by Gregg Gonsalves
From the Introduction
The first two decades of AIDS vaccine research have been a series of disappointments and setbacks. Indeed, while at the epidemic’s outset many predicted that it would be easier to develop a vaccine for HIV than effective treatments, the reverse has been the case. Initial approaches to HIV vaccine development foundered due to the unexpected complexity of HIV-1 as an immunogen and, in part, due to somewhat simplistic research approaches. Now, however, with new insights into HIV pathogenesis, new research tools, new resources, and new commitment from the U.S. government, from research administrators at the National Institutes of Health (NIH), and from the non-governmental and multilateral sectors, AIDS vaccine research is finally getting the attention, resources, and emphasis it deserves.
Our goal in this report is to outline the scientific and practical obstacles in the path of developing a safe, effective, globally deployable AIDS vaccine, to examine the AIDS vaccine research programs funded by NIH — taking 1998 (the last year for which complete data are available) as a single, comprehensive snapshot — and to recommend methods of overcoming those obstacles to accelerate the discovery, development, and deployment of an effective vaccine.
We believe that a vaccine is most likely to emerge from a creative and rigorous synthesis of basic research in human and non-human primate immunology and in HIV virology, with animal and clinical studies of vaccine candidates, delivery routes, adjuvants, and the like. We hope that by examining the scientific issues faced in basic, animal, and clinical HIV vaccine research, we can contribute to overcoming the obstacles and thus contribute to a revitalized, accelerated, intensified effort.