The world’s two richest men, Microsoft chair Bill Gates and investor Warren Buffett, upgraded the AIDS operating system with a huge download of cash and high-profile attention this past summer. First, in June, Gates announced plans to curb his official role at Microsoft and dedicate his full-time efforts to the Bill & Melinda Gates Foundation, which focuses on revolutionizing disease treatment in the developing world, including HIV. Weeks later, Buffett proclaimed plans to donate $30.7 billion, more than half his fortune, to the Gates Foundation, doubling its previous endowment.

First question for many Americans with HIV: How can I cash in? Answer: You probably can’t. Gates does give to a few domestic HIV causes in his native Pacific Northwest, but his focus is international. While Gates will help boost developing nations’ health systems and their ability to distribute antiretrovirals (including granting funds to the Global Fund to Fight AIDS, Tuberculosis and Malaria), the foundation has previously prioritized research for new treatments, vaccines and cures (the foundation could not comment on the exact breakdown of where the Buffet bucks would go).

Indeed, in July, Gates announced that he would give $287 million to vaccine development over the next five years. “An HIV vaccine is our best long-term hope for controlling the global AIDS epidemic,” says the foundation’s José Esparza, MD.

Will the effort finally end our 25-year wait for a vaccine? Robert Hecht, senior vice president of the International AIDS Vaccine Initiative, which will receive $24 million of the grant, says, “We haven’t had the ability to compare results we’ve needed until now, and the money will make a big difference.” Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, which is not slated to receive any of the grant money, says technology is a major impediment to a vaccine and that mere money is no guarantee.

“The three barriers to finding an HIV vaccine are science, science and science,” he says.

In the meantime, of course, people are still getting infected and dying daily from lack of treatment access. Even if a vaccine is developed, the 40-plus million folks who already have HIV will still need meds—likely, for the rest of their lives. Some advocates wish that Gates would put more funds into on-the-ground action. Paul Zeitz, executive director of the Global AIDS Alliance, says, “We need more than technology and cash—we need delivery teams, logistical support and an evaluation system that hold national leaders to a higher standard.” What’s the Microsoft word on that?


What about the legions of people who already have HIV and therefore can’t benefit from any vaccine, regardless of who funds it? After years of scientific defeats, many major researchers have shirked the quest for the cure. But in June, the American Foundation for AIDS Research (amfAR) announced that it would award $1.5 million in grants to help find the grail. “After 25 years, many people hesitate to talk about a cure,” says amfAR research director Rowena Johnston, “but we feel it’s time to take some risks and move forward.” Buzz points to virus reservoirs (places in the body where HIV hides), like the intestine, as a promising starting point. Saddle up!