January 30, 2012

Does the AIDS Healthcare Foundation Oppose Funding Research into an AIDS/HIV Vaccine?

Feature, Health, News, Politics, Research No Comments

Test tubes and other recipients in chemistry lab

Here at Sex and the 405, we have heard many rumors about the AIDS Healthcare Foundation (AHF) since we started reporting on their war on pornography, chief among them that they opposed research into an AIDS/HIV vaccine. Not content to become part of the gossip mill, we decided to dive into the allegations.

When our editrix asked Lori Yeghiayan, associate director of communications at AHF, whether its president Michael Weinstein does not support further development of an HIV vaccine, she responded: “no, that’s not accurate. There was a time — this was probably about five years ago that we had put out an argument about not spending exorbitant amounts of money on clinical trials for a vaccine when it was not really producing results. Not really basic research but actually clinical trials in several countries with thousands of people and that there had been several failures with the vaccine search in that way so we had made an argument about putting money into proven efforts, which is treatment. We are for basic research into HIV and HIV vaccines and new drugs and all that. It’s not accurate to say we’re against it.”

Okay. That makes perfect sense. But just to be sure we had all the information we hit up Google. What we found, from AHF itself, was disheartening.

On May 5, 2008, the 11th Annual Conference on Vaccine Research was scheduled to convene in Baltimore, Maryland. A little over a month before the conference, an editorial (which has since been yanked) appeared on Baltimore Sun in which AHF President Michael Weinstein and AHF Chief of Medicine Dr. Homayoon Khanlou wrote about the futility of continuing to fund vaccine research. The editorial, which remains on RedOrbit.com reads:

To control AIDS, funding must be invested in strategies that work: effective prevention efforts, routine testing and universal access to treatment — and not spent on expensive vaccine research that over 20 years has yielded little of promise other than discovering how not to make an AIDS vaccine.

The latest round of vaccine trial failures (including a large-scale Merck trial halted when the vaccine turned out to have possibly increased subjects’ risk of acquiring HIV) has added to a growing consensus in the scientific community that an AIDS vaccine is a decade or more away, if one can be developed at all.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), recently stated: “We have to leave open the possibility … that we might never get a vaccine for HIV.” That view was shared by leading AIDS expert David Baltimore, who conceded last month that the scientific community is no closer now to discovering an HIV vaccine than it was 20 years ago.

Twenty years of research and the fact remains: a vaccine against a retrovirus, the family of viruses HIV belongs to, has never been successfully developed. It is highly unlikely that there will be an AIDS vaccine — certainly not by any current standard definition of the word.

Having met the public’s criticism of his position, Weinstein elaborated on his position in an editorial for the Los Angeles Times a couple of weeks later:

There are not just two or three AIDS vaccine candidates that have failed. Every AIDS vaccine candidate to date has failed. Leading scientists, including Nobel Prize winner Dr. David Baltimore, have even gone so far as noting that we are no closer to the discovery of an AIDS vaccine today than we were 20 years ago.

In fact, not only have all the AIDS vaccine candidates failed, the latest was hurriedly pulled from clinical trial after the vaccine was found to actually put people at a significantly increased risk of contracting HIV. Twenty-seven years into the AIDS pandemic, countless billions in taxpayer (and private) vaccine funding later, and our leading researchers can’t even meet the most fundamental tenet to “do no harm.”

[...] Currently, the AIDS vaccine establishment continues its taxpayer-funded, repeatedly unsuccessful search for a preventive AIDS vaccine while an alternative many have seen work on multiple levels — successful antiretroviral treatment as both treatment and prevention — goes unchampioned.

This is why the AIDS Healthcare Foundation believes that it is time to pull the plug on U.S. taxpayer financing of the search for a vaccine, and leave it to private donors to back what has been and continues to appear to be a fruitless goal. To continue to invest hundreds of millions of dollars in a government-funded search for an AIDS vaccine in the vain hope of success someday while millions worldwide suffer and die is simply unacceptable when other currently available strategies offer practical — and effective — alternatives.

Dr. David Baltimore, incensed by the name-dropping that linked him to Weinstein’s indictment of the “vaccine establishment” responded in an editorial co-written with Dr. Seth Berkley, a medical epidemiologist and CEO of the International AIDS Vaccine Initiative (IAVI):

This very pessimistic view of the possibility of success in the vaccine quest is a misreading of the situation.

Yes, the Merck trial of an experimental vaccine failed to show efficacy. But it was not a failure as a trial. It had a hugely important outcome: We now know one preparation that will not work as a vaccine. Before this trial we knew only one other direction that had failed, so our knowledge has doubled.

Knowing what not to do is useful because it informs further research. Of course, we would rather have successful trials that tell us we are going in the right direction, but AIDS vaccine development is hard, and negative trials are not a surprise. Because the trial was so professionally accomplished, we can trust its results.

Now what we need are more such trials of materials different enough from the Merck materials that we can learn something from them. The job of the research community is to make the judgment of what materials fit this criterion. But to give up at this point would be criminal. Luckily, the cool heads in the AIDS research community are not giving up — they are searching for new directions. There is a healthy debate about what those directions should be. But to our minds, we need more human clinical research, not less, if we are to find the magic formula that will protect people against AIDS.

Not to be outdone by the Nobel Prize winner, Weinstein returned to the Los Angeles Times opinion page condemning efforts to develop an AIDS vaccine as “self-serving.” He writes:

The search for an AIDS vaccine has lost its scientific purpose and turned into a self-serving quest.

How else to explain the remarks found in David Baltimore and Seth Berkley’s “Keep funding the AIDS vaccine”? Saying simply that “AIDS vaccine development is hard” is not a credible response to recent criticism leveled at the ballooning U.S. budget for AIDS vaccine research and the meager results it has produced. The argument is particularly weak when you consider that nearly $1 billion in public funding is poured annually into this fruitless quest, while millions globally lack access to the revolutionary, life-saving AIDS treatment that was developed more than 12 years ago: antiretroviral medication.

We understand the desire to make treatment available to those affected by HIV and AIDS worldwide, but to actively campaign to kill all public funding for an HIV vaccine is unconscionable. And speaking of self-serving, here’s a question we leave with you: does AHF provide the above-mentioned unchampioned treatments for HIV and AIDS?

The answer, from the AHF website: “Our healthcare centers offer thousands of clients — many of them uninsured — the finest HIV-centered primary care, and our pharmacies specialize in HIV medications. Our researchers conduct trials of the newest drugs and treatment protocols to improve patient quality of life. Through Positive Healthcare, our managed care program in California and Florida, we provide HIV positive Medicaid recipients extra tools to manage their disease.”

Image of test tubes by Horia Varlan.


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