Thus, the failure to proceed to field trials, in the context not of an ideal world but in the real world of successful vaccine development, is unethical and violates human rights. The failure to act, like silence, has moral consequences. At an institutional level, this failure stems from decisions and recommendations made by NIH and its AIDS vaccine advisory committee, both of which are headed by notable scientists who nevertheless lack experience with vaccine development and public health. What is needed is to develop AIDS vaccine candidates according to procedures and milestone-driven strategies which have produced highly successful vaccines which save millions of lives from diseases like polio, whooping cough and measles. It is unethical and violative of human rights to hold AIDS vaccine development hostage to a requirement for scientific exactitude which is unreasonable and may well be unattainable.
Science is an instrument of public health.
The larger responsibility, central to the moral authority and legitimacy of our government, is protection of the public health. The program for AIDS vaccine must be lifted above institutional defensiveness and parochial interests. Failing to proceed is unethical and violates basic human rights.