The prospect for an HIV vaccine seems to be diminishing with the failure of two more trials, even as we spend $800 million or so on research. As quoted in the perspective, Anthony Fauci states that:
"To be brutally honest with ourselves, we have to leave open the possibility . . . that we might not ever get a vaccine for HIV. People are afraid to say that because they think it would then indicate that maybe we are giving up. We are not giving up. We are going to push this agenda as aggressively and energetically as we always have. But there is a possibility, a clear finite possibility that that's the case."
The last decade has seen only two more classes of anti-retrovirals, fusion inhibitors and integrase inhibitors, added to the arsenal. Meanwhile, a friend saw Dr. Fauci give the keynote address at an international conference of HIV researchers and essentially come to the conclusion that we're simply still thinking 'in-the-box' and that our entire thought process has to be radically altered. How do we do this? Where do we start?
To mix analogies, it's like going down a straight road and being told we need to change directions. Well, we've got 359 degrees of other choices - each very expensive. And, not to mention, the z-axis (up and down) gives us even more permutations. It's all fairly terrifying to be lagging behind a virus which can understand our tactics and form defenses quite efficiently.
And if this happens in the developing world where there's only a 'first-line' medicine (Troimune), even the updated lower world-wide prevalence won't avoid a catastrophe.