SciDev.Net

This annual update gives an overview of the latest developments in the global HIV/AIDS epidemic and provides regional statistics on the diseases's spread. It shows that numbers of people living with HIV and the number of deaths from AIDS are growing.

The report presents trends in HIV prevalence, including estimates of the number of young people and women infected in different countries. It discusses how high-risk behaviour such as unprotected sex and intravenous drug use contributes to the epidemic and how external factors such as malaria, tuberculosis, migration or political conflict affect HIV prevalence.

This report from a workshop on “Promoting R&D in Preventive Health Technologies,” held in India in December 2004 outlines the potential role that the biotechnology sector in India could have in HIV vaccine research and development. India, as other “innovative developing countries” such as Brazil and China, has the research and manufacturing capacity to take a significant role in HIV vaccine research and development. The report strongly advocate’s IAVI’s strategy of promoting public-private partnerships in order to finance such developments.

This report by members of the Global Prevention Working Group - which represents a broad spectrum of scientific expertise - provides a region-by-region analysis of gaps in access to HIV prevention measures.

It includes information on current spending and a future projection of what level of funding is needed to achieve the goal of averting 29 million of the 45 million new HIV infections projected to occur by 2010.

This report - the result of a one-year literature review and consultation with experts - provides the case for developing microbicides, and contains a useful account of the recent history of the field. The report notes that although the previous five years had seen a dramatic increase in the number of researchers working on microbicides, progress remains slow.

While there is some overlap with the 2002 reports of the Microbicide Initiative, this document also suggests priorities for stimulating industry investment into research and development of microbicides. These include the need to provide proof of concept (evidence that microbicides can be effective against HIV and other sexually transmitted diseases), and the importance of exploring new sources of investment such as venture capital.

This short report summarises five different sets of priorities for action on microbicides: development, marketing, public health, consumer access and advocacy. These are the key points of reports from five Working Groups of experts, assembled by the Microbicide Initiative, an umbrella organisation dedicated to the production and global use of microbicides. The full report of the Scientific Working Group is recommended reading, which represents a scientific roadmap for understanding microbicides and accelerating their development.

The key points listed in this summary include the need for further research into preventing the HIV virus from crosssing the mucous membranes of the female genital tract, and the roles of other sexually transmitted diseases. It also outlines the complexities and challenges of pre-clinical and clinical testing, and features a table listing products in clinical trials, as of February 2002.

This 94-page document is an extensive state-of-the-art report by the Science Working Group of the Microbicide Initiative. With individual chapters authored by different scientific experts, it provides a scientific road map for the development of a safe effective vaginal microbicide against infection with HIV and other sexually transmitted diseases.

A microbicide is viewed as "a critical adjunct to condoms, as well as complementing current efforts to develop a therapeutic or prophylactic HIV vaccine", with the added advantage that an effective microbicide is likely to be produced more widely and more rapidly than a vaccine.

The report covers topics ranging from basic research, through the challenges of pre-clinical and clinical testing, to key issues in manufacturing, formulation, acceptability and end use. Highlights of the basic science section includes diagrams showing how HIV infection takes place, the HIV life cycle within an infected cell, and steps where microbicides may act. Also included are tables of microbicides in development, and their many sponsors and developers. Final chapters include a section on the global epidemiology of HIV and other sexually transmitted diseases.

This review - which includes a moderate level of technical detail - covers both the progress of microbicides through laboratory and clinical testing, and the social science and market research that supports microbicides as an HIV prevention option.

Particularly useful is the brief information it provides on which companies are developing each product, and the locations of clinical trials. However, it lacks the illustrations and graphic design of other reviews of microbicide development.

In light of disappointing results of the VaxGen trial announced in February 2003, this AVAC report laments the lack of urgency in getting other vaccine candidates out of the lab and into clinical trials. It provides a critical perspective on the design and testing process that scientists and policy makers alike will find useful.

The report examines the reasons underlying the bottleneck, and raises important but rarely asked questions about the choice of vaccine designs entering clinical trials. For example, will the categorisation of vaccines along the concept of geographical clades prove necessary? AVAC calls for a coherent and systematic comparison of vaccine candidates in order to achieve optimisation of vaccine concepts. Currently standing in the way is a prevailing lack of collaboration between different groups of researchers, and insufficient sharing of data and resources.

In its summary the report notes a few key advances in vaccine trials protocol, including the decision by the HIV Vaccine Trials Network and the International AIDS Vaccine Initiative, to provide antiretroviral drug treatment to volunteers who become infected during a trial. A rapid and concerted response to the threat of bioterrorism is heralded as a blueprint for how action against the AIDS pandemic can be speeded up.

This report from AVAC is a clear and concise account of the results and implications of the world's first phase III efficacy trial of an HIV vaccine, the results of which were announced in February 2003. It is relevant for anyone engaged in the effort to test vaccine candidates in clinical trials - scientists, health care workers, community groups and policymakers alike.

Produced with the support of influential organisations including the Bill and Melinda Gates Foundation and the International AIDS Vaccine Initiative, the report represents the views of many mainstream vaccine researchers.

The report highlights criticisms about the data analysis and conclusions, and the recent decision by the US National Institute for Allergy and Infectious Diseases and the Centers for Disease Control to hold a series of meetings with VaxGen to independently analyse the trial data. It also underscores lessons to be learned from the trial.

This document represents a consensus view among a number of partner organisations including people living with AIDS and their advocates, and non governmental organisations that share the goal of expanding access to antiretrovirals (ARVs) for all people living with HIV/AIDS. It describes the gap between access and need in developing countries, and argues coherently that expanding access to ARVs to three million people by 2005 is possible with adequate commitment and resources.

The report provides worldwide figures (up to December 2002) for the number of HIV-positive people with access to ARVs, and reviews the success of existing pilot projects to provide ARVs free of charge to people in resource-poor settings, as well as the national treatment programme in Brazil. It also highlights the work of the World Bank through its multi-country AIDS programme, and the Global Fund to Fight AIDS, TB and Malaria.