Professor Malegapuru William Makgoba, Vice Chancellor of the University of KwaZulu-Natal
Professor William Bishai, Director of the KwaZulu-Natal Research Institute for Tuberculosis and HIV
Distinguished guests and partners from various parts of globe
Ladies and gentlemen
It’s a pleasure to address you today.
I would like to congratulate the University of KwaZulu-Natal and the Howard Hughes Medical Institute on hosting the Research Institute for Tuberculosis and HIV here in KwaZulu-Natal.
My department has a very close relationship with the University of KwaZulu-Natal.
Not long ago I was privileged to talk at the Centre for AIDS Programme of Research (CAPRISA) board and scientific meeting.
While we are on the way to preventing HIV transmission, we are still faced with the terrible reality of HIV and TB co-infection.
It was six years ago that we learned about the outbreak of extremely drug resistant TB in the rural area of Tugela Ferry (KwaZulu-Natal).
The subsequent deaths of 52 patients within two weeks of diagnosis reinforced the urgency of our search for effective interventions to control this disease.
We now know that the problem is not confined to KwaZulu-Natal, with subsequent diagnosis of XDR-TB cases in other parts of South Africa since 2006.
The world-wide attention that South Africa received because of the outbreak and the severity of the problem led the University of KwaZulu-Natal and the Howard Hughes Medical Institute to join forces and to plan and develop K-RITH - as you are all well aware.
The Department of Science and Technology is, of course, delighted to have played a role in providing some of the initial capital for the establishment of K-RITH.
It’s important that we as South Africans remain at the forefront in conducting research and development for HIV and TB prevention, treatment, and diagnosis. This is critical in ensuring that we develop locally suited solutions that will be beneficial and accessible to local communities.
Ladies and gentlemen, HIV and TB have become the greatest public health challenges both nationally and globally. If we look at these two infectious diseases together, some three million lives are lost annually around the globe. And it is Africa that is most seriously affected, with a significant proportion of the people dying from AIDS and TB concentrated in sub-Saharan Africa.
We are still far short of achieving the health-related Millennium Development Goals. If we look at the goal of halting by 2015 and beginning to reverse the spread of HIV and AIDS and tuberculosis, there is a clear significant risk of not achieving this goal in Africa in particular. Yet without good health and taking into account the problem of poverty among our people, economic and social development in Africa will remain extremely difficult to achieve.
In continuing our battle with the two infectious diseases, it will be important for us to address challenges impacting on our health system comprehensively while at the same time intensifying our efforts in research and development for TB, HIV and AIDS diagnosis, prevention and treatment.
As you know, South Africa has the misfortune of having more people infected with HIV and TB than any other country in the world.
We, therefore, need to play a leading role in responding urgently to these twin epidemics.
We will never have a monopoly in the production of solutions to address these complex challenges, and all our efforts should recognise the need for meaningful partnerships with both local and global role players.
As one of the government departments expected to respond to the challenges of TB and HIV, the Department of Science and Technology established the South African TB Research and Innovation Initiative (SATRII). The SATRII research and development plan articulates what needs to be done to develop new tools to transform the prevention, diagnosis and treatment of TB.
The project started well and the initial results from the drug discovery programme have been encouraging. An extensive compound library was acquired by SATRII and screened for anti-TB activity, resulting in the discovery of more than 14 active chemical series, with more than 100 active compounds. These have been identified and prioritised for medicinal chemistry in South Africa.
This discovery offers the potential for the development of TB drugs in South Africa.
In our view, this creates an opportunity for South Africa to build a key scientific platform while fulfilling a critical and complementary gap in the international TB field.
The probes have been confirmed in multiple TB assays in the United States (US) but need optimisation to turn them into drugs.
Partnerships with industry partners will be required to accelerate the drug discovery programme and catapult the probes into the next phase of research and development.
We have also established the South African HIV and AIDS Research and Innovation Platform (SHARP).
This we did with the intention of promoting evidence-based research in finding solutions to the HIV and AIDS pandemic and contributing to the overall aims of the country’s 2007-2011 National Strategic Plan for HIV and AIDS and sexually transmitted infections.
SHARP strives to encourage innovative and basic research directed at understanding the immunology and cytology of the virus.
It also aims to investigate a comprehensive range of interventions necessary to address the HIV epidemic, such as vaccines, antiretroviral therapies, microbicides, post and pre-exposure prophylaxis, and the research and development of diagnostics for HIV and AIDS. Capacity-building initiatives for young researchers form an integral part of the initiative.
In 2004, my department established the Centre of Excellence for Biomedical Tuberculosis Research (CBTBR).
The objective of this initiative is to contribute to local and global research efforts aimed at developing new tools for controlling tuberculosis and to use research as a vehicle for training a new generation of high-quality biomedical research scientists.
The research is aimed at the development of multidisciplinary approaches for understanding the epidemiology of the disease and identification of novel bacterial and host markers that will shorten the time taken to develop new diagnostic tools.
This research is conducted by three of our country’s leading universities: Stellenbosch University’s Division of Molecular Biology and Human Genetics, the University of the Witwatersrand’s Molecular Mycobacteriology Research Unit, and the University of Cape Town’s Institute of Infectious Disease and Molecular Medicine.
We continue to be impressed by the ground-breaking work that these three universities are doing and look forward to more successes in this regard.
We are also encouraged by the work undertaken by one of our science councils, Council for Scientific and Industrial Research (CSIR), on nanoparticle-based drug delivery systems that have considerable potential for treatment of TB.
The group has to date successfully nano-encapsulated four first-line anti-TB drugs into polymeric nano-particles with positive results showing that nano-encapsulated drugs are slowly released over a few days while maintaining the minimum inhibitory concentration.
This project gives us hope that one day we will be in a position to improve TB drug bio-availability and reduce the dosing frequency, with the potential to resolve the problem of non-adherence to prescribed therapy, which is one of the major obstacles in the control of TB epidemics.
I find it especially significant that this symposium on the two major infectious diseases, HIV and AIDS, is being held during this milestone year in which my department has just announced a bilateral partnership with the United States of America (USA) to support the development of tenofovir gel to prevent HIV transmission in women.
This followed the release of the results of the Centre for the AIDS Programme of Research in South Africa (CAPRISA) 004 clinical trials that provided proof-of concept that an ARV-based vaginal microbicide can offer women protection against HIV.
However, in order to realise these opportunities, confirmatory studies have to be conducted urgently.
The Department of Science and Technology (DST), with the United States Agency for International Development (USAID) and other partners, is supporting the Follow-on African Consortium for Tenofovir Studies (FACTS) follow-on Phase III trial to test the safety and effectiveness of one percent tenofovir gel.
These studies are conducted by the FACTS team which comprises members of a number of institutions, i.e. the Wits Reproductive Health and HIV Institute, the Aurum Institute, the Desmond Tutu HIV Foundation, the Medical Research Council, the Medunsa Clinical Research Unit, the Perinatal HIV Research Unit, and the Setshaba Research Centre.
In our view, it is imperative to assess the effectiveness of tenofovir gel in more women in different geographic locations in order to determine whether the CAPRISA 004 study findings may be generalised. Such generalisation would facilitate licensure and provision of this product to women in need in our continent and across the globe.
Earlier this year, we had the opportunity to participate with senior officials from several countries on the continent in the meeting of the African Network for Drugs and Diagnostics Innovation (ANDI).
We are proud to be associated with ANDI, and we believe this initiative will go a long way in assisting us develop a regional approach to the research and development of tools for prevention and control of HIV and TB, and other neglected diseases that threaten the lives of millions of people on our continent.
While we support and build research capacity in the region, it is important that we also build and strengthen our capacity to manufacture drugs and vaccines locally according to Good Manufacturer Practice (GMP) standards.
Africa carries the highest burden of infectious diseases, and it cannot be right that most of the vaccine and drug development resources are concentrated in the developed world.
It is, therefore, important that Africans find workable mechanisms for mobilising funds for research, development and manufacture in relation to pharmaceuticals and other medical products.
Our participation in building and strengthening manufacturing capacity will be vital to address local vaccines/drugs requirements and also to expand efforts to produce high-quality, lifesaving tools at a lower cost for the benefit of our people.
Furthermore, I am proud that we have several internationally-recognised TB and HIV and AIDS research groups that form part of the major international consortia involved in the global effort to fight TB and HIV and AIDS.
In recent years, we have become one of the leading stakeholders in the design and execution of clinical trials for new drugs and vaccines.
I hope that today’s symposium serves as a valuable opportunity for us to reinforce our international partnerships in the areas of infectious disease and health cooperation in general.
From my department’s side, we will continue to work relentlessly to provide a platform for governments, policy makers, researchers, universities, and other stakeholders to share ideas on research, development and innovation and to mobilise resources and forge partnerships to address health challenges.
It is my sincere hope that the outcomes of your deliberations will enhance our knowledge of the issues related to tuberculosis and HIV as well as empower us to contribute to more intelligent policy interventions in our quest to improve the quality of health for the rest of humanity.
We will be waiting for the outcomes of this symposium with great interest.
Thank you.
