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Getting the Global House in Order

This annual report on the global status of AIDS vaccine research and development charts the progress made since former President Bill Clinton's 1997 challenge to have an AIDS vaccine within 10 years. Intended for a lay readership, the extensive report is well written and organised. Its overarching conclusion is that the 2007 deadline is unlikely to be met because of many significant scientific and logistical challenges.

The report is unusual for two reasons. First, it provides a useful account of why there is now such an urgent need for more rapid recruitment of volunteers and preparation of trial sites in developing countries. The report outlines the kinds of problems that have recently delayed readiness for clinical trials, particularly in Africa, ranging from recruitment of volunteers to manufacture of vaccine preparations, and the shortage of trained staff. It lists the activities that need to take place, including careful screening of potential volunteers, community involvement, strengthening of local healthcare infrastructure to ensure adequate support for trial volunteers, and agreement over the provision of antiretroviral drug treatment for volunteers who become infected during the course of the trial.

Secondly, the report contains an analysis of the launch of the Global HIV Vaccine Enterprise, a new consortium established last year by the Bill and Melinda Gates Foundation to coordinate and streamline vaccine research. Following an initial strategy outline published in the journal Science, closed-door meetings have taken place to develop a more detailed strategy, which observers hope will soon be made public.

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