Countdown to a Cure

amfAR CEO Kevin Frost discusses a new research initiative

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by Jeannie Wraight


[dropcap]A[/dropcap]s part of the Countdown to a Cure Initiative, amfAR (The Foundation for AIDS Research) will direct $20 million, of a $100 million dollar investment, to launch the first institute designed specifically for HIV cure research. The Institute for HIV Cure Research would be housed at an accredited university and would have the direct goal of establishing a scientific basis for an HIV cure by the year 2020.

In addition to the Institute, amfAR would offer $80 million dollars in grants to support new and ongoing cure research.

In an interview with Kevin Frost, CEO of amfAR, Kevin explained how The Countdown to a Cure Initiative would work and why it’s so promising in the race to find a cure for HIV.

Jeannie Wraight: Can you tell me a little bit about the initiative and how it came about.
kevin-frostKevin Frost:
It’s an initiative aimed at trying to establish the scientific basis for a cure by the end of 2020.

The initiative itself has several components. The most important component is amfAR’s intent to invest $100 million over six years to get us to that scientific foundation for a cure.

The initiative came about for several reasons but mainly because of a sense that we had [as an organization] that the science around a cure was maturing to a point that if we made a concerted effort and the right investments with that $100 million, that we could actually build the scientific foundation for a cure. So the science is actually what led us there. On top of that, we’ve had some really successful years here at amfAR and we’ve always felt that it was important organizationally not to build up an endowment, and have a huge amount of money in the bank, but to spend the money we raise and speed up the research process. So that’s really what led us to where we are. The initiative itself is largely a research initiative but we have marketing and other components to it.

I love the idea how the research would go together, collaborating with other research and building on what’s been discovered.
That’s exactly right. We think that the science is such that we are actually there and we can really make this push.

Why 2020? Also the “scientific basis”—what does that look like, what are you aiming for?
I’m glad you asked that because we’re very careful about the language we use around here. We don’t think it’s likely in the short term that there’s going to be a single cure for this disease. There are many different approaches that are being looked at right now. We think what’s likely to happen is that we’re going to start curing a few people and then hopefully we will build on that. But right now what we have is one person cured in the Berlin patient, so there’s proof of concept but so far, to date, no one has been able to replicate it.

The scientific foundation of the cure would mean having a very clear and importantly replicable scientific approach to curing people. Now that probably would mean that we will be able to cure some of the people, some of the time but not all of the people all of the time. In fact even vaccines don’t work 100 percent of the time. Our point is that a scientific foundation for a cure is having the knowledge of how to go about it and so far that’s what we don’t have. I fully expect that when we do start to cure people it’s going to be difficult, it’s going to be complicated and it’s probably going to be expensive but the very history of medicine is that we take things that are difficult, complicated, and expensive and we make them easier, simpler to administer and cheap. I’m hoping that will be the case with AIDS, but we think that in order to get there we have to have a clearer understanding of what it means and what it will take to cure people. We have to be able to do that and to prove that it can be done and that’s really what the scientific basis for a cure means.

kevin-frost-2

I’m interested in the logistics of it. So the $20 million grant for the Institute would be at a university. Have you narrowed down the potential universities?
So there are several components to the $100 million grant initiative. One of which is the Institute—that is a $20 million grant. Yes, we have narrowed it down. It’s not an open process. Several institutions have been invited to apply and then those institutions go through several steps, the first of which is known as a letter of intent where they write back to us and say, yes, we are interested. Then they go through the process of writing a full application, which is designed and provided by us. Then we will narrow it down to a few leading candidates and there will be a series of meetings and site visits where we will ultimately make a final selection on where the research Institute itself will live.

And the researchers, those would be researchers from the chosen institution or would you invite specific researchers to participate?
Well, certainly the strength of the application will be largely based on what researchers are already [working at the selected] institutions but we also think that from conversations that we’ve had from people and institutions that a grant of this kind is also likely to attract talent. Meaning, with a $20 million grant for a research institution, it’s very likely that researchers will be attracted to the institution and so we think that it will be an opportunity to bring in some new talent to this as well.

As far as the ARCHE (amfAR Research Consortium on HIV Eradication), a grant program that, as your website notes, “supports collaborative teams of biomedical researchers exploring strategies for eradicating HIV infection,” how will this and the Institute work together or are they completely separate initiatives?
ARCHE is a different approach and on the surface it might even seem antithetical to the Institute approach because the ARCHE requires that the grants be given to multi-instituitions so the institutions, at least two, have to come together with a proposal to collaborate on a research idea in order to be funded by ARCHE. Where with the Institute, our idea is to bring all these smart people under one roof. That’s what I mean when I say it’s not just the approach we’re funding but it’s the approach to funding that is looking at different ways of doing it.

ARCHE has been highly successful already in just its first few years, but we also think that there’s a potential for some synergy. For example, if institution X is also where the research institute is, there’s no reason they couldn’t propose a multicenter research idea with other institutions and be funded under the ARCHE umbrella, for example. So there should be multiple opportunities to be funded.

That’s great. So you would work with other collaborations such as the Martin Delaney continuum or other researchers? Would it be an open thing, not necessarily with just funding but also with research, where it might be more transparent with the research that’s going on where research could build off outside projects. For example, this person is doing this research and we’re working on something that could build off that…could there be that type of collaboration?
I certainly hope so. Collaboration has been the hallmark of our work here at amfAR over the years, so my hope would be that that would continue to be a hallmark of that work.

That’s certainly what slows us down in general; research can be so fragmented and protective.
That’s the very reason why we created the ARCHE initiative. The recognition that it was so protective and closed and fragmented, as you say, that we decided to make it a condition of our funding that you had to work together. In order to get funding you have to come to us with a proposal that actually says “here’s how we’re going to work together.”

This is about cure research in general. Therapeutic vaccines over the past few years are showing a lot of promise in conjunction with other strategies for cure research. Is amfAR interested in looking at anything like that?
Well, we have funded some of that and I think we will continue to try to fund that. Therapeutic vaccine work is very interesting and therapeutic vaccines seem to dovetail very nicely with cure research. We’ve really made cure research our calling card and we are putting it forward as our area of most important investments, but I don’t think it’s to the exclusion of everything else. I do think that we will continue to look at some other areas, including therapeutic vaccines, to try to figure out if there’s something that makes sense for us.


 

This interview has been edited for clarity and space.

For more information, log on to: www.amfar.org.

Jeannie Wraight is the former editor-in-chief and co-founder of HIV and HCV Haven (www.hivhaven.com”>www.hivhaven.com) and a blogger and writer for TheBody.com. She is a member of the Board of Directors of Health People, a community-based organization in the South Bronx and an advisor to TRW (Teach me to Read and Write), a community-based organization in Kampala, Uganda. She lives with her husband in New York City.