The announcement that researchers in Bangkok have completed a trial which shows a 30% reduction in the risk of infection by HIV has been greeted around the world with huge excitement today. Not without reason - scientists have been working hard (and spending freely) on just such a jab for 25 years, and this is the best result they have got so far. The spoils for any drug company that can market an effective HIV vaccine are potentially vast.
But the key word is effective. We do generally like to look on the bright side here at MT, but we can’t help thinking that a vaccine which only provides a 30% reduction in infection isn’t really the answer here. It might even make things worse, encouraging those inoculated to believe they were immune from infection when in reality they were anything but.
The trial – sponsored by the US Army – involved administering a combination of two existing (unsuccessful) vaccine candidates called ALVAC and AIDSVAX, developed by Sanofi Pasteur and VaxGen respectively. Although neither had shown much promise in previous single trials, used in this way – known as a 'prime and boost' strategy – there was a surprise reduction in infection. 51 infections in the vaccine group compared to 74 in the placebo group.
All very good news, as far as it goes. But there’s a lot more work to be done yet. For starters this is only one trial – how replicable will the effect be? And then there’s the little matter of how and why it works – until its mode of action is more fully understood, improving the efficacy is pretty much a case of trial and error. So let’s not call it a vaccine just yet.
From a commercial perspective, the quest for a ‘cure’ for HIV also highlights some of the big questions facing the pharmaceutical sector in the years to come. Despite its prominence in the public mind – largely as a result of the numerous film and TV stars who have sadly succumbed over the years - HIV these days is essentially a disease of the developing world. It’s well on its way to infecting 90m people in Africa alone.
And yet if and when a vaccine or other cure is found and brought to market, the existing big pharma business model – high-margin products for affluent sufferers – more or less guarantees that the vast majority of potential customers won’t be able to afford it.
That’s a lot of business to be turning away, never mind the humanitarian and reputational costs. What to do? Re-engineer an entire global industry to go low-margin, high volume? Or just carry on regardless, maybe subsidising sales in poorer countries with the proceeds from the rich ones? We know which option we think has got the brighter long-term future, but what do you think? Post your comments below.
In today's bulletin:
Jaguar to shut UK plant as Mandelson wades into Opel row
HIV 'vaccine' a false dawn for Big Pharma?
JJB boss has another pop at Ashley - as losses treble
Game Group needs Dan Brown-style saviour
Six million people can't get no (job) satisfaction?