Twenty years ago, as a resident of San Francisco, I watched the heart-wrenching effects of the AIDS epidemic on that city. I decided to study nursing and get involved in prevention efforts. Ultimately, the work led me to Africa, where for more than a decade, I advocated for extensive prevention education programs and access to treatment.

While living in Africa, I tested positive for HIV. Today, I am on antiretroviral treatment and doing very well, and I hope that one day every HIV-positive person in the world will have access to the treatment he or she needs. My diagnosis did not change my unwavering commitment to HIV prevention. But I moved to AIDS vaccine research when current prevention methods failed me. I simply don’t want others to go through what I have gone through. Nearly 7,400 people are infected with HIV every day. For every two people who start treatment, five more are newly infected.

Today is World AIDS Vaccine Day – 13 years to the day when former U.S. President Bill Clinton stated, “Only a truly effective, preventive HIV vaccine can limit and eventually eliminate the threat of AIDS.” Some of the world’s top scientists have been working for decades to design such a vaccine—but it was not until this past year that we knew it was a definite possibility.

Results from a vaccine trial in Thailand—a joint project of the Thai and U.S. governments—showed for the first time that it is possible to reduce the rate of HIV infection in humans through vaccination. Scientists at the organization I work for – the International AIDS Vaccine Initiative (IAVI) – were part of another major advance in the quest for a widely effective AIDS vaccine. They discovered two powerful new antibodies to HIV and also found the site on the virus to which they attach. This site provides researchers a promising new model for vaccine design.

These discoveries and the Thai trial results are thrilling—and I feel confident that we’ll be able to develop an AIDS vaccine. But what really drives me is the altruism that I came across during my 12 years in Africa and that I still hear today. I remember talking to a volunteer who had just found out that he was living with HIV. He had signed up for a study of early immunological markers in HIV infection, a project that could benefit vaccine development. When I asked him why he was doing this, he simply said, “I have seen too many people die, and this is all I can do. I want to be able to tell my children that I did something.”

If you would like to find out what you can do, visit IAVI’s website at www.iavi.org. I really appreciate the dedication of ONE members to fighting global poverty and disease, and I hope you will join us at IAVI in the effort to deliver a major blow to both by delivering an AIDS vaccine!

-Andrea von Lieven is a Clinical Program Manager at the International AIDS Vaccine Initiative (IAVI). She is based in Berlin.

For almost thirty years, the idea of an AIDS vaccine has been sustained by a combination of hope and tireless research. Now, recent scientific developments have reenergized the AIDS vaccine field– including the results of a recently completed AIDS vaccine trial in Thailand proving an AIDS vaccine is possible and the discovery of new powerful antibodies capable of neutralizing the HIV virus.

Although we don’t know when we will have an effective AIDS vaccine ready for licensure, it’s important to start thinking about how a future AIDS vaccine can be incorporated into the fight against AIDS and what the impact might be on the pandemic.

To better understand the game-changing effects of an AIDS vaccine, we at the International AIDS Vaccine Initiative (IAVI) worked with the Futures Institute to develop a mathematical model to forecast the potential impact of a future AIDS vaccine with different levels of efficacy and population coverage.

We then worked with partners in highly-impacted countries with representative epidemics – Kenya, Uganda and Brazil – to apply the model. We also applied the model to the global pandemic. And, we have just started a new project in China.

The findings to date show the tremendous impact AIDS vaccines could have in those hard-hit countries, and, by examining various vaccination strategies, give policymakers a better understanding of how to use a future AIDS vaccine.

For example, according to the model, an AIDS vaccine that is only 50% effective and given to 30% of the global population between 2016 and 2030 would avert 5.6 million (or 24%) of global infections, even if all other existing HIV prevention and treatment strategies were universally availa ble. An AIDS vaccine could avert an even larger number of HIV infections if universal access goals are not met, and a more effective vaccine could have an even bigger impact on top of that.

That’s at least 5.6 million people in this world who wouldn’t need to be put on AIDS treatments for the rest of their lives, and who wouldn’t need to worry about passing the virus on to others.

You can read brief papers on our impact modeling projects by clicking on the following links:

• Estimating the Impact of an AIDS Vaccine in Developing Countries
• Uganda: Estimating the Potential Impact of an AIDS Vaccine
• Kenya: Estimating the Potential Impact of an AIDS Vaccine

There are two main challenges to developing an AIDS vaccine. The first is scientific. IAVI and affiliated researchers, along with others from around the world, are relentlessly focused on building on the recent advances. The second challenge is sustaining financial and political support for AIDS vaccine development. To meet that challenge, we need the help of advocates and activists to engage funders and policymakers to keep the AIDS vaccine mission vital.

You can find out more about what we do at the International AIDS Vaccine Initiative by clicking on this link to visit our website: IAVI. You can also learn more by checking out a recent ONE Q&A with IAVI.

Tell me a bit about IAVI?

Our name stands for International AIDS Vaccine Initiative. We were founded about 13 years ago to help accelerate the development of a preventive AIDS vaccine. I think our mission really describes us well: ensure the development of safe, effective, accessible, preventive HIV vaccines for use throughout the world. We work on every aspect of HIV vaccine development, from work in the lab developing new AIDS vaccine candidates for testing to work with the communities to then test the AIDS vaccine candidates.

What’s a typical day like there?

It really depends on what your role is and where you are based. If you’re a nurse in India, you could be giving a vaccine to a trial participant. If you’re a nurse in South Africa, you could be drawing the blood of a trial participant to see what kind of immune responses the vaccine elicited. In East Africa, a clinician could be administering an HIV test for someone who wants to participate in an epidemiology study. In New York, a scientist could be studying blood samples from HIV positive people to look for clues on how to control the virus.

How do you decide where to test for the vaccine?

We usually look for partners that have a solid background in research—universities, medical labs—and in places where we know the epidemic is severe. There has to be community acceptance and desire to do the research, too. So far, we’ve worked in places from Zambia and South Africa to East Africa to India.

Have you been on the ground to see IAVI’s work in action?

I see our impact the most when I visit our partners who are conducting studies. Each research center has a Community Advisory Board (CAB). It’s made up of people from all parts of the community—people who have HIV and want to protect their families, people who participated in trials before, the clergy, mothers and fathers. They make sure the community has a voice and that their concerns are heard. It’s a great experience because you really get to see how HIV has affected each one of them. It’s a big commitment—but they want this to work and they want the research to advance.

Did anyone’s story really stick with you?

I met one CAB member who was a young woman—probably in her early twenties—and just a regular member of the community. She was HIV-infected and had a family. She was very soft-spoken—quite shy—but she really wanted to be on the Community Advisory Board. She didn’t need to make this commitment—she was newly diagnosed, had a new baby, English was not her first language, and many other people on the board had a higher level of education. But her dedication said a lot. She stuck her neck out so that she could help others.

It’s seems like there’s been lots of exciting news for your organization lately. For instance, the results of the trial in Thailand? I heard it was a hot topic at the recent AIDS vaccine conference in Paris.

Although IAVI was not directly involved in the RV144 trial in Thailand, the results were very exciting for us and others in the AIDS vaccine field. The results showed for the first time that a vaccine could prevent HIV infection in humans. The vaccine combination reduced the risk of HIV infection by about 30 percent. That’s a big deal. But we need to do—and we can do—better.

In other exciting news, IAVI and several partners discovered two new broadly neutralizing antibodies. Now we have to learn as much as possible about them to help us figure out how we can make a vaccine that will cause the antibodies to be produced in the body and prevent HIV from taking hold in the first place. It’s important to let people know how excited we are about these recent advances. It validates a lot of what we’re doing. It tells us we’re on the right track.

How did you first get interested in studying HIV/AIDS?

I’m a physician. I went to med school in San Francisco in the early 1990’s. I spent a lot of time learning how to care for people dying from AIDS. It was such a huge part of medicine then.

Things have changed drastically in those hospitals today—but there are still many parts of the world where it looks just like the hospital where I did my med school training. I’ve lived and worked in Africa and I’ve seen a lot of what HIV can do when there is not enough treatment available. To me, in the long run, a vaccine is the only solution. Treatment and other types of prevention are really important, but I think a vaccine is the real answer. I love helping people with HIV— and I’m happy to work on a vaccine if it means less people in the world have to live with the disease.

So how close do you think we are to an AIDS vaccine?

I don’t have the answer to that. I wish I did. It’s been very difficult so far—largely for scientific reasons. HIV is a retrovirus, which can mutate and change very quickly. What that means is that it’s hard to develop an effective vaccine because the virus is constantly mutating and changing to avoid detection by the immune system. They change the make-up of the flu vaccine every year—but the AIDS virus can change every day. There are some exciting glimmers of hope, which is really motivating. And we probably know more than we’ve ever known today. So it’s false to say we’re close, but we’re going to keep moving ahead.

We must continue to extend current prevention, care and treatment options to as many people as possible to mitigate AIDS here and now, but we must also invest in the future to bring the epidemic to an end. Continued investment in prevention research, to include new tools like vaccines, microbicides and pre-exposure prophylaxis (PrEP), will produce net savings in the long term – and save lives.

In fact, only vaccines have historically ended major viral epidemics. They are proven to be cost-effective and practical. There will be an AIDS vaccine in our lifetime, and we must continue the search.

So today, on HIV Vaccine Awareness Day, I urge you to become informed about AIDS vaccine research. We all have a role to play whether it is as advocates, volunteers, health professionals or researchers.

• Checkout NIAID’s information hub around HIV Vaccine Awareness Day
• The International AIDS Vaccine Initiative (IAVI) has a new website, which features an interview with Dr Anthony S. Fauci (Director, NIAID)
• Global Health TV recently posted four interviews with leading AIDS advocates about their commitment to finding an AIDS vaccine
• IAVI President & CEO, Seth Berkley, recently gave a talk at the Center for Strategic and International Studies (CSIS) as part of their Global Health Policy Center’s speaker series

For those of you reading this blog who are already involved – today (and every day) is an opportunity to say thank you!

-Nicole Schiegg, International AIDS Vaccine Initiative–Washington, D.C.

Dr. Seth Berkley, IAVI’s President and CEO, blogged yesterday “that the Obama administration should extend its fervor for science to its foreign aid policy, putting science and technology at the heart of U.S. assistance to the developing world.” The full post can be found here.

For those of you in the Washington, DC area today, May 11th please come listen to leading African scientists talk about the novel research they are doing to help advance AIDS vaccine science. The Global Health Council, the International AIDS Vaccine Initiative (IAVI) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) are co hosting a congressional briefing on Capitol Hill at 2 PM in the Dirksen Senate Office Building, Room 419. For more information, please contact: Sara Jane Muratori at smuratori@iavi.org.

If you are not in DC, please checkout Global Health TV. Leading AIDS advocates share their commitment to finding a vaccine: Dr David Kihumuro Apuuli, director-general of the Uganda AIDS Commission and Dr Seth Berkley, IAVI. Additional interviews will be posted leading up to HIV Vaccine Awareness Day.

-Nicole Schiegg, International AIDS Vaccine Initiative – Washington, DC