One year before the coronavirus pandemic, Dr. Anthony Fauci attempted to direct the research prowess of the National Institutes of Health (NIH) toward curing what is still a largely incurable and festering global disease: HIV/AIDS. When COVID-19 cases exploded, however, that momentum stopped abruptly. While the world is racing to inject vaccines to defeat coronavirus, Dr. Fauci has renewed the $200 million call to find a cure for HIV/AIDS.
“This collaboration is an ambitious step forward, harnessing the most cutting-edge scientific tools and NIH’s sizable global HIV research infrastructure to one day deliver a cure and end the global HIV pandemic,” said Dr. Fauci when the $200 million joint initiative between NIH and the Gates Foundation was first announced in October 2019. “We aim to go big or go home,” added NIH Director Francis S. Collins, MD, PhD. Shortly thereafter coronavirus derailed the mother of all research plans—until now.
Starting this month the National Institute of Allergy and Infectious Diseases (NIAID), the division of the NIH directed by Dr. Fauci, has begun accepting proposals from the research community for funding to deliver anti-HIV gene therapies, which could cure HIV/AIDS. The renewed commitment was publicly announced in October 2020 and the announcement describes the most significant multi-year funding opportunity focused on curing HIV/AIDS to date, with applications due in March of each year from 2021 to 2023.
Moreover, because the biotechnologies relevant to curing HIV/AIDS and sickle cell disease are often technologically related, the NIH/Gates cure collaboration includes funding to cure both. “This unprecedented collaboration focuses from the get-go on access, scalability, and affordability of advanced gene-based strategies for sickle cell disease and HIV to make sure everybody, everywhere, has the opportunity to be cured, not just those in high-income countries,” says NIH Director Francis S. Collins, MD, PhD. In this country, both HIV/AIDS and sickle cell disease disproportionately affect African Americans. Coronavirus has demonstrated that the time to address our nation’s health inequity is now, as we’ve seen the disproportionate outcomes for the African American community, as well as many other marginalized communities, throughout the pandemic.
An estimated 37 million individuals are currently living with HIV/AIDS worldwide; only two individuals have been cured of AIDS, both recently. Human Immunodeficiency Virus (HIV) binds to, infects, and destroys cells of the human immune system by attaching or “docking” to two proteins, primarily CD4 and CCR5, which are located on the cell surface. Left untreated, HIV depletes the immune system and causes Acquired Immune Deficiency Syndrome (AIDS).
To cure the first two patients of HIV/AIDS, stem cells from naturally HIV resistant donors (who make up less than 1% of the global population) were transplanted into the patients. This required a complex, multi-step process. The next steps relate to taking the science underlying these first two instances of a cure and developing a safe and effective method that may be used to cure all those in need, worldwide.
Two main pathways can be pursued to develop a broadly-applicable cure, ex vivo and in vivo pathways. Ex vivo cell therapy relates to taking a patient’s own stem cells out of their body and using molecular tools to perform “genetic surgery” on the cells to render the cells resistant to HIV, followed by infusing the newly HIV resistant cells back into the same patient where they may grow and give rise to a new, HIV resistant immune system. In vivo cell therapy relates to performing the genetic surgery within patients—without taking their cells out as a first step—delivering the molecular tools directly into the body.
There are multiple academic, biopharmaceutical, and research foundations each developing their own promising biotechnologies to cure HIV/AIDS. At this time, funding and support from donors, foundations and the government are all welcome and necessary to accelerate efforts*. But is it sensible to fight HIV/AIDS in the midst of the coronavirus pandemic?
Make no mistake, HIV/AIDS and coronavirus are different fronts in the same war. Only by sharpening our biotechnological tools by actively and vigorously applying them to develop new vaccines and cures can we strengthen our scientific arsenal against viral outbreaks, including coronavirus.
* Kambiz Shekdar is the president and founder of Research Foundation to Cure AIDS, a 501(c)3 not-for-profit organization with its own biotechnology for in vivo and ex vivo cell therapy and is applying for the NIH and Gates funding to develop a cure that is available to all those in need, regardless of ability to pay.
Editor’s note: A version of this article originally appeared in WestView News.
Rockefeller University alumnus and biotech inventor Kambiz Shekdar, Ph.D., is the founder and president of Research Foundation to Cure AIDS. Contact Kambiz at [email protected].