The President's Advisory Council on HIV/AIDS (PACHA), an advisory panel on AIDS research and policy, has a history of criticizing the government agencies charged with developing an AIDS vaccine and implementing policy for those infected with the virus (Nature Med. 4, 477; 1998). However, there was a more conciliatory tone at this year's annual meeting held in Washington, D.C. on 4–5 October, and the 35-member panel went so far as to voice some support for current government initiatives in HIV/AIDS research and prevention.

One of PACHA's recurrent complaints in recent years has been the foot-dragging in staffing AIDS research leadership positions at the National Institutes of Health (NIH), including the absence of a director for the NIH's new Vaccine Research Center (VRC). However, Gary Nabel, who was appointed to the post in March (Nature Med. 5, 362; 1999) addressed the group on the first morning of the meeting. He discussed VRC's structural organization, HIV vaccine development strategies, and noted that the hiring of several staff members with backgrounds in the pharmaceutical and biotechnology industries, a move PACHA had strongly urged previously, is imminent.

Although one speaker challenged that, at present, the VRC is just Nabel, a secretary, and some good will, Nabel assured Nature Medicine that, in the absence of a functional building on the NIH campus, his laboratory at the University of Michigan has become an off-site NIH laboratory. "We're in a position now where we can implement some [research] ideas," he says. For example, his laboratory could develop constructs for HIV vaccine research. The new building will be operational next year with around 120 laboratory scientists and support personnel.

The VRC's FY99 budget was $18.5 million and its FY00 budget is projected at $22 million. Nabel expects that when the VRC is fully operational, the annual budget will be around $30 million; but comments from PACHA members that this is a small amount of money if the center is to be involved in clinical trials, he agreed that PACHA was "right to be concerned that our costs can be higher."

Although PACHA has long requested that White House Office of National AIDS Policy increase its control over AIDS vaccine development initiatives, that has not happened. And with NIH making its leadership role in the development of an AIDS vaccine even clearer, as evidenced by Nabel's presence at the PACHA meeting, most do not believe PACHA's request, which once filled many basic scientists with angst, will reach fruition.

Deborah Birx, director of the U.S. Military HIV Research Program—a cooperative agreement between the Walter Reed Army Institute of Research (WRAIR) and the not-for-profit Henry M. Jackson Foundation, which sponsors research into military related medical problems—presented the program's budget and progress.

This small but highly respected group has been in the forefront of HIV research despite its small budget: identifying genetic diversity in HIV strains worldwide, documenting dual infection with B and E clades, developing the first serotyping system, setting up a worldwide HIV surveillance network and establishing cohorts for HIV vaccine trials in Thailand and Uganda.

According to Sam Avrett, executive director of the AIDS Vaccine Advocacy Council (AVAC) in Washington D.C. the military program received a congressional 'plus-up,' or extra funding, from Congress that was not included in the president's budget of $15 million for FY96, 97 and 98. This brought their total funds for both basic and clinical research in HIV and HIV vaccines to around $40 million in 1998, according to AVAC's May 1999 report, Eight Years and Counting: What Will Speed Development of an AIDS Vaccine?

But in FY99, the plus-up disappeared. With an additional 10% cut in the budget to support the US military efforts in Kosovo, WRAIR was left with $17 million for the program—a 50% reduction in usable scientific funds. Birx's fears that there would be no Congressional plus-up in FY00 were allayed the day after the PACHA meeting, when Congress agreed to add $10 million to the budget, making an estimated $25.5 million available for the military program. But even with this money—a $5 million decrease in usable funds over FY98—WRAIR's HIV program remains underfunded.

PACHA was additionally concerned that a presidential initiative to budget $100 million for AIDS prevention, mainly in Sub-Saharan Africa, be passed by Congress. And the committee asked for more information about a planned series of meetings—the first one was held by Hillary Clinton in early September—between government officials, business and foundation leaders, and members of community organizations to enlist support for international AIDS programs and policies. PACHA members were invited to this meeting only at the last minute.