Medical researchers are looking at ongoing trials on a number of potential vaccines in the hope that by 2021 an inoculation against the virus may be within sight.
Dr Francis Kiweewa, head of research and scientific affairs, Makerere University Water Reed Project, told The Observer that despite the antiretroviral drugs and preventive methods currently available, a vaccine is key to stopping the growing pandemic.
“With all epidemic diseases we have had in the past such as polio, measles, smallpox and others, none of these outbreaks or infections have been controlled or eradicated without a vaccine. So, is it possible to eliminate HIV without a vaccine? We strongly need it and efforts are going on by researchers to get it,” he said.
Kiweewa said new infections globally are increasing every year with about 1.8 million new infections being recorded in 2016, of which 1.5 million were from sub-Saharan Africa. A vaccine would work by training the body to produce antibodies to attack, kill or prevent HIV infection from multiplying in the body.
Kiweewa said only five HIV vaccine concepts in the last 35 years have reached phase three. This is the stage when they test to see if the vaccine works.
“In phase one, we test and see if the vaccine is safe in humans by testing it on health volunteers. In phase two, we learn more about the side effects of the vaccine and confirm if it has potential to prevent HIV infection,” he said.
He said by 2020 or 2021, they expect results from the clinical trials.
“But even if the trials don’t give us the vaccine, they will give us a lot of information about how to get a vaccine that works in few years after 2021,” he says.
CHALLENGES TO GET HIV VACCINE
For now, Kiweewa said, the greatest challenge researchers are still facing in the search for an HIV vaccine is the virus’ ability to mutate or change which means any vaccine will have to work against all the available HIV types.
“As we are about to get a vaccine, we find that it has changed its shape and the vaccine can’t work on that one. A vaccine that will help us eradicate HIV must be able to respond to all different types of HIV. The mosaic concept uses different combinations that are able to target all HIV types that are available,” he said.
HIV vaccine research is very expensive, costing billions of dollars to reach phase three, “but many fail in labs because there are no funds to move them forward and yet they are developed by poor scientists.”
Another challenge is that Africa’s community involvement in HIV vaccine participation is still very low, which makes the study is expensive too.
“In Uganda, the government’s financial contribution to research is still very low. This is why most studies are done in South Africa where government invests in research and many people are willing to participate,” Kiweewa said.
Moses Nsubuga, commonly known as Supercharger, an HIV activist who has been living with HIV since 1994, says a vaccine will not only benefit HIV-negative persons since the researchers are also developing a therapeutic vaccine for HIV-positive people to boost their immunity and bring an end to the taking of daily antiretroviral medication.
“There are two types of HIV vaccine under trial. These are preventative and therapeutic. The therapeutic vaccine is for people who are already infected to help boost their immunity and fight the infection without using antiretroviral therapy. However, preventative vaccine is given to HIV negatives to train the body to be able to recognise and fight HIV whenever encountered,” he says.
“I have also learnt of the “Elite or HIV controllers” who have been infected with HIV since 1980s but they don’t fall sick; their CD4 counts are high, their viral load is very low but don’t use ART. Researchers worldwide are identifying elite controllers to get some of their antibodies, and make a vaccine out of them which they can give to other infected people,” he says.
He says a vaccine will be given once in a lifetime, and it will highly reduce cases of drug resistance due to failure of taking drugs on time.
Ultimately, according to Nsubuga, a vaccine is cheaper to invest in than buying ARVs daily and it will also save the nation from issues of HIV drug stockouts.
“For example, the government spends Shs 250,000 for my ARVs every month since I am on second-line treatment but we are very many patients. And those who are on first line, they use drugs worth Shs 50,000 per month and they are over one million people,” Nsubuga says.