How close are we to HIV cure and vaccine?

Anti-retroviral drugs (ARVs) during an Exhibition at Kigali Convention Centre on December 4, 2019. Dan Nsengiyumva

Among the avenues that will put healthcare ahead of HIV/Aids is the development of vaccines, cures and multiple prevention mechanisms.

Scientists and activists who spoke to The New Times on the sidelines of the International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) said that there are ongoing efforts in search of vaccines, cures and more efficient prevention mechanisms.

Most chose to be cautiously optimistic on when exactly the advancements will be confirmed successful, they said that vaccines and cure studies could be the much-needed intervention in the fight against HIV/Aids.

Initial expectations indicated that there will be progress in the vaccines by 2021.

Mark Dybul, a member of the Board of Directors for IAVI, the International AIDS Vaccine Initiative said that although the cure and vaccines are not yet in sight, they are also engaging stakeholders to understand how communities might respond to the vaccines and cure.

There is also an awareness that when vaccines become available, they are likely to be partially effective hence the need to manage expectations.

“We are nowhere near a cure, we are nowhere near a vaccine. There are some trials underway and we are further along the way on vaccines. But we are engaging now to understand how the communities are likely to respond,” he said.

For instance, it's ideal to understand stakeholders expectations on the vaccines and cure, their administration dosage and rollout.

This will ensure that whatever the model of administration will be, it will be understandable to the population.

Dybul who previously served as executive director of The Global Fund to Fight AIDS, Tuberculosis and Malaria said that people need to be sensitized before vaccines are available.

For instance, he said that on the introduction of Antiretroviral Therapy and medication, there was widespread concern and hesitance as they did not understand the intervention hence some resistance in the initial phase.
 
“Pharmaceutical companies and research institutions are doing work with the pursuit and hoping to make as much progress as possible and make progress as fast,” he said.

For vaccines, there are some trials underway with findings and initial outcomes expected between 2020 and 2021 after which it could take up to 7 or 8 years before it’s developed into a fully usable vaccine after regulator input.

The current consultation in Africa and beyond also includes ways the public would be open to use the vaccine or cure.

Dybul said that the consultations underway are important in the design process to ensure the relevance.

“There are whole lots of things you look at in terms of acceptability, efficacy, and delivery among other aspects to design. What has been a concern to us is that most of the science has been around things that require chemotherapy or transplant which would not be readily available to the whole world,” he said.

In the process, stakeholders are involving African countries as it’s a continent that has the highest disease burden compared to the rest of the world with about 60 percent of the persons living with the ailment being in Africa.

Linda-Gail Bekker,  the immediate former President of the International AIDS Society said that much work is underway in coming up in regard to prevention of HIV/Aids beyond condoms and Antiretroviral medicine which is being used.

With the efficiency, admissibility and ease of uptake of condoms and ARV tablets and prevention having challenges, they are testing other ways that could aid prevention.

The prevention mechanism under tests will involve aspects such as implants, injectables, or pills that can be taken once a month taking into context that daily pills are not always easy to use.

She said that in the process, they have been taking in lessons on aspects that they need to consider. With that they are doing the trials in Africa to ensure that the outcomes are relevant and implementable in Africa.

Despite substantial progress in understanding and treating the ailment, experts say that existing tools have not effectively controlled the epidemic, and the potential threat of resurgence looms as the largest cohort of young people in history enters early adulthood which experts say that treatment alone will not end the epidemic.

With that experts have recommended that global treatment efforts should be complemented with stronger investments in primary prevention, including research to accelerate the development of a preventive vaccine.

Roger Tatoud Deputy Director HIV Programmes and Advocacy International AIDS Society said that there is a need to expedite the process as the fight against HIV/Aids is constantly missing its prevention targets.

A young lady born with HIV told The New Times said that for her and others like her, a cure is necessary and ought to be viewed as a right.

cmwai@newtimesrwanda.com

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