When the AIDS Vaccine Advocacy Coalition (AVAC) was formed on World AIDS Day in 1995, we were optimistic that with more resources, more cooperation and more scientific knowledge, an AIDS vaccine could be found in time to stem the growing epidemic. A decade later the field has more resources, more cooperation and more depth of scientific knowledge–but still no AIDS vaccine.

While we’ve learned much in the past decade and made great strides in scientific, policy and ethical arenas, the road ahead is still a long one. We travel this road with thousands of others — researchers, policy makers, advocates, trial volunteers and their communities. Thousands more will need to join us before we reach our goal.

In the AVAC Report 2005: AIDS Vaccines at the Crossroads, we lay out what we see as some of the major challenge areas we all will face and offer recommendations for navigating them.

We are also increasingly aware that the global terrain on which trials will be conducted and a vaccine will eventually be provided is rapidly changing. The overall global response to the AIDS epidemic is also at a crossroads.

• The raging global pandemic increases both the need for, and the complexities of, bringing vaccine prevention to the world.
• Provision of existing prevention options and trials of new prevention technologies present the world with difficult research design and ethical issues.
• Though treatment programs are receiving needed priority and attention, access to treatment is still far short of need.

We realize that future AIDS vaccine trials and eventual rollout will be done in the context of other prevention trials, changing required baseline standards of prevention and care, and evolving knowledge expectations and involvement of the communities where trials will be conducted.

AVAC is committed to continuing to be a voice in the ongoing discussions about these issues. For example, the 2005 AVAC Report includes an article to follow up on our report on the trials of tenofovir as pre-exposure prophylaxis (PREP), published earlier this year.   

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