Brussels, 25 Nov 2004
We need a 'Coca-Cola' therapy for HIV/AIDS: well-known, affordable for all and available in every corner of the globe, said Médecins Sans Frontières (MSF) representative, Ronny Zachariah, speaking at a European Commission roundtable on the challenges of research on HIV/AIDS.
All experts present at the roundtable, which took place in Brussels on 24 November and ahead of the World AIDS Day on 1 December, agreed that with the complexity of developing an HIV vaccine remaining such a huge challenge, it is vital to concentrate on prevention and treatment strategies.
'AIDS is certainly not only a very serious problem, but also a very complex problem,' said Dr Octavio Quintana-Trias, the Director of the Health Directorate in DG research. 'Simplistic solutions do not work and do no exist. So we need, in research as well, to develop an integrated approach. Which means doing research for therapy and for prevention.'
'The only solution to the problem of HIV/AIDS is through research,' added Dr Quintana-Trias. 'We know a lot about the disease but there is still a lot to learn and what we need to learn comes only through research.'
According to Dr Quintana-Trias, the answer lies in bringing those working on HIV/AIDS around the world together in one big consortium.
Michael Hoelscher from the infectious diseases and tropical medicine department of the University of Munich, Germany, agreed that the fight against HIV/AIDS needs a concerted approach. 'However,' he added, 'research is not everything. It is important not to concentrate all efforts on therapy because in the long run it does not help. Don't give up on prevention is the message I want to put across.'
According to United Nations data, five people die of AIDS every minute, and there are an estimated 40 million people currently living with the HIV/AIDS virus, of which 80 per cent are in sub-Saharan Africa.
Means to protect people and prevent them from contracting the disease are still lacking in Africa. This is particularly true for women in the 15 to 24 age group. According to the Commission, in some African countries one in four pregnant women is HIV positive.
'Africa is badly in need of prevention tools against HIV/AIDS,' said Stefano Vella, the Director for drug research and evaluation at the Italian Institute for Health in Rome. 'HIV/AIDS is not only a health problem but also a developing problem. African countries are being destroyed economically by this illness. Even the CIA has described the AIDS virus as a threat to security,' added Dr Vella.
The European Commission is at the forefront of the fight against HIV/AIDS, with joint research projects in Europe and Africa being funded under both the Fifth and Sixth Framework Programmes. The Commission's strategy is to support a multi-annual research programme and to concentrate on the development of safer or new drugs and on preventive strategies such as microbicides and vaccines.
Microbicides are the most promising potential tool for women as their use does not require the male partner to use protection. With women being increasingly diagnosed with the HIV infection that is being spread predominantly through sexual transmission; microbicides will provide women with the means to control their own sexual health. Microbicides are gels or creams that can be applied vaginally or intrarectally to neutralise the HIV virus during unprotected intercourse.
Dr Vella noted, however, that like condoms, the problem of microbicides is acceptability. 'Having the tools is not enough, we need information,' he said, pointing out that one of the key gap areas in prevention is marketing.
Dr Zachariah agreed, stating that on top of carrying out research in marketing strategies, the EU needs to concentrate on operational research and capacity building. 'Delivering treatment on a large scale is one of the main challenges. Furthermore, in the short-term, we also need to develop new and adapted diagnosis tools and patient- friendly drugs, especially for children as current treatments are too complex,' he added.
No vaccine has so far been developed to stop the progression of the disease and out of the 15 drug treatments available, not a single one is able to eliminate the infecting virus from the body. In addition, treatment is expensive and complicated to administer, making it particularly difficult in developing countries.
The Commission is providing funding for research into drug resistance; appropriate treatment for children; new classes of antiretroviral drugs; new approaches and new potential strategies for highly innovative research projects. It has also put a lot of hope into the European and Developing Countries Clinical Trials Partnership (EDCTP), the largest ever programme of clinical trials to have targeted Africa.
Although Dr Vella accepted that it would be a long time, if ever, before a successful HIV/AIDS vaccine is discovered, he applauded the EDCTP enterprise. 'EDCTP is the first example of multilateral action,' he said. 'It is a merging of efforts. It is also the first time HIV/AIDS research has been driven by the Africans. It is a revolution.'
'All scientists know how much effort still has to be made for future affordable vaccines and microbicides,' concluded Dr Quintana-Trias. 'Working hand in hand, focusing on the same objectives, research will be the key to success.'
For further information on the EDCTP, please visit: