Overview: Since the AIDS epidemic began in 1981, more than 630,000 Americans have been diagnosed with AIDS and nearly 400,000 men, women, and children have lost their lives to this disease. An estimated 650,000 to 900,000 Americans are believed to be living with HIV.
The Clinton Administration has responded aggressively to the significant public health threat posed by HIV/AIDS with increased attention to research, prevention, and treatment. Overall funding for AIDS programs within HHS has increased by 86 percent to $6.8 billion in FY 1998, with funding for AIDS care under the Ryan White CARE Act rising 230 percent and support for AIDS Drug Assistance Programs increasing by 449 percent. The Medicaid program, which covers an estimated 50 percent of all persons living with AIDS, is also a major source of AIDS treatment funding.
Support for AIDS research at the National Institutes of Health(NIH) now totals $1.6 billion, an increase of 50 percent since FY 1993. In one of his first acts in office, President Clinton signed the National Institutes of Health Revitalization Act of 1993, establishing a permanent Office of AIDS Research at NIH to coordinate all AIDS research. Today, NIH Director Harold Varmus, MD, announced the appointment of Neal Nathanson, MD, as the director of the NIH Office of AIDS Research. Dr. Nathanson has served as a member of the NIH AIDS Vaccine Research Committee.
Development of an HIV/AIDS vaccine is a major component of the Administration's comprehensive approach to the global HIV/AIDS epidemic. On May 18, 1997, President Clinton announced that development of a safe and effective AIDS vaccine is "a global health imperative." He announced a comprehensive AIDS vaccine research initiative and challenged scientists and pharmaceutical manufacturers to work together to develop an AIDS vaccine within 10 years.
To date, the National Institutes of Health has evaluated 23 vaccine candidates and 10 adjuvants (substances that might enhance the effect of a vaccine) in 49 Phase I and Phase II clinical trials to determine the safety of the vaccine candidates and their effect on the human immune system. These studies have been conducted with 2,900 volunteers. NIH currently is exploring a new concept in a study involving 420 volunteers. It tests the effect of two different substances (ALVAC-HIV vCP205 and HIV SF-2 rgp 120) given simultaneously to enhance the human immune response.
Other Actions Aimed At AIDS Vaccine Development:
AIDS Vaccine Funding: Funding for AIDS vaccine research at the National Institutes of Health (NIH) has increased significantly. Total funding in FY 1998 is $153 million, a 17.5 percent increase over FY 1997 and a 53 percent increases since FY 1995. The President's fiscal year 1999 budget includes $180 million for AIDS vaccine research, an increase of 17.5 percent over FY 1998 and an 80 percent increase since FY 1995. AIDS Vaccine Coordination: An AIDS Vaccine Research Committee was created in 1997 to improve the coordination of NIH-supported vaccine activities. The Committee is chaired by Nobel Laureate Dr. David Baltimore of the California Institute of Technology. The AVRC has developed a comprehensive AIDS vaccine research program and advised the NIH on scientific opportunities, gaps in current knowledge, and future directions of AIDS vaccine research.
The Innovation Grants Program for Approaches in HIV Vaccine Research was launched in 1997 to encourage and support creative and novel research with promise for improving and speeding vaccine development. The program also is aimed at attracting new researchers into the AIDS vaccine development field. So far, 58 grants have been awarded, including 28 grants to investigators new to AIDS research. Total funding for the program this year is $13.1 million. Vaccine Research Facility: Construction will begin this fall on a new vaccine research facility on the NIH campus in Bethesda, MD, to house the new Vaccine Research Center (VRC), which initially will focus on AIDS vaccines. The VRC will bring together scientists with expertise in immunology, virology, and HIV vaccine research. It will stimulate multidisciplinary research from basic and clinical immunology and virology to vaccine design and production.