Monday September 10, 2001

South Africa Mobilizes for AIDS Vaccine Trials



PHILADELPHIA (Reuters Health) - South Africa is ready for its first AIDS vaccine trial, according to Dr. William Makgoba, president of the Medical Research Council in Cape Town.

Makgoba told participants at the AIDS Vaccine 2001 meeting here on Friday that part of the effort to stem the epidemic of HIV infection in South Africa over the next 10 years will be a vaccine trial initiative. It has been estimated that by 2005, about one quarter of the South African population will be infected with HIV. However, this number may have already been reached, Makgoba said. HIV infection was the cause of a fifth of all deaths in individuals between the ages of 15 and 49 in South Africa.

All vaccine trials in South Africa will be conducted under the auspices of the South African AIDS Vaccine Initiative (SAAVI), which was established in 1999 with funds from the South African government and a private company, Makgoba said.

He stressed that SAAVI is developing a new model to facilitate AIDS vaccine trials, rather than basing its structure on traditional models driven by ``old values'' and ''imperialistic imperatives.'' SAAVI plans to foster equal partnerships between developed and developing countries and between public and private sectors.

One of SAAVI's goals is to ``galvanize South Africa's scientific community to address and focus on a regional and national HIV vaccine,'' he said. South Africa currently has three vaccines ready to go into clinical trials, he said.

Involvement of community groups is essential to this process. ``Advocacy and education, I think, is at least as important as the basic science,'' Makgoba said.

``South Africa could most probably accommodate a maximum of six AIDS vaccine trial sites,'' he continued. Two sites have already been designated--one in Johannesburg at the Chris Hani-Baragwanath Hospital and one in the KwaZulu Natal province at the R.K. Khan Hospital.

Local physicians in Johannesburg echoed Makgoba's report. In a poster session, Dr. Eftyhia Varas, director of the HIV/AIDS vaccine division of the Chris Hani-Baragwanath Hospital in Soweto, and colleagues described local efforts of building infrastructure for AIDS vaccine trials.

In January 2001, the HIV/AIDS Vaccine Division (HAVD) was officially established in Soweto. HAVD is funded by SAAVI and the International AIDS Vaccine Initiative (IAVI).

The program has been met with enthusiasm by existing local community boards, Varas' team reports. A Community Advisory Board has been organized and community-based educational HIV vaccine workshops have also been set up. Thus far, 68% of local residents have indicated ``they would definitely consider volunteering'' for an AIDS vaccine trial.

A unit has been organized at the local hospital compound that is now ready to test candidate HIV vaccines, according to Varas and colleagues. An area of the hospital has been refurbished to provide a well-equipped and comfortable examination space next to a basic diagnostic laboratory and specimen repository. Identification of a group of patients on whom to test the vaccine is ongoing.

This process is also being undertaken in rural populations. Two early-stage vaccines are scheduled to begin in Soweto in June 2002.

Makgoba ``is one of the heroes in the war against AIDS,'' commented Dr. Neal Nathanson of the US Office of AIDS Research. He has ``shown remarkable leadership under the most difficult circumstances,'' said Nathanson, referring to his involvement in the ``Durban Declaration'' last year at the International AIDS Conference. The declaration was a statement, signed by prominent AIDS researchers worldwide, confirming that HIV is the cause of AIDS, which has been disputed by a small number of politicians and scientists.