Remember Children on HIV Vaccine Awareness Day
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Photo: Jon Hrusa |
Today is HIV Vaccine Awareness Day — an annual reminder that we do not yet have a vaccine against this devastating virus and the disease it causes. I work on clinical and basic research issues for the Elizabeth Glaser Pediatric AIDS Foundation, which has been funding
pediatric-related research to develop an HIV vaccine for more than 20 years.
Why is this day important to us and our mission to eliminate pediatric HIV and AIDS?
While the discovery of therapies to prevent mother-to-child transmission (PMTCT) of HIV may be one of the biggest success stories in the fight against this virus, there is still an urgent need for an HIV vaccine that is safe and effective for infants and children, as well as adults.
You might ask, if we can reliably prevent a mother from passing on the virus to her infant, why would babies need a vaccine? And with all the progress in developing new drugs for treatment, do we still need a vaccine for adults?
The answers are not so simple. Yes, there are amazing drugs available, and those infected can now lead productive lives well past the time we had previously thought possible. This doesn’t however take into account the toxicities of those drugs, the side-effects of a lifetime of taking them, or the potential for the virus to become drug-resistant.
And unfortunately, not everyone around the world has equal access to these life-extending therapies. An
article in last week’s New York Times alluded to the difficulty in sustaining treatment programs in Uganda and other countries where the need is greatest.
For example, in resource-limited settings where the epidemic is most severe, two people become infected for every one person put on treatment – a sobering statistic that will not change anytime soon. Basically, we know that we can’t treat our way out of this epidemic. And despite real progress in reaching more women with PMTCT services, we are only about half way there in terms of coverage.
A pediatric vaccine would add to PMTCT efforts by addressing the issue of transmission through breast milk in resource-poor countries. Breastfeeding is often recommended for HIV-positive mothers in these areas for two reasons: replacement feeding is often not possible due to lack of clean water, and breastfeeding provides greater nourishment and likelihood for child survival. A vaccine would allow babies in the developing world to breastfeed safely, getting all of its benefits without worrying about also getting HIV.
Indeed, a vaccine for HIV would be a game-changing development for both children and adults. Childhood vaccines in use today are far and away the most effective public health tools we have. Vaccines have eradicated smallpox and nearly eradicated polio from the face of the earth. In addition, the infrastructure exists to deliver childhood vaccines in most of the world. Adding an HIV vaccine to these routine immunizations could protect a baby from HIV in breast milk and could also potentially set the stage for lifetime immunity to HIV.
Despite recent setbacks in the search for an HIV vaccine, there are reasons to be optimistic with the current state of research. Last fall, the results of the
third large-scale HIV vaccine clinical trial were the first to show a glimmer of hope.
More than 16,000 volunteers in Thailand participated in the trial, and the results, while not overwhelming, offered at least the possibility that a vaccine could protect from HIV infection. Efforts are underway to build on these results and to tease out any lessons as to why the vaccine might have worked.
We must learn from both our successes and our failures. And we should also learn from the history of vaccine research for other infectious diseases to keep perspective and hope.
Vaccines for scourges such as typhoid, pertussis, polio, and measles took 105, 89, 47, and 42 years respectively to develop from the time the infectious agent was discovered. A mere 25 years and counting without a vaccine for a virus as complex as HIV should not be considered a failure.
So, on this 18th HIV Vaccine Awareness Day, let’s take the positive results from last year and move forward. Let us not forget about the infants and children – they need an HIV vaccine too. And let us have hope for the future, and for the real possibility of creating a generation free of HIV.
Jeffrey T. Safrit, Ph.D, is the Director of Clinical and Basic Research for the Foundation. He has been involved in various aspects of HIV/AIDS research since 1991, including with the Aaron Diamond AIDS Research Center, Bristol Meyers Squibb, and Emory University, prior to joining the Foundation in 2001.