South Africa begins AIDS vaccine trial, cuts funds
Published Monday, July 20, 2009 6:48PM EDT
CAPE TOWN, South Africa - South Africa launched a high-profile trial of an AIDS vaccine created by its own researchers Monday, a proud moment in a nation where government denial, neglect and unscientific responses have helped fuel the world's worst AIDS crisis.
After a government official lauded the project at a ceremony at Cape Town's Crossroads shantytown, the scientist leading the research said state funding had been halted.
The contrast between Monday's hopeful vaccine launch and the revelation of funding cuts raised questions about whether the government was backsliding on its pledge to combat AIDS.
Anna-Lise Williamson, an AIDS researcher at the University of Cape Town, told The Associated Press the clinical trial would continue with U.S. money. But she said South Africa's Department of Science and Technology had pulled its funding in March, while the project's other sponsor, the state electricity utility Eskom, did not renew its contract when it expired last year.
Neither government spokesmen nor Eskom immediately returned calls seeking comment about funding cuts.
The South African vaccine was developed at the University of Cape Town and targets the specific HIV strain that has ravaged South Africa. It is also undergoing safety tests at a trial involving 12 volunteers in Boston that began earlier this year, said Sarah B. Alexander, spokeswoman for the HIV Vaccine Trials Network at the Fenway Institute, an AIDS treatment center where the trial is under way.
The safety trials started in the U.S. to allay any criticism the United States was collaborating on an AIDS vaccine that might be seen as using Africans as guinea pigs, she said.
At Monday's ceremony in Cape Town, one of 36 healthy young volunteers was injected as government officials, AIDS researchers and journalists watched. The event was also attended by American health officials who gave technical help and manufactured the vaccine at the U.S. National Institutes of Health.
The ceremony came on the sidelines of an international AIDS conference where delegates expressed concern about cuts in funding for AIDS research, treatment and prevention programs because of the global economic crisis. A report released Monday says worldwide funding for HIV vaccine research decreased for the first time since 2000, with investments of almost $1.2 billion in 2008, down 10 per cent from 2007.
South Africa has not escaped the economic slowdown, and Finance Minister Pravin Gordhan said in his budget speech this month that while health spending remains a priority, funds would be shifted to those areas seen as most crucial.
AIDS vaccine research has met so many disappointments that some activists have questioned sinking scarce funds into developing a vaccine, saying the money might be better spent on prevention and education.
Male circumcision, for example, has been shown to cut the risk of contracting the AIDS virus by as much as 60 per cent.
But circumcision has not gotten the kind of attention in South Africa that it has in neighboring countries like Swaziland. South Africa's government has failed to seize on the cost-effective procedure, and AIDS activists say circumcision, with its cultural and political sensitivities, cannot be pushed without government approval.
South Africa was the site of the biggest setback to AIDS vaccine research, when the most promising vaccine ever, produced by Merck & Co., was tested here in 2007. Researchers found that people who got the vaccine were more likely to contract HIV than those who did not.
South African scientists working on the latest vaccine had to overcome deep skepticism from their political leaders, who had made unscientific pronouncements about the disease.
During nearly 10 years of government denial and neglect, South Africa developed a staggering AIDS crisis. Around 5.2 million South Africans were living with HIV last year -- the highest number of any country. AIDS strikes men and women alike, though young women are hardest hit, with one-third of those aged 20-to-34 infected with the virus.
In the 1990s, South Africa's then-President Thabo Mbeki denied the link between HIV and AIDS, and his health minister, Manto Tshabalala-Msimang, mistrusted conventional anti-AIDS drugs and made the country a laughingstock trying to promote beets and lemon as AIDS remedies.
In its vaccine initiative, the government decided it was important to target the HIV subtype C strain that is prevalent in southern Africa "and to ensure that once developed, it would be available at an affordable price," said Anthony Mbewu, president of South Africa's government-supported Medical Research Council, which shepherded the project.
Some 250 scientists and technicians worked on the vaccine's development.
Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Disease and a leading AIDS researcher, was in South Africa for the trial launch and said the South African scientists received more money from his institute's research fund than any others in the world, outside the United States. The U.S. also paid to produce the vaccine.
He called it "the most important AIDS research partnership in the world."
But, he warned: "There are extraordinary challenges ahead," referring to the years of testing needed now that South Africa has reached the clinical trial stage.
Monday's launch was put on by the South African AIDS Vaccine Initiative, the lead program of the government-backed Medical Research Council. The deputy ministers of health and science were both at the event and praised the initiative.
Aaron Motsoaledi, a medical doctor who became health minister in May, has promised to try to strengthen AIDS prevention campaigns that were weakened for years by red tape and mixed messages from policy makers.
Even before Motsoaledi took over, the government was promising to sharply step up treatment programs, saying it wanted to provide AIDS drugs to 1.5 million people over the next three years -- up from 700,000 at present. AIDS activists had to file repeated legal suits to force Mbeki to provide AIDS drugs.
But Elise Levendal, interim director of the South African AIDS Vaccine Initiative, said the program has had to lay off scientists because of government funding cuts.
"We have had to refocus," she said. "It is a big blow."
Williamson, the vaccine project's head researcher, said it was crucial to continue testing.
"For vaccine development presently, the South African AIDS Vaccine initiative has no money. If we do not continue working on this, we will never have a vaccine," she said. "It's incredibly important that we keep working."