Hemorrhaging fear

20081 Ebola cases in West Africa were recorded on the penultimate day of 2014. A year wrought with misnomer and confusion that exposed the complete folly of first world countries where ultimately there have only been 5 cases. That is a total of 0.02% of the global burden; a burden I might add that was enough to send main stream America into a panic that had at least a handful of people wearing face masks on planes travelling from Detroit to New Orleans 8,746km away from the epicentre of the outbreak.

It took the treatment of 2 health care workers in Atlanta and the deaths of 2400 people in Africa for the American administration to send 3000 members of the US army to help in the fight against the spread in Guinea, Liberia and Sierra Leone. Spain of course greatly contributed to the fight when officials decided to put the dog of an infected health worker down, even when there was no scientific basis for ending Excalibur's life.  It is concerning to me that in an age where as much as 31 percent of the world's demand for bauxite, cobalt, gold, manganese, phosphate and uranium is supplied by Africa, the death of its people was of little concern until their disease breeched the first world. 

Ignorance can best be explained by this gem from Donald Trump

So basically do good things for the world and you deserve to get a deadly disease. It's a wonder Mother Theresa didn't die of tuberculosis. Yes Africa is the source of many zoonotic diseases but that's because there are larger areas of Virgin mother nature that is more habitable than many other places in the world. Slowly but surely we are encroaching on habitats of things we don't understand yet, interestingly not only because of population expansion but ironically because of the human races intense requirement for more of everything. These sorts of outbreaks are not the concern of the people they infect first but of the whole world. This is not the time for selfish behaviour otherwise at the end of 2015 we will have a pandemic out of Africa that kills millions all around the world. Sound familiar?  

A taste of our own medicine

Sitting in a work meeting the other day (yes scientists have those too), we were posed with an interesting question. Would we, as HIV researchers, be willing to take part in one of the many ongoing HIV vaccine trials given the chance? The reaction was immediate, a series of firm shakes of the head swept the room and then a spattering of hurried excuses – “Well, we aren't really the target population, ethics… blah blah *scientific jargon* blah blah.” That got me thinking, why were the very people who design these vaccine candidates so hesitant to become the lab rats to test their means to change the course of history?After all, every scientist wants to leave a legacy and the best way to anger one is to tell them that even if they win a Nobel Prize, they will never be as famous as a 12 year old pop star.

I feel sure that the answer doesn't lie in a lack of commitment to the cause. Our lab represents some of the most determined to end the scourge of HIV. Being in a field that has been working for 3 decades with no translatable success and continuing to search for the proverbial needle in the haystack is disheartening to say the least. Despite this high level of failure, this group of extraordinary science minds continues to untangle the mess that HIV has left for humanity, bolstered by the fact that any meaningful finding could mean saving millions of people.

Could it be the stigma that is attached to the unknown element of HIV research? On posing this question to non-scientisty types, their reaction was one of horror. “But what if you contract HIV? Would you do that for your science?” Clearly there was a disconnect of knowledge there. In HIV vaccine trials they don’t give you a vaccine, inject you with HIV and hope for the best. This seems like an obvious statement but it is amazing what conclusions the mind can make when perceiving a threat. Those people who are recruited are healthy HIV negative individuals and although some cohorts are high risk for HIV, they are given the best information  possible to prevent infection. 

I think much of the uncertainty in the field lies in some pretty disturbing results in recent vaccine trials. HVTN 502 and 505 trials were stopped during immunisation due to futility. However, in one of the trials there was actually a trend over follow up that showed that the vaccine arm had a higher HIV infection rate than the placebo arm- a very depressing result for vaccinologists anywhere. In fact I was at the conference in Barcelona when this whole story was explained and I can tell you that you could hear hundreds of scientists'  hearts breaking in one audible crack. 

Scientists are very practical people. We only deal in facts. Fact 1: the only vaccine that showed any efficacy only protected at 31%, fact 2: we haven't had much functional success in 30 years. So why do we continue hunting for one? Well quite simply put, it is worth it. Humanity is always worth it. So perhaps the unwillingness to test our own outcome is not because we are snobs or hard unfeeling machines but because we are perfectionists. We are always dissatisfied with our progress. Everyday we work to make sure that anyone who participates in any study is as safe as they can be and that their wonderful contribution is fully appreciated. So the next time you walk past a scientist and think that we are all like Sheldon from Big Bang Theory (physicists are a totally different breed!), give them a high 5 or even better a hug (virologists don't get many of those for obvious reasons) - we are pretty cool!