whether that is licensed microbicide vaccine combination or the introduction of a 50% when rest ofcine the prevention package has risen have to be not perfect to be good enough and i think that is the take-home from high perspective. dr. fauci? >> so 31's not good enough, 95.l never get it's going to be somewhere between the two. thatee with mitchell it's -- i'll take 50. i really would like to see 60. think there's going to be any trouble in proving a becauseis that percent even though we know we have combination prevention, there's of human nature and lack of adherence to that so you have to pick out a highly at-risk population. ethical obligation to offer them things like prep, things like microbicides, et cetera, that at the end of the day human nature will win over and people will get infected and hopefully you'll get enough people in the study that you could show that a works. >> i'll be a little controversial coming from my background of introducing other vaccines and looking at the barriers to vaccine adoption. i introduced hpv vaccine and had 100% efficacy, at least thatst the

highlye to pick out the population and efficacy to offer them things like microbicides. the day human nature will win over and there will be people who will get infected and hopefully you will get enough people in this ready. >> i will be a little controversial for my background introducing other vaccines and looking at the barrier to vaccine adoption. i introduce hpv vaccine and have 100% efficacy. the common strains included in the most common out there. the insuredg at population because you either have private insurance or was covered by the vaccine for insurance program. the threet up take in dose regimen in less than 40% of teenage girls. a lot of barriers. i think we will see it in some of the developing countries as well. strive we really need to for 65-70%. i would hate to go to market was 50% effective. i think you will have all sorts of barriers put up. we also ran scenarios and i talked about the cost of effective barrier or target that you need to reach. the policy may -- policymakers and payers, there may be a high risk population that when you just immuniz

but in the small monkey trial a combination of a microbicide with a vaccine in the monkeys were shown to be much more effective than a little but it doesn't tell us, we've assumed just as a combination of treatment being the most effective treatment, combination prevention is what we will work towards the weather that is licensed by a combination or the introduction of a 50% effective vaccine when the rest of the prevention package has risen. we do not have to be perfect to be good enough. i think that's the take-home from my perspective. >> so 31 is not good enough but we will never get 95. it will be somewhere between the two. i agree with mitchell that i will take 50. i really would like to see 60. i don't think there's going to be any trouble improving a vaccine is that percent because even though we know we have combination prevention, the issue of human nature and lack of adherence to that. so you have to pick out a highly at risk population. you have the ethical obligation to offer them things like prep, and like microbicides, et cetera, et cetera. but at the end of the human n

you have the ethical obligations who offers them things like microbicides, et cetera, et cetera. at the end of the day human nature can win over and people will get infected and hopefully you will get enough people to show that a vaccine works. >> i'll be a little controversial from my background introducing other vaccines and looking at the barriers to vaccine adoptions. so i introduced hpv vaccine, 100% efficacy against four strains that were included but most commonly the common strains out there and i was able with in the united states and insured population, was covered for insurance programs to only get uptake of the three dose regimen in less than 40% of teenage girls. a lot of barriers, we know about anti-vaccine groups, more an issue in developing countries but we will see some of it in developed countries as well. i really think we need to strive for 65%, 70%. i would hate to go to the market with a vaccine that is 50% effective. we will have all sorts of barriers put up not the least of which is cost-effectiveness. we have scenarios on that when i talk about hitting th