[tialaramex]

Emergency Authorization is a regulatory matter, and thus isn't a global decision.

New Zealand did not use Emergency Authorization for the pandemic, because they had elimination so they were able to wait while their medicines agency performed full (but expedited) assessment for the Pfizer mRNA vaccine and gave a recommendation based on that assessment. As a result they didn't even begin vaccinating people until months after some other countries, but (because of elimination) they had zero deaths meanwhile.

So, in some countries regulators might decide an HIV vaccine is something that needs Emergency Authorization and in others not.

Another factor in what you're calling a "10 year process" is how long it takes to collect data from a Phase III trial. I think lots of people still do not appreciate why the Phase III trial for these coronavirus vaccines was so fast. The pandemic meant that huge numbers of people in your control group get infected. This is terrible news for them, some will die, but it means you get very rapid trial results.

So if you're confident that HIV has similar levels of spread, this is "good news" there too, the vaccine trials won't take very long to give results, regardless of whether you are intending to do Emergency Authorization or a normal process.

[MagnumOpus]

> So if you're confident that HIV has similar levels of spread

It does if you do phase III trials in the right countries. In South Africa, there's 15 million HIV cases give or take, and a million infections per year - so trials could yield results rather quickly...

[ebiester]

Clinical trials are quite often global. I'd imagine any vaccine effort would be too.

[tialaramex]

In practice the trial will recruit participants from only a few countries. For example Pfizer's trial of BNT162b2 (their COVID-19 vaccine) recruited in the United States, Germany, Turkey, South Africa, Brazil and Argentina. But not for example Spain, Canada, Israel or Zimbabwe (picking countries off the top of my head at random).

In the ideal case you'd somehow randomly sample the world population, but practical considerations have to be taken into account. As a result it is often the case that we don't yet have a medicine targeted precisely at your gender, age, ethnicity, build, pregnancy status, co-morbidities, profession, and favourite musical genre, but ultimately the medicine which worked on another human who is quite unlike you in almost every way is surprisingly likely to be effective anyway, and so maybe you should try that meanwhile.