HEALTH-UGANDA: The Second HIV/AIDS Vaccine Trials

By Evelyn Kiapi Reprint | | Print |

Evelyn Kiapi Matsamura

KAMPALA, Feb 12 2003 (IPS) - Mutabazi Enos, 33, is a proud man. He was among the 40 Ugandans who volunteered for the first HIV/AIDS vaccine trials in 1999.

Today, Enos stands as an example, proving to sceptics that the vaccine was not harmful.

”The vaccine is not dangerous,” he says.

His family was worried about the vaccine, but being a soldier, Enos decided to risk his life by taking part in the trials, known as ‘ALVAC Vaccine Phase I’.

Uganda launched the second trial on Feb 10. Dr. Ponsiano Kaleebo, who is in charge of the programme, says 50 volunteers will take part in the second trial: DNA MVA Vaccine Phase I.

DNA – deoxyribonucleic acid – carries genetic information in a cell. MVA is the Modified Vaccinia Ankara.

Both DNA MVA – a pair of vaccine – aims to elicit a strong cellular immune response to HIV. British Medical Research Council developed both vaccines at Oxford University, working with researchers from the University of Nairobi, Kenya. The DNA vaccine is manufactured by a British firm, Cobra Biomanufacturing.

The vaccines, tested in volunteers in the United States and Kenya, are based on sub-type A of HIV, the strain of the virus most common in East Africa.

The second trial comes after the first vaccine trial – meant for HIV sub-type B – failed in 1999. Uganda has HIV sub-types A and D.

In Aug 2001, the International AIDS Vaccine Initiative (IAVI) and the government of Uganda signed a partnership agreement aimed at speeding up the development and testing of preventive vaccines.

Every Thursday volunteers meet at the Uganda Virus Research Institute (UVRI) in Entebbe, a town on the shores of Lake Victoria, where they are counselled, screened and educated about the vaccine.

To take the tests, candidates must be healthy, HIV negative, at a low risk of HIV infection, and aged 18-50. Tests are carried out for malaria and liver function, among others. ”This exercise will go on for a period of 18-24 months,” says Kaleebo.

The International AIDS Vaccine Initiative and the Uganda Virus Research Institute jointly run the trials.

Kaleebo says public ”response has been good (compared to the 1991 trial) because of more awareness campaigns”.

”It’s good that they are trying to find a vaccine, but at the same time they should not put people’s lives at risk. The only thing I do not understand is whether after the dose they request the volunteers to expose themselves to the HIV virus. They should explain to the volunteers that they are only conducting trial,” says Irene Namubiru, a social worker in Kampala.

The scepticism appears to be wedespread. ”I would not take that risk. I think it’s a gamble. What if it all goes wrong?” asks Henry Ochieng, a journalist. He says he has ”lost so many people to the disease”.

Erina Nakabiito, a vendor at Wandegeya, a suburb of Kampala, wonders whether the vaccine can cure her daughter who has developed AIDS.

”My grandchildren are suffering. Their mother is dying. Will this medicine (vaccine) save her from dying?” she asks.

Kaleebo says, if the trial succeeds, Uganda will move to an advanced phase.

”IAVI is discussing with different groups to conduct feasibility studies for possible phase II and III trials in 2005,” he says.

IAVI Communications Director, Kay Marshall says Uganda has long been a role model for other countries in responding to the AIDS epidemic. It was the first African country to have an AIDS vaccine trial and the first to have a national vaccine plan.

”But despite the major efforts and successes of Uganda’s fight against AIDS, there are still many people becoming infected with HIV everyday, so Uganda still needs an AIDS vaccine,” Marshall says.

”There have been many cases where medicines and vaccines have not been made available to people in developing countries for many years after they were developed. We want to make sure this does not happen with the AIDS vaccine,” she says.

”The volunteers do not enjoy direct benefits,” Marshall says.

”Rather, they are providing a benefit to their communities and to Uganda and other countries where the epidemic is raging . volunteers are heroes,” she says.

Volunteers receive medical attention and referrals for care for any health problems they have during the course of the trial, which is fully insured.

”This vaccine does not contain HIV, only synthetic copies of small parts of the virus. It cannot cause HIV infection in anyone who receives it,” says Marshall.

Paul Wetaka Innocent, a former volunteer, who now acts as a counsellor and advisor, says the spirit of volunteerism should be encouraged.

”As far as I know, nobody has died of the vaccine trials,” he says.

He also participates in activities to educate high-risk groups like soldiers and their wives about the risks of HIV/AIDS. They perform plays, compose songs and encourage the use of condom. They also discourage children from engaging in under-age sex, and marrying at an early age.

The first HIV case was diagnosed in Uganda in 1982, after the ministry of health had received reports about a strange disease in the fishing villages close to the Tanzanian border. Since then, some 1.5 million Ugandans have been diagnosed HIV positive and up to one million have died of the disease.

The latest records show that the rate of HIV prevalence has fallen from a national average of 30 percent in 1992 to about six percent, the lowest in sub-Saharan Africa.

Uganda’s participation in the vaccine trials is seen as another commitment in the fight against HIV/AIDS.(END/IPS/AF/EA/HE/EKM/MN/03)