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People were very excited recently about this DNA, naked DNA vaccine, but I have heard other people say there are dangers lurking that we have not yet uncovered because we do not have enough experience with it. They are using a similar approach in other diseases.
But I think the only way we are ever going to get a handle on this epidemic is through a vaccine. I am fairly convinced of that. So I am very hopeful that there will be one, and I think that there is certainly enough scientific interest and some very good scientists who are working on it. You could argue about whether there is enough money and enough people and all that. There is always room for more, more money, more people, dedicated to that.
I think this current discussion about whether we need a March of Dimes. What was I reading in the paper this morning about [Dr. Myron] Max Essex saying we need a March of Dimes effort or a Manhattan-Project-type approach. It is an ongoing battle. Some people say that will work and some people say it will not work unless you have the science. It will not work unless you have the science, so I do not really know whether that is the right approach. I certainly think more money could go into vaccine research without being wasted.
Hannaway: Some have the perspective that if a treatment that at least keeps HIV under control becomes the predominant way of trying to help those with the disease in America, that the interest in vaccines for the developing world will decline. Would you have an opinion on that?
Grady: I am afraid that is probably true. The sad reality of the economics of it is that developing anything, including a vaccine, is very expensive and market-driven to a large extent. Even though the need in the developing world is enormous and will continue to grow, the ability to support economically either the product or the process does not exist, and that is a problem.
Harden: We have just about exhausted our questions. I always like to ask if is there anything else that occurs to you that, points that you would like to make, before we stop?
Grady: Only one, and I may have said it already. But I think the experiences that I have had as a nurse in HIV have confirmed, probably, an opinion that I have held for a long time, and that is that nursing is a wonderful profession. The nurses that I have had the opportunity to work with in this context are sensational, almost without exception, courageous, committed, hard-working, very good people.
Harden: This is sort of a special situation in one sense at the Clinical Center, perhaps.
Grady: Right. But also all over. I have had the opportunity to be involved in a continually growing network of nurses nationally that created an organization some years ago, the Association of Nurses in AIDS Care. In the early days, there was a handful of people from all over and we all knew each other. And we still see each other sometimes. Some are no longer involved in that group, but most still are. Although the number of people involved have grown–I do not know them all, obviously–but that initial group was a very special group of people.
Harden: Thank you very much. We appreciate your talking with us.
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