Progress and Promise in R&D
HIV Vaccine Awareness Day (HVAD) on May 18 is a day to renew our commitment to developing an HIV vaccine to end AIDS. On HVAD, we also celebrate the promise and progress of HIV vaccine research and development (R&D) and underscore the critical need for a vaccine to end AIDS.
A safe and affordable preventive HIV vaccine would save millions of lives and save millions of dollars in treatment costs. A vaccine that can prevent HIV infection would teach the immune system to respond to HIV by making antibodies that can bind to the virus and stop it from infecting cells, or by promoting other immune responses that target the virus (Avert.org, 2019).
Background photo: A group of men pull to shore a fishing boat on Lake Victoria in Uganda. In fishing communites in Uganda, the overall HIV incidence is about 5-fold greater than the surrounding agrarian population.
A More Realistic Prospect
In 2019, there is an unbridled sense of optimism in the HIV prevention field, primarily due to scientific progress. There’s also growing consensus that an HIV vaccine is a more realistic prospect than it was a decade ago, and finding one remains an urgent global health priority.
Designing vaccines that address the global diversity of HIV is a major challenge for vaccine researchers. Scientists widely agree that a new generation of vaccine immunogens designed to induce powerful HIV-blocking antibodies present the most promising path toward developing a vaccine that could provide protective and durable immunity against HIV.
To build on progress and secure an HIV vaccine will require sustained and increased international political and financial support.
Background photo: Penny Moore, a Reader and South African research chair of virus-host dynamics at the University of the Witwatersrand and the National Institute for Communicable Diseases, in the lab in Johannesburg. Credit: IAVI Report
A Pathway Forward for HIV Vaccines
IAVI and our partners recently initiated two HIV vaccine clinical trials – IAVI G001 in the U.S. and IAVI W001 in the U.S. and Africa – within six months of one another. Both vaccine candidates are novel designs resulting from more than 15 years of concerted effort to understand the structure of the virus and its interaction with the immune system in unprecedented detail. While there will likely be many other obstacles to overcome, the data from these trials will help investigators home in on the approaches that are promising and optimize them for further study.
Two other vaccine efficacy trials, HVTN 702 and HVTN 705 are ongoing in sub-Saharan Africa and include participation from some IAVI clinical research center sites. The former is testing an optimized version of the only HIV vaccine ever to show efficacy in humans. The latter contains what is called a mosaic insert, which is an engineered protein designed to protect against a wide range of HIV strains. A licensure study for this vaccine regimen is also planned.
In addition, the world will see the first HIV vaccine trial to evaluate vaccine efficacy in the context of oral pre-exposure prophylaxis, or PrEP — the use of antiretrovirals to prevent HIV infection. A Phase IIb/III vaccine efficacy trial known as PrEPVacc will begin later this year in Uganda, Tanzania, Mozambique, and South Africa and will test two vaccine regimens and two options for oral PrEP. This trial is a collaborative effort but one in which African investigators play a leading role. Learn more.
Learn More About IAVI W001
HIV Vaccine Science in Africa, for Africa
Through the creation of pioneering research networks in Africa — the epicenter of the HIV/AIDS epidemic — IAVI has invested in Africa-led HIV prevention science. ADVANCE (Accelerate the Development of Vaccines and New Technologies to Combat the AIDS Epidemic) is a five-year cooperative agreement with the U.S. Agency for International Development (USAID), through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to further the progress of HIV research in the region. Standout work from that program is detailed in this special issue of IAVI Report, which highlights how Africa is contributing far more than samples to scientific research. In fact, the continent’s scientists are actively engaged in developing and testing novel HIV vaccine candidates -- including the candidate being used in the IAVI W001 clinical trial.
The IAVI-Human Immunology Laboratory (HIL), based at Imperial College London, has played a central role in building scientific capabilities in affiliated African laboratories so that they can perform research and diagnostics activities at the same level as in developed-country settings. These partnerships have led to the establishment of fully accredited laboratories (GCLP) in developing countries, ensuring the standardization of laboratory procedures applied in vaccine trials. In addition, the HIL has helped train doctoral and master’s degree students to perform basic and clinical research on the immune system’s response to HIV infection and vaccine design.
Background image: A structural model of the BG505 SOSIP.664 HIV Env protein superimposed on the amino acid sequence of the protein. The ribbon diagram details the positions of the beta-pleated sheets, alpha-helices, and loops that make the BG505 SOSIP.664 HIV Env protein structure. Credit: IAVI Report
Breaking Down Barriers
India is home to the world's third-largest population of people living with HIV. Recognizing the need for research and clinical trial capability that addresses the particular needs of the Indian population, the HIV Vaccine Translational Research (HVTR) Laboratory at the Translational Health Science and Technology Institute (THSTI) NCR Biotech Science Cluster in Faridabad, Haryana, India, was established as a joint initiative between the Department of Biotechnology, THSTI, and IAVI.
Despite advances in treatment and a falling annual infection rate, people living with HIV in India still suffer from intense social stigma. Last year, IAVI, Delhi Dance Theater, and PULSE ensemble, organized this first-of-its kind dance theater performance that aims to communicate the critical need for collaborative and integrated efforts to better understand the persistent challenges of HIV infection. This is something we at IAVI are committed to understanding as we design prevention products -- including HIV vaccines -- for the people who need them most.
Background photo: A person living with HIV takes daily HIV treatment at home in Chennai, India. Credit: IAVI.