As we come to yet another World AIDS Day couched in the context of COVID, it is easy to despair. But that despondency is based, in part, on the juxtaposition of the fights against the two viruses as competitors in a zero-sum game in which gains for one must be matched by lost opportunities, if not outright setbacks for the other. In the realm of developing and producing effective vaccines for the two, it is time to put that view to rest.
Just days ago, the state of affairs for World AIDS Day 2021 seemed clear: a mixed record of progress and ongoing challenges and shortfalls – all to be addressed in the context of a world more disposed to turn at least some attention back to the fight against HIV after a long, intense focus on COVID-19.
But then came news of the Omicron variant of concern and the public health focus swiftly turned back to a tighter focus on COVID – creating a clear risk that the annual day of remembrance and action for a virus that has impacted hundreds of millions of lives, including those who have died, are living with HIV, and whose lives have otherwise been affected over four decades will barely garner a passing mention as Omicron monopolizes the health headlines around the globe.
Vaccines Matter
It is still too early to tell what impact the new variant will have. But one thing is clear: vaccines matter. And we are in a very different world in that regard that we were a little more than one year ago thanks in good measure to the world’s first vaccines using mRNA technology. Because of this groundbreaking new tool and strong financing and political support for the scientists and labs that created it and the other COVID vaccines, the announcement of Omicron was followed almost immediately by announcements from vaccine producers that they were hard at work to tackle the new strain – working to have information in just days about the efficacy of their existing vaccines, and ready, if necessary, to bring online new vaccine versions in a matter of months. In short, in the context of COVID, rapid vaccine development is now (almost) a given rather than a distant dream.
The same can and should become true in the fight against HIV and that progress should build on the gains made in the COVID context, with researchers and developers in the two communities taking advantage of gains made by counterparts to spur advances in their own work as well.
The different trajectories to date in the development of HV vaccines versus their COVID counterparts, had been due, in large part, to the fact that the HIV virus is so different from anything we have conquered in the past.
HIV Research Breakthroughs
However, recent developments have fundamentally altered the environment in which we confront that difference, creating a double reason for hope. This is due to the COVID-19 vaccine advances, but also HIV research breakthroughs and recent announcements that promise to apply those breakthroughs to ongoing search for the grail that is an effective HIV vaccine.
First, the year began with IAVI and Scripps Research, nonprofits in the vanguard on HIV research, announcing that an innovative vaccine approach had successfully stimulated the production of the rare immune cells needed to generate antibodies against HIV in 97 percent of participants in a phase I trial. The trial only involved 48 people, but the results marked a game-changing moment. It was the best news we had ever had on HIV vaccine development.
The road ahead is even more promising thanks to developments that can wed these results to advances in the realm of mRNA vaccine technology. In February, IAVI and Scripps Research launched a collaboration with Moderna to develop and test an mRNA-based HIV vaccine using the approach to develop the necessary immune cells. Then just a few months later in September, the partners announced they were ready to start recruiting for a new phase I study to assess two new mRNA HIV vaccine candidates and NIH announced another HIV candidate.
But the pace may be even faster if other plans to produce mRNA vaccines in Africa bear fruit. Recent months have seen relevant announcements from multiple entities. While the immediate focus of those efforts is on producing COVID vaccines, it is not unreasonable to envisage that one or more of those groups might, in turn, also direct their attention to using that technology to develop or manufacture HIV vaccines on the continent.
With competition and demand spurring progress at a previously unimaginable rate, there is good reason to hope new breakthroughs are on the horizon for both COVID and HIV. And the gains could be even more pronounced if we can seize this moment to change the way we approach the two challenges: seeing them as potentially powerful counterparts in the common quest to defeat pandemics whenever and wherever they emerge.
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