Breakthroughs Blog: HIV/AIDS

  In this guest post, Margie McGlynn, president and CEO of the International AIDS Vaccine Initiative (IAVI), Zeda Rosenberg, chief executive officer of the International Partnership for Microbicides (IPM), and Renate Baehr, executive director of DSW (Deutsche Stiftung Weltbevoelkerung) mark International Women’s Day with a call for continued research to develop new women’s health tools. On this day honoring the political, social, and economic contributions women have made worldwide, nearly 2,000 women will die of AIDS and 790 will perish in pregnancy or childbirth. If we wish to truly advance the health and rights of women globally, we must give them the tools they need to protect their own health. Yet, while the benefits of investing in women—and their health in particular—are well-established and far-reaching, less progress has been made over the past decade toward attaining Millennium Development Goals that address women’s health and gender equality than virtually every other goal.   HIV is a case in point. In the regions hardest hit by the AIDS pandemic, such as sub-Saharan Africa, women bear a disproportionate burden of HIV, accounting for six out of every 10 new infections. A unique combination of factors, having as much to do with biology as with gender inequality, contribute to women’s increased vulnerability. Researchers have made remarkable progress toward developing tools for HIV prevention that could empower women to protect themselves from the virus. Photo credit: PATH/Evelyn Hockstein Fortunately, researchers have in recent years made remarkable progress toward developing tools for HIV prevention that could empower women to protect themselves from the virus. A number of such products and strategies are under development today, including microbicides, AIDS vaccines, multi-purpose prevention technologies (MPTs) and the use of antiretroviral drugs (ARVs) as pre-exposure prophylaxis (PrEP). Take, for example, IPM’s monthly vaginal ring that is currently in the late stages of clinical evaluation. The device slowly releases the ARV dapivirine to prevent HIV. Another product that has already been shown to be partially effective, a microbicide gel containing the ARV tenofovir that is used around the time of sex, is now being tested in a confirmatory trial. And though the latest results from the VOICE trial found that PrEP did not work in that study due to low adherence, a number of other studies have demonstrated that if used consistently, ARVs can do much to prevent HIV. Further, long-acting preventive tools like the dapivirine ring could help address the challenge of adherence for women. IPM and others are also developing MPTs that slowly release ARVs along with a contraceptive to prevent HIV and unintended pregnancy—both leading causes of death for women worldwide. Researchers have also made significant strides toward the development of preventive HIV vaccines. A trial conducted in Thailand four years ago establishes hope that HIV can be prevented by vaccination. Vaccine design too is advancing apace. Scientists around the world have isolated scores of broadly neutralizing antibodies to HIV, uncovering clues to the design of broadly effective vaccines against the highly variable virus. Recent modeling by IAVI suggests that even a partially effective HIV vaccine could significantly reduce the number of new infections among women, if it were deployed in the context of expanded prevention and treatment programs. These models suggest that a vaccine with 50 percent efficacy given to 30 percent of the adult population in low- and middle-income countries would prevent 2.8 million infections in women over 10 years. Vaccines, microbicides and other new preventive technologies could empower women to protect their own health because they could be used discreetly, without the need for negotiation with their sexual partners. Taken together, these new tools and measures could—if deployed with existing methods of HIV prevention—eventually end the AIDS pandemic. Until then, preventing HIV and supporting family planning would improve the health and economic well-being of entire families and advance key development goals. When women are healthy, they have more opportunities for education and employment, which in turn strengthens communities. A paper commissioned by DSW recently reported, for example, that the promotion of HIV prevention and sexual and reproductive health research can help countries make gains toward poverty reduction. This International Women’s Day, we call on the global community to recommit to investing in new preventive tools and health technologies for women. The health of women is, after all, essential to the well-being and economic stability of not only the women themselves and their families—but of entire nations.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Cipla and the Drugs for Neglected Diseases initiative recently announced that their malaria drug has been prequalified by the World Health Organization, an important step toward its roll-out across Asia. A new report from the Kaiser Family Foundation provides a comprehensive look at the Department of Defense's role in global health, including the department’s research and product development efforts. The US Food and Drug Administration has awarded GHTC member Aeras a grant worth $299,525 to spur the development of new vaccines against tuberculosis. A new study finds that the way medical research is funded in the United States has been vastly altered over the last 20 years by advocates asking that research be focused on particular diseases. A widespread vaccination campaign to protect 50 million people against meningitis with a new vaccine has been launched in seven African countries, health officials said Thursday.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. Christopher Austin has been named the new director of the National Center for Advancing Translational Sciences at the National Institutes of Health. A new analysis compares the innovation and science policies of presidential candidates Barack Obama (D) and Mitt Romney (R). A bill signed into law earlier this year that provided the US Food and Drug Administration (FDA) with funding is at risk due to federal budget negotiations. An opinion piece calls on US policymakers to “get serious” about funding scientific and research efforts. A breakthrough tool to combat tuberculosis has been launchedby the Critical Path Institute and the Clinical Data Interchange Standards Consortium (CDISC). The project was the result of collaboration between the Critical Path Institute, CDISC, the FDA, and others through the Critical Path to TB Drug Regimens. Researchers met this week in Boston for the AIDS Vaccine 2012 conference to discuss the latest in efforts to develop a vaccine against the disease.

In this guest post, Margaret McGlynn, president & CEO of the International AIDS Vaccine Initiative (IAVI), writes about a new partnership between IAVI and the Indian government. The post originally appeared on the US Agency for International Development’s (USAID) Impact blog. When you’re dealing with a global public health crisis, having an international presence isn’t just advisable—it is imperative. This applies as much to the development of new tools to prevent disease as it does to treatment. An AIDS vaccine candidate, for example, must be tested in the people who will eventually use it and against the strains of HIV it is devised to protect them from. That’s why (IAVI), in partnership with USAID, has worked diligently over the past several years to establish itself as a truly global nonprofit partner. Using donor funds, IAVI has created an enviable network of research centers in sub-Saharan Africa dedicated to assessing novel AIDS vaccine candidates in clinical trials and conducting supporting epidemiological studies on HIV. These partnerships have made meaningful contributions to the research capacity of many developing countries—a capability that is now helping local researchers tackle other diseases. IAVI and its partners are now applying that same model to support the design of a new generation of AIDS vaccine candidates. Today, IAVI and the Translational Health Sciences and Technology Institute (THSTI), an autonomous institute of the Indian government’s Department of Biotechnology (DBT), launched an HIV Vaccine Design Program near New Delhi. The program is dedicated to the large-scale generation and preclinical evaluation of immunogens, the active ingredients of vaccines. It will focus on devising immunogens capable of eliciting antibodies that can prevent infection by a broad range of the circulating genetic variants of HIV. That challenge, known to researchers as the neutralizing antibody problem, has long stymied progress toward an AIDS vaccine. But recent discoveries of antibodies capable of blocking a number of HIV variants have provided researchers with clues to the design of potentially powerful new vaccine candidates. The HIV Vaccine Design Program will use these insights to develop new methods to generate large numbers of potential HIV immunogens and rapidly assess their potential for use in candidate vaccines. Much of the work will take place in a laboratory housed within THSTI that is being built and staffed with support from IAVI, DBT, and THSTI. The program’s location is no accident. Over the past decade, IAVI has enjoyed a productive partnership for the clinical evaluation of candidate AIDS vaccines with key medical research institutions of the Indian government. Indian scientists have also actively participated in an international consortium of HIV laboratories supported by IAVI to advance HIV vaccine research. The government of India, meanwhile, is in the early phase of its “Decade of Innovation,” a policy that seeks to harness a growing roster of home-grown biotechnology companies, the nation’s deep pool of scientific talent, and global research partnerships to boost innovation in a variety of high-tech fields. The HIV Vaccine Design Program provides an opportunity to engage an emerging economy in the global quest to develop a vaccine against HIV. For India, it creates an opportunity to address a crisis of significant relevance to Indians. As importantly, it seeds the kinds of collaborations that often foster scientific and technical innovation and generate ideas that might be applied to address other diseases that have long hampered development.