Unraveling a Puzzle That Has Mystified Science Researchers Worldwide

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By Deanna Natalizio

Dr. Alan Bernstein is no stranger to the intricacies of health research.
As former director of Mount Sinai Hospital’s Research Institute and an
illustrious reign as president of the Canadian Institute for Health Research (CIHR) under his belt, his sights are now set on leading the world’s latest strategy for the development of an HIV vaccine.

In his most ambitious career move yet, Dr. Bernstein will play the centripetal piece in a puzzle that has mystified science researchers worldwide. The prevention of AIDS has inspired research projects across the globe. The Global HIV Vaccine Enterprise is an initiative designed to implement a shared scientific plan for research. Under the direction of Bernstein, the factionalized style of current research strategies will be restructured under one joint body. If the project’s mandate is carried out to its fullest, the initiative will see the product development of an HIV vaccine as the end result.

Bernstein’s familiarity with bridging fragmented research objectives into a single integrative health agenda has lent to his credibility in leading the Enterprise. The CIHR consists of 13 virtual institutes, each with its own set of science professionals and ideas as to how to improve the health of Canadians.

During his seven year tenure, Dr. Bernstein forged relationships between institute-specific ideals and enabled research initiatives to be guided by their adherence to common goals. His insight also helped shape the allocation and mobilization of CIHR funds.

Closing a chapter of one’s life inspires a retrospective appraisal of the past. The end of seven years is a marker for the many developments that have led to crucial advancements in health research. At the highest level, Dr. Bernstein expresses his pride for all the new directions the CIHR has set for health research in Canada. In regards to the individual programs he has encouraged, he names the strategic training program as one of the most progressive, as it has increased funding for graduate and post-doctoral students. The CIHR values the new information being acquired by emerging young professionals, “We have put a great deal of emphasis on bringing together students from different disciplines across Canada and encouraging them to work together and learn from each other,” notes Dr. Bernstein.

Although he is no longer an active part of the CIHR, Bernstein will always have an invested interest in its current and future undertakings. He compares witnessing the evolution of the institute to watching a child progress through the stages of their education, “I feel like CIHR has now finished grade school and is about to enter middle school. It has passed its beginning stage, and this is a logical point for me to move on and for the agency to take a new direction.”

Like every proud parent, Bernstein has his opinions as to what directions the CIHR should head in to continue to make headway, “Going forward, one of the key opportunities will be to increase CIHR’s emphasis on knowledge translation. There are now so many exciting opportunities to harness the results of research to improve health and build a health system and knowledge economy for the 21st century.” His resignation at the CIHR and his decision to work with the Enterprise has in no way been influenced by the other.

Dr. Bernstein had made up his mind to end his seven year tenure with the CIHR before attaching his name to the Enterprise. “It was difficult to make the final decision to leave CIHR, because I have been very closely associated with the institution from the beginning. My decision to join the Enterprise was made after I decided to leave CIHR, but in many ways, I now feel similar to how I felt when I began at CIHR in 2000, because many of the challenges at the Enterprise are the same.” Dr. Bernstein’s past experiences are a useful tool for overcoming obstacles that mirror those of seven years past.

One of the challenges he names is the difficulty of garnering support from different sectors. Dr. Bernstein is now dealing with a world of divergent opinions that are not only separated by scientific practice, but geographical expanse. “One of the greatest lessons (from CIHR) was about the challenges and rewards of getting people from very different disciplines to work together. The strength that I bring to the Enterprise is the ability to bring researchers together to achieve a common goal.”

Whether he is working with citizens of the same nation, or representatives from around the globe, Dr. Bernstein is looking for a universal human quality. The special ingredient he is in search of is a demonstrated willingness to cooperate, “By helping people see for themselves how working together can benefit everyone, I believe we can help address scientific challenges that cannot be answered by one field alone. It doesn’t happen on its own. They have to want it and see that there is something to be gained. Building an HIV vaccine needs to be a collective effort, and I feel that many of these lessons are very important in the way the Enterprise does its work.”

Less strong willed individuals would cower away in fear of failure when faced with the Herculean task of affiliating a global effort. Dr. Bernstein credits his personal feelings concerning the AIDS epidemic as the base upon which all of his active work with the Enterprise will be founded on, “I believe AIDS is one of the most serious health problems facing humanity today, and an effective HIV vaccine has the potential to save millions of lives. Science has a crucial role to play in addressing global health challenges like HIV. I think that the Enterprise has an important role to play in bringing together scientists, governments, industry, and advocates in order to build a truly global effort to develop a vaccine as quickly as possible.”

Bernstein pays tribute to the global approach taken by the Enterprise for its ability to benefit its aims rather than impede them. “The fact that the public cares a great deal about HIV vaccine research motivates all of us. Everyone wants to work on important problems, and I believe, to a certain extent, the public interest provides more impetus for people to work together because we know the world is watching,” notes Bernstein. The failure of a global initiative leaves the entire world at blame, with not one person or nation singled out, or likewise excluded, from censure. The degree of cohesion between nations remains to be seen, but the Enterprise will undoubtedly spark the much needed global discussion of AIDS research.

The Enterprise’s backing by the Bill and Melinda Gates Foundation has also helped garner AIDS research the global attention it deserves. The generous amount of $300 million pledged by the Foundation has greatly assisted the funding of the Enterprise. Dr. Bernstein considers the Foundation’s financial contributions important for obvious reasons, but wishes to emphasize its non-monetary endowments. “It is important to recognize that the non-financial aspects of Gates’ leadership are almost more important. By playing such an important leadership role, the Gates Foundation has drawn the attention of the entire world to neglected areas of global health and helped draw in many others – including national leaders – to these efforts,” he comments.

Dr. Bernstein makes it no secret that he is a relative outsider to the field of vaccine research. He considers this incapacity to be a strategic advantage to the Enterprise’s undertakings, “Because I am relatively new to this field, I don’t have a pet theory or set of preconceived ideas, and therefore, I believe I can be seen as a neutral convener.”

As the impartial voice in a noisy whirlwind of global commentary, Bernstein realizes that his duties require him to take on the role of listener rather than dictator. “I think the biggest challenge is to listen to all the voices in the field and carve out a niche that ensures we are adding value and speeding the process of vaccine development.”

His first steps as director will be taken towards engaging in meaningful conversation with the respective organizations linked to the Enterprise. “I look forward to meeting with the leadership of the Enterprise’s partner organizations and facilitating a conversation about how the field can move forward. I feel it is especially important now to convene a broad and inclusive conversation to map out a coordinated strategy.”

Dr. Bernstein believes national standing to have played a factor in his appointment, as he is represented as the Canadian head of a world effort. “I think that in many ways, my appointment speaks to Canada’s traditional role of being an honest broker in international efforts.

That has always been a phrase that has been applied to Canada, and I hope it applies here.” In terms of advancing health research, the CIHR has become a model worthy of being emulated by other countries. Dr. Bernstein’s appointment is a reflection of Canada’s status as a country leading health innovation.

Considering the breadth of the Enterprise’s goals and the fact that it is in its earliest stages of strategy implementation, Dr. Bernstein does not overestimate the amount of time it will take for the Enterprise to reach its first breakthroughs. “If there is anything I have learned over my 35 year scientific career, it is that science doesn’t yield to a timeline. Scientific “home runs” are relatively rare, but by pulling together the best minds from around the world—and from the private sector, academia, and governments—we can gradually progress toward an effective vaccine. I cannot give you a date, but I am certain we will one day develop an effective HIV vaccine.”

Dr. Bernstein has received much acclamation from medical professionals who believe his appointment will bring increased momentum to the project.

Preconceived expectation is accompanied by Dr. Bernstein’s own brand of optimistic realism as he readily admits, “Science is by definition a journey into the unknown.”

The world has waited with bated breath for a preventative measure to combat AIDS, as past crusades have had a less than formidable track record. Despite the cautionary label attached to his pursuit, Dr. Bernstein maintains an undaunted outlook, “I do not believe any of us would be involved in HIV vaccine research if we did not inherently believe a vaccine was possible. The human immune system is incredibly inventive and adaptable, and we already know that many people are able to live for many years with HIV. Science does not progress neatly from one successful experiment to another, but I believe that with sufficient commitment, the world can one day develop a successful HIV vaccine, just as we have developed vaccines for numerous other diseases.”