A framework for HIV/AIDS vaccine research in Zimbabwe
Two decades into the HIV pandemic, sub-Saharan Africa continues to bear a disproportionate burden of the HIV infections. Whilst most countries in sub-Saharan Africa have established National AIDS Control Programmes, interventions such as behaviour modification, condom promotion and treatment of other sexually transmitted infections have not been sufficient to significantly reduce the incidence of HIV infections. Zimbabwe has not been spared by the epidemic, and currently records one of the highest HIV prevalence rates in the world. Whilst efforts to promote known interventions for HIV prevention must be strengthened, preventive HIV vaccines remain the best long-term solution to control the HIV pandemic. However the search for an HIV/AIDS vaccine has been dogged by serious scientific, ethical and operational challenges. Firstly, there currently is no data that unequivocally establishes the existence of sterile immunity against HIV in humans. Secondly, HIV/AIDS vaccine development has been hindered by the extensive variation of HIV, with the various types and subtypes being found in different geographical locations. This genetic variation poses serious challenges to vaccine development. It is not clear whether a vaccine based on antigens of one subtype can protect against a different subtype. This cross protection is essential since the various subtypes are now widely spread all over the world. Operationally, most developing countries where the burden of HIV is highest, lack the capacity to participate effectively in vaccine development, due not only to lack of expertise but more importantly the financial and technical resources for project management, process development, scaling-up and manufacturing issues for vaccine research and development. Furthermore, there are no harmonized international ethical guidelines and regulations for HIV/AIDS vaccine development including requirements for entry into clinical trial, progression through advancing stages of clinical trials, and licensure. In recognition of these challenges, the international scientific community (International AIDS Vaccine Initiative) and other stakeholders have accelerated global vaccine efforts to search for HIV/AIDS vaccine. Although several African countries have participated in international collaborative projects, including HIV prevention trials, infrastructures and capabilities to conduct HIV vaccine trials are virtually non-existent on the continent. It is also recognised that the proactive participation and effective coordination of African scientists, institutions and the community is necessary in order to ensure that appropriate HIV vaccines are developed for Africa. In recognition of this need, African scientists convened a consultative meeting in Kenya under the auspices of the Joint United Nations Programme on AIDS (UNAIDS) to discuss strategies to accelerate the development of HIV vaccines in Africa. This paper presents a framework, based on the recommendations of the Nairobi consultative meeting, on an African Strategy for an HIV Vaccine, that could be adopted for the implementation of the various facets of HIV vaccine research in Zimbabwe.
The Zimbabwe Science News Volume 35 (1+ 2) 2001, pp. 51-54