Uganda Leads the Way in Testing AIDS Vaccine

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Posted to the web February 12, 2003

Nairobi

Trials of a preventive HIV/AIDS vaccine began on human volunteers on Monday in Entebbe, Uganda.

The vaccines are currently the only ones being tested on humans that are tailored for the subtype of HIV most common in eastern Africa - subtype A. Most other vaccines focus on the B strain, which is found in the US and Europe.

Scientists do not yet know whether separate vaccines will be necessary for the different strains.

"The vaccines do not contain HIV, and cannot cause HIV infection," said the International AIDS Vaccine Initiative (IAVI), which is conducting the trials with the Uganda Virus Research Institute (UVRI).

The two vaccines - one a naked DNA formulation, and the other constructed from a weakened pox virus - were developed as part of an IAVI-sponsored partnership between research teams at the University of Oxford, in England, and the University of Nairobi, in Kenya. They are intended to boost the immune system to allow it to produce cells which can destroy others which have contracted the HIV virus.

The idea reportedly came from a group of commercial sex workers in Kenya who were found to have a degree of immunity to HIV/AIDS, despite being infected on a regular basis.

The first phase of the trials needs a total of 50 volunteers, only some of whom have come forward. "We will need many more men and women from all walks of life to come forward to help find a vaccine to prevent AIDS," said Seth Berkley, President of IAVI.

Trials of the vaccine combination are ongoing in Kenya and the UK. "If the vaccines continue to show promise in these early stage trials, they will progress to larger scale trials in additional sites in Uganda and other parts of East Africa," the IAVI statement said.

The Uganda National council for Science and Technology approved the trial in 2002. It was also reviewed and approved by the Science and Ethics Committee at UVRI and reviewed by UNAIDS.

In 1999, Uganda was the site of the first AIDS vaccine trial in Africa.

"Uganda has long been at the forefront in responding to AIDS. It is only natural that we would be involved in the search for a vaccine to help end this epidemic," said Dr Kihumuro Apuuli, Director general of the Uganda AIDS Commission.

[Volunteer information is available every Thursday from 5 pm until 7 pm in the Golf View Inn in Entebbe. Alternatively, view www.iavi.org/uganda ]

This is one of the more hopeful stories I've seen recently about AIDS in Africa. If the trials are successful, do you think drug companies will charge a price that's affordable to African Health Ministries? If not, do you think world opinion will put sufficient pressure on the pharmaceutical industry? And if they do decide to charge a lower price, how will these companies make a profit? After all, it's a lot of $$ to devise, market and test a new drug. Will the funding be through something like debt forgiveness, or something else?

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I only fail to understand how can efficiency of the vaccine be proved or disproved experimentally. Does this mean that the attempts to infect the volunteers with HIV will be undertaken after vaccination? And what if the vaccine is inefficient? And what will happen to the control group having received placebo instead of vaccine?

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streissd, they follow the volunteer population and see who gets it and who doesn't. The vaccinated population should display a similar percentage of HIV cases as the general population if the vaccine doesn't work.

I wonder how volunteer the voulnteers were. I'm glad it's happening somewhere, I wonder what Nairobi gets out of it besides possible prevention from contraction.

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Yeah, I also wonder how voluntary the volunteers are. I suspect they're getting some sort of funding for this, but then again, we pay people in the US for participating in medical experiments. The only thing is, those experiments usually aren't quite so life-and-death.

I think how it works is that the people who are vaccinated just go about their business. In this case, these are sex workers, so their business brings them into contact with HIV. Then, I suppose, they are tested at somewhat regular intervals to determine whether they've been infected. I don't know if the Johns are tested although they probably should be as well (even though I'm assuming they aren't vaccinated). After all, it's possible that a sex worker would not come into contact with infected clients for, say, 6 months, and of course she wouldn't come down with HIV. Those kinds of situations need to be accurately separated from real results of sex workers who do come into contact with infected clients during that same time, and then their contraction (or not) of HIV.

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I wonder what role the women who seem immune to HIV play in this..... they aren't very clear about it.

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I have never been in any contact with the so-called "sex workers" (I guess, this is a politically correct definition of regular prostitutes), but I have heard that they never render their services without condom. This may distort results of the experiment: how can we know whether the prostitute remained intact due to vaccine, or as a result of condom usage? Or these volunteers signed an obligation not to use contraceptives? Then they are crazy...

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This is Africa....

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Yeah, Africa is going to be different. Love the new job title - sex worker.

Any successful vaccine is going to have to have government funding, which will very probably be the United States or United Nations. Pharmaceutical companies are simply not in a position to donate stockholders money.

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Of course, they are not. Pharmaceutical companies are businesses and not charity funds.

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Uganda Leads the Way in Testing AIDS Vaccine

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