“An HIV vaccine has escaped the innovative scientific community with good reason: the HIV virus is both complicated and evasive….Yet, recent clinical trials of an mRNA vaccine offered promising early-stage results.”
June marked the 40th anniversary of the first reported AIDS case. On the anniversary, UNAIDS released a strategy to end HIV/AIDS by 2030, a goal that seemed unthinkable over 40 years ago. Yet since 1981, the innovative scientific community has delivered a series of treatments that revolutionized the outlook for HIV/AIDS patients.
Those early days of 1981 were not unlike what we experienced with coronavirus last spring. Hospitals began to see cases of a mysterious pneumonia with few options for how to treat it, just as physicians across the country struggled to identify effective treatments for COVID-19 patients last March. Indeed, Dr. Anthony Fauci – who dedicated 40 years of his career to combatting HIV/AIDS – recalled “the first few years were the darkest years of my medical career, because I was working countless hours taking care of desperately ill young men.”
In the 1980s and 1990s, just as it did through the COVID-19 pandemic, the science delivered solutions to help get us through the darkest days. By 1986, the innovative community discovered the first therapy that could be used effectively to combat HIV with AZT, though it was not without limitations. Scientists quickly learned that the virus rapidly developed resistance to the treatment, rendering it less effective than initially hoped.
Since that time, through incremental innovation, scientists and clinicians continued to refine the treatment, reducing the regime of pills patients must take from 28 pills a day to just one. More recently, the innovative scientific community developed a highly effective prophylactic drug, PrEP, which reduces a person’s risk of contracting HIV by 99%. Taken together, these developments turned a virus that was previously a death sentence into the equivalent of a chronic disease.
Yet, despite these technological advancements, an estimated 1.5 million individuals are newly infected with HIV each year, and 37.6 million people globally are living with HIV, according to UNAIDS. Over 40 years into the HIV/AIDS epidemic, the one major advancement that has eluded scientists continues to be a vaccine. And this is where the mRNA technology unleashed during the global pandemic may offer hope.
mRNA Delivers the Light
An HIV vaccine has escaped the innovative scientific community with good reason: the HIV virus is both complicated and evasive. Dr. Fauci noted that the challenge with HIV lies in the fact that the virus mutates quickly and rapidly integrates into the genomes of cells. Yet, recent clinical trials of an mRNA vaccine offered promising early-stage results.
In February 2021, the International AIDS Vaccine Initiative (IAVI) and Scripps University in California announced the results of their Phase I trial of an mRNA HIV vaccine candidate. The study found that the vaccine lead to the production of rare immune cells needed to create antibodies against HIV.in 97% of participants. IAVI and Scripps now plan to partner with Moderna – the newest household name in the mRNA field – for additional clinical trials to further refine the technology.
Through the journey to develop effective therapeutics and – hopefully soon a vaccine – for HIV, we learned many of the same lessons as we did in the quest for treatments and vaccines for COVID-19. In both the early 1980s and now, we were surrounded by darkness and uncertainty as to how to handle the viruses; and yet, the science delivered the light.
Both the evolution of treatments for HIV/AIDS and response to the global pandemic shed light on the transformative power of innovation and America’s thriving innovation ecosystem, empowered by public-private sector collaboration. Over the last year, the biopharmaceutical industry, academic community, the government, and non-profit sector condensed every avenue for innovation into one: defeating COVID-19. That partnership resulted in multiple effective vaccines in less than a year’s time. This success gives us new hope that, working together, organizations like IAVI, Scripps University, and Moderna may be able to make concrete progress towards the ever-elusive HIV vaccine, building off of the lessons learned on the application of mRNA during the global pandemic.
But perhaps the biggest lesson we learned was that innovation, at its best, is always incremental. The science behind the revolutionary mRNA vaccines dates back to the 1990s. Scientists tried – and failed – for decades to harness the power of mRNA. On the backs of those failures, the innovative community was able to identify and refine what the technology could be effectively used to combat: COVID-19.
Strong Legal Frameworks are Key to Success
It is clear that working together, we can achieve more. But we need the right legal and regulatory framework in place to do so. Effective intellectual property (IP) protection supports America’s thriving innovation ecosystem by providing the legal certainty that high-risk, high-capital innovations will be protected.
Yet, Congress has recently taken steps to undermine this framework through legislation imposing foreign price controls on medicines, which could endanger the future of the United States’ innovation ecosystem. America’s leadership in biopharmaceutical innovation is rooted in its system of market-based pricing for medicines and long-standing respect for IP protections. The U.S. free market system and strong IP framework have enabled the private sector to thrive by creating incentives for innovators to invest in the research and development (R&D) of new medicines in the United States. Never before has the value of the U.S. system been so clear, with multiple effective vaccines discovered and delivered across the country in less than a years’ time.
With the right framework in place, the innovative community can deliver life-changing solutions to the next generation of medical challenges. We are on the cusp of the development of countless new technologies to tackle previously untreatable conditions, be it an HIV vaccine, effective treatments for Alzheimer’s, or new therapeutics to combat historically untreatable cancers. It is imperative that Congress continue to support America’s innovation ecosystem and the public policies which built it if we are to conquer future medical challenges.
The Goal is in Sight
As for the future of HIV, new annual HIV infections have fallen 73% between 1981 and 2019, according to the U.S. Center for Disease Control and Prevention. And while that 73% decrease is impressive, we know it’s not good enough.
The innovative scientific community won’t stop until the number of new cases gets to zero.
The goal of defeating HIV/AIDS by 2030 is a mere nine years away, and it is still early days in the development of an mRNA HIV vaccine. But with the promise of the technology unleashed during the pandemic, we think that goal may very much be in sight.
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