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National Institute of Allergy and
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Tuesday, Nov. 3, 2009

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NIAID Director Fauci Discusses Compelling Scientific Challenges in HIV/AIDS Research

Research Efforts toward a Cure and New Tools of Prevention are Critical


Approximately 2.7 million people were infected with HIV worldwide in 2007—an average of more than 7,000 individuals each day. In the United States, nearly 600,000 people have died of HIV/AIDS, and an estimated 1.1 million people currently are living with HIV infection. Each year for about the past 15 years, approximately 56,000 people in the United States have become newly infected with HIV.

In a new article in Health Affairs, Anthony S. Fauci, M.D. and Gregory K. Folkers, M.S., M.P.H., discuss the urgent imperative both to scale up proven tools of HIV treatment and prevention, and to develop bold new interventions—from curative therapies to vaccines and other new prevention modalities.  Dr. Fauci is director of the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health. Mr. Folkers is health scientist and chief of staff in the Immediate Office of the Director, NIAID.

The authors note that only a fraction of people who need HIV treatment, prevention and related services is receiving them. Even if access to scientifically proven HIV services were greatly improved by increased funding or improved efficiencies, slowing and ultimately ending the HIV/AIDS pandemic also will likely require major advances in two areas. First, curing a sizable proportion of those already infected with the virus such that lifelong therapy is not required; and, second, developing more powerful prevention tools to slow the rate of new infections. The authors assert that the scientific challenges related to these two goals are the most important issues in HIV/AIDS research today.

The authors explain that a cure theoretically could involve complete eradication of HIV from the body, a “sterilizing cure.” Alternatively, a cure could shrink the amount of HIV in a person’s body to the point where the immune system could control the infection without antiretroviral drugs: a “functional cure.”

Other compelling challenges in HIV/AIDS research relate to developing, assessing and validating new approaches to blocking HIV transmission. These approaches include:

  • Reducing HIV transmission by reducing viral load—Increase the number of HIV-infected people on antiretroviral drugs to reduce the amount of virus in their blood, benefiting their health and making them less likely to transmit the virus to others.
  • Pre-exposure prophylaxis with antiretroviral drugs (PrEP)—Antiretroviral therapy administered to high-risk, uninfected people to protect them from HIV infection.
  • Topical microbicides—Creams, gels or other substances for application to the vagina or rectal mucosa to prevent HIV infection.
  • Preventing or treating co-infections—Preventing or treating diseases such as malaria, tuberculosis, parasitic diseases or other sexually transmitted infections that may increase a person’s susceptibility to HIV or the likelihood that he or she will transmit HIV to others.
  • HIV vaccines—A vaccine that prevents HIV infection or slows the course of disease, benefiting the individual and potentially reducing his or her infectiousness to others.

The authors conclude that it is essential to sustain a robust HIV/AIDS research agenda to develop these interventions, which have the potential to be truly transforming. Without such tools, the scope and burden of the HIV pandemic will continue to grow.

ARTICLE: AS Fauci and GK Folkers. Investing to meet the scientific challenges of HIV/AIDS. Health Affairs 28(6):1629-41; DOI 10.1377//hlthaff.28.6.1629 (2009).
WHO: Anthony S. Fauci, M.D., director of NIAID and chief of the NIAID Laboratory of Immunoregulation, is available for interviews.
CONTACT: To schedule interviews, please contact the NIAID Office of Communications at 301-402-1663 or

For more information on HIV/AIDS see the NIAID HIV/AIDS portal. Also visit for one-stop access to U.S. Government information on HIV/AIDS.

NIAID conducts and supports research—at NIH, throughout the United States, and worldwide—to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at

About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit

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Last Updated November 03, 2009