The WHO-UNAIDS HIV Vaccine Initiative, set up last week, aims to heighten international cooperation on AIDS vaccine research in the face of mounting urgency as the epidemic spreads.

"The new initiative provides an independent forum wherein everyone working on HIV vaccines, from the industry or from research agencies, and from affected communities, can identify common ground for collaboration and coordination," says Jose Esparza, coordinator of the new initiative. "This should help capitalise on the extensive experience of all organisations."

The HIV Vaccine Initiative will focus on strengthening the capacity in developing countries to ensure that vaccine trials are conducted with the highest ethical and scientific standards, he claims.

A major challenge facing HIV vaccine development is finding a vaccine that will be effective worldwide, including developing countries, where 95 per cent of infections occur. "Vaccines are among the most cost-efficient interventions to prevent infectious diseases," says Barry Bloom, dean of the Harvard School of Public Health and head of the new joint WHO-UNAIDS Vaccine Advisory Committee. "We are fortunate that new initiatives are being proposed to expand availability of existing vaccines in developing countries and to conduct research to develop new ones," he says.

The multitude of HIV strains and the number of potential vaccines being tested make it imperative to coordinate research efforts. "Vaccine development efforts require concentrated international coordination and collaboration with the full involvement of industrialised and developing countries, the public and private sectors, governmental and non-governmental organisations, and the pharmaceutical industry," Esparza says. "They also require the creation of financial incentives to stimulate more research and development."

Less than 20 years after AIDS was identified, it has become the most important infectious disease, the first cause of death in Africa and the fourth worldwide. More than 15,000 new HIV infections occur every day, most of them in developing countries, and over 33 million people now live with HIV or AIDS.

The involvement of both WHO and UNAIDS in promoting AIDS vaccine development goes back nearly a decade. In 1991, WHO spearheaded a vaccine development effort that assisted Brazil, Thailand and Uganda in elaborating the framework to conduct vaccine trials under the highest ethical and scientific standards. All three countries have either conducted, or are now conducting, such trials.

The AIDS vaccine effort shifted to UNAIDS after the programme's creation in 1996. UNAIDS established a vaccine team whose advisory committee was headed by Bloom. The committee, which has now become a joint WHO-UNAIDS committee, provided a unique forum for collaboration, wherein scientists from different agencies and disciplines were able to meet to exchange ideas and explore future avenues of research.

The urgent need to accelerate the development of an AIDS vaccine prompted UNAIDS and WHO to join forces and officially establish the HIV Vaccine Initiative to coordinate that development. The joint initiative will profit from the experience of both organisations and from existing wisdom gleaned from vaccine efforts against two other major killers, tuberculosis and malaria.

"This is the ideal team," said Esparza. "UNAIDS brings with it its expertise in social and behavioural research and community participation, which is essential for the conduct of human vaccine trials. Any future vaccine is also an integral component of AIDS prevention and control." WHO brings its vast experience in vaccinology and the conduits it has established with pharmaceutical firms in developing earlier vaccines. WHO will also be essential in the delivery of an effective vaccine once it is discovered, Esparza says.

And if an ideal team can find an ideal solution to combat this killer disease, it would be an ideal situation indeed.