"Knowing the impact of the death of one child on one family, it is too much," Yamada said at the BIO International Convention held this week in Boston.

Within a couple of years, vaccines against malaria and TB will be brought to the developing world for final-stage testing, while advanced trials of a few HIV vaccines are already under way in Africa and China, experts said.

The vaccines are specific for the strains of HIV found locally in those regions, said Seth Berkley, president and founder of the International AIDS Vaccine Initiative.

"We are most proud of our clinical trials in Zambia, Rwanda and India. We are seeing extraordinary enrollment rates," Berkley said.

The treatments are likely to be only moderately effective, he said. But given the large number of people with HIV and the devastation of the disease, even a small reduction in its incidence is worth going forward, he added.

In the meantime, scientists will keep searching for a more potent vaccine. In the laboratory, they have their sights on a form of a simian immunodeficiency virus, which attacks monkeys, that is altered to be harmless.

"We know it works better than anything else so far. We should have focused on it long ago," Berkley said.

Non-profit foundations, rather than the private sector, are largely leading and funding the vaccine effort against malaria, HIV and TB, said Christian Loucq, interim director of the Malaria Vaccine Initiative. Big drug companies see the small profits to be made on vaccines in developing nations and thus have not taken the initiative to develop them, Loucq said.

"It's viewed as a problem of no market," Loucq said. Malaria is especially challenging in attracting private companies, he noted.

"It's a slightly bigger problem to raise interest in malaria because it doesn't affect the developed world; it's mainly (a disease of) poor people."

However, the non-profit groups are moving to fill the gap, having raised and spent hundreds of millions of dollars so far.

The Malaria Vaccine Initiative has raised about $275 million from the Gates Foundation, the Rockefeller Foundation and USAID. The initiative gives the funds to drug companies such as GlaxoSmithKline to develop the vaccines.

Within a year the initiative is preparing to bring a malaria-prevention vaccine to 16,000 children in Africa, Loucq said. It is one of 10 possible anti-malaria vaccines in various stages of development.

Malaria, a blood parasite transmitted by mosquitoes, infects 300 million to 500 million people each year and causes the death of 1 million, mostly children.

The group's goal is to have a vaccine by 2015 that prevents malaria in 50 percent of people for at least one year, he said.

On the TB front, the group hopes to have that disease under "global control" within 15 to 20 years, said Jerald Sadoff, president and chief executive officer of Aeras Global TB Vaccine Foundation.

To that end, the foundation will bring a tuberculosis vaccine for final testing to South Africa and the south of India by 2008, Sadoff said.

TB is an airborne bacterial disease that infects 8 million people a year and kills 2 million, many who also have HIV, he said.

Sadoff noted that some TB strains have become resistant to treatment, including the deadly XDR strain. It was found in South Africa last year, when 51 of 52 people infected with it died within 20 days, he said.

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International AIDS Vaccine Initiative
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