On November 6, Alan Bernstein, executive director of the Global HIV Enterprise, delivered an open lecture entitled “Global Science for Global Challenges” to a capacity crowd at the Lyman Duff Amphitheatre.
The former president of the Canadian Institutes of Health Research, Bernstein described his career path as a “random walk.” Bernstein completed a bachelor’s degree in mathematics and physics before beginning his PhD in genetics. More than 20 years later, and having never done any research work on the virus, he became the head of the Global HIV Enterprise.
Yet Bernstein holds that one of the major reasons for his career success lies in the fact that he was able to bring a fresh approach to his various positions.
“Most real breakthroughs in science happen by people who know nothing about the breakthrough they’re doing,” Bernstein said.
He suggested that often the creative, outside-the-box ideas come from individuals who are free from the dominant paradigms of a particular field.
Last month, an article in the New England Journal of Medicine described the first successful HIV vaccine trial in Thailand, now referred to as the “Thai trial.” The Thai trial took the innovative approach of combining two separate HIV vaccine candidates, neither of which had worked individually.
Bernstein pointed out that many of the supposed “experts” in the field were opposed to the Thai trial from the get-go, claiming that it would be a waste of time and resources. And despite the surprisingly positive outcome of the trial, the results remain controversial: critics note that the vaccine only showed a 31 per cent efficacy from a limited sample.
According to Bernstein, however, the potential of this trial result is enormous. He noted that whereas 31 per cent efficacy is not license to produce a vaccine, it does represent a higher success rate than the first polio vaccine trials in the thirties. These polio vaccines were subsequently refined and have virtually eradicated the disease. Bernstein envisions a similar fate for HIV.
He further emphasized that the proper way to interpret these results is to consider the incremental nature of scientific progress.
“It’s actually very rare in science that you hit a home run,” Bernstein said, “In [the HIV vaccine] field, there is an expectation that this will be different, and unless a trial confers 100 per cent protection, there’s something wrong with it. We don’t get that anywhere. It’s unrealistic to expect…home runs; to demand that is to guarantee failure.”
Perhaps more than anyone, Bernstein understands the challenges facing the developers of a viable HIV vaccine. HIV is the most efficient virus at subverting the immune system, and there is no perfect HIV animal model. But the success of the recent HIV trial has given Bernstein hope.
“I’m quite optimistic that we’ll get a vaccine one day,” said Bernstein.
Bernstein also had an important message for the students in the audience. “One of the messages I want to convey to everyone here is just how important young people are to [HIV vaccine development], and to global health and to Health Canada. Science is all about young people…because young people, by definition, see things with fresh eyes.”