In an unusually candid admission, the federal chief of AIDS research says he believes drug companies don't have an incentive to create a vaccine for the HIV and are likely to wait to profit from it after the government develops one.
And that means the government has had to spend more time focusing on the processes that drug companies ordinarily follow in developing new medicines and bringing them to market.
"We had to spend some time and energy paying attention to those aspects of development because the private side isn't picking it up," Dr. Edmund Tramont testified in a deposition in a recent employment lawsuit obtained by The Associated Press.
Tramont is head of the AIDS research division of the National Institutes of Health, and he predicted in his testimony that the government will eventually create a vaccine. He testified in July in the whistleblower case of Dr. Jonathan Fishbein.
"If we look at the vaccine, HIV vaccine, we're going to have an HIV vaccine. It's not going to be made by a company," Tramont said. "They're dropping out like flies because there's no real incentive for them to do it. We have to do it."
"They will eventually — if it works, they won't have to make that big investment. And they can make it and sell it and make a profit," he said.
An official of the group representing the country's major drug companies took sharp exception to Tramont's comments.
"That is simply not true. America's pharmaceutical research companies are firmly committed to HIV/AIDS vaccine research and development with 15 potential vaccines in development today," said Ken Johnson, senior vice president of PhRMA, the Pharmaceutical Research and Manufacturers of America.
"Vaccine research is crucial to controlling the AIDS pandemic and our companies are well aware of the need to succeed in this vital area of science," Johnson said.
In an e-mail response for comment, Tramont said the HIV vaccine mirrors the history of other vaccines. "It is not just a HIV vaccine — it's all vaccines — that is why there was/is a shortage of flu vaccines," Tramont wrote.
The quest for an AIDS vaccine has been one of science's biggest disappointments despite billions of dollars and years of research. Part of the dilemma is that such a vaccine must work through the very immune system that AIDS compromises.
The failure in the last couple years of one of the more promising vaccine candidates has bred some frustration.
The United Nations' top HIV/AIDS official acknowledged earlier this year at a conference that it was no longer realistic to hope that the world will meet its goal of halting and reversing the spread of the pandemic by 2015. A British delegate to that conference predicted it might take 20 years before such a vaccine is created.
The International AIDS Vaccines Initiative, a not-for-profit group that is pushing for an AIDS vaccine, said there are more than 30 vaccine candidates being tested mostly on a small scale in 19 counties, but it acknowledges many are pursuing a similar theory of science that may prove futile.
"If the hypothesis is proven incorrect, the pipeline of candidates now in trials will be rendered mostly irrelevant. Strong alternative hypotheses have been largely neglected," the group said.
IAVI estimates total annual spending on an AIDS vaccine is $682 million.
"This represents less than 1% of total spending on all health product development," IAVI said. "Private sector efforts amount to just $100 million annually. This is mainly due to the lack of incentives for the private sector to invest in an AIDS vaccine — the science is difficult, and the developing countries that need a vaccine most are least able to pay."