
Canadians to start HIV vaccine clinical trials - pg
http://www.ottawacitizen.com/health/Canadians+start+vaccine+clinical+trials/5890341/story.html
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ajju
_Kang has been studying HIV since 1987._

This guy has been working on fighting one virus for almost 25 years. I can't
quite compare what I aim to do with my startup to preventing HIV, but we
certainly hope to have a massive positive impact on the world. So when I feel
impatient about changing the world now, this should put things in perspective.

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9oliYQjP
Nobel peace prizes are not normally awarded to philanthropists. But I'm just
going to leave this link here. It's a photo of Bill Gates with Prime Minister
Stephen Harper announcing funding for HIV vaccine research in 2007.

<http://pm.gc.ca/grfx/news/PM-feature-20070220-Gates.jpg>

Source: <http://pm.gc.ca/eng/media.asp?id=1544>

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droz
It is laughable to think that someone who funds research should be given an
award. The people doing the actual research deserve an award leaps and bounds
above and beyond the one providing funding.

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tolmasky
I don't think you need to be _so_ antagonistic against the funders. Not to
mention that there are different awards for different things. I think it would
be perfectly fine (and that all the members involved would agree) if the
researchers were given the Nobel prize in Biology and the funders the Peace
prize.

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rdl
That would be a great compromise -- an HIV vaccine would probably do more for
world peace than at least half of the winners of that prize to date.

Another option would be to name the actual vaccine after the funder.

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msbarnett
> That would be a great compromise -- an HIV vaccine would probably do more
> for world peace than at least half of the winners of that prize to date.

What makes you say that? Improve the human condition and eliminate much
suffering, absolutely, but do much for world peace?

Has there ever been a war fought over HIV?

> Another option would be to name the actual vaccine after the funder.

Or, we could name it after the thing it vaccinates against.

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rdl
HIV contributes to violence, civil wars, unstable governments, etc. in Africa.
It's actually gotten a lot better in the past 10 years, but in the
1980s/1990s, there was a time when countries looked like they might collapse
in the sub-Sahara due to high numbers of HIV/AIDS victims, orphans, etc. It
was disproportionately affecting 15-35yo workers, and the fatalism caused by
"will probably die from AIDS anyway" led to a lot more individual and
organized violence.

Dealing with HIV, a general explosion in commodities prices, end of the Cold
War, and hands-off Chinese infrastructure investment (tied to commodities, but
without trying to influence the government, and thus acceptable) has gone a
long way to help Africa. Urbanization, IT/Communications (and access to
regional/global markets), and foreign direct investment helps a lot too.

~~~
msbarnett
Thanks for the response, that was very informative.

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defen
> It will test how effective the vaccine is by comparing a vaccinated and a
> non-vaccinated group, Kang said in the video.

So I was going to ask how clinical trials for vaccines are done, and this part
kind of answers it, but now I'm curious - if there's no control group that
gets a placebo injection, how do you control for the fact that people may
behave differently if they think they've been given an anti-HIV vaccine?
Unless I'm misreading this and "non-vaccinated" means placebo.

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redthrowaway
A couple things:

1) We generally know the strength of the placebo effect and the rate of HIV
transmission among at-risk groups, so we can control for it, and

2) Not sure the placebo effect is particularly relevant. First, a vaccine that
shows little to no benefit over the control (placebo or not) is not an
effective vaccine. Second, placebos aren't effective for _everything_. I
highly doubt the effectiveness of a placebo at preventing HIV transmission
(although it would be difficult to test ethically).

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ghshephard
The placebo effect is important because it might _increase_ rate of HIV
transmission by resulting in more risky behavior. Or, it might reduce rate of
HIV transmission by causing the person to focus on the possibility of
infection more.

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NolF
Both vaccine and non-vaccine groups receive appropriate counselling (this part
can be double blind even) regarding HIV, risk behaviors, and as a trial
vaccine it might no be 100% effective etc etc... You assess the impact of
behavior changes via surveys and interviews to see if there has been a
significant increase in risk behavior and the control for it.

It would be unethical to give a placebo to someone for this kind of disease.

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ghshephard
Until the treatment is proven - it may turn out to be the case that the
placebo is more beneficial than the treatment.

If you knew that it would be "unethical to give a placebo to someone" then you
wouldn't have to do the trial!

Indeed - there have been situations in which the Trial turns out to be so
positive - that the study is canceled, and all participants are given the
treatment. I think that was actually the situation with the circumcision
trials - circumcision turned out to be so ludicrously low risk, and so
effective at reducing HIV infections in heterosexual male populations in
Africa, that they, ethically, had to prematurely end the study and circumcise
all the participants.

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baddox
Why does Canada need permission from the FDA?

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rdl
They want to make sure the trials are recognized by the FDA as well, so the
resulting drug (if successful) can be sold in the US without repeating early
stage trials.

Outsourcing clinical trials to other countries (usually India or SE Asia) is
one of the biggest advances in drug development in the past 20 years.

The vaccine is also being manufactured in the US for these trials (it requires
BSL3, and I don't think there's a Canadian production facility which meets
that).

~~~
redthrowaway
>Outsourcing clinical trials to other countries (usually India or SE Asia) is
one of the biggest advances in drug development in the past 20 years.

Not really what I'd call an advancement. It's being done because it's cheaper,
the health and safety regulations are practically non-existent, and if
something goes wrong then the subjects have very little recourse.

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ars
That's the cynical reason.

The non cynical reason is that subjects in the US often take or have taken
various other drugs. Depending on what they are checking those drugs may
affect the results.

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rdl
Making it cheaper (and thus allowing more drugs to be tested, or to allow
inventors to raise less money and thus keep more equity ownership, thus being
better able to develop future drugs) isn't really cynical either, IMO.

I _want_ pharma companies to make huge profits. I just want them to create
vastly more surplus value for society in the process, vs. live via regulatory
capture. If I could pay Novartis $10k/yr to be totally healthy and do fat
lines of coke/mdma/mushrooms every day with no exercise, and have a 200 IQ as
a side effect, I'd be quite happy.

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asdkl234890
_I want pharma companies to make huge profits._

I want new drugs to be developed faster and cheaper. This has very little to
do with the _profit_ of _huge_ companies.

