Researchers must 'press ahead' with HIV/AIDS vaccine efforts, opinion piece says
HIV/AIDS "prevention research has hit a major roadblock" because more than "150 recent prevention trials, including vaccine and microbicide candidates, failed to protect participants against HIV infection," Udo Schuklenk, a professor at Queen's University and the Ontario Research Chair in Bioethics and Public Policy, writes in an opinion piece in Toronto's Globe and Mail. Schuklenk adds that it is "inevitable that the question is asked: Is there a point when we should concede defeat and abandon further trials?"
With the HIV/AIDS "death toll standing at 25 million lives lost prematurely, and 33 million people currently living with the disease, the unpleasant truth is that we have no choice other than to press ahead with trials," according to Schuklenk. Antiretroviral drugs have "become more sophisticated, and no one knows for sure how long people will be able to cope with the side effects of such powerful agents," Schuklenk writes, adding, "For every person being treated in the developing world, roughly five new people" contract the virus. "It is far from clear that we can win this numbers game," and although "significant inroads have been made, it remains that the vast majority of people in developing countries who could clinically benefit from AIDS drugs have no access" to them, according to Schuklenk.
As HIV/AIDS vaccine trials "continue unabated, so do the equally unsuccessful microbicide trials," Schuklenk writes. Although their "scientific rationale seems as shaky, if not shakier, than those of vaccine candidates," microbicide trials "continue because they are seen as the last best hope of protection for women in developing countries," according to Schuklenk.
Researchers "will only ever know after a trial whether it has been futile," Schuklenk writes, adding, "At this point, there is no reason to assume such trials will necessarily fail." Rather than "dwelling on the failures, we should focus on ethical concerns such as the provision of care to people who seroconvert during trials, or people who become more susceptible to infection due to their trial participation," according to Schuklenk, who adds, "We have to ensure that no trial participant is left without adequate clinical care, at the very minimum." Schuklenk concludes, "Talk about pulling the plug on HIV vaccine and microbicide trials needs to end sooner rather than later" (Schuklenk, Globe and Mail, 6/19).
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