How vaccine research is failing the youth

Being young in each decade means something different. Each generation has new challenges and struggles, new fashions, new pressures. Some things though, remain universal. In the 80s in this country the struggle referred to fighting an oppressive government and perhaps now it means a similar thing. We have bridged the gap between the 80s boomboxers and the millennials with a dark and ominous threat, HIV/AIDS and with no vaccine or cure in the foreseeable future, this looks to be set in. Despite this, we have come a long way in South Africa. From scandal that radiated from the division of AIDS in the early 90s (a ridiculous musical, a strange solvent turned injectable) to the early 2000s where our own president denied HIV causation and our minister of health “solved the world’s problems” with the African potato, we have been plagued with a series of poor political decisions. These have I’m pleased to say resulted in some great decisions; we have the highest governmental rollout in the world of ARVs and a mother to child transmission rate of less than 2%. We have great research culture in HIV too. Some of the brightest young minds are working on the best way to solve multiple problems. But vaccine research, now that’s a tricky business and it is really the only way to ensure a bright future for the youth.

I have just entered the world of HIV vaccine trials. I need to mention upfront that clinical trials are hard. It will take a minimum of 5 years to run safety and feasibility trials and product development is a nightmare. This is only after all the basic science has been completed which often takes a decade (monkey studies, idea development). But these are things that cannot be helped. So why do I say the vaccine field has failed? Vaccine trials feel very much like the blind leading the blind. Often decisions have been made completely out of line with sound scientific basis. There are many reasons for this, some more sinister than others. One is as a result of old dogma, which is a problem with science in general. There are almost always great innovations coming out from literature but people in the higher echelons make the decisions and sometimes they push their own agendas and sometimes they are nervous. Understandably; these trials use stupid money. A failed trial means lack of funding and more worryingly a dangerous trial means loss of faith in vaccines- something the world can simply not afford. The recent spate of measles related deaths is the US and polio-induced paralysis in children is a direct result of the anti-vaxxers movement. They are inspired by a paper, which has since been retracted for falsification, that showed a link between autism and vaccination. A lot of damage can be done by a poorly run trial but the misnomers that come from media are equally destructive.

Another argument for quick decisions within a vaccine research body can be made for progress for progress sake. This is important. We cannot wait another 20 years to get the perfect vaccine immunogen and we will learn from negative results. Having said that, we have to be going forward with new brave ideas. Some of them will fail but they won’t fail because they aren’t well conceived. We will head into the unknown but it should not be blindfolded or wearing blinkers. We need leadership that really gets it -that is not detached and far removed from the lab work, is not exclusively feeling the pressure of finance alone and is happy to listen to the bright minds they hire to run the trials and trusts them to input ideas.

The world is a scary place for the youth. 90% of the time we are in murky waters. We still have many of the same problems but we can’t solve them with 100 year old tools. We can no longer err on the side of caution and we can no longer allow politics to govern science. The field of science needs to start really listening and stop patting itself on the back for Nature papers no one ever implements into policy. Where is the application? Doing proof of concept studies with no measurable product in a clinical trial is a scary thought. What are we saying to the volunteers? “Please give us your time. If this works, we can’t give it to you because it is completely impractical.” We have to improve and we have to be better for those who are yet to come. We need to make it normal for the youths only problems to be a trivial shortage of selfie sticks or what to wear on Friday nights and not a fear of contracting a death sentence. A tall order-one I hope will be realised in my lifetime.

Bacteria horror

Hugs

Feeling lame

Pacman

Viral irony

Pablo-esque evolution

Le Inspirational

I recently met a personal hero of mine. I couldn't think of anything remotely intelligent to say and instead stood grinning like an overbaring Cheshire cat while we took a selfie. The only thing that I could think was she has a Wikipedia page. Clearly this is something Françoise Barré-Sinoussi doesn't regard as one of her greatest achievements: the discovery of HIV or the 2008 Nobel Prize for Physiology and medicine probably ranks up there. 

I wondered, while I stood there looking geeky, what she thought of these young PhDs gawking at her. In the speech she made later that day she said that scientists place too much emphasis on high impact papers. She said when you go to bed at night, papers that no one reads do not matter. At which point a bunch of people in the audience (predominantly clinicians and scientists) rolled their eyes; these people probably were also on a nature paper recently. She said that she tells her students to get out of the lab and to meet the people affected so they can look them in the eye and understand, not at a biological level but at a human level. That is where greatness is born.

I began to wonder if that is a lesson only learned by science's elite as they get older. Had she been awarded the Oscar of science at 25 say, how would her attitude be different? Filled with the folly and arrogance of youth or bolstered her to greater heights at a younger age? How much do these awards mean to the people who get them when they are only given 20 odd years after the fact?

Of course these mullings would all have been better things to think than "She has a Wikipedia page" when I met this great science mind. It is unlikely that I will ever be in close proximity to her again but with any luck, I will take her message to heart. Remember who you are working for. It is not for honour or accolade, it is for the people - past, present and future. A scientists reward: the selfish joy of discovery. And then there's a realisation that your tiny piece of information fits into an never ending jigsaw puzzle, the greatest one ever built. And if it doesn't fit, well, someone is bound to stand up and tell you that at a conference. Ah science, thy fickle beast!

B cell development: basically a romcom for the ages

I've always thought of our universe as a complicated version of one of the scenes from Men in Black. Will Smith peers into a locker containing an entire world of tiny aliens who think he's almighty because he is larger than them. What if all living things are really just small world's within bigger worlds within gigantic world's : worldception? Think about it: what if Bob the skin cell feels like he is just a cog in the policing machine for the man? Then one day he gets cruelly sloughed off just because you walked into a door. Supposing this is true, it should hardly come as a surprise that our cells' interactions very closely mimic our relationships or perhaps more accurately, a scene from The Notebook. 

Our immune system is a perfect example of the rollercoaster of love. They say that as soon as you stop looking for love it finds you. Well no one looks for disease and it finds our cells all the time. I never promised this would be a good analogy. Never the less the B cells have feelers out all the time, searching for meaning, searching for something to ignite their fire so to speak. Once they spot something they like, much like our version of brown hair or eyes that are as deep of the ocean, they activate. Secrete a bunch of things and start overreacting. Pretty much what happens to humans. 

Now although some B cells don't need any help to get to a happy chaotic stage much like humans, the majority need some company. And occasionally they need matchmakers. Certain cells provide T cells with an antigen or some attractive feature so that when a hunky naive B cell comes along they are ready to turn on the charms. Of course there are external factors at play, and certain factors drive the adonis B cells into different zones of the tissue. Think of the T zone as the awkward dating pool - the mesh of clubs, boring movies, sweaty hands etc. If the B cell doesn't find a T cell that matches what he is looking for he moves on. Likely to a place called the B cell zone. A place really where everyone hangs out and pretends they "don't need no woman" or whatever they tell themselves. In actuality what they are doing is just hoping to survive and go into dirt bike riding or some other crazy hobby until they again get sucked into the T zone. 

If the B cell does find what they like then they get trapped in the dating zone and they form a couple with the T cell. This of course changes both parties; for one once bonded it would be bad if the B cell went back off to scope out the rest of the T cell zone hoping for a more curvy possibly blonde T cell. Not only do they individually become pretty clingy but they strengthen their bond with reciprocal favours; bringing home flowers, washing the dishes, promising to fix the garage door. Eventually they form a synapse or as I like to call it, marriage. They move together out of the awkward dating pool and into their own place. Here they begin to divide and form a happy family called the primary focus. It is here that the sexy slim B cell often changes into a rather large flabby shadow of his former self, the plasma cell. However scattered throughout the home are cells that help provide complements (punny if you are an immunologist) to each of the cells and ultimately their marriage survives and they are average. 

Some B cells, like some people enjoy change and instead venture off into a new location with their partner. Here they change radically excelling in career and producing the best antibodies. Their partners change too. Occasionally there can be too much change and often B cells can no longer recognise the complements or attracting factors. Soon he's too busy working nights to notice Ben his eldest cell just apoptosed. The B cell is now barely himself mutating and hypermutating and now hangs out with his buddies in the dark zone. Sometimes the B cell gravitates back to the light zone once he has matured past his midlife crisis where he will be reunited with his T cell partner. Often the B cell and the antibodies he expresses have changed too little or too much and they must now fight for the affections of his partner or die. I realise this went medieval pretty quickly. 

Okay so perhaps not exactly like the Notebook - but still a better love story than Twilight. 

The PhD condition

I've heard of people spending 8 years finishing their PhD. When I was an overachieving undergraduate I would turn my wet noobish nose at these "lazy sloths of science". I mean clearly, CLEARLY these people were just sitting around the nespresso machine  and had never touched a pipette. Then I met science. Not the kind of science you read about in books, nor the kind in movies where lethal diseases can be vaccinated before the well groomed scientist in the heels rushes out to dinner with Brad Pitt. Science - the mysterious mush of the unknown. And everyday since I have been filled with the uncomfortable thought that it is out to get me.

I think I always knew I would be a scientist. When I was two I asked my dad where the light went when you switched it off. The feeling that I get when people ask what I do is a bit, I imagine, how Rocky Balboa felt when he reached the top of the stairs. I say imagine because I am not so skilled with the running thing, or the walking thing for that matter. " Ooh a scientist" they coo. "So what does that entail? "Then, as I explain enthusiastically I watch their eyes glaze over. But it doesn't matter for I am a scientist!

It was a natural progression then that I would do my PhD and about a month ago, I registered. But as much as I love what I do, I cannot shake the feeling of dread that I do not have what it takes. Science, it turns out is not just experiments and research and questions and answers - all things I am good at. Instead these things are only a tiny proportion of overall career. Much of science is being a glorified hobo begging the likes of Bill Gates for money. Slowly we add accountant to our resume. Not something I even remotely wanted to do with my life.

Then there is the never ending politics. If someone gives you a plasmid ( basically just a tiny nothing snip of DNA) and they are a big shot but did no other work for the project you were working on, they must be an author on your paper while someone else, who probably did a huge chunk of work gets bumped to acknowledgements because they only have a honours or something. Is it fair? Nope. Will it change? Nope. Getting bounced around by huge egos is they way it works and as your research gets into bigger journals so the pressure to bow down increases. Politician. Right, another thing I never studied.

Marketing is another huge part of research. So many Cell and Nature papers show obvious things. Things that are by no means innovative but they are repackaged  in the most amazing story. It's a bit like Shades of Grey. BEST MARKETING STUNT EVER. It's porn in Mills and Boon form; both of  which have been around forever; not innovative just repackaged. Generally scientists became scientists so they could be swathed in the warm comfort of no social contact. Instead we must become advertisers and more and more dolly our science up because bar charts are no longer enough. In fact infographics with 42 keys are the only way to go. Promotions....I can *gulp* do this.

It is not hard work I am afraid of, in fact I revel in it. However no matter how hard one works, it is never enough for the prying eyes of the PhDs  whose whole life is devoted to the lab. They eat there, sleep there, probably don't have a shower very often and then casually claim that anyone who is exercising or going home to a partner/child is simply weak. Having a life is just not okay. So as if all the pressure from the additional careers that we have taken on isn't enough, our own peers are constantly trying to undermine us. It's a  cut-throat world - and you just thought it was like an episode of big bang theory. 

The worst part of all this is that the two year old, the one who was so inquisitive about the world around her, is slowly receding into her shell. She fears speaking out lest her ideas be stolen from her or someone attacks her dreams of discovery. Galileo was killed by the church and I still think he had it easy.