Asia-Pacific, Development & Aid, Global, Global Geopolitics, Headlines, Health

HEALTH: AIDS Vaccine Still in Sight of Mankind

Marwaan Macan-Markar

BANGKOK, Jul 15 2004 (IPS) - Local communities in developing countries are coming in for lavish praise for the new bonds they are forging with the scientific world in the search for the elusive AIDS vaccine.

Such interactions have helped move developing countries from the margins of vaccine research four years ago to centre stage by 2004, as evident from the on-going trails being conducted in parts of Africa, Asia and Latin America.

These people are the real heroes and heroines for taking risks and showing tremendous courage in taking part in this experiment, said Dr. Jose Esparza, a leading AIDS vaccine researcher affiliated with the Seattle-based Bill and Melinda Gates Foundation.

”The communities involved in the trials are not only mature enough to accept to participate, but are also demanding to participate in the trials,” Esparza told IPS after he delivered a speech on the current status of developing a vaccine for HIV at the 15th International AIDS Conference, being held here from Jul. 11 to 16.

”These communities are actually demanding to participate in the trials because they have realised that without their participation they will not have a vaccine for their children,” he added. ”Today, people in the developing countries are the ones who see that their involvement is the best way to ensure once a vaccine is developed they will have access to it.”

Thailand, in fact, is the current venue for the world’s largest AIDS vaccine trial, expected to involve 16,000 volunteers between 20 to 30 years but as of June this year only 2,500 people had enrolled in the experiment.

The other developing countries throwing their weight behind various vaccine development initiatives range from Brazil, Cuba and Peru in the Americas, Botswana, Kenya and Uganda in Africa. In Asia, a trial is soon to begin in India.

”It is critical that developing countries conduct AIDS vaccine trials because the incidence of new HIV infections is among the highest in these areas,” states the New York-based International AIDS Vaccine Initiative (IAVI), an independent body of researchers established to advance the cause of AIDS vaccine development.

The current global estimates of HIV rates bears this out, with Sub- Saharan Africa being home to 25 million of the 38 million people infected with the killer disease, while South and South-East Asia being home to 6.5 million HIV patients and Latin America having 1.6 million patients.

In a background note released at the AIDS conference, IAVI drew attention to the significant achievements towards vaccine research given the prevailing involvement of local communities in countries such as Thailand.

”The trials themselves were major milestones,” it stated. ”They demonstrated that it is possible to recruit thousands of volunteers for an AIDS vaccine trial and retain them over a three-year observation period.”

But according to Dr. Supachai Rerks-Ngarm, who is heading the on-going vaccine trial in Thailand, the involvement of communities poses many challenges through out every stage of the trial.

”Disseminating all the information about the trial is a key issue for us, since the people need to know what they are getting into,” he told IPS.

”We also need some time at the initial screening phase of all the volunteers, and during the initiation phase we have to be sure that those who are willing to participate are afforded the same standards in all 67 sites involved in the trial,” he added.

Yet that is not all, say non-governmental groups, given the ethical questions that have hounded the search for AIDS vaccine since efforts got underway in 1987.

”These ethical issues have arisen due to the nature of AIDS and what kind of behavioural change a vaccine trial will produce,” Dr. Mohga Kamal Smith, health policy advisor for the British development agency Oxfam, told IPS.

That stems from the possibility that a volunteer injected with a placebo during the trial assuming that he or she has been vaccinated from AIDS and then indulging in risky sexual behaviour that could result in him or her being infected with HIV – the virus that causes AIDS.

”It is quite different from other disease where trials were conducted for vaccines, such as measles, where you don’t go out of your way to be infected,” said Smith. ”This is not so with AIDS, where you can go out and get infected.”

According to her, it is important that the science is well developed before ”we go to trials.”

That, however, will not be easy, given the consensus about the nature of HIV being highlighted at some of the scientific sessions at the International AIDS Conference, which has attracted over 17,000 participants from 160 countries.

”During the last year, the scientific community has come to grips with the fact that developing an HIV vaccine is probably one of the most difficult scientific challenges that biomedical science is confronting,” Esparaza said Thursday during his speech.

Among the reasons behind that conclusion is the pace at which the virus is mutating.

And during the conference, researchers working on developing an AIDS vaccine held out little hope that humanity was on the verge of receiving a vaccine soon.

But Esparza believes a vaccine is possible because ”experimental vaccines can protect monkeys. These experiments show that protection occurs under ideal conditions.”

A vaccine for humans, however, depends on the number of ”phase-three efficacy trials” that have to be conducted, the likes of which is currently happening in Thailand involving communities in a province south of Bangkok.

”This takes time, four-five years to conduct,” he added.