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In January 2025, Kevin Saunders wasn’t too worried that the Trump administration was coming for his Human Immunodeficiency Virus research at Duke University.
The administration had stalled National Institutes of Health meetings to review grant proposals, effectively freezing funding distribution and sending shockwaves through the scientific community. But Saunders, as associate director of the Duke Human Vaccine Institute, was among the leaders of a national consortium of researchers that for 20 years had been working toward inoculating people against the deadly virus. The group had a $21 million average annual budget and, since its creation, had received close to $600 million from the federal government. It seemed too big, and too important, to let it lapse.
The consortium funding cycles occurred predictably since 2005. Every seven years, the NIH awarded a new grant. Three cycles in a row, Duke won. With the current cycle ending in 2026, Saunders expected the request for applications for the next round would be released last spring.
March 2025 arrived, but the paperwork didn’t.
By April, despite recent positive meetings with the NIH, there was still no news about Duke’s grant renewal. By May, Saunders had lost hope. “I would like to think that I was always optimistic it was coming,” Saunders said recently. “But that would be kind of a lie.”
On May 30, the team received the news directly from the NIH: The funding application for 2026 was not going to be released. The money for the HIV vaccine research consortium could run out in about a year.
NIH Director Jay Bhattacharya wrote last year that the agency is focusing on “implementation science and other research directions to improve the uptake of and access to existing medical and behavioral interventions,” aligning itself with the Make America Healthy Again movement. “Research on HIV/AIDS prevention, treatment, and cure will continue as needed to support this goal,” Bhattacharya wrote.
To many, though, it was an existential threat to HIV vaccine research. No other organization in the country had the infrastructure to bridge basic research and vaccine manufacturing at the scale of the 100-plus researchers in the consortium, Saunders said. Duke, which has long been at the forefront of HIV vaccine research, would be hit especially hard.
‘We Now Have Proof’
In 1981, a weekly Centers for Disease Control and Prevention report described several young, previously healthy homosexual men in Los Angeles who were sick with a rare lung infection. The report received little initial attention. But within months, it was clear that it marked the opening chapter of a global pandemic. “Everyone started to die,” LGBTQ activist Cleve Jones said in a 2004 interview with PBS. New York and San Francisco became ground zero. The illness, eventually known as Acquired Immunodeficiency Syndrome (AIDS) was widely, and inaccurately, framed as a “gay disease.” The deaths mounted quickly. “One by one, all these familiar faces disappeared,” Jones said.
One Sunday morning in the spring of 1984, Dani Bolognesi’s home telephone rang. He had just finished his morning coffee in his Duke Forest house, Bolognesi recalled recently.
Then 43, Bolognesi was the type of scientist who carried his curiosity outside the lab: He would take his team tuna fishing off the coast near Morehead City, then draft plans for NIH grant applications with them in the boat cabin afterward. At Duke, he was an associate professor of surgery and studied viruses in animals, modeling human illnesses. It was important work, but Bolognesi wanted to tackle human disease.
On the other end of the phone was his longtime collaborator, Robert Gallo, then the head of the NIH National Cancer Institute’s Laboratory of Tumor Cell Biology. Gallo had been hunting for the cause of AIDS. He long suspected a viral culprit, but that morning, he sounded certain.
Gallo had isolated HIV as the virus and confirmed it through blood testing in patients, research he published in the journal Science a few months later.
“We now have proof,” Gallo told him. “We need to start thinking about vaccines and therapy for something that can become a pandemic.”
Most viruses invade healthy cells, triggering them to raise a “red flag” for destruction by the immune system. The body then produces antibodies—proteins that target bacteria and viruses—which recognize and neutralize the virus and linger in case of a return attack.
But HIV attacks the immune system itself. It disguises its presence within these defense cells, hiding in plain sight and dismantling the body from within. As immune cells die, the infection progresses to AIDS. In those days, AIDS was fatal. And it was spreading.
Gallo’s call wasn’t long, but it carried an urgency Bolognesi still remembers 40 years later. The charge was simple: Get moving on HIV research.
In the early years, federal funding for AIDS research was extremely limited. Then-President Ronald Reagan didn’t mention the disease publicly until 1985. Sick men and women were often turned away from hospitals and denied funeral services. But anger and urgency from patients eventually coalesced into a movement. Groups like AIDS Coalition to Unleash Power (ACT UP) marched to demand access to health care.
By September 1984, Bolognesi’s team had established its base of operations in Duke’s Animal Laboratory Isolation Facility.
He worked closely with Barton Haynes, then an assistant professor of medicine at Duke who had received a similar phone call from Gallo. They traveled monthly to meet him at the NIH, Haynes said, work that eventually coalesced into something more concrete: trying to develop the first HIV vaccine.
The vaccine mechanism was unremarkable by the standards of immunology at the time. For decades, vaccines exposed the immune system to a harmless version of a pathogen, giving the body a chance to learn its features before a real infection ever occurred. The approach worked for hepatitis B, so why not HIV?
But trials in chimpanzees at the Yerkes National Primate Research Center in Atlanta weren’t successful. The promise the scientists observed with laboratory-grown virus strains did not translate to the viral strains circulating in humans.
That turned out to be a feature of the virus. When HIV copies its genetic code into an infected cell, it introduces small errors. Multiplied by the billions in an untreated patient, the virus splinters into countless versions of itself, becoming difficult to identify by a single antibody. The laboratory strains did not face the same pressures to adapt.
In other words, HIV mutates too quickly to address with a traditional vaccine.
Bolognesi began consolidating Duke’s resources. In 1989, he established the Duke Center for AIDS Research, pulling disparate labs together under the same leadership to collaborate.
Meanwhile, Bolognesi and Haynes had another idea: an organization that would take vaccine candidates from research labs to production. As an academic institution, rather than a commercial one, it could pursue long-shot leads while also training the next generation of scientists. They published a paper on the idea in 1990, then founded the Duke Human Vaccine Institute that year with grant funding from the NIH and with Haynes at the helm.
That new team spent the next 10 years studying HIV’s cellular shape: Which parts of the outer surface were vulnerable? When HIV mutated, which elements of its shell remained constant?
By 1999, the third essential component for developing a vaccine fell into place: the HIV Vaccine Trials Network. Formed by the National Institute of Allergy and Infectious Diseases (NIAID) and headquartered in Seattle, the network could test potential vaccines in human trials across international sites. But there was still no umbrella organization to coordinate or fund the work.
Faster Than Ever
By the early 2000s, HIV was no longer deadly among Americans with access to treatment. Protease inhibitors, which prevented the virus from replicating, could be combined with other drugs to transform the disease from a death sentence into a chronic, manageable condition. In 1996, the year after their release, U.S. AIDS deaths declined by 13%.
But around the world, it was a different story. In South Africa, only half of women who tested positive for HIV could access treatment. In India, nearly 30% of sex workers didn’t know that condoms could prevent transmission. Even in the United States, Black, gay men in the South were still dying.
Bolognesi’s team branched off to focus on HIV treatment in the early 2000s. Haynes remained focused on a vaccine.
He’d trained at the NIH after his medical residency, so he was familiar with its grants. When it came to HIV, he saw labs across the country working independently, often duplicating each other’s efforts.
In 2003, Haynes and 23 collaborators—including Anthony Fauci, then director of NIAID—published a paper in Science calling for a new approach. They proposed global coordination of basic science labs, manufacturing facilities, and clinical trial sites to develop an HIV vaccine.
In 2004, the National Institutes of Health endorsed the release of a $300 million, seven-year grant application to establish a center for HIV/AIDS Vaccine Immunology that consolidated labs under the leadership of a collaborator.
“The point was you had to work together,” Haynes said in a 2024 talk.
Duke won the grant in 2005, with Haynes as its leader. Supplementary funding from the Bill and Melinda Gates Foundation further solidified Duke as a leader in HIV/AIDS vaccine research.
The project was intended to work in stages, funded through recurring grant cycles. In the research phase from 2005 to 2012, the consortium funded basic research on how HIV evolves over the course of infection, and the immune responses it triggers in both humans and primates.
At the consortium’s first meeting soon after the award in July 2005, Haynes set the pace of research. “We’re going to comply with all state, federal regulations, but we’re also going to do this faster than any science has ever been done,” he told his colleagues.
Every Tuesday, Haynes held an hour-long call with consortium leaders and NIH. Every Wednesday, researchers presented their recent findings. Their first breakthrough came in 2009, when a trial the U.S. Military Research Program conducted with 16,000 adult volunteers in Thailand identified two potential vaccines that successfully primed the immune system to destroy HIV-infected cells. While they only lowered the risk of HIV infection by about a third, it was a start. Haynes’ group later identified antibodies that contributed to immunity in some of the patients, which would become the focus of future research.
By the end of the first grant cycle, the consortium determined that producing an HIV vaccine was possible, though likely still years away.
Duke won a second seven-year grant for $139 million. Now that researchers understood the mechanisms of HIV, they wanted to identify several vaccine candidates to put into production.
The most promising mechanism was becoming increasingly clear to Haynes. While trials like the one in Thailand produced “non-neutralizing antibodies,” Haynes thought the right candidate would produce “broadly neutralizing antibodies” in patients.
Say a robber was attempting to break into a home. Non-neutralizing antibodies could follow the robber around the house, but they couldn’t stop the crime. But broadly neutralizing antibodies could keep the robber from ever entering the house. They could prevent transmission of the virus in the first place.
Haynes called them “the holy grail of HIV-1 vaccine development.” They target a stable part of the virus, block it from entering immune cells, and rally healthy cells to destroy the tagged viruses.
Scientists had discovered that some people living with HIV for decades developed these rare antibodies by chance. But most did not. By 2013, more than 30 broadly neutralizing antibodies had been isolated and characterized. The next challenge would be training the body to produce them.
The Execution Phase
HIV rates have dramatically declined worldwide, but progress began to plateau. The challenge for infectious medicine specialists is that patients must keep up therapy or preventative regimes. “The problem is with competing interests like, where am I going to eat today? I don’t have a car to get to my clinic appointment. I can’t pay my bills,” Duke infectious disease provider Lance Okeke said. “If you don’t fulfill those basic needs, then understandably so, treatment of HIV is secondary.” Okeke says only a vaccine can truly end the crisis.
In 2019, the consortium entered its third phase: Developing and testing a viable vaccine.
Saunders, who joined the Duke Human Vaccine Institute in 2014, worked with collaborators to design candidates.
The vaccines were shared with colleagues at the Center for AIDS Research, the organization Bolognesi established in the late 1980s, for scrutiny and debate.
From there, the most promising options entered the HIV Vaccine Trials Network to test their safety and efficacy.
Data flowed back to the Duke Human Vaccine Institute to guide the next round of vaccine design.
If researchers could stabilize the antibody targets in the lab, map their mutation pathways, identify antibody precursors, and then induce immune cells to produce them, they might have the blueprint.
A May 2024 clinical trial of a vaccine candidate developed at Duke offered a glimmer of hope. But the study was cut short when one of the 15 patients suffered an anaphylactic reaction to a nonessential substance in the vaccine.
The trial stopped, but Haynes told a colleague to analyze the results they had up to that point. The findings were shocking: the vaccine produced low levels of Haynes’ “holy grail” of broadly neutralizing antibodies.
“Our next steps are to induce more potent neutralizing antibodies against other sites on HIV to prevent virus escape,” Haynes said in a Duke Health publication in 2024. “We are not there yet, but the way forward is now much clearer.”
‘I Don’t Plan on Going Down’
In January 2025, the Trump administration paused PEPFAR, the program created by President George W. Bush to provide low-cost HIV treatments to underserved regions. In July, the administration dismantled the U.S. Agency for International Development, moving foreign assistance into the State Department. John Bartlett, who leads Duke’s clinical HIV efforts and works part-time in HIV/AIDS clinics in Tanzania, said he has already seen reductions in support groups, decreased access to medications, and fewer educational programs abroad.
On the morning of June 2, 2025, Saunders faced a Zoom grid of 25 colleagues.
Three days earlier, Science had broken the news that HIV vaccine consortium funding would end. “But I don’t plan on going down,” Saunders told his fellow researchers.
Saunders went through a list of every alternative funding source the consortium would pursue. They’d work on multiple grant applications simultaneously, and also pursue funding to develop HIV treatments rather than a vaccine. If their work didn’t fit the grant application, they could adapt.
In September 2025, the NIH announced a new grant program, the Consortia on Structure-based Immunogen Design for HIV, replacing the current consortium funding. Haynes planned to apply.
But the application was never released. In late March, the NIH said that it would significantly reduce the kind of grant that the consortium had been winning, focusing instead on broader funding pools that many types of researchers could compete for. That same month, Haynes heard from the NIH that the consortium’s new funding opportunity had been eliminated.
The NIH declined to comment. In a blog post in January, NIH officials wrote: “Simplifying administrative processes to reduce burden for the scientific community and the NIH is one of several ongoing NIH priorities for 2026.” Later in March, officials wrote: “Forecast listings are informational, and some may not result in a published opportunity.”
Both the consortium and Duke’s individual vaccine researchers can still seek federal funding, but they’ll have to apply for grants for each aspect of the work rather than a central source supporting all stages of vaccine development.
“We are going to try to channel as much money as we can to [Haynes] and his group,” Stuart Shapiro, a program officer for HIV and AIDS at the NIH, told The Assembly. He said his group hopes to renew small grants to Duke investigators for another year to add buffer time while they try to find new funding for the consortium. But that will take months, if not longer, Shapiro acknowledged.
“We’re still going to be able to develop vaccines, but it’s going to make it slower,” Shapiro said.
The consortium has eight trials of vaccine candidates that are currently active or are planned to begin in the next year.
“It takes years to gain the momentum that we’ve built over time with vaccine research,” Okeke said. “There’s never a good time to interrupt groundbreaking scientific programs like HIV vaccine research. But in light of the findings of the last year or two, this is the most terrible of times to actually start pulling that funding.”
Saunders only has enough funding to make the vaccine for one of the eight trials. After that, he thinks private grants might make up for some portion of the consortium’s funding. But it will be hard to cobble together $129 million.
Without the NIH, “it doesn’t exist,” he said.
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