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Shots in the Dark: The Wayward Search for an AIDS Vaccine
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Excerpted from From the New England Journal of Medicine, June 7, 2001
"Cohen believes that a major obstacle to the successful development of a vaccine has been the domination of the field by "reductionists'' (mostly virologists) who are interested primarily in understanding the pathogenesis of HIV infection and the interaction of the virus with the immune system. Cohen also cites other obstacles. These include a lack of interest on the part of major pharmaceutical companies in developing an AIDS vaccine because of concern about liability and profit; disagreements about the relevance and importance of animal models; differing views regarding what a vaccine could achieve (prevention of infection vs. protection of the already-infected from disease); ethical problems related to the design of placebo-controlled trials and the treatment of vaccinated persons who became infected during the trials; and the limited interest among industrialized countries in supporting vaccine research.
Cohen argues that this wayward search for an AIDS vaccine could have been avoided through the centralization of leadership and the unification of direction from the outset, along the lines of the March of Dimes model that was so successful in the development of a poliovirus vaccine. Such leadership would have designed a master strategy to deal with the obstacles to vaccine development, rigorously compare vaccine strategies, and follow up promising leads... "
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"Cohen believes that a major obstacle to the successful development of a vaccine has been the domination of the field by "reductionists'' (mostly virologists) who are interested primarily in understanding the pathogenesis of HIV infection and the interaction of the virus with the immune system. Cohen also cites other obstacles. These include a lack of interest on the part of major pharmaceutical companies in developing an AIDS vaccine because of concern about liability and profit; disagreements about the relevance and importance of animal models; differing views regarding what a vaccine could achieve (prevention of infection vs. protection of the already-infected from disease); ethical problems related to the design of placebo-controlled trials and the treatment of vaccinated persons who became infected during the trials; and the limited interest among industrialized countries in supporting vaccine research.
Cohen argues that this wayward search for an AIDS vaccine could have been avoided through the centralization of leadership and the unification of direction from the outset, along the lines of the March of Dimes model that was so successful in the development of a poliovirus vaccine. Such leadership would have designed a master strategy to deal with the obstacles to vaccine development, rigorously compare vaccine strategies, and follow up promising leads... "
Click here to purchase the Paperback through Amazon.com.
Click here to purchase the Hardcover through Amazon.com.
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