On the heels of last week’s elating news that scientists finally had a handle on suppressing AIDS with new drugs comes this week’s sobering word: There is no hope for an AIDS vaccine for at least another five years - and the chances even then are slim.
By then, millions of people worldwide appear certain to become infected.
“If we have in hand the product that will be ultimately effective,” said Anthony Fauci, one of the country’s top scientists, referring to an AIDS vaccine candidate currently being tested, “the timetable tells us it will not be ready until 2001 or 2002.”
“And that is if, if, if,” said Fauci, director of the National Institute for Allergies and Infectious Diseases.
Scientists say a vaccine, which prepares the immune system to squash the virus before an infected person gets sick, is the only hope for vast numbers of people across the world.
No major disease has ever been wiped out by therapeutic drugs, which are used to contain disease after a person becomes sick, and most of the developing world couldn’t afford those drugs anyway. Such diseases as polio and smallpox were eradicated because vaccines were developed.
But developing a vaccine that is safe, effective and cheap presents gigantic scientific, financial and social difficulties.
The AIDS virus, the human immunodeficiency virus, is wily. It mutates rapidly. It targets the immune system, which makes vaccination - preparing the immune system for the onslaught of infection - complicated. And there are as many as eight different types of HIV worldwide.
Activism by AIDS victims, understandably, has always tilted toward finding a cure, for a vaccine is of little use to those already infected. And drug-makers in America and western Europe are reluctant to invest in vaccine research because it is difficult and financially risky.
“Trying to get vaccine manufacturers interested is very hard,” said Donald Burke, a scientist at the Army Reed Institute of Research. “If I was on the board of these companies, I would not be interested in making a vaccine for Rwanda.”
Yet, that is precisely where AIDS is going to wreak its maximum havoc: on the Rwandas of the developing world.
By 2000, AIDS will double mortality rates in many parts of Africa - rates that are already eight times as high as in the industrialized world, said Robert Quinn, a scientist at Johns Hopkins University.
In that year, there will likely be around 26 million people infected with HIV worldwide, taking the total number of infections since the epidemic started to 40 million. More than 500,000 actual cases of AIDS have been reported in the United States, and more than 300,000 people have died from the disease.