In addition to the many resources mobilized in response to COVID19, it is essential not to overlook other pandemics that still have a great and lasting effect and on which equally important and lifesaving work has been concentrated. A recent seminar series called Life Sciences Across the Globe focused on global experts discussing how to advance life sciences. World-renowned HIV researchers were among those presenting.
The Institute of Infectious Disease and Molecular Medicine (IDM) at the University of Cape Town (UCT) held its monthly seminar on 4 August. The series is a collaboration between the Howard Hughes Medical Institute and Janelia Research Campus.
The IDM’s Education Committee chair, Associate Professor JoAnn Passmore, emphasized the institute’s focus on diseases relevant to Africa and its commitment to training the next generation of African scientists.
“The world currently has more than 40 million [people] living with HIV, many of whom live in sub-Saharan Africa. HIV researchers have been focusing on the endgame: a cure for HIV.
Strategies towards a cure
Sharon Lewin is a physician and basic scientist who specializes in infectious diseases. Lewin is the inaugural director of The Peter Doherty Institute for Infection and Immunity, a joint venture between the University of Melbourne and Royal Melbourne Hospital in Australia. In addition to developing clinical trials to develop a cure for HIV, she conducts research to understand why HIV persists despite treatment.
The goal of reaching 95% of people living with HIV on treatment by 2025 is a challenging one, given that 1.8 million new infections occur annually in the world.
Due to antiretroviral therapy, the face of HIV has changed dramatically. With a daily dose of one tablet, antiretroviral therapy is now more straightforward. Additionally, treatment is relatively cheap, mostly accessible, nontoxic, and available to at least 70% of the world’s population.
“People will have to inject themselves every other month just to keep their virus under control with new advances in antiretroviral therapy. Since antiretroviral therapy isn’t perfect, we need a cure,” she said.
HIV testing is a core strategy in HIV prevention. A person who tests positive and begins treatment gradually becomes less infectious. We are treating it as we prevent it.
Destigmatizing testing is key – HIV testing and COVID19 testing are two very different things. We need to normalize testing since people don’t like to get tested for many reasons. In contrast, testing people frequently, with their consent, and starting treatment [early] is very effective. Those actions have led to reductions in HIV over time.”
Bringing it home
Thumbi Ndung’u is a professor of infectious diseases and the Max Planck group leader at Africa Health Research Institute. The Females Rising through Education, Support, and Health (FRESH) cohort is under his care. FRESH aims to empower young women through the programme and to encourage participation and feedback in a bidirectional manner.
Ndung’u noted that the highest HIV prevalence is in KwaZuluNatal. According to Dr. Emily Wong’s research published in Lancet Global Health this year, 36% of males and 60% of females aged 25 to 44 are HIV positive.
“As someone living in a resource-limited environment, the most exciting approaches revolve around early diagnosis and early immune therapy and these approaches are probably more likely to be implemented in these settings,” said Ndung’u. “There’s also evidence that this is achievable. So combination approaches will likely form the first line of HIV cure strategies.
“We have a history where we have seen that developing interventions by themselves is not enough. Instead, we need to make sure that interventions are tailored to the communities that will benefit from them.”
Hope and healing
Over the past 30 years, of the 78 million people who have been infected with HIV, 39 million have died of it.
The evolution of the virus and the eras of despair, hope, and most recently, the hope that a cure might be in sight.
“The cure for HIV will come. We’ve got to be optimistic. We’ve got to believe.”
There are a variety of barriers that can make it difficult to continue treatment, continue at scale, and continue well. Politics, discrimination, stigma, accessibility, and specific regulations are some of these barriers. This epidemic is far from over.
Working with community advisory boards and including those served in terms of education is crucial to ensuring that the community has a voice.
“The best science is relevant science. Relevance asks, ‘What is the priority?’ Science then asks the right question. If asked and listened to, the community frames the context. And together, the community and science can find the right answer.”