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

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majority of infected individuals, however, live in the developing world, and it is here that
the epidemic is spreading most rapidly.
* Most of the research funding from the public sector is done through researcher originated
mechanisms. Although this is an excellent way to make new scientific breakthroughs, it is
not necessarily the most effective way to develop a particular product.
* The expertise and resources for vaccine product development reside overwhelmingly in
the larger commercial vaccine companies. The opportunity costs of investing in HIV
vaccines, the perceived returns to investment and the potential costs (including liability)
have meant that only a few companies are investing substantially in preventive HIV
vaccines.
* Small biotechnology companies have been active players in vaccine development to date.
They are, however, constrained by their reliance on venture capital for funding which, in
general, has a limited time horizon for investment without quantifiable success.
* The limited resources being invested in HIV vaccine research and development has meant
that HIV vaccine development is following a sequential, not a parallel approach. Given the
many scientific uncertainties remaining, the development and testing of multiple empirical
approaches in a parallel fashion, rather than sequentially, will be a faster route to the
development of safe, effective, and inexpensive vaccines appropriate for widespread use.
* Vaccine approaches perceived as more speculative are not being actively pursued by
commercial vaccine companies, even though they may offer other desirable attributes,
such as the potential for higher efficacy or use with fewer doses.
* Candidates developed from sub-types of HIV found in areas where most new infections
are occurring are not being aggressively developed in parallel to the developed country
prototypes, even though many scientists are of the opinion that efficacy testing can be
done much more effectively and expeditiously in high HIV-incidence developing country
sites.
* Scientists and public health officials from developing countries have little involvement in,
or influence on, the decision-making process for the development of preventive HIV
vaccines.
The participants concluded that a new global HIV vaccine initiative should be established with the
primary mandate of accelerating the development of preventive HIV vaccines. The main role of
the initiative should be to redress system or market failures with respect to product development
and its activities should focus on reducing the obstacles to vaccine development and filling the
gaps in the current effort. By focusing on the obstacles and gaps, the initiative would
complement, not compete with, the existing efforts in HIV/AIDS vaccine development, such as
national programs and private sector vaccine development. The initiative was seen as providing
support to a number of parallel development efforts prior to the time when a definite choice
between alternative strategies can be made. A secondary goal of the initiative would be to work
with organizations such as WHO, UNICEF, and other national and international agencies, to
ensure that once a vaccine is developed that it is made available for use throughout the world
with the least possible delay.