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Many experts admit that despite intensive global efforts, an HIV/AIDS vaccine remains elusive, and might never be found.

In an article published online today (28 September) by The Lancet, Robert Gallo at the Institute of Human Virology in the United States addresses points recently raised by the journal's editor Richard Horton in an article that "seriously questioned" the possibility of developing a successful vaccine against HIV.

Gallo agrees there are many challenges, mostly due to the particular biology of the HIV virus. But, he says, there is also hope. To be successful, argues Gallo, HIV vaccine research needs to change focus to directly address these biological challenges.

In his article, Gallo, who in the 1980s co-discovered that the HIV virus was the cause of AIDS, outlines the biological obstacles to HIV vaccine development and discusses certain approaches that suggest that they can be overcome.

Among other points, he says most researchers have accepted that a vaccine will be unlikely to block infection completely. Instead, a useful vaccine would reduce the amount of HIV in the body with the expectation that it will remain low, and not develop into full-blown AIDS.

Gallo praises the Gates Foundation's Grand Challenges programme as an example of how to best structure HIV vaccine research. In the Grand Challenges obstacles are first identified by research teams and then put to scientists worldwide, who compete to solve them.

He also mentions a new programme of the US National Institutes of Health, known as CHAVI (Center for HIV/AIDS Vaccine Initiative). This programme will gather HIV immunology experts to address key issues and allow them to branch out and mobilise other groups in their attempts to solve them.

Whether a vaccine will be found by these two methods, or by individual centres working with pharmaceutical companies, remains to be seen, concludes Gallo.

Link to full article by R. Gallo in The Lancet*

Link to full article by R. Horton in The New York Review of Books

*A free registration is needed to view this article.

Reference: The Lancet doi 10.1016/S0140-6736(05)67395-3 (2005)