In 2008, when the story of Timothy Brown, ‘the Berlin patient,’ made headlines after Brown was found to be functionally cured of HIV, Kevin Robert Frost was brand new in his role as CEO of amfAR (the Foundation for AIDS Research).
During one of his first speeches as the group's chief exec, Frost shared his excitement about the Berlin patient and what his apparent cure meant for HIV research. What it meant, according to Frost, was that developing a ‘cure’ for HIV that could be reproduced and implemented clinically was an attainable goal—and something to strive for immediately.
Frost’s call-to-action was not universally praised. In fact, his discussion of a cure as a potential reality elicited a maelstrom of criticism.
"There were a lot of negative responses," Frost told BioPharma Dive in an interview. "I was accused of giving people false hope, and people even suggested that I should be removed as CEO of amfAR. Others thought that discussing a cure was not the purview of amfAR.
"Fortunately, I had the support of the Chairman of the Board."
The time is now
What exactly was so audacious about Frost’s comments?
"To a lot of people, ‘cure’ is still a four-letter word," Frost explained. "Why did we not see a ramping up of investments in a cure after the Berlin patient? I was determined that if we were going to get a cure for HIV, we needed to say it publicly."
Seven years later, Frost found himself and amfAR in a much better position to publicly advocate for a cure and to put some money behind the effort. "In response to a vacuum in the research arena, we decided that we would move cure research forward by making a significant investment and leveraging our weight to work for a cure."
On November 30, amfAR announced the establishment of the amfAR Institute for HIV Cure Research, based at the University of California San Francisco (UCSF). The new institute was established with a $20 million grant, a significant portion of amfAR’s $100 million cure research investment strategy. And the institute's audacious goal is to find a cure for HIV by 2020.
An unprecedented level of collaboration in HIV research
Location is a major advantage for the institute. San Francisco is the number one location for scientific thought leaders in HIV—and many of them have committed to working on the cure through the institute.
This mega-collaborative effort involves teams of scientists focusing on every aspect of cure-related research—including basic science, late-phase clinical trials, and every stage in between—and addressing every possible avenue from antibodies and assays, to wild-type viruses, and X4-Tropic virus. It’s an all-out, no-holds-barred, collective quest to discover and develop a cure for HIV.
Other collaborators include the Gladstone Institute of Virology and Immunology (GIVI) and Blood Systems Research Institute, as well as Oregon Health and Science University; University of California, Berkeley; Gilead Sciences; and the Infectious Disease Research Institute in Seattle, Washington. In addition, Geovax, which develops vaccines, and the Infectious Disease Research Institute (IDRI) are key players in the cure research initiative.
Frost likens the effort to finding a cure for HIV to putting a man on the moon or developing an atomic bomb. Like these efforts, finding a cure for HIV is a big project that requires a concerted collaborative effort by the best minds in the field.
"The science is ripe enough," he said. "Cure research challenges are no longer challenges of discovery—they are technological challenges. We can clearly define the problem, so now we need a tool to overcome the problem.
"When the U.S. decided it wanted to get an astronaut to the moon, NASA was established in 1958. Eleven years later, Neil Armstrong and Buzz Aldrin walked on the moon. Likewise, when the government wanted to develop an atomic bomb, the Manhattan Project was created in 1942. By 1945, the research team was test-detonating a nuclear weapon in a desert in New Mexico.
"Now our goal is to find a cure for HIV, so we’ve created the Institute for Cure Research."
The 4 key challenges to finding the cure
According to Frost, the primary barrier to a cure is the existence of latent viral reservoirs, where HIV can hide out even if a patient has undetectable levels of virus in their blood. There are four key challenges that must be overcome in order for there to be a cure: Scientists must pinpoint the precise locations of the latent reservoirs of virus; determine how they are formed and persist; quantify the amount of virus in them; and finally, eradicate the reservoirs from the body.
With Dr. Paul Volberding, a UCSF Professor of Medicine and renowned researcher, leading the institute, there is a great deal of scientific star-power on board, bolstered by a significant investment and the ability to exploit various academic synergies.
If saying the word ‘cure’ during a speech is audacious, then having the word ‘cure’ as part of a $20 million institute’s name is declarative.
And what about that 2020 target date? SERMO, a global social media network exclusively for doctors, recently polled 1,249 doctors around the world with the question, "When do you think there will be a cure for HIV?"
The answers broke down as follows: 12% think that we’ll have a cure for HIV/AIDS in 5 years; 32% think we’ll have a cure in 10 years; 16% think we’ll have a cure in 15 years; 18% think we’ll have a cure in 20 years; 5% think we’ll have a cure in 25 years; and 17% think we’ll have a cure in more than 30 years.
When we asked Frost the same question, he said that he would fall somewhere in the 10-year window. But, given the resources and intellectual capital being deployed, a cure could come even sooner. Of course, when that cure comes, Frost’s 2008 speech will seem prescient and forward-thinking, even by those who criticized his ambition.
"I have confidence in where the science has brought us and where it is taking us. I’m optimistic and excited about the future," said Frost.