Essex Criticizes AIDS Drug Research

The chair of the Harvard AIDS Institute attacked the direction of current AIDS research in a recent article, charging that drug companies neglect preventative vaccines in favor of more profitable therapeutic treatments.

In an article in this month's issue of Technology Review magazine, Max Essex criticizes research's overemphasis of corporate profit margins and lack of clinical studies in developing countries.

"Existing treatments cost tens or hundreds of thousands of dollars per person, yet they purchase just one or two more years of life," he wrote. "By contrast, a vaccine to prevent HIV infection would save not only lives but also money, costing $100 or less to administer."

Biotechnology companies can make more money from drugs that will be used recurrently by AIDS patients than by developing preventative vaccines that would be used only once, Essex said in an interview yesterday.

"U.S. trials have been more targeted towards therapeutic intervention as opposed to preventive infection," he said.

Essex's article also charges that there is little financial support for research targeting the needs of underdeveloped countries.

"You can accomplish a lot more doing trials in the third world," Essex said.

Preventative vaccines should be based on HIV subtypes found in Africa and Asia...Testing prototypes in countries where HIV is spreading rapidly could significantly reduce the amount of time it will take us to arrive at a workable HIV vaccine," he wrote.

Tun-Hou Lee, professor of virology at the School of Public Health, said yesterday he agrees with Essex's assessment of the value of AIDS medicine trials in underdeveloped countries.

[Researching vaccines in this country] is extremely expensive and inefficient," said Lee, who researched an AIDS vaccine that is currently undergoing pre-clinical analysis.

"In developing countries there is a higher instance of infection [thus] vaccines can be tested in a broader population with a greater degree of certainty," he said.

Essex said he attributes the lack of necessary vaccine research in developing countries to "international communication and global health economics where this scientific vaccine development dichotomy is not realized."

Partially because of corporate interests, researchers rarely developing vaccines in less-profitable developing nations, he said.

"In a case like [AIDS] there are benefits for the West [in doing research in developing countries] but they are not immediately translated to single companies who are the ones to make the venture progress direction," he said.

Essex said he feels that the solution to directing AIDS research towards vaccine trials in developing countries lies with not-for-profit international health organizations.

"I think that the thing most likely to happen is that an agency such as the World Health Organization (WHO) or the United Nations would get together with the countries of the West and convince them that they need some coordinated plan," he said.

Jose Barzellato, formerly of WHO and currently director of reproductive disease research at the Ford Foundation, said he agrees with Essex's assessment of the AIDS research problem.

"In general there is a greater need for more research in developing countries," Barzellato said. "WHO, the Ford Foundation, and the Rocke-feller Foundation have been promoting the development of local scientists [in underdeveloped countries] for years.

Tun-Hou Lee, professor of virology at the School of Public Health, said yesterday he agrees with Essex's assessment of the value of AIDS medicine trials in underdeveloped countries.

[Researching vaccines in this country] is extremely expensive and inefficient," said Lee, who researched an AIDS vaccine that is currently undergoing pre-clinical analysis.

"In developing countries there is a higher instance of infection [thus] vaccines can be tested in a broader population with a greater degree of certainty," he said.

Essex said he attributes the lack of necessary vaccine research in developing countries to "international communication and global health economics where this scientific vaccine development dichotomy is not realized."

Partially because of corporate interests, researchers rarely developing vaccines in less-profitable developing nations, he said.

"In a case like [AIDS] there are benefits for the West [in doing research in developing countries] but they are not immediately translated to single companies who are the ones to make the venture progress direction," he said.

Essex said he feels that the solution to directing AIDS research towards vaccine trials in developing countries lies with not-for-profit international health organizations.

"I think that the thing most likely to happen is that an agency such as the World Health Organization (WHO) or the United Nations would get together with the countries of the West and convince them that they need some coordinated plan," he said.

Jose Barzellato, formerly of WHO and currently director of reproductive disease research at the Ford Foundation, said he agrees with Essex's assessment of the AIDS research problem.

"In general there is a greater need for more research in developing countries," Barzellato said. "WHO, the Ford Foundation, and the Rocke-feller Foundation have been promoting the development of local scientists [in underdeveloped countries] for years.