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The AIDS challenge

Less about a vaccine and more about treatment and prevention

Scientists are no closer today to an HIV vaccine than they were 25 years ago, when the virus that destroys the human immune system was identified. The conclusion, announced last week at a National Institutes of Health conference of AIDS researchers, is a huge blow to everyone — patients, governments, health advocates and researchers — who has looked forward to an effective shield that would help contain the devastating viral infection.

Two human trials of a promising vaccine have been halted since late last year after reviews of the data indicated the vaccine did not protect the recipients but may have made them more likely to contract HIV infection.

Faced with those distressing results, the researchers have made the call, wisely, not to chase shadows. They will refocus attention on basic research and direct more of the available resources to developing approaches that improve current prevention and treatment alternatives. Disappointing as the development is, the failure of the vaccine route does not mean it is a permanent dead-end. Scientific breakthroughs rarely follow a deliberate timetable.

Much has been accomplished globally over the years. We know more about the nature of HIV/AIDS and about treatments and prevention. Total spending on HIV/AIDS has increased, rising between 1996 and 2007 from about $300 million to nearly $10 billion.

Still, HIV/AIDS is a potent global threat, weakening the fabric of societies and economies in many regions. A quarter-century later, the impact of the viral disease remains sobering.

The latest estimates from the World Health Organization and UNAIDS put the number of new infections at 6,800 per day. In 2007, HIV/AIDS claimed 2.1 million lives. More than 33 million people worldwide live with the infection.

The challenge in containing the AIDS pandemic goes well beyond a disappointing quest for a vaccine. The failure emphasizes again that for the foreseeable future, global success in controlling the viral infection will depend on applying the precautions research has taught in 25 years, the simplest of which is to avoid complacence about risky behavior.

Scientists are no closer today to an HIV vaccine than they were 25 years ago, when the virus that destroys the human immune system was identified. The conclusion, announced last week at a National Institutes of Health conference of AIDS researchers, is a huge blow to everyone — patients, governments, health advocates and researchers — who has looked forward to an effective shield that would help contain the devastating viral infection.

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