But then I stumbled across today's NY Times article that bungles the recent HIV vaccine trial news and, importantly, includes a misplaced quote to UK-based Riders for Health, one of the charities that inspired me to do Enduro Africa. I couldn't just sit there and do nothing.
What the Times published was a recycled piece still dripping in cynicism:
Bloggers with a taste for biostatistics — and one rival AIDS vaccine specialist who declined to be quoted — said it would take only a handful more infected Thais in the vaccine column to shift the results from “statistically significant” to meaningless. Even one more would have weakened the data enough to make headlines saying “One Quarter Protected” more likely, given the way journalists round off numbers.
Actually, the margin is even closer than that. Add a single additional infection to the group assigned to the treatment arm and the 95% confidence interval would include 1.0. In other words, the observed difference could have been statistically insignificant due to a data entry error or because someone was unable to use a condom or clean needle during a single exposure event. One person.
But this fact obscures a more important one that the author fails to appreciate: After years and years of null or adverse results from HIV vaccine trials, the unexpected findings this week open a world of possibilities that will move the ball further along. Even with that hypothetical case, the findings would still be in the same direction, pointing us to new research that could yield better understanding of the mechanisms underlying an effective immune response to HIV or shed light on why a vaccine might work for some (and not others).
Curiously, the author quotes a Riders for Health representative in making the case that access to an effective vaccine would pose a whole new set of challenges, even if the findings were a "slam dunk," as we like to say here in DC:
"Millions of children across Africa still die of measles simply because the vaccine doesn’t reach them,” said Barry Coleman, founder of Riders for Health, a British charity that buys and fixes motorcycles for African health workers. "People with AIDS don’t need," he added, “another breakthrough that does not reach those who need it most."Very true. And one could quickly make a long list of inexpensive, efficacious health promoting technologies that go underutilized for lack of access. There certainly is a need to put greater emphasis on better disseminating existing tools that work, but should we cease looking for new prevention tools at the same time?
Without a doubt, caution is in order with respect to these vaccine trial results. And, let me be the one to say it for the record, if no one has thus far: There's no HIV vaccine just around the corner. No responsible agency would recommend licensure or scale up for a vaccine with only 31% efficacy.
Still, what we have now is movement in the right direction that may lead to broader discoveries in immunology and public health. No one has declared this product to be a "miracle." What we need most is a bit of perspective here, the cynics among us included.
See the NY Times' If AIDS went the way of smallpox