Out of Africa, an Aids Vaccine is on the way - and it will empower women most

Monday May 17 2010

By Alash'le Abimiku and Seth Berkley

Africa has long borne the brunt of the Aids pandemic. The disease has spread across sub-Saharan Africa at an alarming rate, leaving in its wake millions of orphans, felling men and women in their most productive years and rendering countless families destitute.

Yet, as we mark this year’s World Aids Vaccine Day on May 18, we have more reason than ever to be hopeful that we will have the tools in hand to reverse the spread of HIV. 

Over recent months, scientists have reported several advances in Aids vaccine research and development. Last November, researchers established for the first time that an Aids vaccine can reduce the risk of HIV infection in humans: the results of the largest Aids vaccine trial ever conducted revealed that a combination of two experimental vaccines given to volunteers in Thailand provided modest protection against HIV.

In September, the International Aids Vaccine Initiative and its partners around the world announced the isolation of two new broadly neutralising antibodies against HIV, which were both identified from a single volunteer in Africa with the support of African researchers.

These antibodies reveal a vulnerability of HIV that vaccine designers may find easier to exploit than any hitherto identified. Adding to this good news, researchers at the National Institutes of Health subsequently reported the discovery of a third such antibody.

But much work lies ahead. Researchers will, for example, now have to carefully study the newly discovered antibodies and figure out how to elicit similar antibodies in people to protect them from HIV infection.

Similarly, researchers will now explore the data from the Thai study to better understand how a more effective Aids vaccine must work.

The world urgently needs such a vaccine. Unlike existing tools for HIV prevention, immunisation would not depend on behaviour change to effect a reversal in the tide of the pandemic.

For this reason, Aids vaccines would be of particular value to women, who are for a number of reasons at far greater risk of HIV infection.

With access to such vaccines, women would be empowered to protect themselves from HIV regardless of the choices made by their male sexual partners.

The research critical to Aids vaccine development will have to be done on a global scale. Indeed, both of the major advances in the field last year arose from international collaborations, in which researchers from the global North and South worked hand in hand.

Clinical facilities dedicated to Aids vaccine development in Kenya and Uganda played a central role in the discovery of the new antibodies.

Such successes underscore the continuing need for robust clinical trial networks that are equipped and staffed to help design and assess vaccine candidates in developing countries.

This is especially true because we know that the best science emerges when research is conducted as close as possible to the problem it seeks to address.

Recent successes in HIV vaccine research and development are also testament to the contributions of tens of thousands of human volunteers — the unsung heroes of the Aids vaccine effort. Their participation is indispensable to the search for an Aids vaccine.

To date, tens of thousands of people around the world have participated in clinical Aids vaccine research.
Many of these volunteers are Africans, who live in some of the areas worst affected by HIV and Aids.

About 1.4 million people in sub-Saharan Africa lost their lives to Aids in 2008 alone, a number equivalent to the entire population of the city of Kampala.

It is statistics such as these that have motivated many Africans to participate in the search for an HIV vaccine, not only as volunteers, but as researchers, advisors, advocates and representatives of communities.

No one in this region has been left untouched by the epidemic. But the good news is that today, a number of African-led organisations — such as the African Aids Vaccine Programme, which is co-ordinating centres of excellence across the continent to facilitate regional collaboration in Aids vaccine research — are taking a far more active role in battling the pandemic.

This is only appropriate. Curbing the Aids epidemic in sub-Saharan Africa is critical to the economic growth of the region.

An effective and accessible Aids vaccine would be a vital asset in any such campaign — and Africa’s people have a great deal to contribute to its discovery.

Dr Alash’le Abimiku is co-chair of the African Aids Vaccine Programme Steering Committee; Dr Seth Berkley is president and CEO of the International Aids Vaccine Initiative