a plan is produced.
In 1994, NVAC, a 15-member expert panel consulted by CDC, had identified public health policy goals
including "adequate support of research on vaccinepreventable diseases of adults, adult vaccines, adult
immunization practices, new and improved vaccines,
[and] international programs for adult immunization."
NIAID currently has a number of vaccine research
initiatives in progress. In the category of "immunization
practices," the institute is studying how to improve compliance through the development of alternative routes of
administration such as mucosal and oral delivery systems, including plant vectors, for a host of vaccines.
Most recently. NIAID has entered into a cooperative research and development agreement with Aviron

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