Vaccines: His best shot

Bruce Walker didn't want to sit next to Terry Ragon on the 24-hour plane ride from Boston to South Africa. He had only recently met the wealthy, Cambridge, Massachusetts-based software executive and was about to spend two full days touring AIDS-ravaged Durban with him in hope of obtaining a donation. Walker, an immunologist and physician at Massachusetts General Hospital (MGH), wanted to give Ragon some space and get some work done, but Ragon insisted they sit together. During the flight, he peppered Walker with questions about his research in South Africa. He also warned him not to get his hopes up. "I go on a lot of these kinds of trips, and I don't give people very much money," Ragon said.

Walker was disappointed, but he stuck to the plan. He took Ragon to the crumbling, 100-year-old McCord Hospital, where he followed doctors and visited impoverished, young people with HIV. "All three of the patients I sat in with were going to die, and one of them was dying right there in front of me," says Ragon. He had been to Africa before but never had he so intimately seen the pain and suffering caused by AIDS.

As the trip neared its end, Walker knew that it was time to broach the subject of money again. He had been trained by MGH fundraisers to give potential donors a range of options. For a modest sum, US$5,000–20,000, Ragon could fund lab equipment or nurses — $1 million might fund a small clinical trial. But on a whim, Walker decided to float a more ambitious idea: creating an institute in which researchers from different fields could focus solely on HIV vaccines under one roof, with the kind of funding that would enable high-risk projects. "I thought the idea was half-baked," says Ragon, "but it intrigued me."

That was in March 2007. Talks continued, and about a year later Ragon and his wife, Susan, agreed to give $100 million over 10 years to create the Ragon Institute of MGH, MIT and Harvard. Established in early 2009, with Walker as its director, the institute was a positive note at a challenging time for HIV vaccine development. In late 2007, the pharmaceutical company Merck announced that a high-profile vaccine candidate in a large phase II clinical trial failed to protect people from infection with HIV, and even increased the risk of infection for some

Researchers say that the trials — two of only three major vaccine efficacy studies undertaken in 25 years of research — have reminded them of just how little they know about harnessing the immune system to block this deadly disease. Researchers have called for a return to basic HIV research (see 'Where the money goes' ). But they need stronger interdisciplinary collaboration, innovative trial designs and, perhaps most of all, freedom — through funding — to take chances. Now, many say that the Ragon Institute has the opportunity to put these factors to work. Walker can clearly draw the money, and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, says that Walker can also gather the right team. "He has a special talent for getting groups of people together from diverse backgrounds in a collaborative, synergistic way," he says. "The challenge," says Herbert Virgin, an immunologist at Washington University in St Louis, Missouri, and head of the institute's external scientific advisory board, "is now putting it all together to generate a vaccine.

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