Foundation Comments on AIDS.gov about IMPAACT Trial Network
September 27, 2010
Representatives from the Foundation recently voiced their concerns of changes coming from the National Institutes of Health (NIH)
that could impact pediatric and maternal HIV research. The structure of clinical trial networks that facilitate HIV/AIDS research are being reevaluated as NIH plans for future research programs. One of the networks in danger of restructuring is the International Maternal Pediatric Adolescent AIDS Clinical Trials (IMPAACT)
, a network that has been critical in understanding the transmission of HIV from mother-to-child, and discovering how to prevent transmission to children.
The Foundation supports the preservation of a network solely dedicated to maternal and pediatric AIDS research, covering issues including vaccines, PMTCT, and treatment. Foundation Ambassador, Jamie Gentille
, and the Foundation's Director of Clinical and Basic Research, Dr. Jeff Safrit
, recently commented on the AIDS.gov blog post
about IMPAACT and its continued importance in HIV/AIDS research. Read their responses below:
I appreciate this open discussion and the opportunity to voice my perspective. I am 31 years old and have been HIV positive since I was 3 years old. I acquired the virus through a tainted blood transfusion during open heart surgery. In my 28 years of living with HIV, I have seen the dramatic progress that researchers have made in the treatment and prevention of HIV. I participated in my first Phase 1 Clinical Drug protocol at NIH when I was 10 years old, at which point there were only a handful of medications approved for HIV-infected children. Since then, I have grown up to be a healthy and happy adult, because of the groundbreaking advances made in pediatric HIV research.
We are now at a crossroad, faced with several options of continuing our work in HIV/AIDS research. I wholeheartedly urge us to choose a path that continues to delve into the world of pediatric HIV/AIDS research, and that builds on our amazing success. I am a part of a population of people who can offer a tremendous amount of information about the long-term effects of HIV infection and antiretroviral therapies. It would be tragic to walk away from the tremendous potential of this. Where would we be if, 30 years ago, we didn’t pursue these research opportunities? I probably wouldn’t be here. Similarly, children all over the world would not have a fighting chance at a healthy life with HIV.
In a relatively short amount of time, researchers have gleaned vital information about pediatric HIV and perinatal transmission. This progress will continue, but only if we choose to actively pursue this knowledge and research. As someone who has directly benefitted from this groundbreaking research, and who believes in the incredible potential of continued research, I passionately implore NIAID to remain focused on HIV/AIDS research in the pediatric population.
Dr. Jeff Safrit
Director, Clinical & Basic Research
Prevention of mother-to-child-transmission of HIV....arguably the most successful prevention tool available today. We clearly know how to reduce MTCT in utero and intra-partum to 1-2% in resource rich settings and are working towards that goal in the rest of the world where access to ARVs and PMTCT services is challenging. We are also tackling transmission during breastfeeding through PROMISE as mentioned above. At this point, It would be easy to say ‘mission accomplished’.
However, the reality is that there are still 1200 infants born with HIV EVERY DAY, necessitating more research on many fronts. Understanding how to bring these proven prevention methods to scale is an obvious area of research that has implications for every prevention modality from PMTCT to PrEP and microbicides. If we can’t reach the populations that need these prevention tools, the best prevention methods are useless. And while we may know how to reduce transmission to low levels with ARV, we still don’t really understand the basic science of mother-to-child transmission events. Critically, why is it that 60% of infants born to HIV+ women will remain uninfected despite no therapy whatsoever? Why can an infant be exposed to HIV in mother’s milk every day for up to 2 years and not get infected? If we knew the answers to these questions, we’d be that much closer to the ultimate prevention tool, an HIV vaccine.
As the Clinical Trial Networks are restructured to address the global HIV pandemic, we must maintain a focus on the unanswered basic and implementation science questions that will reduce the number of infants born with HIV. The most efficient way to do this is by maintaining a network dedicated to HIV in women and children. This will also ensure that advances in other areas of research, in therapeutics and vaccines, will not leave women and children behind.
For more information on IMPAACT and the Foundation's response to the restructure proposals, read the Foundation blog