Explores relationships and discrepancies between important research-based medical advancements and subsequent real world implementation. Advancements in the management and potential elimination of infectious diseases such as HIV and TB will be addressed, as related to development and implementation of effective diagnostics, vaccines, or treatments.

1. In search of HIV vaccine: Progress and Challenges Shiu-Lok Hu Department of Pharmaceutics University of Washington 7th Annual Western Regional International Health Conference April 5, 2009 From Discovery to Delivery: Benchwork to Global Health

2. As a result of the HIV/AIDS epidemic, life expectancy in Africa has reduced to levels at the beginning of the 20 th century Impact of AIDS on life expectancy in five African countries 1970–2010 Life expectancy at birth (years) Source: United Nations Population Division (2004). World Population Prospects: The 2004 Revision, database. Botswana South Africa Swaziland Zambia Zimbabwe 1970–1975 1975–1980 1980–1985 1985–1990 1990–1995 1995–2000 2000–2005 2005–2010 70 65 60 55 50 45 40 35 30 25 20 4.1

3. Discovery of HIV Luc Montagnier * Francoise Barré-Sinoussi * Pasteur Institute, France HIV-1 1983; HIV-2 1986 * 2008 Nobel Prize laureates

4. The ability to propagate HIV in tissue culture helped the identification of the virus as the etiologic agent of AIDS and enabled the development of the first diagnostic test for HIV infection Gallo et al., Science . 1984 May 4;224(4648):500-3. Popovic et al. Science. 1984 May 4;224(4648):497-500. Schupbach et al., Science. 1984 May 4;224(4648):503-5. Sarngadharan et al., Science. 1984 May 4;224(4648):506-8. Schupbach et al., Science. 1984 May 4;224(4648), 607-10.

5. First antiviral drug against HIV First generation reverse transcriptase (RT) inhibitor: AZT

6. Percentage of persons surviving through June 2005, by years after AIDS diagnosis cohorts during 1981–2003 and by year of diagnosis — United States Source: CDC. Twenty-Five Years of HIV/AIDS — United States, 1981–2006. MMWR 2006. 2001‒2003 1996‒2000 1993‒1995 1981‒1992 0 25 50 75 100 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Years after AIDS diagnosis % Figure 12

7. Percentage of population living with HIV in need of treatment who are receiving antiretroviral therapy Africa, 2007 For every two HIV-infected individuals receiving antiviral therapy, five more become infected The Millennium Development Goals Report, United Nations, 2008

9. Most successful vaccines made to-date are against pathogens that can elicit protective immunity as a result of natural exposure

12. HIV vaccines approaches *Vaxgen: AIDSVAX ® (gp120 envelope antigen); antibodies *Merck: Recombinant adenovirus (Core antigen) ; cell-mediated immunity recombinant protein (gp120) peptide scaffolds naked DNA live-recombinant vectors (poxvirus, adenovirus, bacterial) whole-inactivated virus live-attenuated virus HIV Vaccine developer* 2 0

13. Direct evidence indicating the possibility of immune protection against primate lentivirus infection and AIDS has been largely provided by non-human primate models

14. Sooty mangabey SIVcpz Chimpanzee HIV-1 SIV Sykes monkey Mantled guereza L-Hoest’s monkey Mandrill Red-capped mangabey Vervet monkey Greater spot-nosed monkey Slide courtesy of Beatrice Hahn Origin of HIV: Cross-species transmission of simian immunodeficiency viruses SIVsyk SIVcol SIVlho SIVrcm SIVgsn SIVmnd SIVver SIVsm HIV-2 SIVmac

15. Improved AIDS-free survival in immunized monkeys after challenge with a chimeric primate immunodeficiency virus (SHIV89.6P) Li et al., J. Virol.82: 638-651, 2008