HIV研究人员如何克服挫折并维持疫苗试验

在他的第一个任期内，特朗普总统在国情咨文中提出了这一大胆的提议。

During his first term, president Trump made this bold proposal during a State of the Union address.

我的预算将要求民主党人和共和党人做出必要承诺，在十年内消除美国的艾滋病疫情。

My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in The United States within ten years.

我们已经取得了惊人的进展。

We have made incredible strides.

几十年来，消除艾滋病部分依赖于疫苗的开发。

For decades, eliminating AIDS has depended in part on the development of a vaccine.

特朗普政府在美国消除病毒的目标，推动了对疫苗的研究，并增加了对美国及全球艾滋病援助的资金。

The Trump administration's goal of eliminating the virus in The US led to a swell of research into a vaccine and funding for AIDS relief both in The US and around the globe.

自发现病毒是导致晚期艾滋病疾病（我们过去称为艾滋病）的原因以来，艾滋病研究就已经展开。

HIV research, has been in place since the discovery, of the virus as the cause of, advanced HIV disease, which we used to call AIDS.

这是约翰·布鲁克斯，前疾控中心艾滋病预防司首席医疗官。

That's John Brooks, former chief medical officer to the CDC's division of HIV prevention.

由于主要通过联邦支持的持续资金投入，我们现在取得了重大突破，发现了一些令人惊叹的药物，既能治疗艾滋病以维持患者健康，也能预防艾滋病。

We are now at a place due to consistent funding through mostly federal support that's discovered amazing drugs that can help us both treat HIV to keep a person healthy, but also to prevent HIV.

但在他的第二个任期内，特朗普总统削减了数千个公共卫生岗位，并大幅削减了科学研究的经费，包括用于开发艾滋病疫苗和治疗艾滋病的拨款和资金。

Then during his second term, president Trump slashed thousands of public health jobs and gutted funding for scientific research, including grants and funds for developing an HIV vaccine and treating AIDS.

该政府还暂停了全球艾滋病援助项目的资金，使全球的科学家们对研究的未来感到担忧。

The administration also suspended funding for global AIDS relief programs, leaving scientists around the globe worried for the future of their research.

如果我们能拥有疫苗，那将是非常了不起的。

A vaccine would be incredible if we could have it.

这将带来巨大的公共卫生影响、巨大的经济效益，以及过去和现在所推动的科学进步。

Enormous public health impact, gigantic economic benefits, as well as the scientific advancements it will provide and has provided in the past.

艾滋病治愈也是如此。

Ditto for an HIV cure.

想想看，一项在非洲进行的富有前景的疫苗试验原定于一年前启动。

Consider this, an ambitious and promising vaccine trial in Africa was supposed to launch a year ago.

当特朗普政府削减资金后，像传染病专家琳达·盖尔·贝克尔这样的研究人员不得不调整方向。

When the Trump administration cut funding, researchers like infectious disease specialist Linda Gail Becker had to pivot.

这件事太重要了，我们必须把工作做完。

This matters too much to not finish the work.

现在，一项规模缩减的试验正在启动。

Now a paired down trial is getting underway.

来自NPR，我是胡安娜·萨默斯。

From NPR, I'm Juana Summers.

本周，在NPR政治播客中，我们回顾特朗普总统的第一年。

This week on the NPR Politics Podcast, president Trump's first year.

你知道，这一届特朗普总统任期的问题不仅仅是缺乏制衡机制。

You know, it's not just that there aren't really the guardrails on Trump's presidency this term.

更糟糕的是，他正在做的一些事情根本不符合保守主义理念。

It's that he's doing things that are just not conservative.

我们在NPR政治播客中深入剖析共和党正在发生的持续转变。

We unpack the ongoing transformation of the Republican Party on the NPR Politics Podcast.

请在NPR应用程序或您收听播客的任何平台收听。

Listen on the NPR app or wherever you get your podcasts.

如今，许多人担心人工智能可能是一场泡沫。

There is a lot of fear these days that AI could be a bubble.

所以，尼克，是吗？

So, Nick, is it?

我不知道。

I don't know.

对。

Right.

很难说清楚，但经济学家说有一些线索可能在某种程度上帮助我们预测泡沫。

It is hard to tell, but there are some clues that economists say might kind of sort of help us predict bubbles.

在《Planet Money》播客中，揭秘泡沫检测的黑暗艺术。

On the Planet Money podcast, the dark art of bubble detection.

在NPR应用或您收听播客的任何平台收听。

Listen on the NPR app or wherever you get your podcasts.

这是来自NPR的《Consider This》。

It's consider this from NPR.

科学家表示，针对艾滋病病毒的疫苗研究进展比以往任何时候都更深入，但特朗普政府对科学研究的削减使这一努力受阻，包括在非洲一项有希望的艾滋病病毒疫苗试验已被完全终止。

Scientists say research into a vaccine for HIV is further along than it's ever been, but Trump administration cuts to scientific research have set that effort back, including a promising trial for an HIV vaccine in Africa, which was shut down altogether.

NPR的阿里·丹尼尔讲述了那里的研究人员如何不肯放弃的故事。

NPR's Ari Daniel has the story of how researchers there refused to give up.

彭妮·摩尔带我走进约翰内斯堡传染病国家研究所的一个房间。

Penny Moore leads me into a room at the National Institute for Communicable Diseases in Johannesburg.

房间里有六台大型的绿白相间的冰柜。

It's a raid with half a dozen large green and white freezers.

这些冰柜里存放着我们实验室所有研究工作的样本。

These are the freezers that contain samples that are the basis of everything we do in the lab.

摩尔是威特沃特斯兰德大学的病毒学家。

Moore is a virologist at the University of Edwatersrand.

她打开其中一台冰柜的盖子，取出一摞结霜的试管。

She cracks open the lid of one of the freezers and pulls out a tower of frosty tubes.

这很重，我很难搬动。

It's heavy and hard for me to lift.

这些是血液和细胞。

So this is blood and cells.

这些样本是过去二十年间由117名南非女性反复捐赠的。

All samples that have been donated over and over again for two decades by the same group of a 117 South African women.

她们生活在受艾滋病影响最严重的社区，她们捐赠样本是因为希望看到这场对她们而言真实而严峻的疫情早日终结。

They live in the communities that I'm most ravaged by HIV, and they donate their samples because they hope to see an end to an epidemic that is really, really real for them.

这些样本帮助穆尔和她的团队多年来逐步拼凑出病毒的详细图景——它是如何感染人体、如何潜伏，以及在全球不同地区甚至在单个个体体内如何变化。

These samples have helped Moore and her team piece together a detailed portrait of the virus over the years, how it infects, how it hides, and how much it changes across different parts of the world and even within a single individual.

我们从这些冷冻库中学到的东西，真是令人惊叹。

The amount we have learned from these freezers, it's just astonishing.

然而，去年大部分时间里，她都担心这一切可能化为泡影。

And yet more spent much of last year worrying that it might all amount to nothing.

因为就在她和同事们即将取得一项大胆突破——一项横跨非洲的创新艾滋病疫苗试验之际，计划却突然崩溃了。

Because just when she and her colleagues were on the brink of something audacious, an innovative HIV vaccine trial across Africa, the bottom dropped out.

为了解释清楚，让我回溯到去年年初在桑给巴尔的一次会议。

To explain, let me rewind to early last year to a meeting in Zanzibar.

那场著名的桑给巴尔之行。

The famous the famous Zanzibar trip.

桑给巴尔是位于非洲东海岸外的一个热带群岛。

Zanzibar is a tropical archipelago off the East Coast Of Africa.

佩妮·摩尔说那里热得要命。

Penny Moore says it was crazy hot.

那种地方，你只要一站起来就会汗流浃背。

One of those places where you just consider standing up and you break out in a sweat.

这次聚会是在一家坐落在湛蓝海洋边缘的酒店举行的。

The gathering took place in a hotel perched on the edge of a brilliant blue ocean.

有来自非洲各地的研究人员和临床医生，还有国际科学顾问。

There were researchers and clinicians from across Africa, and then there were the international scientific advisers.

他们逼得我们精疲力尽，只为确保我们在有限的资金下做到最前沿的科学研究。

They grueled us to within an inch of our lives to make sure that we were doing the very best cutting edge science we could do with the amount of money we had.

这笔资金总额为4500万美元，由美国国际开发署拨款，用于研制一种预防艾滋病的尖端疫苗。

That amount was $45,000,000 awarded by the United States Agency for International Development to create a state of the art vaccine to prevent HIV.

这项拨款旨在推动整个非洲大陆的团队合作，开发一种能在不同非洲社区中发挥作用的疫苗。

The grant was intended to get teams across the continent to collaborate on developing a vaccine that would work in different African communities.

他们在肯尼亚的病毒和我们在博茨瓦纳的病毒不一样。

The virus that they have in Kenya is not the same as the virus that we have in Botswana.

也和塞内加尔的病毒不一样。

It's not the same as the virus that they have in Senegal.

因此，理解这些疫苗对当地病毒的效果，才是关键所在。

And so understanding how these vaccines will work for the local virus is what makes it relevant.

在桑给巴尔的会议上，人们真的感受到了一股推动力。

At the meeting in Zanzibar, there was a real feeling of momentum.

兴奋之情达到了顶点。

The excitement was through the roof.

这是佩妮·摩尔的同事，诺诺·姆基塞。

This is Penny Moore's colleague, Nono Mkise.

我们正站在一件粉色事物的开端。

We're at the beginning of something pink.

但就在会议即将结束时，佩妮·摩尔说，气氛突然变得沉重了。

But just as the meeting was about to wrap up, Penny Moore says the mood darkened.

特别是看到那么多美国人突然开始频繁查看手机，聚在一起低声交谈。

From the number of Americans particularly checking their phones all of a sudden and talking to one another in little huddles.

出了问题。

Something was wrong.

新上任的总统特朗普刚刚签署了一项行政命令，冻结了所有对外援助。

Newly inaugurated president Trump had just signed an executive order freezing all foreign aid.

突然间，一切都变得悬而未决。

Suddenly, it seemed everything was up in the air.

我记得会议结束时，美国国际开发署的同事对我说：我不确定还能不能再见到你。

I remember at the end of the meeting, USAID colleagues saying to me, I'm not sure if I'll see you again.

我完全低估了这会对项目造成多大的打击。

I I completely underestimated how much it would gut the program.

但穆尔和她的同事们很快就会得知真相。

But Moore and her colleagues would soon find out.

回到约翰内斯堡后，她说华盛顿方面发来了正式的停工指令。

After returning to Johannesburg, she says the official stop work orders arrived from Washington.

就在试验即将开始的几周前，一切突然停滞了。

Just weeks before the trials were to begin, everything came to a sudden halt.

所有的资金都消失了。

All the money was gone.

在很多方面，我们刚要开始冲刺，腿却被砍断了。

In many ways, we've kind of had our legs cut off even as we're beginning to run the sprint.

传染病专家琳达·盖尔·贝克尔就职于开普敦大学。

Infectious disease specialist Linda Gail Becker is based at the University of Cape Town.

当资金突然中断时，她说自己经历了悲伤的各个阶段。

When the funding collapsed, she says she cycled through the stages of grief.

最初是难以置信。

There's disbelief in the first instance.

然后是愤怒的情绪，因为我们付出了巨大的努力，赢得了这笔资助，并且正在履行我们承诺的事情。

Then there is emotion that basically is angry because we'd worked damn hard, we'd won this grant, and we were doing what we had said we would do.

但渐渐地，贝克尔和她的同事们开始说

But gradually, Becker and her colleagues started saying

这件事太重要了，我们必须完成这项工作。

This matters too much to not finish the work.

一段疯狂申请资助的时期开始了。

A period of frantic grant writing began.

我们拿出了乞讨的碗，说：这很重要。

We brought out the begging bowl to say, this is important.

你们能以某种方式帮助我们吗？

Can you help us in some way?

最终，他们从南非医学研究委员会和盖茨基金会获得了资金，但这笔资金只是原美国国际开发署资助的一小部分，且仅限于南非境内，这意味着他们不得不放弃研究疫苗在不同非洲人群中对病毒不同变体的疗效。

Finally, they got funding from the South African Medical Research Council and the Gates Foundation, but it was a fraction of the original USAID grant and only focused inside South Africa, meaning they had to sacrifice studying how the vaccine might work against different versions of the virus within different African populations.

佩妮·摩尔。

Penny Moore.

这是一个简化的版本。

It's a bare bones version.

我们仍然能得到答案，但这会耗费我们时间。

We will still get the answer, but it's gonna cost us time.

好几年。

Years.

这可不是小事，因为人们一直在不断感染这种病毒。

Which is not trivial because people are getting infected with this virus constantly.

尽管不得不缩减规模，摩尔表示，HIV疫苗研究比以往任何时候都更接近成功。

Despite having to scale back, Moore says HIV vaccine research is farther along than it's ever been.

她带我回到她实验室的冷冻室，那里存放着丰富的科学宝藏，这在很大程度上要归功于那117位女性多年来捐赠的样本。

She takes me back into that freezer room in her lab, which contains an embarrassment of scientific riches, thanks in no small part to those a 117 women and the samples they've donated over the years.

这些样本教会了我们关于HIV的一切知识。

These samples have taught us everything we know about HIV.

并揭示了真正的科学宝藏——一种在少数几位女性血液中出现的独特抗体，被称为广泛中和抗体。

And have revealed a veritable pot of scientific gold, a unique kind of antibody that showed up in the blood of a few of these women, something called a broadly neutralizing antibody.

这种广泛中和抗体可以阻止我的病毒、你的病毒，以及任何其他人的HIV病毒。

A broadly neutralizing antibody could stop my virus and could stop your virus and could stop an HIV virus from any other person.

但要促使人体免疫系统产生这些抗体非常困难。

But it's difficult to coax the human immune system to produce these antibodies.

这个疫苗试验正试图找出更简单的方法来实现这一点。

This vaccine trial is trying to figure out how to do that more easily.

经过近一年的延迟，缩减后的试验终于开始了。

At last, after nearly a year of delays, the pared down trial is getting underway.

在开普敦郊区，一座大型砖砌建筑矗立在菲利佩村之上，这是一个艾滋病肆虐的贫困社区。

On the outskirts of Cape Town, a large brick building rises above Felipe Village, an impoverished township where HIV is rampant.

在几层楼之上，我发现了阿梅莉亚·姆菲基，她是疫苗试验的社区联络官。

A few levels up, I spot Amelia Mfiki, the community liaison officer for the vaccine trials.

这对南非来说是一个绝佳的机会，证明我们能够依靠南非的资金，在南非为南非人做事情。

This is a great opportunity for South Africa to prove that we can do things in South Africa for South Africa with South African financing.

姆菲基走向一间房间，那里有大约二十名来自社区的年轻女性，正在听取有关参与试验的信息。

Mfiki makes her way to a room where 20 or so young women from the community are gathered to hear about participating in the trial.

艾滋病疫苗。

HIV vaccine.

25

25

19岁的南迪普·哈蒙戈认真聆听。

year old Nandeep Hamongo listens attentively.

她说她的社区面临着强奸、以性换利以及意外怀孕等问题。

She says her community struggles with rape, sex traded for favors, unplanned pregnancies.

我们大多数人害怕感染HIV。

Most of us are scared of getting HIV.

这就是为什么她很乐意参与这项研究。

Which is why she'd happily be involved in the research.

我太兴奋了，老兄。

I'm over the moon, man.

我太兴奋了。

I'm over the moon.

是的。

Yes.

因为她为自己能带来改变而感到自豪。

Because she's proud to be making a difference.

是的。

Yes.

很大的一个。

A big one.

巨大的改变。

A big difference.

所以我会

So I

我问她，如果这个研究团队能够找到疫苗，一个没有艾滋病毒的世界会是什么样子？

ask her, if this team of researchers are able to find a vaccine, what would a world without HIV be like?

自由地生活？

Living free?

是的。

Yeah.

本周，新疫苗试验的首批接种已开始注入受试者体内。

The first shots of the new vaccine trial started going into participants' arms this week.

这里是NPR新闻，我是阿里·丹尼尔，来自南非开普敦。

For NPR News, I'm Ari Daniel, Cape Town, South Africa.

阿里为本报道的采编工作得到了普利策中心的资助。

Ari's reporting for this story was supported by a grant from the Pulitzer Center.

比尔及梅琳达·盖茨基金会是NPR的财务支持者。

The Gates Foundation is a financial supporter of NPR.

本集由马洛里·余和基拉·瓦基姆制作。

This episode was produced by Mallory Yu and Keira Wakim.

本集由丽贝卡·戴维斯和柯特尼·多宁编辑。

It was edited by Rebecca Davis and Courtney Dorning.

我们的执行制片人是萨米·扬尼根。

Our executive producer is Sammy Yannigan.

这是NPR的《就此而言》。

It's Consider This from NPR.

我是胡安娜·萨默斯。

I'm Juana Summers.

这是《新鲜空气》的联合主持人塔尼娅·莫塞利。

This is Tanya Moseley, cohost of Fresh Air.

你可以在深夜电视节目或YouTube上看到你喜爱的演员、导演和喜剧演员，但《新鲜空气》能让你深入了解他们。

You'll see your favorite actors, directors, and comedians on late night TV shows or YouTube, but what you get with Fresh Air is a deep dive.

与比莉·艾利什、奎斯特洛夫、爱莉安娜·格兰德、斯蒂芬·科尔伯特等众多名人共度高质量的对话时光。

Spend some quality time with people like Billie Eilish, Questlove, Ariana Grande, Stephen Colbert, and so many more.

我们会提出你在其他地方听不到的问题。

We ask questions you won't hear asked anywhere else.

收听来自NPR和WHYY的《新鲜空气》播客。

Listen to the Fresh Air podcast from NPR and WHYY.

在《哦我的天啊》与斯科特·卡特一起，聆听信徒的声音。

On Ye Gods with Scott Carter, hear from the faithful.

我告诉我那位非常虔诚的天主教母亲，她该去见见耶稣了。

I told my very Catholic mother that she needs to meet Jesus.

以及那些不信教的人。

The faithless.

我真的不相信上帝。

I just so don't believe in God.

还有无畏的人。

And the fearless.

服务他人，与人建立联系。

Serve people, connect with people.

这才是我们茁壮成长的方式。

That's how we thrive.

如果人生是个谜，我们就来调查。

If life's a mystery, we investigate.

谁干的？

Who done it?

我祈祷幽默之神

I pray that the humor god

无论你在哪儿听播客，都请认真收听《Ye Gods with Scott Carter》。

Listen religiously to ye gods with Scott Carter wherever you get your podcasts.