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September 2004 NORA Discusses Vaccine Research and the “Bangkok Conference” On Monday, September 13, the National Organizations Responding to AIDS (NORA), for which AIDS Action serves as the convener, held its monthly meeting, which featured a discussion of the role vaccines play in efforts to reduce HIV transmission as well as some commentary on the July 2004 XV International AIDS Conference held in Bangkok, Thailand. Peg Willingham from the International AIDS Vaccine Initiative (IAVI), who serves on the NORA Executive Committee, introduced the two featured speakers: Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition (AVAC)—an international organization working to enhance HIV vaccine research and development—and Michael Carrigan, government affairs associate for AIDS Action. Mr. Warren opened his remarks by observing a curious irony of HIV prevention. For sexually active individuals, condoms are the best prevention, he noted, yet no one wants to use them. When it comes to a preventive vaccine for HIV, though, “everyone wants to use it, even though it doesn’t exist.” Building on his observation, he cautioned that “waiting for the magic vaccine, the magic bullet…is quite naïve—and for a number of reasons. For example, even though there are there are 22 HIV vaccine products currently in development, an effective vaccine is still years if not decades away—making it unrealistic in the mean time to reject other prevention methods. Moreover, developing a vaccine is only the first step in the long and complicated process of “getting it into people’s arms.” He reminded NORA coalition members the work that has been required to provide anti-retrovirals to individuals worldwide, which he suggested was a comparable challenge to supply vaccine. “We learned a lot about treatment roll out,” he reminded, “and it’s not easy.” For these reasons, Mr. Warren advocates a comprehensive approach to HIV prevention, which would include a shift in attitudes about HIV vaccines. He suggested that vaccines be considered as one option rather than only option for prevention. “As soon as we get into the rhetoric of my solution or yours, we lose,” he warned. “We need additional options but not replace one option with another.” His suggested comprehensive approach includes increased use of existing resources such as male and female condoms, anti-retroviral medications, and counseling. He also stressed the importance of research into microbicide development. (The Alliance for Microbicide Development defines a microbicide as “a range of products, potentially in gel, cream, film, or suppository form, being developed to prevent the transmission of HIV and other sexually-transmitted infections when applied topically [to the vagina or anus].”) However, here again, Mr. Warren stressed that when a successful microbicide is invented and distributed, it too must complement, not supplant, other HIV prevention tools. Michael Carrigan followed Mr. Warren’s remarks with some commentary on the International AIDS Conference. According to Mr. Carrigan, he had attended the conference with two other AIDS Action staff members; however, his comments reflected his own personal views and not necessarily those of AIDS Action. Mr. Carrigan was emphatic about the importance of U.S. non-governmental organization (NGO) representation at the conference. He explained, “The U.S. is a part of the globe and we therefore cannot continue to neglect the importance of the domestic epidemic in the ‘global HIV crisis.’” Mr. Carrigan went on to urge NORA members to contemplate and then answer for themselves the question, “What have been the outcomes of the international conference, which boasted “Access for All” as its theme? In closing, he mentioned an inherent contradiction he had perceived in the conference’s theme when comparing it to the content of its program. In many key speeches, he noted, national leaders emphasized that HIV is a disease concentrated in certain “high risk” populations and, in doing so, they subtly placed a division between HIV and the “general” population. He asserted that leaders and advocates must reject this misconception, because it makes people think they are not vulnerable to infection and increases stereotyping as well as prejudice and discrimination against HIV positive individuals. For more information about the information contained in this article, readers can access the following resources: The AVAC Web site at http://www.AVAC.org. and the July 30 Special Edition of The Weekly Update on the XV International AIDS Conference at http://www.aidsaction.org/communications/weekly_updates/073004/index.htm. For more information about NORA, e-mail Jessica Tytel at jtytel@aidsaction.org. |
