DOCTORS CLAMOR FOR AIDS VACCINE

Conference: The need is greatest in poor nations. But the push for human
trials raises ethical, political and social questions.

Geneva- Frustrated proponents of AIDS vaccine development are pushing for
accelerated human trials of experimental vaccines, a leading researcher said
as the 12th world conference on the disease opened Sunday.

"If we in the West had a 25 percent infection rate among our adults - the
way Namibia, Botswana and parts of South Africa do - we wouldn't be having
this debate about testing of experimental vaccines already proven safe," Dr.
Max Essex of the Harvard AIDS Institute said in an interview.

With the human immunodeficiency virus infecting someone in the world every
11 minutes, Exxex's exasperation is widely shared among researchers and
specialists at the conference.

The conference theme, "Bridging the Gap," might equally refer to the chasm
between rich and poor nations in access to costly AIDS treatment, or the
large gaps in scientists' knowledge about the essential qualities of an
anti-HIV vaccine.

More than 40 experimental AIDS vaccines have been developed so far, but only
last week did the first enter large-scale human tests. Critics say the U.S.
government is too cautious about human AIDS vaccine experiments, preferring
to concentrate on more test-tube research first.

"If it were just a matter of developing a vaccine for the United States and
Europe, I'd say, 'Fine, let's wait and be sure.'" said Margaret Johnston, a
leading vaccine specialist. "But there's too much urgency."

Rubaramira Ruranga, a major in the Ugandan army, added a personal note of
urgency. "I have lived with HIV myself for 13 years," he said. "I don't fear
HIV because I already have it, but I live in fear for my sons and daughters.
How long will we have to wait for a vaccine?"

Noting recent success in suppressing the AIDS virus with costly drugs,
Ruranga said such measures would do little good in places like Uganda.
"Drugs have never stopped an epidemic," he said.

Johnston, formerly the federal government's chief AIDS vaccine adviser, is
principal author of a report issued Sunday by the International AIDS Vaccine
Initiative, a group formed two years ago at the time of the last global AIDS
conference in Vancouver.

The report, billed as a blueprint for AIDS vaccine development, is intended
to "put us on a fast track toward the goal," said Dr. Seth Berkly, the
group's president. It calls for spending $300 million to $500 million above
current levels over the next nine years.

Berkly announced that the chairman of Microsoft, Bill Gates, and his wife,
Melinda, have pledged $1.5 million to his group's program to set up vaccine
development teams in developing nations.

The U.S. government has increased its commitment to AIDS vaccine research
and is implementing some of the ideas suggested in the critics' report, said
Dr. Anthony S. Fauci, leader of the federal government's AIDS research efforts.

The quest for an AIDS vaccine, first promised 14 years ago by the Reagan
administration, has proved far more difficult than anyone imagined. Many
doubt that researchers can meet the 2007 goal for an effective vaccine set a
year ago by President Clinton.

The reasons are complex, involving scientific, ethical, political and
economic obstacles.

"We're having this debate now because AIDS activists aren't putting on
pressure the way they did to get drugs to save their lives," Essex said.
"And companies that make AIDS drugs are satisfied with the $1 billion a year
they will lose if we had an effective vaccine."

Vaccines against most diseases work by stimulating the production of
antibodies. But recent research suggests antibodies alone will not stop HIV;
and perhaps antibodies will not even be partially protective because the
virus wears a sugar coating to mask the proteins that an anti-body could
recognize.

Moreover, scientists now know that laboratory-grown strains of HIV stimulate
the production of antibodies that are totally ineffective against "wild"
strains recovered from infected patients.

This insight has forced Vax-Gen, manufacturer of the vaccine that entered
human trials last week, to reformulate its product to include components of
a "wild" stain.

But the VaxGen vaccine does not stimulate the immune system defense, called
cellular immunity, with HIV. Thus, many researchers doubt it will protect
people against the virus.

Checked-by: Melodi Cornett