Experts Warn Of Decade-Long Setback After Trump Cuts HIV Vaccine Research

Forbes

2 days ago

NEW YORK - DECEMBER 1: Marina Kemelman, Research Associate at the AIDS Vaccine Design and ... More Development Laboratory, collects bacteria transfected with DNA as part of research at the laboratory's campus in the former Brooklyn Army Terminal December 1, 2008 in New York City. The laboratory, seeking a vaccine to prevent the spread of AIDS, is part of the International AIDS Vaccine Initiative (or IAVI), a global not-for-profit, public-private partnership working to accelerate the development of a vaccine to prevent HIV infection and AIDS. December 1 is the 20th annual World AIDS Day around the world. (Photo by)
It was a rare moment of bipartisan unity. Standing before a joint session of Congress in January 2019, President Donald Trump boldly pledged to eradicate a disease that claims one life every single minute: HIV/AIDS.
'Scientific breakthroughs have brought a once-distant dream within reach,' Trump exclaimed. 'My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. We have made incredible strides.' Then, he added, 'we will defeat AIDS in America and beyond.'
That was then and this is now. Last week, a group of scientists working on promising HIV vaccine studies were reportedly informed that the administration plans to revoke their research grants in a move experts warn could set the movement back years.
When the global AIDS crisis peaked in the early 2000s, roughly 5,000 people were dying every single day from the disease. Thanks to the leadership of governments, the private sector, and philanthropists, the world invested more resources into the AIDS fight than ever before. This spurred nearly two decades of progress—not just against AIDS, but across global health broadly. Since 2004, AIDS-related deaths have been reduced by roughly two-thirds.
But recently, progress has slowed. Covid-19 proved a major health disruption that reversed years of hard-fought gains. Efforts to reduce mother-to-child transmission rates have slowed. Global health funding is now under siege not just in the United States, but across Europe, too. And the world is no longer on track to meet critical 2030 AIDS targets.
The great paradox here is that never in human history has there been more tools available to fight AIDS. The cost of antiretroviral drugs has fallen from $27 a day in 2000 to as little as 10 cents a day. Now, experts say what's needed to get the fight back on track—and eventually end the threat for good—isn't just better diagnostics and therapeutics, but long acting preventatives. Fortunately, it's an area that's seen great progress.
Dubbed the 'breakthrough of the year' in 2024 by the journal Science, Gilead Science's lenacapavir is a long-acting injectable vaccine that has proven incredibly effective at preventing HIV infections. It represents a major step forward from the prevalent pre-exposure prophylaxis (PrEP) pill and mitigates some of the major privacy, stigma, and adherence issues that come with taking daily medication.
The next step forward could be a vaccine with even longer immunity—one that gives patients lifetime protection. Researchers have been pursuing this laudable goal for years, but last week, the Trump administration announced plans to terminate research grants at two preeminent institutions, the Duke Human Vaccine Institute and the Scripps Research Institute, totaling $258 million. The researchers were told that the administration wanted 'to go with currently available approaches to eliminate HIV.'
On the other hand, global health experts are warning that without new resources, President Trump's promise to end HIV within ten years is destined to fail—and when combined with the administration's other actions to cut and halt global health programs, HIV infections and deaths could actually rise for the first time in decades under his watch.
'I find it very disappointing that, at this critical juncture, the funding for highly successful H.I.V. vaccine research programs should be pulled,' Dennis Burton, an immunologist at Scripps, told The New York Times. Meanwhile AIDS groups, including the AIDS Vaccine Advocacy Coalition described the decision as inconceivable and shortsighted.
The grant news marks the latest blow to the HIV/AIDS community, which has endured devastating domestic and global funding cuts in Trump's second term.
San Francisco, which was one of the first epicenters of the domestic AIDS fight, has long relied on funding from the federal government to support community-based health programs that help reduce HIV transmission. These initiatives have helped the city make outstanding progress against the disease, but Centers for Disease Control and Prevention (CDC) grant delays have threatened testing, treatment, and care continuity. Even southern states which President Trump won decisively, and which account for 50% of all new U.S. HIV infections, have not been spared. According to the Foundation for AIDS Research (amfAR), cuts to domestic HIV prevention programs could spark over 14,000 additional deaths from AIDS-related causes and 143,000 new HIV infections. Earlier this year, HHS closed its Office of Infectious Diseases & HIV policy that quarterbacked the government's domestic AIDS response.
Abroad, global health programs have fared even worse. In January, the Trump administration halted funding for The President's Emergency Plan for AIDS Relief (PEPFAR), a bipartisan program that has saved over 26 million lives. In a congressional hearing last week, Secretary of State Marco Rubio said that, '85 percent of recipients are now receiving PEPFAR services.' He also said that no one has died as a result of the aid freeze, a notion journalists and health experts scoff at.
According to Brooke Nichols, an infectious disease mathematical modeler and health economist at Boston University, over 57,000 adults and 6,000 children have died as a result of the PEPFAR funding freeze and the discontinuation of global health programs. Even if those numbers are inflated, as some have contended, the number of lives needlessly lost is still likely in the tens of thousands.
While some experts remain hopeful that the recent cuts will eventually be restored, the prospect of an AIDS-free future that President Trump himself once espoused appears grim. "This is a decision with consequences that will linger. This is a setback of probably a decade for HIV vaccine research," Burton warned.