Washington Post: The Fight for an AIDS Vaccine
By Sebastian Mallaby
Seth Berkley wants to develop an AIDS vaccine. He wants a new way of
harnessing science for the poor. He wants, for good measure, to help
remake the international system. What's more, he's off to a good start.
Berkley runs something called the International AIDS Vaccine Initiative,
which he set up in 1996. At the time, there was just about no interest in
developing a vaccine to combat the HIV virus, even though vaccines have
been at the center of every other human triumph over viral epidemics, from
smallpox to polio to measles; and even though HIV infects nearly 6 million
people every year.
That crazy lack of interest reflected the shortcomings of both government
and markets. Public research centers shied away from the quest for a
vaccine because they felt pressure from people who had already
contracted the virus and who, understandably, wanted research on
treatment, not vaccines. Besides, vaccine development seemed risky. It
requires expensive clinical trials that are fraught with ethical dilemmas: One
trial group gets vaccines, the other gets placebos, and you only get results
when participants get HIV.
Meanwhile the private sector had its own reasons for failure. AIDS is a
political disease, fraught with noise and name-calling: Companies usually
avoid such territory. Worse, the biggest market for vaccines lies in poor
countries, which cannot pay much for them. The drug firms feared that, if
they spent years and millions developing a vaccine, political pressure would
oblige them to supply the fruits of their efforts at affordable
prices--meaning at a loss.
Confronted by this double failure of government and business, Berkley bet
that a non-profit pressure group might have more success. He based his
bet on a new device to marry public goals with private-sector ingenuity: A
sort of cross between traditional philanthropy and venture capital. Having
identified two groups of researchers, in North Carolina and in Britain, he
invested $9.1 million in them; but instead of demanding a share of future
profits in return for this capital, he demanded guarantees that a successful
vaccine would be distributed cheaply in poor countries.
This "social-venture capitalism" has impressed illustrious benefactors. Last
year Bill and Melinda Gates gave $25 million to Berkley's efforts, and that
vote of confidence helped to bring in more millions, notably from the British
government. What's more, the Gates team seems to regard Berkley's
method as replicable: They have followed up with gifts to funds that seek
vaccines for malaria and tuberculosis. It is too early to say for certain, but a
new model for poor-country assistance seems to have been born.
Moreover, the Berkley story is part of a broader one, concerning the role
of non-governmental organizations in international politics. Since the
collapse of the Seattle trade summit last month, it has been tempting to
regard non-governmental organizations (NGOs) as disruptive: Thanks at
least partly to their protests, a chance to promote prosperity was missed.
But, on subjects ranging from global warming to human rights monitoring,
the impact of NGOs is hugely positive.
Berkley's vaccine initiative is another reminder of this positive potential. His
tiny outfit is nimbler than governments and multilateral bodies; but it is not
too tiny to goad those big bodies into action. Since Berkley started
shouting about the scandal of the neglected vaccine, governments from
New Delhi to Johannesburg to Washington have awakened to the need for
research. The United Nations and the World Bank are turning up their
interest. Last week Al Gore addressed the United Nations on the AIDS
pandemic, and declared the administration committed to "maximum
The next challenge for Berkley will test his influence to the limit. His
social-venture capital idea has stimulated efforts to supply a vaccine, but
more work remains on the demand side. Even if a vaccine is offered to
poor countries for no more than the cost of making it, some won't find the
money. So Berkley wants to set up a purchasing fund with cash from rich
governments, so that the vaccine can be bought and distributed the
moment it has been shown to work.
How to make this happen? Berkley has an ally in the World Bank, whose
boss, Jim Wolfensohn, is big on partnerships with NGOs. The bank, in
turn, has allies in the rich governments that fund it; and all these people
want to be on the same wavelength as hip philanthropists such as Gates. At
the upcoming shmoozathon in Davos, Switzerland, Berkley will be winning
converts; and he has hopes for a White House conference on vaccines
scheduled for March. "It is not too late for Clinton to secure his legacy,"
Berkley suggests. "He could announce the creation of an international fund
for AIDS vaccines, and he could do it flanked by Nelson Mandela and Bill
The writer is a member of the editorial page staff.
© Copyright 2000 The Washington Post Company