Creating a supportive environment

Creating a supportive environment for
trials relies on involving community leaders
and members. Community representatives
are critical for designing and conducting
trials – formally, as Community Advisory
Board (CAB) members7 – but also in
the day-to-day interactions they have
with volunteers. Medical and faith-based
leaders are playing growing roles in
educating others and encouraging
support for the trials.Challenges ahead
Despite progress achieved through new
vaccine research partnerships, a
number of challenges remain. Securing
adequate sources of funding for the
long-term effort, as well as efficient and
effective allocation of those resources,
are on-going battles. The private sector
has a central role in providing expertise,
while building upon the strengths of
public sector and academic institutions.
With one or two exceptions, AIDS
vaccine research operates outside of
national AIDS control programmes and
budgeting cycles. Even though there
has been considerable investment in
training, there is still a shortage of human
resources - scientists, clinicians,
laboratory technicians, counsellors and
community mobilizers - to undertake
vaccine research in many countries,
especially in Africa. The current efforts
to scale up programmes should
increase the capacity to run trials; and
the growing number of trials should,
conversely, increase the capacity to
scale up HIV prevention and treatment
programmes.
The ethical standards for trials need to
be strengthened through an integrated
country planning approach based on
national and community partnerships,
and through developing, and compliance
with, clinical, ethical and regulatory
standards. And finally, there is a need
to plan to surmount potential barriers
to AIDS vaccine access, for example
through regulatory and licensing
harmonization, health systems
strengthening, and development of
improved procurement and financing
schemes – in preparation for, rather
than after, a vaccine is found.
No one should have any doubts that
developing and supplying an AIDS
vaccine will both be expensive and
require long-term commitments by
governments and the private sector with
support from civil society, including
faith-based organizations. However,
the tens of millions of HIV infections
averted and the costs saved on AIDS
treatment, care and support will greatly
outweigh such expenditure. While we
may not know when we will have a
vaccine, scientists are certain that one
is possible.
Dr Kate Taylor, Senior Director, Policy
and Advocacy. International AIDS
Vaccine Initiative.