Opening address by the Minister of Science and Technology, Naledi Pandor, MP, at the HIV Research for Prevention: AIDS vaccine, microbicide and ARV-based prevention science (HIV R4P) conference, ICC, Cape Town
The five Co-chairs of HIV Research for Prevention 2014 conference:
Prof. Helen Rees of the Wits Reproductive Health and HIV Institute in South Africa,
Prof. Sharon Hillier of the University of Pittsburgh,
Prof. Eric Hunter of Emory University,
Prof. Robin Shattock of Imperial College London,
Dr Anatoli Kamali of the Medical Research Council/UVRI Uganda Research Unit on AIDS,
Dr Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases,
Researchers,
Conference organisers,
Ladies and gentlemen.
It's a great pleasure to join you today as South Africa hosts this international conference dedicated exclusively to biomedical HIV prevention research. I'm really pleased to see so many of you from across the globe coming here to advance the field of HIV prevention through sharing of information and knowledge.
I think we are all meeting here today with a sense of optimism regarding the fight against HIV/AIDS. Thirty years ago, the global picture was depressing – we were faced with increasing rates of HIV infections and there was very little hope for those infected in those early years. Now, after much concerted efforts by the global research community, the overall situation has improved significantly.
Today we are talking about approximately 30 drugs that have been approved for use by people living with HIV/AIDS, and many more are in different stages of development. Today we have affordable, highly effective HIV drugs, as well as increasingly affordable testing, counselling and prevention services.
Today we have a range of tools for tackling HIV, which now include prevention of mother-to-child-transmission, male circumcision, pre-exposure prophylaxis, microbicides and more recently convincing data for prevention as treatment, with strong scientific agendas towards a vaccine and a cure.
We now know that earlier treatment initiation in HIV-positive people can reduce the risk of HIV transmission, and that the use of ARVs in HIV-negative people can reduce the risk of infection.
Most importantly, we know that it will take a combination of biomedical, behavioural and socio-economic interventions for us to achieve the ultimate goal of "zero new HIV infections, zero discrimination and zero AIDS-related deaths".
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.
South Africa, through the Department of Science and Technology (DST), has been investing in HIV research for many years now. The DST's investment in HIV research began in 1999, when we established, together with the Department of Health, the South African AIDS Vaccine Initiative (SAAVI). This was a national initiative that involved multidisciplinary teams across the various South African institutions, working with international partners, working to achieve an effective and locally relevant HIV vaccine in the shortest time possible.
One of the highlights from this programme was the development and testing of two candidate HIV vaccines, which have just completed Phase I clinical trials in the US and South Africa. Furthermore, we were able build a strong a strong clinical trial infrastructure in the country through SAAVI. These sites are now recognised as capable sites globally and contribute to the global search for a HIV vaccine.
By 2009, the DST’s support for HIV research was expanded to include other interventions such as diagnostics, ARVs, microbicides in addition to vaccines. We created the South African HIV Research and Innovation Platform (SHARP) to fund pioneering HIV/AIDS research and facilitate the development of innovative solutions to the epidemic.
We are currently supporting a number of HIV-related projects at various stages of development through a programme called the Strategic Health Innovation Partnership (SHIP) which incorporates SHARP under the auspices of the South African Medical Research Council.
The role of this programme is to facilitate the interaction of South African HIV/AIDS researchers and to create a National Network of Collaborating Research Centres in HIV/AIDS. Currently, a number of multi-institutional, multi-disciplinary, product development projects covering diagnostics, vaccines and microbicides are being pursued to advance the objectives of SHARP.
In addition, we have, since 2010, supported a phase III clinical trial involving the microbicide, 1% Tenofovir gel. Many of you will recall that this is a licensure study that is aimed at confirming and expanding the ground breaking findings of the CAPRISA 004 Tenofovir gel trial. We had the privilege of collaborating with Prof. Helen Rees, who is here with us today, on the confirmatory trial for CAPRISA 004 and we are optimistic that the study will provide us with safety and efficacy data needed for product registration.
Although a vaccine is still many years away, we have noted considerable progress globally in understanding the development of broadly neutralising antibodies, those that can neutralise HIV from multiple subtypes and which would be critical for a vaccine to work. Here in South Africa, the researchers at the National Institute for Communicable Diseases (NICD) together with other partners recently announced how they were able to isolate broadly neutralising antibodies and elucidate the pathway followed by the immune system to make these potent antibodies (CAP 256).
As part of our HIV Vaccine Strategy, the Strategic Health Innovation Partnership will be investing in a number of projects aimed at moving these recently discovered CAP256 broadly cross-reactive neutralising antibodies towards potential products for active and passive immunisation.
We are especially grateful to the international scientific community for continuing to collaborate with us in this work. I would like to assure you that the DST remains committed to providing the necessary support as we move towards establishing a broadly neutralising antibody consortium, a key HIV vaccine program that will harness the promising broadly neutralising antibodies results in South Africa towards active and passive immunisation strategies.
Ladies and gentlemen, allow me to take this opportunity to re-affirm the commitment of the South African government to HIV prevention as an essential component of an effective response to HIV/AIDS. Indeed, South Africa attaches particular importance to the fight against AIDS with prevention at the heart of the country’s National Strategic Plan for HIV, Sexually Transmitted Infections and TB (2012-2016) (NSP). The NSP acknowledges that the trajectory of the global response to AIDS will depend to a large extent on our ability to prevent new infections in future.
It goes without saying that without prevention the number of affected people will continue to escalate and the disease will continue spreading and threatening our health care system. As no single HIV prevention method offers complete protection against HIV, our focus is on offering a package of effective, evidence-based HIV interventions together. In this way, we will be better positioned to respond to the epidemic in a more comprehensive manner than would be possible with individual interventions.
I think one of the challenges that we are faced with today is to translate the new health knowledge generated into products that have a significant impact on society. This is especially critical in a fiscally constrained environment where funders and donors have considerable interest not only in knowledge generation but also in realising the benefits from their investments in research by moving research into clinical practise.
We are challenged not only to be certain that an intervention is safe and effective, but also affordable, accessible and meets the needs of those most at risk of infection. This can only be addressed by involving broad groups from researchers, policy makers, health workers to target affected communities through constructive dialogue during the R&D process.
I am raising this issue because we are increasingly requested to evaluate the impact of the work that we fund and I am confident that we have the best minds in this room to assist us navigate how we can ensure that the work that we do transform health outcomes.
As you engage in discussions during this conference, I especially request you to be ever mindful of that which we know to work in reducing transmission and how we can implement that knowledge and take it to scale for the benefit of our communities. While noting that the development of some interventions such as vaccines remains a daunting scientific challenge, in our view the implementation of already available interventions that have been demonstrated to work would take us a step further in reaching the final objective of ending the HIV epidemic.
In conclusion, I sincerely hope that by the end of this conference, there will be a renewed momentum towards the research and innovation for biomedical HIV prevention tools.
Thank you for your kind attention.
Contact:
Lunga Ngqengelele
Cell: 082 566 0446
Tel: 012 843 6799
