Q & A With Bill Snow

Talks at the annual AIDS Vaccine Conference, held this year in Boston, reflected dramatic shifts in the HIV prevention landscape. The conference also stressed the work of young and early investigators. VAX Science Writer Regina McEnery sat down with longtime AIDS vaccine advocate Bill Snow, appointed six months ago to lead the Global HIV Vaccine Enterprise Secretariat, for his perspective on the conference.

This year, the opening plenary talks didn’t focus solely on vaccines. Is this the first time the conference has included talks on other strategies?

People have always had to consider what’s going on in the epidemic. You can’t run vaccine trials in a vacuum. Anything that has to do with the clinical end of things has had to be responsive pretty much on the spot to changes like [antiretroviral drugs] getting distributed more widely and voluntary male circumcision. It just didn’t show up in the titles as much as it did this year.

This conference also had a considerable number of young and early career investigators taking on leadership roles or presenting data. What kind of impact did this have on the conference as a whole?

I think it had a huge impact. If you look at the program, there were a lot of speakers who had not spoken at previous conferences or held such a high visibility spot. What that does is it makes the conference much more interesting. You hear the people who are doing the work instead of the people who are managing the work, and you tend to hear more specifics.

In your talk opening night you said the field is “short on research and long on little tweaks and new ideas that make for indecision and conflict.” Can you elaborate?

It really has been an insider’s game. The few 1,000 [scientists] who work on this are excited; they can gauge the progress and they know the joy of the little victories and the disappointment of little defeats. But in the end, in the outside world, we have to justify what we are doing and the best way to do that is to let people know what we are really accomplishing along the way and not just talk about the pot of gold at the end of the rainbow.

You pressed the field to either validate or cast aside the results of the RV144-correlates analysis. Were you chastising the field for taking too long?

No. What I meant is that we’re halfway to answering that question and we might be able to answer it without an efficacy trial if we are really smart about it. Right now, people are chasing after what they think happened. We don’t know whether what they think happened is really causative. We need to know that before we start redesigning all our vaccine studies.