On Feb. 19, “Ending HIV: The Journey to a Vaccine,” a new documentary, premiered at Boston’s Museum of Science. The premiere was preceded by a conversation with Dr. Anthony Fauci and Dr. Larry Corey, who discussed their personal involvement in HIV vaccine efforts, what the future may hold for science and what young people can do to help the cause.
“Ending HIV: The Journey to a Vaccine” discusses the decade-long global fight for an HIV vaccine, focusing on the various forms of collaboration and commitments that drove it.
Fauci is most known by our generation for his spotlight during the COVID-19 pandemic. However, in the world of public health, he is known as one of the nation’s leading experts on infectious diseases, with a big legacy in the HIV/AIDS pandemic.
Corey, the second guest speaker, is the former president and director of the Fred Hutchinson Cancer Center. He is known as a renowned expert in virology, immunology and vaccine development.
Starting from the first reported cases of HIV in 1981 and continuing to the current status of global HIV burden, the documentary showed an expansive perspective on community involvement, clinical studies and infectious disease.
HIV is a complex, shape-shifting virus, making a potential vaccine very difficult to develop. HIV uniquely integrates into the immune system and mutates rapidly to attack the immune system, making it difficult for a vaccine to recognize the virus and create antibodies to fight it –– what vaccines aim to do. The documentary stressed the importance of listening to affected communities and giving them a seat at the table. As public health officials like Fauci learned, effective decision making and awareness campaigns required that scientists meet people where they were. Going to places like gay bars to spread the word about preventive measures and provide opportunities for involvement in the process was integral in fighting the HIV pandemic.
The documentary showed a global perspective, highlighting how different regions of the world have different strains of HIV, known as subtypes or clades, that are identified by letters. For example, southern Africa suffers mostly from subtype C, while the majority of HIV cases in the United States are subtype B. The documentary framed these subtypes as an added challenge to producing a vaccine, highlighting the need for a vaccine that can protect cells from any strain.
The film emphasized that to produce a comprehensive vaccine, high-income countries must partner with low-income countries, in a mutually beneficial way where the latter can collect data and the former can supply medical interventions. Further, the film stressed that access to medical advances –– such as an HIV vaccine –– is integral because all people deserve medical care regardless of where they are from.
The decades of studies for a vaccine to prevent HIV were discussed chronologically in the latter half of the documentary. Two big medical advancements are antiretroviral medications and pre-exposure prophylaxis. Antiretroviral medications suppress the virus and keep it from reproducing, in turn stopping the disease from progressing. Pre-exposure prophylaxis is a highly effective daily pill or injection for HIV-negative individuals to prevent contracting HIV. However, the cost of this treatment is huge, limiting the spread of utilization globally.
A big breakthrough emphasized in the film was the discovery of the role that broadly neutralizing antibodies could play in creating a universal HIV vaccine. The Antibody Mediated Prevention trials from 2021, which enrolled over 4,600 volunteers across many continents, demonstrated the feasibility of creating potent antibody combinations that block HIV.
When asked what they hoped the audience would take away from this movie, Corey expressed the importance of the community side of the film, saying, “science is about people.” Fauci built on Corey’s comments about infrastructure, hoping viewers of the documentary see that through decades of experiments, researchers can achieve great innovation such as anti-retroviral drugs.
The documentary emphasized how investment pays off in the world of science. Fauci highlighted how the process of developing an HIV vaccine paved the way for the expedited creation of a COVID-19 vaccine. He listed some of the lessons he took away from his time, addressing both HIV and the COVID-19 virus, such as to always “expect the unexpected” and understand that “misinformation and disinformation is the enemy of public health.”
Despite having some bias given their profession in the healthcare field, both experts emphasize the huge impact of infectious diseases beyond just the initial moment of infection –– these viruses can spread across multiple organ systems. “I think infectious diseases cause most other diseases,” said Fauci.
The later statements from Fauci and Corey held more political weight, with messages about the U.S. administration’s attitudes towards science. The final question asked the speakers to give the audience one action item to take with them. Fauci responded with one word –– “vote.” This was met with loud applause from the audience.
Altogether, this event provided insights into the progress toward an HIV vaccine and the challenges that we must overcome to succeed. A takeaway from the evening was that it is possible to rid the world of HIV in the future. There is hope for a vaccine that can entirely eliminate the virus globally, but this calls for global attention and collaboration.