HIV Vaccines - Accelerating the Development of Preventive HIV Vaccines for the World: Summary Report and Recommendations of an International Meeting

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amount spent on health research. The most recent survey of expenditures on health research
conducted by the Commission on Health Research for Development estimated that in 1986
US$ 30 billion was spent worldwide on health research, of which less than 5% (US$ 1.6 billion)
was spent on developing country-oriented research. Between 1986 and 1993 the total amount
spent each year on health research increased markedly. This means that in 1993 expenditures on
HIV vaccine research and development represented substantially less than 0.5% of the total global
health research budget.
Public sector
The public sectors of the major developed countries are the main source of funding for HIV
vaccine research and development. In 1993 it is estimated that they provided over 80% of the
total global expenditure in this area, or between US$ 125 million and US$ 130 million (see
Table 2). Their efforts to fund research on HIV and AIDS are constrained, however, by overall
budgetary and human resource limitations, and the competing demands of other important
diseases affecting human health. There is also competition for funds earmarked for HIV/AIDS
research between basic research activities directed at increasing current understanding of the
virus, activities directed at developing therapeutics to treat those currently infected, and activities
directed at developing a preventive HIV vaccine. Of the three, preventive vaccine development
has received the smallest proportion of the available funding. For example, in 1993 less than 10%
of the US government's budget for HIV/AIDS related research and development activities was
spent on preventive vaccines (see Table 2).
Within the public sector, the national health research agencies control the majority of the funds,
and hence expenditures are also influenced by their general mission - to promote the health of
persons living in their own country. The development assistance agencies, whose mandate is
directed towards those living in developing countries, have not been active funders of HIV vaccine
research and development to date.
Private sector
The private sector is an important source of funds for health research. The Commission on Health
Research for Development estimated that in 1986, the private sector accounted for over 40% of
the total amount spent on health research (US$ 13 billion out of US$ 30 billion). Estimates of the
amount invested by the private sector in research and development activities related to preventive
HIV vaccines are difficult to make. Results from an informal survey of the key players, however,
suggest that in 1993 pharmaceutical and biotechnology companies invested less than US$ 25
million in preventive HIV vaccines, or under 15% of the total expenditure.
Both large pharmaceutical companies and the small biotechnology companies have been active
players to date in HIV vaccine development. Funds for investment by the large companies come,
in general, from within the company. The small biotechnology companies, however, rely primarily
on venture capital for funding which, in general, has a limited time horizon for investment without
quantifiable success. The prospect of price controls on health care in the United States is also
making preventive vaccines a less attractive investment prospect.
The resources that have been invested by industry in the development of preventive HIV vaccines
have been targeted predominantly at those approaches perceived as being safest (i.e., least likely
to have untoward side effects and, consequently, with less potential for litigation should such