This paper discusses how researchers promote the use of research in policy by examining the practices of 'boundary organisations' that cross the boundary between science and politics to facilitate evidence-based policies and programmes. It identifies key lessons for organisations looking to engage policymakers and decision-makers.

The study focuses on the Regional Network on AIDS, Livelihoods and Food Security (RENEWAL), a regional 'network of networks' active in Kenya, South Africa, Uganda, and Zambia which engages government officials on programmes that could inform policies on food, nutrition and HIV/AIDS. It describes the challenges and successes of efforts to promote research in these areas; challenges include adherence to scientific principles while maintaining close relationships with political authority, and ensuring accountability to the communities within which the research is conducted.

The paper offers recommendations to strengthen efforts to get research into policy, and concludes that the concept of a boundary organisation can help researchers engage people and processes that have decision-making power.

This special issue of the journal Philosophical Transactions of the Royal Society B: Biological Science explores how vaccines can fulfil their full potential for addressing global health challenges. It charts the progress to date, reviewing successes as well as challenges in the development and distribution of both human and veterinary vaccines.

The articles describe how vaccines can help mitigate and treat the world's major infectious diseases such as malaria, tuberculosis and HIV/AIDS, as well as chronic diseases, such as cancer. They explore vaccine policy and financing, ways to accelerate the development of new vaccines, issues surrounding public acceptance, and the logistics of getting vaccines to where they are needed. Also discussed is the use of vaccines to treat diseases in livestock — making an important link between health interventions, agricultural output and economic consequences.

The papers in this issue were presented at the meeting, 'New vaccines for global health', held at the Royal Society in London, United Kingdom, in November 2010.

This report gives an overview of progress in developing an HIV/AIDS vaccine, including new adjuvant strategies, novel vectors for antigen delivery and presentation, and alternative ways of eliciting antibody responses. The authors call for continued commitment to basic research to identify an effective and affordable HIV vaccine.

This Nanomedicine paper reviews a range of strategies based on nanotechnology that are currently being used or tested to improve HIV/AIDS treatment and prevention. The authors review nanomedical advances in antiretroviral therapy, gene therapy, immunotherapy, vaccines and microbicides.

They conclude that nanotechnology promises great improvements in all of these areas but they warn that the field still faces many challenges including the toxicity of nanomaterials, their stability in physiological settings and the question of how to mass-produce them.

This paper explains how interdisciplinary collaboration in health, nutrition, and agriculture has helped the Millennium Villages Project in 12 African villages meet the Millennium Development Goals.

Global science is increasingly under pressure to become more interdisciplinary. Econutrition is a good example of a cross-sector concept that joins environmental and human health, focusing on crosscutting areas such as agriculture and ecology.

Soil erosion and decreasing biodiversity causes environmental damage that lowers food production. A lack of food results in malnutrition and illness that, in turn, lead to poorer labour productivity and poorer agricultural management.

The Millennium Villages Project emphasises community engagement and leadership, and the case study from the Nyanza Province near Lake Victoria in Kenya illustrates that this can work well in improving nutrition.

One-fifth of adults in the area have HIV and many have malaria and TB. People in the region go hungry for up to seven months a year and are malnourished. The villagers constructed a health clinic and organised teams of community healthcare workers trained in nutrition.

Farmers receive fertilisers and plants if they donate ten per cent of their harvest towards a school lunch programme that concentrates on providing missing nutrients. For example, by adding local crops such as sweet potatoes common vitamin A deficiencies are eliminated. The key to success, say the authors, is to ensure that farmers are supported, especially in producing a variety of crops.

This article unpicks the links between nutrition and HIV/AIDS, and looks how to break the cycle between the two. Every year millions of dollars are pumped into tackling HIV/AIDS including antiretrovirals and research for vaccines and drugs. But poor nutrition remains a major barrier to preventing sickness and death from the virus.

The effects of poor nutrition on HIV status are clear: malnourishment weakens the immune system. But it also has indirect non-biological effects. For example, a lack of food can trigger dangerous coping strategies such as selling sex for food or selling assets, both of which lead to economic instability and a higher risk of HIV infection.

People with HIV are less able to absorb nutrients. And crucially, undernutrition also affects the ability of HIV-infected people to process antiretrovirals such as nevirapine.

The authors call for better targeting of food aid to HIV-infected people.

This paper proposes a model to provide better access to fairly priced antiretroviral (ARV) drugs for HIV-infected people in poor countries, while also safeguarding the interests of ARV manufacturers.

The authors explain what governments and brand and generic companies are doing to increase the availability of ARVs in developing countries, taking examples from Brazil, Canada, China, India, the United States and Thailand. They also discuss the implications of creating more South–South partnerships to produce and market ARVs; and the impact that the UNTAID–Clinton Foundation coalition has had on lowering ARV prices in developing countries.

The authors recommend an incentive-based strategy that includes international donors bulk-purchasing generic ARVs, individual governments providing financial relief packages for generic companies, and the WHO brokering negotiations between brand and generic companies.

This series of commentaries and research articles — published by The Lancet, the Peking University Health Sciences Centre and the China Medical Board — addresses China's major health challenges, strategies and future. It has been produced by a group of 63 scientists from 10 countries with Chinese scientists making up two-thirds of the authors.

The research papers give scientific evidence on key health issues including the emergence and control of both infectious and chronic non-infectious diseases in China as well as the performance of China's healthcare system.

Authors of the series' commentaries further discuss a range of topical issues affecting China's health system, including the state of biomedical science and technology (see 'Progress in Chinese biomedicine a massive challenge'), medical research ethics, the lessons learnt from China's schistosomiasis control programme and the challenges the country faces in controlling HIV/AIDS.

In this editorial* (J Infect Dis 189:2149-53, 15 June 2004), Marc Butlerys and his co-authors review the success and progress of strategies aimed at the prevention of MTCT during breastfeeding, and outlines the challenges for future research. These include the refinement of antiretroviral drug regimens, and the use of (still experimental) alternatives such as antibodies to clear any HIV that crosses to the baby during breastfeeding.  

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In this commentary article, timed to precede the international microbicides conference held in London in March 2004, researchers Robin Shattock (United Kingdom) and Suniti Solomon (India) provide a brief overview of the scientific strategies being used in microbicides research and development.

Written for general readers with a scientific or medical background, the article contains some technical terms but also has a useful graphical illustration showing the targets of microbicide action. These include directly killing or immobilising HIV, and preventing cells that line the female genital tract from transporting the virus to deeper tissues in the body.

In this commentary article, HIV vaccine researcher Ron Desrosiers presents his view that the main reason we do not yet have a vaccine for HIV is due to unsolved scientific questions rather than a bottleneck in conducting clinical trials. Accordingly, he advocates a "renewed, coordinated and focused effort" on basic research rather than clinical trials for "feeble" candidates that "stand little chance of being effective".

Desrosiers is well known and respected in the HIV research field for his contribution to the scientific debate, and presents five lines of evidence for his contentions. These include the failure of immune responses elicited by current vaccines in HIV-infected individuals to control the virus; the failure of the animal models much favoured by researchers to fully represent HIV infection in humans; and the ability of new strains of HIV to 'super-infect' individuals already infected with another strain, even if their immune system appears to be controlling the first infection. He also disagrees with the aim of the recently formed "Global Vaccine Research Enterprise" of placing more candidates in clinical trials more quickly. 

The article is written for general readers with a scientific background, and assumes knowledge of how the immune system works and relevant technical terms. Nonetheless, it is a well-argued piece that provides much food for thought for the vaccine community and policymakers alike.

This optimistic review, by Marc Bulterys and colleagues at the US Centers for Disease Control and Prevention, summarises recent advances in preventing mother to child transmission (MTCT) of HIV-1. Without any intervention, the risk of MTCT is 15 to 40 per cent, amounting to 1,700 new paediatric infections a day.

In the West, interventions combining elective caesarean section and antiretroviral drugs have reduced this risk to around one per cent. However, such measures require a well-established infrastructure and healthcare system that is expensive and lacking in most of the developing world. The authors state that it is therefore necessary to explore the potential of simpler, less expensive treatment options.

The article includes a detailed account of individual clinical trials on the use of antiretroviral drugs to prevent MTCT, as well as pilot programmes to expand prevention of MTCT in developing countries. It also contains useful tables summarising the current knowledge of factors affecting MTCT, a list of completed phase II/III clinical trials of antiretrovirals (up to February 2002), and outlines a model for implementing a programme preventing MTCT in developing countries.

The authors of this scientific article use a mathematical model to warn that while the widespread use of antiretrovirals in developing countries could be an effective tool for prevention of HIV infection - as well as treatment - the benefits could be masked by an increase in risky behaviour that promotes the spread of the virus.

They argue that antiretrovirals should be viewed as a non-conventional prevention tool since the drugs have both preventive and therapeutic effects and are given to infected, rather than uninfected, individuals.

In this article, leading vaccine researchers and advocates join forces to call for a global strategy for developing an effective HIV vaccine. The goal, they say, would be to unite teams of researchers in a series of coordinated global HIV vaccine centres, each with the critical mass, focus and scientific expertise for a more rapid and systematic approach to vaccine development.

The authors point to the recent success of the Human Genome Project in achieving the full sequencing of the human genome within a shorter than predicted timeframe. They say this provides an encouraging model, which highlights the need for a common vision among funders and major stakeholders, including those from developing countries.

Written by a virologist for a clinical readership - but likely to have broader appeal - this article describes in some technical detail the challenge that the unique biology of HIV infection poses to vaccine development. It provides an expert view of the strengths and weaknesses of current vaccine designs, the kind of immunity they trigger, and safety issues.

Letvin argues, with reference to animal studies, that a vaccine may still be worthwhile even if it fails to completely eliminate HIV from the body (known as 'sterilising immunity'), on the grounds that it would enable people to control their virus infection sufficiently to live longer and healthier lives, as well as lower the chance of the virus spreading to others.