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Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

nytimes.com

11–20 of 64 posts

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#11
Given what I learned in recent years about the scientific process I'm always a bit wary of making this a "spend XXX money to get YYY results".

We have issues like that still a sizable amount of medical studies are unpublished because they don't produce the desired result the funder wants, that experts think a vast amount of studies are simply research waste due to poor methodology or that the majority of pre-clinical cancer studies can't be replicated. How much better could we be at tackling diseases if science wouldn't have these problems?

Sure, more funding is one part of the equation. But I increasingly get the feeling that if modern science wants to make a significant step forward they need to clean up their methodological problems. And that will not necessarily cost more, in many situations it may even cost less. (E.g. don't pay for studies that won't get published later or that are methodologically so weak that they won't produce actionable results.)

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#12
The title of the article seems to suggest no vaccines are available for these diseases, but at least in the case of tuberculosis there is one [1]. The article does refer to it:

“The foundation still hopes to show that booster doses of BCG, a century-old childhood tuberculosis vaccine, can protect adolescents and that a vaccine candidate it is developing with GlaxoSmithKline, the pharmaceutical company, will stop latent tuberculosis from becoming active.”

[1] https://www.cdc.gov/tb/topic/basics/vaccines.htm

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#13
post #4

This article is seriously lacking. For example this: https://www.hiv.gov/federal-response/funding/budget says: "With the generous support of the American people, the U.S. government has annually committed more than $6.6 billion to bilateral HIV/AIDS programs, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and NIH international HIV research." And yet the entire world spent 3B on all vaccine research combined…

> unless most of the research is not for a vaccine This. Only a small sliver of that would be for vaccine research, probably at a handful of labs.

So under the assumption that the researchers involved are smart people, they believe that this is the best use of the money.

So why should I believe a random article that increasing specifically vaccine spending is the right thing to do?

If it's only a small sliver, them to get the massive increase the article wants, total spending must go up massively. Either that or the researchers are not directing their money in the right proportions, which seems unlikely to me.

Whatever the correct situation is, the article is seriously lacking for not even mentioning any of it. And if that's the case, I am inclined to disbelieve the entire thing.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#14

Can anybody briefly describe how a 3x funding increase would change things from "may not be able to invent" to "[likely] to be able to be produced in the foreseeable future"? I'm very disappointed that news articles no longer hit on even the most fundamental questions like this. Instead articles now take a position (you should be in favor of donating money to [x,y,z]) and then go from there. This seems to challenge b…

For some science, the baseline is very high. You can't do X-ray crystallography of organic compounds, for example, without a synchrotron.

Absolutely, but I think we become desensitized to numbers. $3,000,0000,000 is alot of money.

In trying to find the costs of a synchotron I came upon this article [1] that mentions the construction of an entire campus surronding a synchrotron, experimental facilities, and so on. The entire construction project and synchotron cost £263 million. That's at government level efficiency, which is to say significantly overpriced, and of course is also just a one-time expense. Even this one time inefficient cost however is only about 10% of our annual spend. The ongoing spend related to maintenance of the facility would of course be a small fraction of that upfront cost.

I just don't understand how one can argue that a 3x increase in funding can be expected to yield massive exponential gains in output.

[1] - https://www.theage.com.au/national/synchrotron-will-cost-tax...

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#15

Can anybody briefly describe how a 3x funding increase would change things from "may not be able to invent" to "[likely] to be able to be produced in the foreseeable future"? I'm very disappointed that news articles no longer hit on even the most fundamental questions like this. Instead articles now take a position (you should be in favor of donating money to [x,y,z]) and then go from there. This seems to challenge b…

For some science, the baseline is very high. You can't do X-ray crystallography of organic compounds, for example, without a synchrotron.

DNA's structure was deduced from X-ray crystallography using a conventional X-ray tube, most laboratory protein crystallography doesn't require a synchrotron light source.

Here's a typical unit:

https://www.rigaku.com/en/products/protein/micromax007

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#16
post #13

Earlier quoted context omitted.

> unless most of the research is not for a vaccine This. Only a small sliver of that would be for vaccine research, probably at a handful of labs.

So under the assumption that the researchers involved are smart people, they believe that this is the best use of the money. So why should I believe a random article that increasing specifically vaccine spending is the right thing to do? If it's only a small sliver, them to get the massive increase the article wants, total spending must go up massively. Either that or the researchers are not directing their money in…

Researchers are usually bright people, but funding is often decided by entirely different people, and policy. But anyway ...

Vaccines, as well as antibiotics are hard to find/make and eithee have high price sensitivity, nobody will pay a million for a dose of vaccine, or as with new antibiotics, will only be used as a last resort to combat bacterial resistance. As most medical research today is made by for profit companies, less money is spent on things that are harder to make money on.

Many 'easy' vaccines are already done, and the same goes for antibiotics, so there is. need to move public funding into the entire pipeline for these kinds of substances. Almost forgot, antivenoms also suffer from this, mostly because there are many venoms, and few victims.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#17
post #7
post #4

This article is seriously lacking. For example this: https://www.hiv.gov/federal-response/funding/budget says: "With the generous support of the American people, the U.S. government has annually committed more than $6.6 billion to bilateral HIV/AIDS programs, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and NIH international HIV research." And yet the entire world spent 3B on all vaccine research combined…

The budget comes from desperation, which is unaffected by futility. Researchers are well aware that funding goes to those who claim that there is hope. Voters demand that we do something, and throwing money at a doomed cause is something, so therefore we must do that. ... and my point is proven by the downmods: nobody wants their hopes crushed, no matter how unjustified

Budgets also come from perceived market demand. Is the market for HIV maintenance products bigger or smaller than the market for HIV vaccination drugs?

(Cynically I'd remark a one-off HIV vaccine shot would eliminate the need for lifelong maintenance drugs, and shareholders get the best returns with that latter...)

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#18
post #15

Earlier quoted context omitted.

For some science, the baseline is very high. You can't do X-ray crystallography of organic compounds, for example, without a synchrotron.

DNA's structure was deduced from X-ray crystallography using a conventional X-ray tube, most laboratory protein crystallography doesn't require a synchrotron light source. Here's a typical unit: https://www.rigaku.com/en/products/protein/micromax007

The MicroMax™ 007 HF is the most widely used home lab X-ray source for protein crystallography and a popular source for small molecule crystallographers who need the additional flux of a rotating anode generator.

Yow. I thought I had a pretty hardcore home lab with my Faxitron cabinet machine.

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#19

There is already prep, a once a day pill that if taken consistently, is over 95% effective at stopping HIV infection, I've heard some sources say it's 100% effective. While it's not medically considered to be a vaccine, most vaccines for other conditions have a lower effectiveness rate. There is work being done to turn prep into an injectable chip in the arm, like long term contraceptives, but for HIV prevention.

Can you point us to a source regarding this pill? Is it in clinical trials?

Re: Vaccines Against H.I.V., Malaria and Tuberculosis Unlikely, Study Says

#20
post #19

There is already prep, a once a day pill that if taken consistently, is over 95% effective at stopping HIV infection, I've heard some sources say it's 100% effective. While it's not medically considered to be a vaccine, most vaccines for other conditions have a lower effectiveness rate. There is work being done to turn prep into an injectable chip in the arm, like long term contraceptives, but for HIV prevention.

Can you point us to a source regarding this pill? Is it in clinical trials?

You must be North American, it has been in broad use for years: https://www.cdc.gov/hiv/basics/prep.html
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