It is being tested on 500 volunteers in North America and South America, Africa and the Caribbean, vaccine project director Gary Nabel said.
“Realistically, if we have a licensed vaccine in less than 10 years, it would be pretty miraculous,” Nabel said in an interview.
“I'd be delighted if either one of them (NIH or Merck) shows some degree of protection.”
In addition, a modified version of the Vaxgen trials continues on 16,000 volunteers in Thailand, who are receiving an added T-cell vaccine booster.
A lot depends on money. Global research gets about US$800 million a year, an increase over funding levels three years ago but still short of the US$1.1 billion needed, IAVI says. To attract private firms like Merck to the unprofitable field, the US and other governments have provided some funds — with the requirement all results are shared.
For the vast majority of people with HIV, however, Acquired Immune Deficiency Syndrome (AIDS) is a still death sentence.
Only about 10 percent of those infected are aware of it, the Bill Clinton Foundation says, and treatment has fallen far short of the World Health Organization's goal of reaching 3 million HIV-positive people with life-prolonging medications by last year.
But 1.1 million people now take some form of anti-retroviral therapy, quadruple the number over three years, thanks to a belated public-private effort and a new-found willingness of Western countries to fund generic drug products for developing countries.
Most of the drugs are paid for by the UNAIDS or the US' separate global AIDS program.
Generic versions of the three common first-line drugs — zidovudine (AZT), lamivudine and nevirapine — are cheaper. And technical advances have made them easier to take.
US drug regulators in early last month approved the first generic 3-in-1 antiretroviral pill for its foreign programs, a medicine made by Aurobindo Pharma of India and taken only twice a day. That means AIDS patients are more likely to take it, compared to the 12 to 30 pills they used to have to take throughout the day and night.
The US Food and Drug Administration (FDA) also recently approved a once-a-day pill for domestic users that could further revolutionize treatment in developing countries if a generic version were approved.
The wealthy Bill and Melinda Gates foundation is credited with jump-starting AIDS research, pumping US$1.1 billion over 10 years into the field. At the top of the Gates' priorities is AIDS prevention, “especially methods that women can control,” and Norick's International Partnership for Microbicides gets about US$60 million a year from them.
“Melinda Gates ... gets the women's issue,” IPM's Norick said. Gates understands why young women who often do not have control over their sex lives “are more vulnerable.”
Among the dozen or so microbicides being tested are gels containing the same drugs now administered orally to HIV-positive patients — which researchers hope will kill off the virus in the vagina before it takes hold in the woman's body.