Dr. Mark Wainberg PHOTO: CLAUDIO CALLIGARIS

Leading the charge against AIDS

Dr. Mark Wainberg, director of the McGill AIDS Centre, has been a leading AIDS researcher since 1984. His lab at the Jewish General Hospital's Lady Davis Institute for Medical Research, in collaboration with pharmaceutical company Biochem Pharma, was the first to identify 3TC, one of the leading medications in the battle against AIDS, as an effective antiviral drug. Among other research, Wainberg is currently working on the development of an HIV vaccine. This summer, Wainberg was named president of the International AIDS Society when he attended the organization's biennial convention in Geneva. The society is the world's largest organization of AIDS researchers and clinicians. Wainberg's appointment is for two years. He recently spoke to the McGill Reporter's Sylvain Comeau. What are your plans as president of the International AIDS Society? We're going to work towards improving access to (anti-AIDS) drugs in poor countries. We are going to ask industry to drop the price of their drugs in the developing world, and to work on developing new and cheaper ways of treating people. Another focus will be to promote HIV prevention. We will try to convince countries that have the highest infection rates to launch information campaigns promoting safe sex. It's very ironic that, in Canada, where the risk of contracting HIV is relatively low, we have no problem discussing condoms and safe sex fairly openly. Meanwhile, in developing countries like Kenya and South Africa, where the risk is greatest, you hear very little about safe sex. There are no billboard campaigns, for example. Why is that? The political leadership to enact these measures is not in place. So I'm going to be meeting with political leaders, and encourage them to launch these kinds of campaigns. I hope that my position as president of the society will give me a certain moral authority, so that people will listen to my message. What else are you planning in the area of prevention? We will promote new research approaches to interfere with the development of HIV. There has been little progress, so far, in the development of an HIV vaccine. My own lab has been working on one for a few years, but we are not even ready to start human trials (of our experimental vaccine). So what other alternatives are available? One promising area would be vaginal microbicides, which a woman would insert before intercourse to prevent infection. This could be an effective alternative to condoms, because there are religious and cultural taboos against condom use in several countries. What are the main obstacles to the development of microbicides? The pharmaceutical industry has not recognized the profit potential in these products. We will lobby them to work on microbicides by convincing them that there may be more profits in this approach than they have ever dreamed of. In fact, a recent study shows that women would be willing to spend quite a bit of money on a product if it was shown to provide reliable protection. We also have to encourage scientists to work on this approach. I intend to speak, at every scientific conference I attend, on the need to quickly move into these areas. That's all part of my mandate. Is your lab going to work on microbicides? We have already begun to do so. We can't tell other people to do it without making the investment of time and money ourselves. What is your approach? Our approach is aimed at developing a microbicide which would attack the virus's nucleocapside protein. That would prevent reverse transcription, which is one of the first steps in virus replication. In turn, that would prevent human cells from becoming infected. Attempts to interfere with virus replication after infection are really treatment, which is much more difficult than prevention. This is not treatment; this would be a way of avoiding infection in the first place. What progress are you making on your HIV vaccine? We have developed a form of the virus that replicates a little, but does not cause disease. So it creates an immunization response, to prepare the body in case of infection with the virulent form of HIV. Our next step will be to test its effectiveness and safety on monkeys. We won't start human trials for at least another two years. What else are you asking from the scientific community? I'm going to speak to my colleagues about attending the next International Conference on AIDS in Durban, South Africa, in the year 2000. It's expensive and time consuming to get there, but we have to go, in order to show solidarity with the developing world. This will be the first time that the conference is held in a developing country. It's important that we show solidarity with the millions of people around the world infected with HIV, and who have little or no access to drugs. What was the most promising development discussed at the International Conference on AIDS in Geneva, and what was the most discouraging? The most discouraging thing was that there hasn't been tremendous progress since the last conference (in Vancouver) in terms of developing newer and better combinations of drugs. We're still working with the same combinations that worked for us then. Also, it was brought home to us again that we have no way of completely eliminating the virus from the blood of an infected person. The virus has too many ways of hiding. In addition, the number of people infected continues to increase at an alarming rate. During the meeting in Geneva, which lasted a week, one hundred thousand people became infected. That comes to five million people a year, and most of those people live in developing countries, where they will never have access to drugs. The most promising thing was that we heard about a couple of new drugs that might make a difference in the future. Will you continue to lobby the Canadian government for additional funding? Yes. We have to keep up the pressure, and get as many people as possible to be part of the pressure campaign. We have to enlist the support of HIV community groups, people living with HIV. In Canada, for the renewal of the National AIDS Strategy (a federal government allocation of $44 million per year to support HIV prevention, research and treatment) last year, the lion's share of the credit has to go to AIDS activist groups. They made it clear that they wouldn't take no for an answer, and they ended up getting yes for an answer. In recent years, you seem to have taken on the role of an activist, as well as a scientist. I am an HIV activist, without question. I have always been proud to march hand in hand with people infected with HIV, in support of their causes. And they have supported goals that we have striven for, such as more money for research. They are our partners.