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

nytimes.com

21–30 of 64 posts

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

#21
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?

This is a medication that’s far beyond the clinical trial phase and is widely available in many countries, though still subject to some large-scale trials for this particular usage. There’s lots of information on sites like https://www.iwantprepnow.co.uk - it’s available through the healthcare system in some parts of the UK, purchasable privately in others, and from what I understand available on some insurances in the US.

It’s a combination of two antiretroviral drugs also used in HIV treatment (Tenofovir and Emtricitabine) and the effectiveness of it can’t really be overstated - my understanding is that there are only two documented cases of someone correctly using this drug becoming HIV-positive, and in both cases due to rare strains with resistance to both drugs.

It’s not a vaccine, but it does change the picture massively for at-risk groups.

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

#22
post #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 We have issues like that still a sizable amount of medical studies are unpublished because they don't produce the desired result the funder wants, that experts think a vast amount of studies are simply research waste due to poor methodology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…

> don't pay for studies that won't get published later or that are methodologically so weak that they won't produce actionable results.

Most typically, to make studies methodologically stronger, you require a bigger sample, ie more subjects, to increase power while maintaining or even improving significance. And that would make it more expensive.

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

#24

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.

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 overpr…

It’s $0.5 per person.

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

#25
AIDS/HIV seems largely containable through PReP. I don’t know if long term pervasive but not universal use of PReP by those at risk would eventually lead to resistance to the medications used, though.

Malaria probably can be eliminated for single digit millions of dollars through gene drive against specific species of mosquitoes which carry it.

TB scares me, mainly due to high risk populations and XDR variants.

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

#26

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.

The thing that worries me about antiretroviral drugs is that they mess with mechanisms that are innate to the reproduction of cells.

Their effects can, e.g., be clearly seen in changes to the bone marrow, which IIRC has some of the fastest-reproducing cells in the human body.

We don't have long-term data yet on what this does to users of this drug.

My wife has to take such drugs as she has HIV, and I wouldn't be surprised if it ended up shaving a few years off her life expectancy. She's fine now, but who can predict the cumulative effects? Of course, since without the drugs her life expectancy would be drastically lower, she obviously takes them, and they are a godsend.

But I'm kinda waiting for the other shoe to drop.

What I'm saying is: it's great that we have this option, and it should be used where it makes sense. However don't think that this medication frees you from worry in the same way vaccinations typically do. The tradeoff is much different.

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

#27

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…

Look at all the money thrown into all of wars. Not just the longest-running war in history in Afghanistan and the War on Terror. But the War on Drugs. War on Poverty. What about global warming--how much money is thrown into that? Are we really making progress. Meanwhile every day I see homeless people on the streets, and read about stories of police murdering, beating, or swat raiding innocent people over nothing. Ho…

>> longest-running war in history

https://en.m.wikipedia.org/wiki/List_of_conflicts_by_duratio...

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

#28

Earlier quoted context omitted.

Look at all the money thrown into all of wars. Not just the longest-running war in history in Afghanistan and the War on Terror. But the War on Drugs. War on Poverty. What about global warming--how much money is thrown into that? Are we really making progress. Meanwhile every day I see homeless people on the streets, and read about stories of police murdering, beating, or swat raiding innocent people over nothing. Ho…

>> longest-running war in history https://en.m.wikipedia.org/wiki/List_of_conflicts_by_duratio...

In US history, sorry it made sense as implied when I was typing it.

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

#29

Earlier quoted context omitted.

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 overpr…

It’s $0.5 per person.

That's great in a single-variable universe, but in ours unfortunately there are a million other "it's (only) $0.5 per person" things. It's like letting the public choose what students have to learn - "but this is sooo important!" (and this, and this, and this,...).

I don't understand that kind of argument. You have to choose the right level of scale for what you are looking at. I would not trust an architect (of buildings) who is a particle physicist, or a forest(-system) manager whose specialization is the cell. Some things need to be looked at the the higher (compound) level to get any useful results.

EDIT (for the reply below, to which I cannot reply?):

> I find it important / useful for myself to put it into context.

Well, my point is that you don't.

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

#30
post #25

AIDS/HIV seems largely containable through PReP. I don’t know if long term pervasive but not universal use of PReP by those at risk would eventually lead to resistance to the medications used, though. Malaria probably can be eliminated for single digit millions of dollars through gene drive against specific species of mosquitoes which carry it. TB scares me, mainly due to high risk populations and XDR variants.

Yeah, while we may never win the war against HIV and Malaria, we will continue to make progress towards prevention and treatment, and they will become less and less of an issue with time.

With TB we seem to be losing on both of those fronts, and it is indeed something to be scared of...

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