Researchers from around the world recently converged on Boston for a scientific conference dedicated to one of the most pressing challenges of our time: The development of safe and effective vaccines for the prevention of HIV, the virus that causes Aids. They had much to discuss, given the extraordinary progress in this area of research, much of which has been widely reported in the press.
What is less well known, perhaps, is how much that progress stems from the contributions of scientists in Africa, who continue to work with thousands of volunteers to find solutions to the Aids crisis. With steadfast support from governments and civil society organisations across Africa, scientists on the continent have played key roles in everything from the basic science that underlies vaccine design to the clinical evaluation of Aids vaccine candidates.
Much of this work has been conducted in partnership with Western government agencies, such as the United States Agency for International Development and its counterparts in Europe, as well as an array of international and regional HIV care and research organisations — including the Centre for HIV/AIDS Vaccine Immunology (CHAVI) of the US National Institutes of Health (NIH), the Collaboration for AIDS Vaccine Discovery (CAVD) supported by the Bill & Melinda Gates Foundation, the International Aids Vaccine Initiative (IAVI) and the European and Developing Countries Clinical Trials Partnership. But African scientists have been front and centre, and their governments have backed their efforts. African researchers have helped establish proof of concept for other HIV prevention strategies as well, most notably for microbicides against HIV, medical male circumcision and the prophylactic use of antiretroviral drugs.
Research in this arena has also helped build the technical capacity essential to seeding medical and biotechnological innovation. We have witnessed nothing less than a silent revolution in African science over the past several years. If sustained, this revolution could have very positive implications for both the public health and, in time, the economies of the region.
Take, for example, the evolution of the Kenya AIDS Vaccine Initiative. KAVI was launched a little more than a decade ago, the brainchild of a small band of prominent HIV researchers in Nairobi. Established as a partnership between UK’s Medical Research Council MRC-UK), IAVI and the Kenyan government, KAVI’s goal was to test HIV vaccines devised to prevent the subtypes of HIV prevalent in East Africa.
To accomplish that task, however, researchers at Kenyatta National Hospital had to first train their staff to conduct research with the rigour required to win regulatory approval for a future vaccine. With the support of IAVI, they ensured that their staff technicians, scientists and research physicians were trained in Good Clinical Practices, and that their labs obtained certification for compliance with Good Clinical Laboratory Practice (GCLP), a stringent, internationally recognised badge of laboratory quality. Throughout the past decade, KAVI researchers have spread those skills to colleagues across sub-Saharan Africa, even as they have tested a series of Aids vaccine candidates in clinical trials.
KAVI recently obtained a grant from the Canadian government to help develop biomedical research labs across the region, help them earn GCLP accreditation, and to build its own capacity to conduct cutting edge research in the subfield of mucosal immunology. Further, as a member of the Networks of Excellence programme run by the European and Developing Countries Clinical Trials Partnership (EDCTP), KAVI is today deeply engaged in building capacity for the conduct of clinical trials in East Africa.
On the strength of its experience in clinical research, KAVI has also begun to branch out to assess treatments for other ailments, including tuberculosis. It is only fair to note that none of this would be possible without the active — and proud — support of the Kenyan government, which has consistently made resources and personnel available for these and many other HIV prevention projects.
Similarly, since Ugandan scientists completed the first Aids vaccine trial on the continent more than a decade ago, they have become major players in HIV prevention research. In fact, the Uganda Virus Research Institute in Entebbe was selected as a central laboratory by CAVD, which co-ordinates a global programme in Aids vaccine development. It is also a co-ordinating centre for EDCTP’s East African Networks of Excellence and, through its partnership with MRC-UK, was a key participant in the NIH-funded CHAVI.
UVRI researchers contributed to the development and standardisation of experimental methods employed to assess immune responses to Aids vaccine candidates and conduct relevant basic research. Today, the technical capacity of UVRI and other research facilities in the country is increasingly being applied to support advanced research in vaccinology, virology and the immunology of HIV infection.
South African scientists have put their nation on the map in HIV prevention research as well, and not just for HIV vaccine development, in which they have played a leading role in both the design and clinical evaluation of candidates. A team led by scientists affiliated with the NIH-funded Centre for the Aids Programme of Research in South Africa provided the first evidence, in 2010, that a microbicide—in this case, a vaginal gel infused with an ARV—can prevent HIV transmission.
Further, a South African biotechnology company, Elevation Biotech, has participated in the complex business of HIV vaccine design with funding from IAVI and BMGF. Now South Africa has launched a research programme in partnership with the government of India to design and develop vaccines against HIV, probably the first instance of South-South collaboration in HIV vaccine design.
It is only right that researchers in sub-Saharan Africa focus as much as they do on the HIV crisis. After all, no other part of the world has been quite as severely affected by the pandemic. Though that pandemic remains far from contained, the good news is that the contributions of African scientists are making a tangible difference to the development of new HIV prevention technologies. Indeed, African participation in such research is now a proud tradition, one we expect will continue unabated until the day we have in hand a safe and effective Aids vaccine.
Prof Pontiano Kaleebu is director of the Medical Research Council at the Uganda Virus Research Institute Unit on Aids and cofounder of the African Aids Vaccine Programme. Prof Omu Anzala is principal investigator, Kenya Aids Vaccine Initiative and current chair of the Department of Medical Microbiology at the University of Nairobi