IAVI: researching an AIDS vaccine in East Africa

As part of the Imagine2030 campaign we want to show that innovation is not just something for the future. Medical advances being made right now will shape how we fight diseases of poverty in the future, and are delivering changes every day. It will be these advances, and the organisations behind them, that will bring us closer to our goal: an end of diseases of poverty by 2030.

Focusing on World AIDS Day, and the fight against HIV & AIDS, we sat down to talk with Dr. Anatoli Kamali, PhD, the Regional Director – Africa for the International AIDS Vaccine Initiative, based in Nairobi, Kenya. Dr. Kamali talks about the work of IAVI, and the potential benefits an AIDS vaccine could bring.

DSW: Can you explain a little what IAVI Africa does, and how it is advancing the search for a HIV vaccine?

Dr. Kamali: The International AIDS Vaccine Initiative (IAVI) is a not-for-profit organization with the mission to ensure the development of safe, effective and accessible AIDS vaccines. IAVI’s Africa work is to examine and understand the extent of HIV epidemic in Africa, and to contribute to the development of an AIDS vaccine that can ultimately help to end the epidemic. Our work is conducting epidemiological studies to better understand how the virus is transmitted and how the disease progresses, and engaging communities at the epicenter of the epidemic to generate data that informs vaccine design; evaluating promising AIDS candidates through clinical trials among populations who most need it; capacity building initiatives that enable the conduct of HIV vaccine research in Africa, such as laboratory infrastructure and training the next generation of African scientists; and extensive work on advocacy, policy and communication to promote HIV vaccine research and development, with a special focus on donors, policymakers and political leaders.

The work in Africa is conducted in collaboration with a network of leading scientific institutions in East and Southern Africa (centers of excellence in Uganda, Rwanda and Zambia, Kenya and South Africa). To date we have a network of over 10 clinical facilities with fully equipped pharmacies and accredited laboratories with ability to conduct state of the art research. The facilities are run by highly trained African scientists. Together the clinical centers have capacity of recruiting 5000 volunteers per year in clinical trials. A total of 23 early (phase 1 and 2) AIDS vaccine trials, 25 non-vaccine efficacy trials (phase 2b/3, including for microbicides and treatment), and over 20 epidemiological and mucosal immunology studies have been conducted in collaboration with the research centers in Africa.

The IAVI Africa work is coordinated in the Nairobi Regional office with a hub in Johannesburg.

What kind of an impact would a HIV vaccine have on the fight against HIV & AIDS, in East Africa and beyond?

UNAIDS estimates indicate that by 2015, 36.7 million people were living with HIV/AIDS, of whom 25.5 million live in sub Saharan Africa and 19 million are from eastern and Southern Africa. There were approximately 2.1 million new HIV infections in 2015 and 46% of these were from east and Southern Africa. Since 2010 the number of new infections has remained static despite the current behavioral (ABC strategy) and biomedical interventions (such as PrEP, treatment as prevention, male medical circumcision), and HIV testing and counselling.  Thus the current preventive efforts are unlikely to stop the epidemic. We also know that vaccination is the most effective public health strategy for controlling epidemic infectious disease. Therefore, a safe and efficacious AIDS vaccine could be the most cost effective tool to combat the HIV/AIDS epidemic. Modelling studies have indicated that a 70% efficacious and well-adopted vaccine could prevent the majority of annual new HIV infections within 25 years after introduction.

IAVI is an international, not-for-profit, Product Development Partnership working across sectors and borders to advance the research and development of effective, safe and accessible AIDS vaccines for global use. Partnering with academia, industry, government, philanthropy, civil society and communities, we catalyze innovation and help translate findings into new products that will help end HIV/AIDS. Our investments in research, capacity and collaborations advance our own projects and the promising candidates from other researchers.

What is the one thing that you would want European politicians and donor governments to help the kind of research that you are doing?

We would ask European politicians and donor governments, as well as civil society and researchers, to keep the development of an AIDS vaccine a priority in health and development agendas, and to help advance the research with supportive policies and sustained funding. The partnership between Europe and Africa can help us achieve this important mission.    

What, in your opinion, is the key obstacle standing in the way of global health research from fulfilling its potential?

Global Health research has already achieved the development of important new drugs, diagnostics and vaccines to combat infectious diseases and epidemics, saving millions of lives in our region and globally. Major advances have also been made in AIDS vaccine research – to bring this to the finish line we need more incentives for international collaborations across regions and sectors, and sufficient resources across the entire product development chain.

What is in the development pipeline from IAVI in the coming years?

Over the coming years, IAVI will design and test novel AIDS vaccine candidates based on promising results in early studies with new immunogens and delivery systems. We will also develop innovative preclinical and clinical models that facilitate the rapid prioritization of candidates, and conduct new clinical trials of the promising candidates. There are currently in IAVI’s portfolio 5 vaccine candidates in clinical trials and another 6 in early development / preclinical studies; we also support over 20 additional development efforts for AIDS vaccines and other HIV prevention and vaccine technologies.

What is your one hope for how the world will look in 2030?

My hope is that by 2030 considerable progress will have been made in the discovery of an AIDS vaccine and that ultimately a vaccine will be available to all those who need it globally. The world will hopefully be better prepared to manage global emerging and re-emerging epidemics, and that technology, infrastructure and resources will be available in the current low income countries to reverse the 10/90 gap, with substantially more resources devoted to health research in developing countries, where over 90% of all preventable deaths worldwide occur.

Learn more about IAVI here.

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Anatoli Kamali, PhD

He is currently the Regional Director – Africa for the International AIDS Vaccine Initiative, based in Nairobi, Kenya. He trained at Makerere University in Medicine and Surgery and also holds Master of Science at the London School of Hygiene and Tropical Medicine, UK, and PhD in Public Health from the City University, UK. Kamali is also an Honorary Professor, Department of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine. Previously he was the Deputy Director and Head of HIV Epidemiology and Prevention Programme, MRC/UVRI Uganda Research Unit on AIDS, and Head of Department of Epidemiology, Uganda Virus Research Institute, Entebbe.  

He has been involved in HIV/AIDS research since 1989, and he has led several prevention studies including early HIV vaccine trials, Ebola vaccine trials, phase III microbicide trials; prophylactic trials among HIV infected individuals, HIV epidemiological studies in general populations and high risk cohorts (female sex workers and fishing communities). He participates in several international scientific collaborations with institutions in the UK, USA and Africa. He was a member of the UK Microbicides Development Programme (MDP) that conducted a large efficacy and safety phase III microbicide trial for vaginally acquired HIV infection.

He has served on several scientific boards for international organizations such as the WHO, UNAIDS, International Partnership for Microbicides, and Data and Safety Monitoring Board for the National Institute of Allergy and Infectious Diseases Division of AIDS (NIAID) Vaccine and Prevention. He has published over 100 scientific peer reviewed articles and book chapters.