Sunday, Jun 29, 2003
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By N. Gopal Raj
The HIV/AIDS problem is rapidly moving centrestage in India. HIV infections are said to be rising twice as fast in South Asia as in sub-Saharan Africa, currently the worst-affected region in the world. There could be 20-25 million new infections in India by 2010, according to some estimates. Although it is 20 years since the Human Immunodeficiency Virus (HIV) was shown to be the causative agent behind AIDS, a vaccine has remained elusive. Earlier this year, the sole candidate vaccine to have made it to the final phase of clinical trials was found to be ineffective. Although treatment methods for HIV/AIDS have made considerable progress, transferring concepts for HIV vaccines into clinical application had lagged, points out the policy paper being published in Science. The paper is authored by well-known names from leading research institutions, funding agencies and international organisations. N.K. Ganguly, Director-General of the Indian Council of Medical Research, is among the authors. "Tens of millions of lives are dependent on the development of a safe and effective HIV vaccine. It is essential that we aggressively explore all mechanisms that might expedite this process,'' they remarked. They want to see the development of a roadmap for a Global Vaccine Enterprise, rather along the lines of the Human Genome Project, which sequenced the entire human genome. Its aim would be to create a large number of candidate vaccines using all possible routes and an efficient system of clinical trials to identify the effective vaccines. Since diverse approaches have to be tried simultaneously in order to find the best vaccine, they have suggested setting up some six to 10 Vaccine Development Centres. Each centre will be devoted to the development of a particular HIV vaccine approach. As many of the fundamental scientific questions impeding the AIDS vaccine development remained unsolved, these centres will have to be supported by "a series of coordinated HIV vaccine scientific consortia''. Facilities are needed to produce the candidate vaccines in sufficient quantities for clinical trials as well as methods for carrying out "large, comprehensive, coordinated, international clinical trials''. But, even without so ambitious a project, alarm bells are being sounded over the inadequacy of worldwide funding to fight HIV/AIDS. Most recently, the UNAIDS has estimated that, even with the increased funding promised by the United States and the European nations, this year's anti-AIDS spending in low and middle income countries will only be $4.7 billions. That is far short of the $10 billions annual spending required by 2005. "We have come a long way in committing additional resources to fight HIV/AIDS, but much more still needs to be done,'' says Peter Piotr, Executive Director of the UNAIDS. A paper in a recent issue of the British Medical Journal pointed out that India was spending only Rs. 300 crores annually, much less than what was needed to fight the epidemic. Large investments at the outset of the epidemic would slow its progress more than those at a later stage, noted two scientists from the University of California at Berkeley.
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