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Question: How did you arrive at the IAVI?

Seth Berkley:  I was interested in science actually and decided to go into medicine as an area of science that could do some good. I started out in the area of internal medicine, seeing patients, something I liked; got involve din setting up and working in some of the first community health type projects and enjoyed that but wanted to expand into public health. After I did my residency, I went to the Centers for Disease Control and did infectious disease work. After that, I went to Massachusetts and worked in the state health department to understand how things worked at the state. There, I was going to settle down and do some teaching and work in the state but President Carter and the Taskforce for Child Survival asked me if I would go to Uganda to help President Museveni who had just taken over to try to rebuild the health system of Uganda, which was an absolute tattered mess after 15 years of kind of craziness. It was an amazing opportunity to go do it. I took a look at it. I did not go to do AIDS but when I was there, of course, I started asking questions like what’s the male/female ratio of cases so far, what’s the age distribution -- simple things. People hadn’t looked at that so I began to look at it. Then we set up the first surveillance system for AIDS and my moment, my epiphany came when we did a suro [ph?] survey, a survey of the population, random, and took blood and looked to see whether people were HIV positive. The numbers came back and I said to my girlfriend who was doing the analysis, I said this can’t be right. You’ve made a decimal place error and she said “I think it’s right.” We went to the lab people and said the lab test doesn’t work and of course, it did. That was really what defined to me the magnitude of the problem, or at least the iceberg part of the problem, the big part under the water. So at the end of that, I left, came back, and ran the health program for the Rockefeller Foundation and there, a group of people came to me since this was my area of research and said the AIDS vaccine effort is dead. That’s how I got involved in looking at and then starting IAVI.

Question: What is the mission of the IAVI?

Seth Berkley:  At that moment in time, people perceived the AIDS epidemic as being bad, very bad and it’s interesting because even now, the statistics are much worse than they were perceived even at that moment. But the question was, why was there not a vaccine? When people first figured out that this was a virus, people said we need a vaccine. That’s how we deal with viral illnesses. So it would’ve been the natural thing to do. In fact there were predictions that they’d have a vaccine within a couple of years. Initially, it turned out to be a very difficult science challenge and on top of that, there was a lot of pressure to try to develop drugs for this virus. At that moment in time, we didn’t know how to make drugs for viruses but the activists, in a sense, they deserve the Nobel Prize. They pushed and said you’ve got to make money available and you’ve got to drive science, and so that’s what they did. So there was this intense push to get drugs, which is by the way why we have more drugs for HIV than all other viruses put together, but the vaccine effort really dropped down. There was not a lot of money, not a lot of attention, not a lot of activism, not a lot of focus on the needs of the developing world. And so the question was could we do something about that and that was really the origin of the International AIDS Vaccine Initiative. The question was should it be a consortium of companies, should it be a for-profit, not-for-profit and since there’d never been this type of product development initiative, we ended up having a lot of consultation and decided to create a not-for-profit product development, public/private partnership. The mission of the organization is to try to accelerate the development of an AIDS vaccine for use throughout the world and the critical part in the mission statement is to ensure it. In other words, we don’t have to be the ones to develop it; we just want to make sure it happens.

 

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