The promising results of a seven-year test of an HIV vaccine on 16,000 volunteers in Thailand are being hailed as a breakthrough in the fight against HIV/AIDS, which the World Health Organization (WHO) calculates has infected 33 million people worldwide.
Nevertheless, even the Thai and US research scientists involved are cautioning they are still a long way from producing a truly effective protection. The vaccine administered, which was a combination of two older immunogens that had not proved effective, appears to have only given protection to a third of the recipients. The medical world is looking for a far higher rate of protection than that.
However, the exciting reality is the vaccine was effective on a significant minority of volunteers. What scientists need to figure now is why. How precisely did the vaccine work to defend against infection and can that effect be enhanced so that virtually everyone can be protected? This research may yet prove a dead end. There may be exceptional circumstances that promoted the effectiveness of the vaccine in that third of the test subjects.
From here on in, it can be expected that the big pharmaceutical companies will be boosting their own research along with that in academia, to see if they cannot duplicate the results of the Thai trials and take them on further to at last discover a vaccine that is three times more effective. Three years ago the giant Merck abandoned trials of what had initially seemed a highly promising vaccine.
There will, of course, be fortunes to be made for the pharmaceutical corporations that can bring a working vaccine to market. It is perhaps notable that the Thai trials were of a vaccine that targeted the B and E strains of the HIV virus, which are prevalent in the lucrative markets of North America and Europe. It is probable it would not work against the HIV C virus, which is the main strain in Africa. It would, therefore, be good to believe that the Thai research will prompt a renewed debate on how an effective vaccine, if and when it is discovered, will be made available in those parts of the world where it cannot be afforded.
The dispute in recent years over the cost and provision of anti-retroviral medicines to slow the onset of full-blown AIDS was not edifying. The pharmaceutical companies have to recoup the often-substantial investments made in every new medicine. They also have to produce profits for their shareholders and for fresh investments. But the question is: Is it ethical for a business that produces an exclusive medical silver bullet, to capitalize on it to the exclusive benefit of its balance sheet and ignore those, so often in wretchedly poor countries, who really need it?
Big pharma would argue that any deep discounting to the Third World would be a slippery slope. If done for an HIV vaccine, the same demand would be made for every other medicine it produces. This is probably correct. But what actually is wrong with variously charging rich and poor what they can afford?
