Human Immunodeficiency Virus (HIV), a virus that causes Acquired Immuno-Deficiency Syndrome (AIDS), is one of the world’s most serious health and development challenges.
Since the beginning of HIV/AIDS epidemic, more than 70 million people have been infected with HIV and an estimate of 35 million people have died. In 2016, about 36.7 million people worldwide were living with HIV – of these nearly 18.8 million were women and girls while 2.1 million were children under 15 years. Sub-Saharan Africa remains disproportionately affected by the epidemic accounting for nearly two-thirds of the people living with HIV globally. Many of these African countries hardest hit by HIV are also struggling with disease burden, food insecurity climate change and poverty.
Prevention helps reduce HIV incidence rates, a good example would be Elimination of mother-to-child transmission (EMTCT). Globally since 2010, there has been a 50% decline in new HIV infection among children due to mothers having access to antiretroviral medicines which reduce the viral replication of the virus consequently reducing the risk of transmitting HIV virus to their babies before birth, during birth or during breastfeeding. In spite of advances in our scientific understanding of HIV or increased funding and implementation of current treatment and prevention programs by governments, global health community and civil society organizations – many people living with HIV or at risk of getting HIV still do not have access to prevention, care and treatment which is critical in achieving 90-90-90 targets. While existing HIV/AIDS tools are critically important in curbing the epidemic, a vaccine is essential to conclusively and sustainably end AIDS epidemic in Africa.
For this year’s 2018 HIV Vaccine Awareness Day commemoration, WACI Health AfNHi, collaboratively with IAVI and MESHA with technical and financial resources through AVAC convened a science café on 15th May 2018 with media, HIV Vaccines Advocates civil society and scientist. The meeting objectives were to take stock of the challenges, successes and current efforts in finding a HIV vaccine. This meeting also sought to examine the current HIV research landscape towards a vaccine and also to give insight on the importance of carrying out such research. Treatment options for HIV infection have improved a lot over the last three decades however HIV medicines can have side effects, be expensive and hard to access in some countries. Also, some people may develop drug resistance to certain HIV medicines calling for change of medicines.
Building on the success of the RV144 trial in Thailand which provided proof that an HIV vaccine could really work, two HIV vaccine candidates are now in these large trials. There are about 12 clades (also called strains or sub-types) of HIV which exist in the world. HVTN 702 or Uhambo, a Phase III trial ongoing in South Africa, enrolled 5 400 men and women is testing a vaccine designed to prevent clade C – the most common HIV clade in Southern Africa. Meanwhile HPX2008/HVTN 705 or Imbokodo, a Phase IIb currently in 5 countries across sub-Saharan Africa enrolled 2 600 women. In this region, more women are getting HIV than men and the test vaccine in Imbokodo trial is designed to protect people from more than one clade of HIV.
Researchers are working tirelessly to avail two kinds of HIV vaccines namely preventive and therapeutic. A preventive HIV vaccine will be administered to an HIV negative person so as to teach their immune system to recognize and effectively fight HIV in case they are ever exposed to it in future. A therapeutic HIV vaccine is designed to improve the body’s immune response to HIV in an HIV positive person. Researchers are also evaluating therapeutic HIV vaccines as part of a larger strategy to eliminate all HIV from the body and cure people of HIV. Neither licensed preventive nor therapeutic vaccines exist yet!
Current prevention tools for HIV such as using condoms consistently and correctly, male circumcision and pre-exposure prophylaxis (PrEP) work well. But researchers believe a preventive HIV vaccine will be the most effective way to completely end new HIV infections!
During this commemoration, Kenya based HIV Vaccine advocates paid tribute to Dr. Julia Amayo:
Dr. Amayo paved way for the success we celebrate today. As an advocate, she believed strongly in the power of community engagement in all processes including HIV research and development. Dr. Amayo was certain that Kenya was on the right path to getting an HIV vaccine. Doing everything within her capacity to make this a possibility, Dr. Amayo was a member of the Community Advisory Board in HIV vaccine research and development. In addition to this, she represented Nairobi region as a member of the HIV Vaccine Support Network (VSN) and also contributed substantially in developing HIV Vaccine Research and Development Guidelines – the final one in Kenya! Apart from this, Dr. Amayo participated in a survey that assessed community and health care workers’ knowledge of HIV vaccine research and development. This is the survey that informed the development of the HIV vaccine toolkit by International AIDS Vaccine Initiative (IAVI).
We will not forget your efforts and struggles for an HIV free generation in Africa.
Thank you Dr. Julia Amayo