HIV/Aids is no longer the death sentence it once was. But while millions of HIV positive people lead healthy and productive lives, we still have nine million people who still cannot access treatment. We also have a long way to go on preventing new infections.
Late last year there was great news: a groundbreaking study confirmed what many people hoped - that early treatment of people who are HIV positive also helps prevent new infections. By starting people on Anti-Retroviral drugs (ARVs) earlier, it reduces the chance of passing on the virus to an HIV negative partner by a massive 96%. In addition, the World Health Organisation (WHO) and UNAIDS combined existing research and evidence to develop a Strategic Investment Framework (SIF) for HIV/Aids that showed that by increasing smart and focused investments now we can turn the tide against this disease and can realistically start talking about the end of Aids.
Or can we? Without a vaccine, will we really be able to beat HIV/Aids? Is our continued investment in vaccine R&D still valid, given this new evidence? Today, on World Aids Vaccine Day, I would like to give seven reasons why we must continue our search for an Aids vaccine even as we push to treat those needing immediate care and support - it's not an either/or, but an and.
One: We need a vaccine because we simply won't be able to eliminate HIV/Aids without one. While some diseases run their course (like a flu epidemic), this won't happen for HIV. The evidence is clear: through vaccines we've been able to eradicate smallpox, are on the brink of eradicating polio, and have massively driven down measles deaths in just a few years. If we're serious about ending Aids, we're going to need a vaccine.
Two: There are no quick fixes, and a vaccine is a critical part of the longer-term response. Even the most optimistic campaigners will admit that mobilizing the billions of dollars to fully fund the Strategic Investment Framework is going to be difficult in the current economic climate, and implementation is going to take some time. This makes working in parallel on the development of a vaccine to get this additional arrow into our quiver even more important.
Three: Vaccines are phenomenally cost-effective public health interventions. By preventing people from getting HIV, we save the cost of treating them and also all of those they would have passed the virus on to. A new paper by the Futures Institute and the International Aids Vaccine Initiative (IAVI), indicates that based today's trends a future vaccine could free up between $46 and $95 billion in averted treatment costs during the first 10 years of its introduction. Rob Hecht and Dean Jamison, with the ReThink HIV project, concluded that investment in the development of an AIDS vaccine could pay itself back twice over under the most conservative assumptions, and by as much as 67 times. Earlier this week, the Copenhagen Consensus think tank came to a similar conclusion. Aids vaccine R&D is a huge value for money investment.
Four: Even a partially effective Aids vaccine would have an enormous impact. Recent modelling from IAVI shows that using very conservative modelling, even a vaccine that was 50% effective and given to only 30% of the population would prevent between 1.5 and 5.2 million new HIV infections between 2020 and 2030, depending on how much of the Strategic Investment Framework is ultimately implemented. These numbers are much higher if the eventual vaccine is more effective or could be distributed widely.
Five: The moment we have a vaccine we know how to get it to the poorest and most vulnerable, quickly. The Global Alliance for Vaccines and Immunisation (GAVI) has proven itself adept at launching new vaccines in the developing world simultaneously as they are launched in the developed world. GAVI has developed innovative financing tools and invests in immunization systems so that the most marginalized communities can be reached. GAVI has also begun to flex its muscle as a purchaser of huge quantities of vaccines to drive prices down. And while there is always room for improvement, the principle of differentiated pricing with developing countries getting reduced and affordable prices for vaccines is already firmly entrenched in the vaccine industry. We can proceed with confidence that as soon as an Aids vaccine is available, the most vulnerable will be able to access it incredibly rapidly.
Six: Aids vaccine research is an investment with benefits for donor nations too. With aid budgets being squeezed almost everywhere but Australia and the United Kingdom, spending that has additional benefits at home is hugely important. Research and development spending, even on a disease such as HIV/Aids, is typically not made from a country's aid budget. In Europe for example, the EC is currently developing "Horizon 2020" - an €80 billion war chest to fuel high-tech R&D within European universities, research institutes, and companies. Investments in cutting-edge biotechnology at home that help build the tools to help us beat killer diseases globally are truly win-win.
Seven: We do this because we should and because we can. Without underestimating the difficulty of developing an Aids vaccine, rapid advances in science hold more promise now than ever before. If JFK was with us today he might say:
We choose to create an Aids vaccine. We choose to create an Aids vaccine, not because it is easy, but because it is hard, because that goal will serve to organise and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win.
JFK's original quote, of course, was a challenge to put a man on the moon - a seemingly impossible feat back in the 1960s. Yet the footprints of the Apollo astronauts will pass above our heads tonight.
We can't wait to get the millions of people who need Aids drugs onto treatment. We can't wait to scale up our response and fully fund the Strategic Investment Framework. But we also can't wait to develop an Aids vaccine - it is simply one of the best investments we can make in the health of the world's people.
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