Organizers of the IAS cure meeting showed "a real failure of imagination" in not including cell and gene therapy approaches on the program because they are expensive and not readily applicable to Africa, said Jeff Sheehy.
Sheehy is a longtime San Francisco AIDS activist who sits on the governing board of the California Institute for Regenerative Medicine (CIRM). The institute was set up under a $3 billion bond issue approved by voters to promote research on cures for diseases.
It has supported a small HIV clinical trial using the technology of Sangamo BioSciences to modify a patient's own CD4 cells to give them the ccr5-32 mutation that confers resistance to HIV.
Sheehy acknowledged that the Sangamo approach, should it pan out, is likely to be expensive at first. But it might be particularly useful for patients whose CD4 counts do not increase significantly when they start HAART.
The economics might also make sense for the urban poor with issues of daily survivalhousing, food, etc.that compromise their ability to adhere to a daily HAART regimen.
He believes middle-income countries like Brazil and China are likely to jump on cell-therapy research because "they pay First World prices" for HAART but costs for doctors and technicians are significantly lower than in the US.
CRIM is putting $10 million-$12 million a year into HIV cure research, "about a fifth of what NIH is spending, more than other governments, more than amfAR," said Sheehy, "but we are not invited to the table. I feel stigmatized."