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The first trial in Africa to test two new HIV vaccines began this week in Uganda, raising hopes for an end to the epidemic that affects millions of people across the continent.
The Africa-led PrEPVacc study will test two experimental combined vaccines to see if they can provide protection against HIV in those most at risk of infection.
At the same time, participants will be offered a new form of daily oral pre-exposure prophylaxis (PrEP), which scientists say will give vaccines the best chance of working.
The safety of both vaccines has been tested in previous clinical trials in Africa, Europe and the United States.
More than 1,600 people between the ages of 18 and 40 are expected to participate in clinical trials over the next three years in Uganda, Tanzania, Mozambique and South Africa.
The study is funded by the Partnership for Clinical Trials in Europe and Developing Countries, supported by the EU.
“PrEPVacc offers two great opportunities: first, for Africans to be able to participate and lead the first HIV prevention trial to test two ways to prevent HIV, a scourge that has ravaged the continent,” said researcher Professor Pontiano Kaleebu in chief of PrEPVacc.
“Second, an opportunity to develop the capacity of African sites to do future testing themselves and encourage our own future leaders,” he said.
Professor Jonathan Weber, Dean of the Faculty of Medicine at Imperial College London, which sponsors the PrEPVacc trial, said: “The first participants in the PrEPVacc trial in Masaka [Uganda] help their communities and the world by answering important questions about how best to prevent HIV in the future.
“I have been working at Imperial College London on ways to prevent HIV since the virus was first discovered and I am extremely proud that we now have this trial led by Africans and supported by Europe which starts in Uganda.
Weber said the significance of the study was that it “will exclude or encourage the development of two different vaccine combination regimens to prevent HIV.”
More than 35 scientists, clinicians, social scientists, community liaison officers and support staff from the Uganda Virus Research Institute and the London School of Hygiene and Tropical Medicine are involved in the trial in Uganda.
An estimated 20.7 million people are living with HIV in eastern and southern Africa. In 2019, the region recorded 730,000 new infections and 300,000 AIDS-related deaths, according to UNAids data. At least 15 million people are receiving treatment.
“In case the vaccine prevents HIV infection, we’ll be excited. But even if that doesn’t protect, we learn anyway. There is no such thing as a failed trial. The science we learn from the study allows us to improve and have better vaccines, ”Kaleebu said.
Professor Sheena McCormack, head of the PrEPVacc project, based in the Medical Research Council’s clinical trials unit at University College London, said the trial would also answer questions raised about PrEP. “Its results will be valuable in informing future implementation and uptake strategies by stakeholders and local champions across East and Southern Africa where PrEP uptake is currently low.
Milly Katana, HIV prevention activist and member of the project’s steering committee, said the trial was timely. “The implementation of the PrEPVacc trial comes at a time when the world values vaccines more in the management of global pandemics like HIV and Covid-19… The world, especially women, needs more interventions that can protect individuals against HIV.
However, Asia Russell, executive director of the Health Global Access Project, asked why Uganda is undertaking a vaccine trial when many people still do not have access to antiretroviral drugs.
“Ugandans are constantly urged to donate their bodies for science,” she said.
According to the Ugandan AIDS Commission, the HIV epidemic remains a major threat to public health in Uganda. About 1.5 million people are living with the virus, up from 1.2 million in 2010. Each year, the country records 53,000 new infections and 21,000 AIDS-related deaths.
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