Africa takes action to overcome challenges for HIV vaccine development

17 OCTOBER 2005 | YAOUNDÉ, CAMEROON -- A ministerial level meeting is set to review the current status of HIV vaccine research and development, as well as a range of challenges concerning Africa's active participation and contribution to this area, in collaboration with various stakeholders and partners.

About 200 HIV vaccine stakeholders, including African and international scientists, research agencies, donors and government and regional organization officials are taking part in the Third Forum of the African AIDS Vaccine Programme in Yaoundé, Cameroon, 17-19 October 2005. Mr Ephraim Inoni, Prime Minister, Republic of Cameroon, opened the Forum.

"On top of the great scientific challenges that need to be overcome in order to develop an HIV vaccine, Africa is currently facing the need to strengthen capacity in many areas in order to support such research," said Dr Luis Gomes Sambo, World Health Organization (WHO) Regional Director for Africa. This includes legislation, vaccine regulation, ethics, research policy and ability to negotiate with sponsors of clinical trials and pharmaceutical industries.

Among the issues to be covered in the Forum are:

• Current status of HIV vaccines and present scientific challenges, including research in the European Union and the United States;
• Experiences of seven African countries in the development and implementation of National HIV Vaccine Plans: what has been done and what more is needed;
• Work of new partnerships and initiatives, such as the Global HIV Vaccine Enterprise, the International AIDS Vaccine Initiative (IAVI) and South African AIDS Vaccine Initiative (SAAVI);
• Ethical, legal and policy issues for clinical trials in Africa; and
• Development of strategies for future access to HIV vaccines.

The Forum is expected to produce, at the end of the three-day meeting, a set of recommendations for further work to strengthen research capacity, particularly regarding the ability to conduct phase III trials, in Africa.

As of end 2004, an estimated 25 million Africans were living with HIV out of the 40 million people infected worldwide. "Africa stands to gain maximum benefit from an eventual HIV vaccine as the continent most affected by AIDS," said Dr Catherine Hankins, Chief Scientific Adviser at the Joint United Nations Programme on HIV/AIDS (UNAIDS). "A safe and effective HIV vaccine for Africans will only become a reality if Africans are full participants in HIV vaccine research.”

Five African countries are currently conducting phase I and phase II clinical trials of candidate HIV vaccines: Botswana, Kenya, Rwanda, South Africa, Uganda, soon to be joined by Tanzania. The first clinical HIV vaccine trial took place in the United States in 1987. Eighty trials — including two phase III trials in Thailand and the United States which did not demonstrate any significant level of efficacy — have taken place throughout the world testing more than 50 different candidate vaccines. One large scale phase III trial involving 16 000 volunteers is currently under way in Thailand.

"A major scientific challenge for developing a safe and effective vaccine that will protect the African population is the extensive variety of HIV sub-types existing in Africa, including in Cameroon," said Dr Marie-Paule Kieny, Director, WHO Initiative for Vaccine Research.

The development of a safe, highly effective and accessible HIV vaccine should be acknowledged as a long-term challenge: it will neither be easy nor will it be fast. More in depth basic and clinical research is necessary to develop more products. Multiple clinical trials, requiring intense international collaboration and cooperation will be needed. Once a vaccine is discovered, a major challenge will be to ensure its access to all populations in need.

The Forum is organized by the African AIDS Vaccine Programme (AAVP), the WHO Regional Office for Africa, and the WHO-UNAIDS HIV Vaccine Initiative. AAVP is a network of African scientists working to promote and facilitate HIV vaccine research and evaluation in Africa, through capacity-building and regional and international collaboration. The first Forum was held in South Africa in 2001, the second in Ethiopia in 2003.

The Forum has been sponsored by multiple national and international agencies, including the Agence Nationale de Recherche sur le SIDA, France (ANRS), Bill & Melinda Gates Foundation, Canadian Network for Vaccines & Immunotherapeutics (CANVAC), Canadian International Development Agency (CIDA), Centers for Disease Control & Prevention, United States (CDC), International AIDS Vaccine Initiative (IAVI), National Institutes of Health (NIH), South African AIDS Vaccine Initiative (SAAVI), Swedish International Development Cooperation Agency (SIDA/SAREC) and the United States Military HIV Research Program (USMHRP).

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