Washington Post looks at NIH-funded HIV vaccine trial in Thailand

The front page of today's Washington Post includes a lengthy story on the controversy surrounding the lone phase III HIV vaccine trial currently underway and details its links to the failed VaxGen trial of a few years ago. No news here, but a good feature recounting the failures of every large-scale trial of HIV vaccine candidate to date. An excerpt:

"For the past three years, such [research subject enrollment] gatherings have been held all over Thailand, exhorting young adults to take part in the largest, most expensive, most resource-intensive AIDS vaccine trial ever. Funded by the National Institutes of Health, it ultimately will involve 16,000 people and last 3 1/2 years.

But as the trial moves forward, at a cost of more than $120 million, some researchers are raising questions about its validity. They disparage its science, question its ethics and doubt its efficacy."

Unlike most large clinical trials in which there is significant confidence that the product being tested will likely be approved for public use, there's almost no one who would claim with a straight face that the vaccine in this trial has any chance of being the vaccine. Even in today's Post story, unnamed NIH scientists attempt to lower expectations, saying that the trial "may reveal new things about HIV" even if the vaccine itself fails.

This may be true, but it's a radically different goal to set for a 16,000-subject clinical trial. The ethical questions of asking for so many research volunteers for this type of exploratory work are many, as are the criticisms from the scientific community that the limited public research dollars for HIV vaccine research could be far better spent.