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.