LAUSR

The way forward requires all stakeholders—funders, researchers, product developers, trial networks and advocates—to analyse closely what the field has learned to date, develop clarity on the critical scientific challenges and agree on a coordinated strategy to pursue answers. Since early 2020, two trials of different HIV vaccine candidates and two trials testing antibody-mediated prevention (with implications for vaccines) showed no overall efficacy in preventing HIV acquisition. The AMP trials confirmed that a broadly neutralizing antibody (bnAb) can offer efficacy, when the circulating variants of HIV are highly sensitive to the bnAb neutralization. Because only a minority of circulating strains associated with incident HIV infection were neutralized by the single VRC01 bnAb, these studies suggest that a combination of bnAbs is needed to achieve broad protection. While almost four decades of research have yet to deliver a licensed HIV vaccine, they have been an engine of discovery, providing vaccine know-how, technology, clinical trial network and site infrastructure, researchers and advocates that galvanized the development of multiple COVID-19 vaccines in record time.