The Race for an HIV Vaccine
Ruy RibeiroImagine a world in which children are raising children because their parents have died. Such is the situation in much of Africa today because of the scourge of HIV/AIDS. Human immunodeficiency virus (HIV) is responsible for one of the largest epidemics of modern history. Today 40 million people are infected worldwide and more than 3 million die every year. In the country where I was born, Mozambique, one in six adults is infected. In neighboring Botswana, life expectancy is only 34 years; in 1985 it was 65. Most young adults in these countries die of acquired immunodeficiency syndrome (AIDS), leaving behind a rising number of orphans. Even in the USA, there are more than 1 million people infected with HIV. We urgently need a HIV vaccine, yet, it has remained out of reach after 25 years of research.
AIDS is the late stage of HIV infection, which occurs when the immune system is so weak that it can not fight the many infectious bugs that we are all exposed to daily. When people are sick with HIV, catching common infections, such as pneumonia, can be deadly. The ideal way to combat this epidemic would be to integrate prevention, vaccination and treatment. These are all difficult tasks. Due to HIV virus' modes of transmission (sexual activity and injection drug use), prevention involves changes of behavior that are very difficult to accomplish. Treatment is still very expensive, at least hundreds of dollars per person per year. In some of the poorer countries, a family can not afford more than a few dollars for health care per year. So the best hope for eliminating HIV is a vaccine.
The reason children get vaccinated is because vaccines are one of the best health measures ever developed. In the richer countries, vaccines have almost eliminated childhood diseases; indeed, smallpox has been totally eradicated worldwide! But so far it has proven exceedingly difficult to develop a vaccine for HIV infection. This is because: 1) HIV mutates rapidly, so a vaccine will have to cope with its variability; 2) HIV infects and destroys the immune system, which vaccines are supposed to prime to fight disease; 3) HIV in general is not very susceptible to the effect of antibodies, the basis for the success of many other vaccines. In this Café, we will explore the science of HIV and why it is so important to develop a vaccine for it. Success in developing such a vaccine will represent one of the greatest achievements of medical research in human history.
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