AIDS is a tough one. It has a shifting antigen. If anyone remembers Stephen King's The Stand, that was the premise for Captain Trips.
If they can inoculate against AIDS, then the human race may just survive the next millennium.
That's not necessarily a given.
Even in EU countries (former HIV researcher, had MD colleagues in a country with budget issues).
Can you elaborate as to how this would improve the prospects of humanity as a whole? If anything, such a development would enable a greater proliferation of other dangerous pathogens.
Right now, HIV is a manageable condition, but ONLY because of the availability of drugs which suppress the virus. The virus eventually learns how to get around the drugs, at which point the patient either switches drugs or dies in a few years.
Without drugs, HIV is (near) 100% fatal. And since it takes a few years to kill, infected people have plenty of time to pass it on. Which they do.
Also, the first HIV infection feels like a minor cold. Most people would not even know they were HIV positive (until their immune system collapsed), were it not for lab testing.
Then just apply some basic epidemiology to these facts, and you see that you have a disease which has the potential to infect (and thus kill) a sizeable percent of the population. As in double-digit percentages.
No, it wouldn't necessarily.
While it's true that a vaccine would apply selection pressure and create a fitness gradient for HIV to evolve against, the virus is still bound by its genetics.
The rate at which we're developing vaccines is increasing dramatically. If our new methods are good enough to quickly adapt, then HIV may have a limited state space left to explore. A single remarkable vaccine could even do this on its own if we're lucky.
The virus can't easily descend down a fitness well to make a jump to a new gradient (ie. dramatic change of receptor bindings).
If you're talking about novel viruses, that's a wholly unrelated issue. There's of course a giant reservoir of zoonotic viruses that may one day make a leap to humans, but if anything, our work to rapidly develop vaccines may give us an increased advantage against new viruses if and when they arise.
Finally, if you're talking "hygiene hypothesis", that under-stimulation of the immune system creates auto immune disorders, has increased interaction with gut flora, or changes the dynamics with which cancer clearance happens, then you may be onto something. But this is a huge unknown where we have a lot of study left to do.
(On a personal note, I left my pursuit of biochem because when I studied it, the prospects looked to be moving at glacial pace and the tools felt akin to using punch cards and truth tables. The problems are massive, dynamical, and it looked too daunting. After the last decade and a half of bio discoveries and innovations, I've changed my outlook completely and am incredibly bullish on biotech. We are going to make incredible strides in the next few decades that will in many ways mirror the rise of tech. I want to find my way back to the field someday.)
On the other hand chemistry is highly temperature sensitive and at some point proteins will just denature. Then again you cannot have rapid growth without water, as plants need evaporation to transport minerals and such from the soil into the plant. And what about phosphorus anyway? Soon most soils may be nothing but dirt. You cannot work around the phosphorus erosion. Once it's lost, it's lost. We better start recycling our feces and the dead now. You kinda need to harden all life, not just humans and crops.
To quote Seven of Nine, survival is insufficient. We could survive without a vaccine or a treatment, it would mean tens of thousands of years and billions of people dying from AIDS until our species adapts and HIV becomes just another retrovirus (as some other primate species have with related SIV viruses). We should aim higher than "survival" and end the suffering caused by HIV, and with a vaccine we could do so in this century.
AIDS killed 700,000 in 2020.[1]. That’s worldwide. It’s not even in the top 10.
Diarrheal diseases, entirely preventable with clean water supply, kill three times as many.[2]
Or heart disease which killed ten times as many.
[1] https://www.unaids.org/en/resources/fact-sheet [2] https://www.who.int/news-room/fact-sheets/detail/the-top-10-...
The critical distinction is outcomes: until relatively recently, the only outcome of an HIV infection was eventual death from AIDS. This is still the default outcome in most of the world.
Plenty of things kill more people than AIDS, but most of them have substantially less severe individual outcomes: many people survive them, or the social/political solutions are substantially more tenable (healthier eating, access to potable water). And that's even before we consider how AIDS research has advanced the field of medical virology as a whole.
My entire statement was “we don’t need an AIDS vaccine to survive as the human race”.
If AIDS was risking our survival than diarrheal diseases should as well?
After all, we are only saving a small cities worth of people per year.
What point are you actually trying to make?
The assumption is that a vaccine would be long lasting, preventative, and likely cheaper if not cheap. That's not only a significant improvement in quality of life in developed countries, that's truly life changing/giving if available in less developed countries. The COVID vaccines and potentially this are examples of capitalism done right.
The HI virus is very slow (not called "Lentivirus" for nothing) and invests itself in the very stemcells of the cells that would be fighting it. This means it can hide from the immune system, and even the antiviral drugs can only push it back. But by the same token, if it is pushed back into the deepest refuge, it can't really "flood" back into the rest of the body, it has to do so at a a trickle.
If there is a viable vaccine around, even if the virus manages to hide from total extinction in a host at first, it will get squashed whenever it tries to come back into the "light" of the immune system.
At least I hope it will work that way...
So... if HIV has already damaged your immune system, can it take advantage of the vaccine?
Perhaps figuring out that is what the tests are for.
It takes the virus years to reach the viral loads necessary to damage the immune system to a noticeable degree. Sure, HIV has some tricks before that point, but patients are generally not immunocompromised until AIDS enters the picture.
There have even be experimental treatments where HIV infected patients who also got Leukemia got treated with radiation, and then a stemcell donation from someone with such an immunity. And they are indeed cured (for practical purposes, there are some details...). Unfortunately, those donors are rare and the radiation therapy etc is probably worse than the chronic antiviral therapy, which is why this is not a more common treatment for HIV.
Of course, inducing these particular antibodies has been the goal of various immunization efforts. Unfortunately this proved more challenging than it might seem.
But a vaccine, especially if it is affordable and works for a long time will go even further in ending this pandemic that has gone one for 40+ years.
As long as there’s no antiviral therapy resistance.
I'm actually thinking more about the vaccination against a shifting-antigen bug.
That's big juju.
Just to be somewhat anal, AIDS is much more common in Southern Africa, where homosexuality is generally either legal or the laws against it weak and unenforced.
It's also much more correlated with race than sexuality. In South Africa, it affects something like 15% of blacks vs 0.3% of whites. Women are also far more likely to have HIV, especially younger ones. I think it's around 30% for pregnant women.
Outside of the West, AIDS is definitely not something that mainly gay men get.
Precision is next to godliness.
Unaffordable pharmaceuticals is a purely American problem and I have no idea why you guys think it's normal or put up with it.
[1] https://www.chemistwarehouse.com.au/buy/100885/tenofovir-dis...
It’s cheap in Australia because it’s generic. It’s generic now in the US too, and guess what? It’s $40 per month in the US.
A major reason why you've entrenched interests is that they have safe seats they can depend on. The US has major issues with acts of gerrymandering that create those safe seats. Most forms of PR are much more resistant to gerrymandering than FPTP is. And if you want people who'll do something regarding healthcare costs, you need to get rid of those safe seats and make them accountable.
Given the number of gun owners and the number of pharmaceutical companies that let people die in agony to keep the medical insurance industry afloat, it should surely be a serious enough problem to warrant changes in corporate policy.
If you take PrEP periodically (2+1+1) that will even last you a lot longer (depending on the frequency of course). I am very glad PrEP exists, and already optimistic about its impact in reducing transmissions. But if we can replace this with a one-shot vaccine, that would be groundbreaking.