How far are we from an HIV vaccine?

According to Prof. Anthony Fauci, a director in the US National Institutes of Health (NIH), scientists are more optimistic than before. A breakthrough in getting a vaccine for HIV will be the final blow to the virus if the vaccine is effective, safe, affordable and accessible to all. A vaccine would be better than all preventive technologies being studies and processed because it is taken once for a lasting protection. It would have no adherence issues, Fauci says. 

Bill Gates, the founder of Microsoft and one of the big funders of HIV research predicted that the HIV vaccine should be available by 2030. And that it would be the end of the virus that has killed millions in the past three decades.

"When we reach that point, cases will start going down everywhere around the globe for the first time since the disease was discovered more than 30 years ago," Gates said. "We may not see the end of AIDS, but both for malaria and AIDS, we're seeing the tools that will let us do 95-100% reduction."

However, doctors close to research are uncomfortable with a specific time period. It can be longer and it can be shorter, they said. What matters is that people continue using all the available prevention technologies to avoind HIV infection.

Gates expects the vaccine in 15 years because he is excited by the many trials going on in many countries. Researchers are trying new candidates, new systems, new technology and a host of others are learning from trial results details about our immune system and the virus. 

In all these, two developments do stand out as the future hope for an HIV vaccine.

The biggest success in HIV vaccine development so far has been the large-scale study among 16,000 volunteers in Thailand, which demonstrated, for the first time, that an HIV vaccine can provide about 31% level of protection. It was published in 2009. Unfortunately, this is not enough protection to warrant licensing because public health experts generally want a vaccine to protect at least 70% to 80% of people vaccinated. 

Researchers are therefore following up on this study with other trials using an improved Thai vaccine regimen, altered to see if it can be more protective and longer-lasting. The trial, called HVTN 100, is going on in South Africa and the US. If all goes well, the next phase will be another larger trial beginning in late 2016 or early 2017. Dr. Linda-Gail Bekker, who is leading the South African trial, believes it could lead to the first licensed HIV vaccine. She is deputy director of the Desmond Tutu HIV Centre at the University of Cape Town.