By: Kathleen LaPorte
Dr. Jose Esparza spoke to a mix of University students, faculty and Athens locals at the University Chapel this past Monday, February 11th, about his personal journey in medicine and his role in the search for and development of an HIV vaccine.
Esparza is the Senior Advisor on Vaccines at the Bill and Melinda Gates Foundation and has worked for over 20 years in helping to develop an HIV vaccine. He spoke as part of the Voices from Vanguard lecture series hosted by Grady College of Journalism and Mass Communication.
Esparza hoped that his lecture would be more than a scientific talk and would “inspire and inform” University students and faculty. Developing an HIV vaccine is one of the most difficult challenges that modern medicine has faced, said Esparza. In order to develop a vaccine for any virus, a scientist must take many steps and conduct many tests.
Esparza explained his passion for studying medicine, particularly viruses, through his life journey. “Like many kids I wanted to be a scientist, specifically a chemist,” said Esparza. As a young boy in Venezuela there were limited opportunities to study medicine and that is how I ended up at University of Zulia in Venezuela.
In his second year of medical school an outbreak of Venezuelan Equine Encephalitis brought Esparza face to face with a virus of epidemic proportions. “I was fascinated by such a complexity and it was at that point that I decided to dedicate my professional career to the studies of viruses,” said Esparza.
Esparza continued his studies at Baylor College of Medicine, where he earned a PhD in virology.
Through his studies Esparza assisted various medical experts in exploring a variety of different viruses. Esparza said these studies and relationships contributed to his interest in vaccine development.
In 1986 Esparza joined the World Health Organization in Geneva. As part of the World Health Organization’s efforts to combat HIV around the world, Esparza was asked to develop a “biomedical research unit.” This research unit’s purpose would be to gather research and diagnostic test to look at the development of a HIV vaccine.
After working with the World Health Organization in the development of multiple research projects and initiatives to combat HIV and AIDS around the world, Esparza joined the Gate Foundation in Seattle.
His work with the Gates foundation has continued to revolve around the ongoing research and development of an HIV vaccine.
The development of modern vaccines required comprehensive research of competent viruses, extensive animal testing and strictly regulated clinical trials to test for efficacy.
Esparza outlined for his audience multiple studies and tests conducted across the world in search of a new vaccine. Researchers looked at a new approach for an HIV vaccine that would be a “two-arm” method. Esparza said “the two-arm method of the new system has defined the difference on scientific alliances that have guided HIV vaccine research over the years.” The goal for the most effective HIV vaccine would be one that engages the immune system to combat the HIV virus and also creates cell-mediated immunity where the body recognizes and destroys cells infected with HIV.
Many of the first clinical trials of these new types of vaccines displayed a variety of responses and results, including controversy and resistance in some countries. Some foreign countries felt that the United States was using their people and resources as guinea pigs for the States’ own drug development.
The 2003 clinical efficacy trials that were carried out in North America and Thailand resulted in negative findings and did not provide the results researchers had hoped. Nonetheless, these trials gave scientists more information to continue their development of the vaccine. Recent findings, released in 2009, on the effectiveness of the RV144 vaccine in clinical trials in Thailand showed promising results. “People receiving the [RV144] vaccine had less HIV infection,” said Esparza. Compared to research participants who received a placebo, there was a reduced rate of infection among research participants who received the vaccine.
Esparza’s lecture outlined the clinical trial, explaining the 16,000 volunteers’ roles as research participants. The vaccine was administered on a 1-to-1 ratio with placebo and there were a total of six shots administered to each research participant. Over a three-year trial each participant was given HIV reduction counseling and his or her blood was tested for HIV every six months.
“The vaccine was found to have an efficacy of 31%,” said Esparza. While this efficacy did not meet the researchers’ standards for vaccination production of 51% efficacy, it showed a definite trend in a reduction of the HIV virus in the research participants who received the vaccine.
This experiment “showed a possible correlation between a vaccine and protection,” said Esparza. From here, researchers must look at what part of the vaccine was effective and use this information in the “next generation of vaccines.”
Esparza ended with a strong call for further research and efforts to come in combating HIV and AIDS around the world. “We will never give up, because we believe an HIV vaccine is absolutely necessary to stop the AIDS epidemic.”
I had the opportunity to talk to Esparza after his lecture and ask for some of his advice and wisdom for students pursuing an education and career in medicine, and here is what he had to say:
Kathleen : What would be your best advice for students in deciding what they want to pursue a medical career?
Dr. Esparza : “Follow your passion and be open-minded. In my presentation, I mentioned several changes in my path. It’s a common denominator; I wanted to use science to solve problems. So you have to be passionate about what you do, medicine is exciting. Although I never practiced medicine, I behaved as a physician; my mind is always the patient. Do something that is important and that you care about.”
Kathleen : What do you think has been your greatest learning experience throughout this whole process [of working to develop an HIV vaccine] and your entire career?
Dr. Esparza : “I think it is very important to be open minded, I mean the worst thing a person can be is intolerant. You have to be open minded to science. Today I mentioned an example of how we pursuing scientific explanations to various vaccines and actually in the results there were some difference. You have to be prepared to accept results different from the ones you originally predicted. So open mindedness is a very important thing. I think open mindedness is very important when you deal with people. When you go patients, to test a new intervention, you have to be able to start a dialogue that understands the niche of the other person. So it is not you imposing your patients approach but it is actually dialoguing and getting to understand what motivates other people. So I think through my career what I have done is exactly that, to maintain a tolerance to views that are different than mine”