New HIV infections would decrease by 40 percent within ten years after the launch of an HIV vaccine, experts said at an HIV Vaccine Awareness Day event on Monday hosted by AVAC, IAVI and the Bill and Melinda Gates Foundation. Advancements in technology have paved the way for an effective HIV vaccine, but progress is threatened by cuts to research and development funding, particularly from U.S. government agencies which provide 70 percent of all global R&D funding for an HIV vaccine, panelists said.
That 70 percent comes from the National Institutes of Health, the Military HIV Research Program, and USAID, said Yegor Voronin of the Global HIV Vaccine Enterprise. Other top funders include the Bill and Melinda Gates Foundation and the Canadian HIV Vaccine Initiative. Total investments in HIV vaccine R&D were $811 million in 2013, which represents a 28 percent drop in funding since 2006.
“We are dealing with less money and yet the science is more revealing than ever,” Margaret McClusky of USAID said. “This is not the time to take our foot off the pedal, at all.”
That revealing science refers to advancements within the last five years in finding antibodies capable of neutralizing a broad array of HIV strains. “The single biggest challenge is that HIV is hypervariable – it mutates so rapidly,” said Michelle Dees of IAVI. “HIV is probably the trickiest virus we’ve ever encountered,” because of the variability, she said.
Because of HIV’s variability “we’ve had to change the way we’re doing vaccinology which has had far reaching benefits for other diseases,” Dees said. “The novel methods used for finding antibodies can be used for influenza and other diseases,” she added.
Yegor Voronin said researchers now have the technology to look at and understand the most minute details of how viral envelope proteins work. “In previous vaccines, the proteins used weren’t representative of what the protein actually looks like,” he said. Now that there’s technology that allows researchers to reconstruct what a protein looks like, “we can apply what we’ve learned to vaccine development,” he said.
HIV vaccine development has also strengthened health systems in the places a vaccine is needed most, said Dr. Gaudensia Mutua of the Kenya AIDS Vaccine Iniative. Over 1500 community health workers have been trained as a result of clinical vaccine trials in Kenya, Tanzania and Uganda, she said, and vulnerable populations including female sex workers and men who have sex with men are being brought into the healthcare fold because of vaccine trials.
KAVI has two clinical sites that are very modest but are able to meet the needs of a clinical trial while fitting into the environment they recruit from, Mutua said. The site she manages, the Kangemi Health Center Clinic, is located in a Nairobi slum and is made up of eight shipping containers yet provides HIV and TB services on top of serving as a vaccine clinical trial site.
A vaccine “will change the pandemic in a way that nothing else can,” McClusky said. After commemorating HIV Vaccine Awareness Day for twenty years, she said, she’s ready for the day she can celebrate the beginning of the end of HIV with a vaccine.