U.S. belt tightening could hit AIDS efforts - official

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A tighter 2006 budget for the National Institutes of Health could force the world’s No. 1 funder of medical research to pull the plug on some AIDS research and other projects that don’t prove their value, a top official said on Monday.

The Bush administration’s 2006 budget calls for a $163 million, or 0.5 percent, increase in the NIH’s $28.8 billion budget, said Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, or NIAID. That compares with a doubling of the overall budget between 1997 and 2003.

"Our belt is being tightened for us,” Fauci told a news conference at the American Association for the Advancement of Science, saying that may hit AIDS vaccine research especially hard.

The Bush administration has proposed its tightest budget as it seeks to curb budget deficits that have soared on its watch.

Fauci said AIDS vaccine trials would have to meet certain intermediate goals, or “milestones,” to get continued funding and may be stopped partway through to concentrate on more promising research.

“Through the years, HIV/AIDS (research funding) has usually done at least as well as and usually better than other diseases,” Fauci said.

“However, as we now approach ‘06, ‘07, ‘08 and ‘09, it has become clear that not only will there be a less than 2 percent increase in the NIH budget, that the previous largess that was associated with all research, particularly HIV, is now not going to be a reality for the future.”

Fauci said the heads of NIH institutes such as his had been told to reexamine the entire research portfolio.

That will mean working even more with private industry and groups such as the nonprofit International AIDS Vaccine Initiative to get “the most bang for the buck,” Fauci said.

That will also mean setting milestones for clinical trials, such as many of the ongoing AIDS vaccines trials. Those that don’t show early results could be shut down, he said.

PAYING FOR THE GROUNDWORK

NIH provides or pays for much of the basic research that leads to the development of drugs, vaccines and other treatments. Those are eventually licensed to private companies to turn into marketable products.

Fauci said of the $600 million or so being spent globally to develop an AIDS vaccine, $520 million was being spent by NIH and perhaps $60 million more was being spent by the U.S. Department of Defense. Groups like IAVI make up almost all the rest.

NIAID was also looking hard for areas of overlap and redundancy, for instance with the Centers for Disease Control and Prevention, Fauci said.

That may mean cutting back some AIDS vaccine research, even though virtually all health experts agree a vaccine will be the only way to stop the pandemic. Fauci said that was a difficult decision because, although there were 30 AIDS vaccine trials ongoing in people, no one was very close to having a vaccine that would prevent infection.

Vaccines against measles, mumps, polio and other viruses cause the body to produce antibodies—immune system proteins that attack invaders.

No AIDS vaccine does that and the current candidates being tested affect another arm of the immune system—the so-called cellular response in which immune cells called T-cells recognize and destroy infected cells.

Experts hope an eventual AIDS vaccine will provoke both responses, preventing infection and stopping the virus from spreading in the body.

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