New Home, New Expectations for African AIDS Vaccine Programme

Nearly 250 policymakers, scientists, and HIV prevention advocates gathered from December 13-15, 2009 for the 5th Forum of the African AIDS Vaccine Programme (AAVP), which was held in Kampala, Uganda, the new home of the Programme’s secretariat. At the forum, Marie-Paule Kieny, director of the Initiative for Vaccine Research at the World Health Organization (WHO), announced that the Uganda Virus Research Institute (UVRI) had won a competitive bid to host AAVP’s secretariat for the next five years. “Thank you for recognizing the important role that this country can play in the work of finding an AIDS vaccine,” said David Kihumuro Apuuli, co-chair of the 5th AAVP Forum and director general of the Uganda AIDS Commission.

AAVP is a network of organizations involved in AIDS vaccine research that was formed in 2000 to support the development of and future access to an HIV vaccine that is suitable for use in Africa. Since its inception, AAVP has been supported by the WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its secretariat housed in Geneva, Switzerland. Kieny said her organization would work with UVRI to finalize a hosting agreement within six months. The agreement will convert AAVP into a legal entity with its own governance structure and systems, allowing it to fundraise independently for its activities.

There was consensus among those who attended the Forum that better HIV prevention strategies are urgently needed in sub-Saharan Africa, and that research into new prevention technologies, including an AIDS vaccine, should be continued and strengthened in the region, which is home to 22 million of the world’s 33 million people living with HIV/AIDS. Participants at the forum were brought up to speed on the results of recently completed HIV prevention trials, the largest among these being the 16,000-person AIDS vaccine efficacy trial conducted in Thailand, which provided the first evidence that an AIDS vaccine could prevent HIV infection in humans.

“The costs of treating an ever-increasing number of people are not sustainable,” Ugandan Health Minister Stephen Mallinga said at the Forum’s opening. He added that the revised treatment guidelines issued by the WHO in December, which suggest antiretroviral therapy (ART) be initiated earlier, would “pose problems for Uganda.” Based on the previous guidelines, ART reaches fewer than half of those who need it in most African countries, and 1.4 of the estimated two million AIDS deaths in 2008 occurred on the continent.

Uganda’s First Lady H.E. Hon. Janet Museveni, the chief guest at the Forum’s opening, expressed full support for AAVP’s mission and vision, and said Uganda had been a trailblazer in AIDS vaccine research—the first AIDS vaccine trial to ever be conducted in Africa was done at UVRI in 1999. “By conducting HIV research, Africa is gaining the capacity to manage any other medical catastrophe that is waiting to pounce on us in the future,” she said. “That may be the silver lining on the cloud that is AIDS.” Mrs. Museveni envisions an expanded role for AAVP, incorporating tuberculosis, malaria, and other diseases with a disproportionately high burden in Africa.

Representatives from development agencies and organizations involved in conducting clinical trials expressed their hope that a re-invigorated AAVP, with a fully staffed secretariat based in Africa, would be better able to support HIV vaccine research and development on the continent. They said they were willing to work with AAVP to secure political and financial commitments from African governments, and to leverage the regional and international collaborations needed to accelerate progress in the quest for an AIDS vaccine. —Daisy Ouya, Program Manager, Information, Education, and Communication at IAVI in Nairobi, Kenya