Shots In The Dark: The Wayward Search For An AIDS Vaccine

Jon Cohen

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Review

It has been two decades since the first reported case of AIDS and the need for a vaccine is yet again highlighted by the current statistics.  According to the most realistic estimates, over 40 million people are infected by the HIV virus, with16,000 new cases every day.  Over 35% of the population in Zimbabwe and Botswana carry the virus and over 1 in 5 of most of the other countries in Sub-Saharan Africa, including South Africa.  The World Health Organisation says that on average a child born in the area today (2001), will have a life expectancy of about 40 years as opposed to 70 in pre-HIV times.

The successful drug treatments that have helped sufferers in Western countries are unaffordable in precisely those places in Africa and Asia where the disaster is at its worst.  This account of the history of a search for a vaccine comes therefore at a time when the mood amongst scientists has seldom been grimmer.

American Jon Cohen has been a free-lance journalist covering the AIDS field for over 12 years.  His account begins with the now famous press conference in Ronald Reagan’s White House in 1982 with the inappropriate attempts at humour by an ill-informed spokesman heralding a period of several years during which the Administration never even mentioned AIDS.

The best account of the early years of the crisis is still Randy Shilts’ And The Band Played On pbk £12.99, and some of the heroes and villains survive to this day and reappear in Cohen’s telling of later events.  Larry Kramer, gay activist and still very much the ‘Angry Old Man’ and good guy / bad guy Robert Gallo, figure prominently in the strange and sad story that Cohen has to tell.  He recounts the lack of scientific co-ordination, the ethical dilemmas that accompany any vaccine development, the conflicting interests and priorities of multinational drug companies and the fiendish complexities of the virus itself with geographic variations of HIV sub-types and a far from complete understanding of immune responses in individuals.

What a relief then that the author possesses an admirable gift for clarity in his choice of metaphors to help us get to grips with the complex issues of biochemistry and immunology.  He can spot the phoney and he clearly identifies the champions in this complicated and aggressive world: Luc Montagnier (whose own book, Virus: The Co-discoverer Of HIV Tracks Its Rampage And Charts Its Future hbk £18.95, is a remarkably sanguine account of the double-dealings involved in the discovery of the HIV virus); the tired but still magnificent Jonas Salk; and the tragically missed Jonathan Mann whose death on Swissair Flight 111, can truly be considered catastrophic.

The conclusions that Cohen reaches are simple and forthright.  We need international co-operation at every level.  There must be an end to the quest for individual financial rewards by the drug companies, research has to continue on chimpanzees and other primates in spite of animal rights protests, and governments, great philanthropic institutions, insurance companies and drug companies must co-operate to grapple with the solution to a world-wide problem, the gravity of which cannot be underestimated. - review by Stewart Grimshaw