Towards a science-led solution for HIV/Aids

By Minister Naledi Pandor

As we prepare to host the 21st International Aids Conference (Aids 2016) in Durban later this month, South Africa has made progress in implementing and funding evidence-based prevention and treatment interventions.

South Africa has now been able to put 2.4 million people on  ARV treatment and reduce the rate of mother-to-child HIV transmissions from 8 percent in 2008 to 2.7 percent in 2012. The increase in ARV treatment has resulted in a reduction in the number of people dying as a result of HIV infection and a significant reduction in the levels of mother-to-child HIV transmission rates.

We also appreciate global efforts that are currently underway to pursue the “HIV cure” agenda. Currently, a number of strategies are being investigated in this regard and we acknowledge that all of these strategies will be more efficient in combination with each other, alongside the use of ARVs to at least protect the immune system of patients to prepare them for a cure.

However, the main challenge remains - we remain many years away from eliminating HIV as the epidemic continues to outpace our efforts to control it. The number of newly infected people each year continues to outnumber those who gain access to treatment. We need new prevention tools if we are to escape this epidemic. Investment in research and development for new prevention tools remains a critical goal for us all.

I am proud of South Africa's large cohort of Aids scientists who undertake research into HIV prevention and treatment, as well as trends in the spread of the epidemic.

The South African government is currently supporting a number of HIV research projects on broadly neutralising antibodies, which include a proof-of-concept study for the production and characterisation of CAP 256 monoclonal antibodies in plants, the development of novel ARV therapies for the treatment of latent HIV infection, the identification of host and viral targets that can be developed as future therapeutics for attaining a functional cure for HIV, the identification of biomarkers that will identify women who have asymptomatic sexually transmitted infections and who are at risk of HIV infection, and the development of a better and more robust second-line ARV regimen for HIV infection.

On the diagnostics front, SHIP (the Strategic Health Innovation Partnerships), a unit of the South African Medical Research Council (MRC), with funding from the DST, is currently supporting a project at the University of the Western Cape.

The primary role of the project is to take Exatype, an easy-to-use web-based programme for routine HIV drug-resistance testing in South Africa, and facilitate the development and commercialisation of a fully scalable diagnostic test that will have no limits in relation to the number of analyses that can be run concurrently.  This will mean a reduction in the costs and time involved in analysing data about viral DNA compared to conventional methods. Exatype provides considerably higher sensitivity than conventional HIV-resistance testing approaches.

The technology, developed over five years by Prof. Simon Travers and his team of researchers at the South African National Bioinformatics Institute, has been tested in collaboration with a number of researchers in South Africa.

In addition to the research efforts, a government-driven and fully integrated pharmaceutical company (Ketlaphela), with a specific focus on the local manufacture of ARVs, has been established.  Ketlaphela is expected to bridge the gap between research and development capabilities in South Africa, and innovation, by adding the chemical manufacturing of active pharmaceutical ingredients, tablet formulation and targeting the burden of diseases, initially for South Africa and subsequently expanding into SADC and Southern Africa.

In order to sustain this cutting-edge research, a concerted effort has been made to train the next generation of scientists, so that talent is available for continued local scientific leadership to help address the scourge of HIV and other diseases.

Training master's and doctoral candidates continues to be high on the list of priorities for DST and a number of instruments have been established to help build the scientific base to conduct research on HIV, among other things.  These include the DST-National Research Foundation Centre of Excellence in HIV Prevention at CAPRISA, the South African Centre for Epidemiological Modelling and Analysis, and the South African Research Chairs Initiative.

When we gather at the Aids 2016 conference in two weeks' time, South Africa will share its experiences in this area with global policy-makers, scientists, community members and other stakeholders. I believe significant progress has been made in developing the scientific base in terms of human capital, infrastructure and R&D expertise for HIV research. Going forward, South Africa will build on this base and continue to forge strategic partners with global partners as research and development efforts for the diagnosis, prevention and treatment of HIV are intensified.

Naledi Pandor is Minister of Science and Technology.

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