We can win the AIDS war with drugs and vaccines

If we can bail out the banks, surely we can keep up the pressure on HIV

LAST week, the United Nations released what are probably the most optimistic figures on AIDS since the disease was first identified. New infections have fallen drastically, mainly through the use of drugs that can stop people passing on the virus.

Sensing that HIV is finally on the run, AIDS experts have argued strongly that these preventive programmes should be scaled up as rapidly as possible.

A week can be a long time in the politics of AIDS. On the eve of World AIDS Day, news emerged of savage cutbacks in global programmes to supply the drugs.

At a meeting last week in Ghana, one of the biggest programmes, the UN's Global Fund to Fight AIDS, Tuberculosis and Malaria, warned that donors are retrenching. Overall it has only $11.7 billion of the $20 billion it needs: Italy and Spain have failed to pay up for two years. With no choice but to scale back operations, we may lose our best opportunity yet to turn the tide against HIV.

Against this gloomy backdrop comes some unexpectedly good news that serves as a reminder of what is at stake. One of the big disappointments in the three-decade fight against HIV is that we don't have a reliable vaccine. So far only one, called RV 144, has shown any sign of working.

Now encouraging experiments in mice and monkeys suggest that a non-traditional vaccine may work. The idea is to bypass the immune system by injecting muscles with genes that turn them into factories for pumping out potent antibodies against HIV (see "Muscle-based gene therapy beats HIV".

It will take a year or two before the treatment can be tested in humans and there is no guarantee it will work. Even if it does there will be obstacles, as moral panics over the HPV vaccine and religious scaremongering over polio eradication in parts of Africa have demonstrated.

Still the promise is tantalising. It is conceivable that a combination of drugs and vaccine could eradicate HIV altogether. The task will be a lot easier if we keep up the momentum with the tools already at our disposal. A world that bailed out the banks to the tune of trillions surely cannot let AIDS off the hook for the want of a few paltry billion.

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