THE BUREAUCRAT AS HERO:

The highly effective Covid-19 vaccines now sending the US epidemic into retreat were whisked with lightning speed through clinical trials thanks, in many ways, to HIV paving the way.

In March last year, Fauci began overseeing the retooling of three major HIV global clinical trials networks into the Covid-19 Prevention Network (CoVPN). This meant teams of investigators already skilled at recruiting and retaining diverse participant populations, dealing with byzantine regulatory requirements and paperwork and conducting necessary statistical analyses soon enrolled tens of thousands into trials that have given the world the Moderna and Johnson & Johnson vaccines.

Fauci praised the "elegant science" that went into selecting the most promising Covid-19 vaccine candidates - a process, he stressed, facilitated by the pioneering efforts of HIV vaccinologists. Over the decades, such researchers honed the methods that in Fauci's words allowed scientists to "determine the precise confirmation of the SARS-CoV-2 spike protein that allowed maximal immunogenicity, thus leading to high efficacious vaccines".

Larry Corey, director of the HIV Vaccine Trials Network - one of the three National Institutes of Health-funded networks that collaborated to launch the CoVPN - said that without the HIV research field, scientists would not have had at the ready the non-human primate research model that was used to transition from laboratory studies to human clinical trials of Covid-19 vaccines.

"We were able to do this in 11 months, start to finish, because science does build on science," said Corey, who has run the HVTN out of the Fred Hutchinson Cancer Research Center in Seattle since 1999.

On the east coast, Myron Cohen, a professor of medicine at the University of North Carolina and co-principal investigator of the HIV Prevention Trials Network, a CoVPN collaborator, took his own global team's expertise in developing broadly neutralizing antibodies against HIV and channeled it into the increasingly fruitful effort to bring to market cocktails of monoclonal antibodies that attack SARS-Cov-2.

Other HIV experts have leapt at the chance to lend their skills to the Covid-19 endeavor. One is Steven Deeks, a leader in the HIV cure research field at University of California, San Francisco, who said his lab's extensive experience with the thorny logistics of establishing long-term research cohorts allowed them to start a study following people with "long Covid" in mere weeks.

HIV specialists have been among the most prominent voices educating the public and combating misinformation about Covid-19. Monica Gandhi of UCSF has championed evidence-based optimism and sanity in the face of anxiety and hysteria; Julia Marcus of Harvard has advocated harm-reduction methods to curb SARS-Cov-2; and Carlos del Rio of Emory University has covered anything and everything in between.

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