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At the end of the article the author asks `"After all, can you think of any other U.S. enterprise that has been
studied and investigated for 25 years and on which many billions of
dollars have been spent without any results?"

The answer is a resounding "yes" -- cancer research!

Mike




http://www.latimes.com/news/custom/scimedemail/la-oew-khanlou25apr25,0,7034531.story


From the Los Angeles Times


BLOWBACK


No results? No research money.


When even scientists acknowledge that 25 years of research
haven't born any fruit, it's time to stop searching for an AIDS
vaccine.


By Homayoon Khanlou and Michael Weinstein



April 25, 2008



The search for an AIDS vaccine has lost its scientific purpose and
turned into a self-serving quest.


How else to explain the remarks found in David Baltimore and Seth
Berkley's "Keep funding the AIDS vaccine"? Saying simply that
"AIDS vaccine development is hard" is not a credible
response to recent criticism leveled at the ballooning U.S. budget for
AIDS vaccine research and the meager results it has produced. The
argument is particularly weak when you consider that nearly $1 billion
in public funding is poured annually into this fruitless quest, while
millions globally lack access to the revolutionary, life-saving AIDS
treatment that was developed more than 12 years ago: antiretroviral
medication.



The recent Merck vaccine trial that Baltimore and Berkley mention was
not only a failure, it actually endangered lives by increasing the
likelihood that study participants would contract the virus. The Merck
trial was also not an anomaly. There have been 25 years of repeated
AIDS vaccine failures at high cost to taxpayers. To call for more
human clinical research -- as Baltimore and Berkley do -- defies
common sense and endangers lives. Important insights into the basic
mechanisms of the virus and the human body's response to it are still
missing. So where is the science to back up their call for more money?
And can such an expense be justified if measured in human lives lost
because of lack of access to treatment that can cost as little as 50
cents a day?



The best way to break the chain of infection is to prevent an infected
person from passing it on to others. A number of extraordinarily
effective approaches to achieve this already exist. The spread of
infection would be significantly curbed if we focused primarily on the
source of all new infections: the 33 million people who are currently
estimated to be carrying the virus. Effective pre- and/or
post-exposure prophylaxis treatments are an example of a possible
approach. A focused antiretroviral pre-prophylaxis effort in high-risk
populations, such as commercial sex workers, would be a highly
cost-effective way to prevent the spread of infection.


There is also mounting evidence to demonstrate that patients with
undetectable viral loads -- achieved through antiretroviral treatment
-- have a much lower rate of transmission, perhaps a rate even lower
than could be achieved with a successful vaccine. Still, these
lifesaving drugs are currently unavailable to all but the smallest
fraction of the people who need them. What might a nearly $1-billion
annual investment in the worldwide scale-up of antiretroviral
treatment buy in terms of transmissions prevented?


In a post-Merck-failure research climate, the scientific
community has come to a consensus: an investment in basic science is
needed. Such research does not require the enormous, and enormously
expensive, global clinical trial apparatus currently in place for AIDS
vaccine research. In fact, according to recent reports,
researchers with Berkeley's International AIDS Vaccine Initiative and
the Center for HIV/AIDS Vaccine Immunology -- employing funds from the
U.S. HIV vaccine research pot -- plan to focus on such areas of basic
science research as the genetic sequencing of new HIV viruses, an
investigation into how genetic factors might control HIV infection and
inquiry into the possible reasons why some people exposed to HIV do
not progress to AIDS. However, the U.S. government already allocates
several billion dollars a year to funding basic AIDS research. So what
is the purpose of setting aside another $1 billion annually under a
separate HIV vaccine research umbrella?


To date, there has been no evidence that there will ever be an
AIDS vaccine. In fact, in apoll of more than 35 top HIV/AIDS scientists in Britain
and the U.S. conducted by Britain's Independent newspaper and
published this week, "nearly two-thirds believed that an HIV
vaccine will not be developed within the next 10 years" and a
"substantial minority of the scientists admitted that an HIV
vaccine may never be developed."



Resources are not limitless. To date, there has been no evidence that
there will ever be an AIDS vaccine. It is time for an honest
reassessment of funding priorities and a redeployment of resources
into delivering antiretroviral medications to the people who need it.
It is time to pull the plug on U.S. public funding for HIV vaccine
research.



After all, can you think of any other U.S. enterprise that has been
studied and investigated for 25 years and on which many billions of
dollars have been spent without any results?


Homayoon Khanlou, MD, is chief of medicine, U.S., and Michael
Weinstein is president of the AIDS Healthcare
Foundation.
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