Since the advent of HIV/Aids in the early 1980s, a lot has been achieved in the war against the scourge. Interventions such as condom use, behaviour change communication, and use of anti-retroviral drugs (ARVs) for treatment or prevention have reduced the burden of the disease in the country. Kenya’s HIV prevalence rate is now 5.6 per cent, a big drop from the 10.5 per cent recorded in 1996 when the disease was at its peak. Today about 36,000 people die of Aids-related illnesses annually as opposed to 51,000 in 2010. But irrespective of the progress made, the number of new HIV infections is still high in Kenya, just as is the case in most sub-Saharan African countries. Kenya records about 100,000 new HIV cases each year, according to government statistics. “We have tried as much as possible but the infections are still high. This is because interventions are still not reaching all people. And others simply don’t embrace them for various reasons,” said Anatoli Kamali, Africa Regional Director of the International AIDS Vaccine Initiative (IAVI). Prof Kamali noted that Africa is in dire need of an Aids vaccine to complement existing interventions and bring down infections. Just as has been the case with other viral infections that reached epidemic levels such as mall pox and polio, health experts foresee vaccines playing a key role in reducing the HIV burden and potentially eradicating it. Researchers are working on various candidate vaccines but none is ready for use. “Coming up with new vaccines is a long process. We need to keep testing and improving on what we have until we eventually get a product that is safe and effective against the targeted diseases,” said Prof Kamali. He noted that sub-Saharan African scientists need to be actively involved in the development of vaccines against the disease because the region is the worst hit globally. Marianne Mureithi, chief research scientist at the KAVI Institute of Clinical Research, based at the University of Nairobi, noted that this approach is important as the disease mutates geographically. “HIV has very many sub-types. What we have in our region is different from what you get in the West. So Africans need to be involved in developing future vaccines so as to ensure that the final product meets our needs,” said Dr Mureithi. Compared to other parts of the world, sub-Saharan Africa has the highest number of HIV strains. They include subtypes A, C and D. On the contrary, much of the population in Europe and the United States is mainly affected by subtype B of the virus. As a result, a great majority of HIV clinical research has been conducted in populations where subtype B predominates, despite this subtype representing only 12 per cent of global HIV infections. In contrast, less research is available for subtype C. Yet, nearly 50 per cent of all people living with the disease, especially in the high burden countries of sub-Saharan Africa, are affected by this strain. “We are the epicentre of HIV infections. So if we are to get a vaccine, it is crucial that we get one that is suited for Africa and made by Africans. “This doesn’t mean that we should work alone. Collaboration with both local and international partners is key in the scientific community. But we need to play an active role in the entire development process to ensure that we get a vaccine that tackles the HIV subtypes we have here,” Dr Mureithi told the Business Daily. Most research on vaccines has been done in developed countries even for infections that are more prevalent in Africa, said Prof Kamali. “We need to be involved in the early stages of research work so we don’t end up adopting ready made products that may not be ideal for the type of diseases that we have,” said Dr Mureithi. According to Prof Kamali, Africa has come of age and can take up advanced research projects compared to two decades ago when most countries lacked capacity to undertake cutting-edge studies. He said that collaboration between governments and donor funding agencies had led to the establishment of world class institutions in Africa that can conduct high level scientific research that meets global standards. Dr Mureithi noted that early generation scientists who went abroad for further studies have come back home to spearhead vaccine research and mentor upcoming scientists. She said governments, together with regional bodies such as the African Academy of Sciences, are also helping by mobilising funds to promote local research. At the international level, IAVI has set up an initiative known as VISTA which is aimed at strengthening the capacity of research institutions to ensure that African scientists increasingly contribute to, and take leadership in, AIDS vaccines design and development. Prof Kamali noted that involvement of Africans also enhances future acceptance of new vaccines by their governments, policy makers and affected populations. Without their support, adoption of health innovations is often curtailed by suspicion, resistance or long bureaucratic processes before new products can be approved. Agencies
