Today is World AIDS Day, another year has passed, steady progress has been made, and I feel a growing sense of guarded optimism.  Certainly from the standpoint of treatment, a single pill once a day is now reaching almost two thirds of people in need worldwide, and the injectable long duration ART is on the horizon, with promising initial results.  Advances in the cure field have been buoyed by studies in animal models showing dramatic reduction in viral loads with administration of broadly neutralizing antibodies, and human trials are planned and underway.   In addition to these exciting data on broadly neutralizing antibodies, new data suggest that T cells can play a key role, and non-neutralizing antibodies as well.

 

But we remain far from the goal.  The challenges of an HIV vaccine, in my opinion the only real solution to the global epidemic, remain daunting.  Although pathways to development of broadly neutralizing antibodies have been uncovered, the ability to elicit these with immunization remains elusive  and much is yet to be learned about the very basics of vaccinology, from B cell to T cell to dendritic cell to innate immune responses that will allow us to add both preventive and therapeutic HIV vaccines to the arsenal.

 

We have been blessed with incredible talent and resources to play a leading role in the global effort to end the HIV epidemic, and have the facilities to work effectively as a team in the best biomedical environment on the planet.  On the optimistic side, in the coming year we will see clinical trials of candidate HIV vaccines from the Ragon/BIDMC moving forward.  Other vaccine candidates in development will be tested, and clinical grade broadly neutralizing monoclonal antibodies will be ready for human trials.  New faculty recruits over the past year, and others to come, will expand the team in important new directions.

 

We have done well with what we have been given and the team we have built, but we must believe that we can do much more, and we must do it.  The prospect of emerging drug resistance means that we cannot act fast enough.  As the world acknowledges the gains made and the lives lost since the first cases were reported in 1981, now 33 years ago, let us redouble our efforts to accelerate progress each and every day.

 

Best regards and many thanks for being part of this effort,

 

Dr. Bruce Walker