19 Aug #HVAD2018 in Uganda - Engaging Media, Interrogating Domestic Financing for Vaccine Research

Objectives of the meeting/engagement

• To update media owners and managers on ongoing HIV vaccine research with the aim of increasing their knowledge and interest in the subject.
• To mobilize media bosses and interest them in the HIV vaccine story so that they can start giving it consideration, if not priority in their platforms.
• To explain the media bosses how the HIV vaccine story is not a vain subject, should not need to be news before it can run and needs to be kept alive.
• To lay the groundwork for continuous dialogue and collaboration between the media owners and managers and scientists working in the area of HIV vaccine research.
• To build a cohort of media bosses who are interested in HIV vaccine research and will therefore demand it from the reporters or enforce coverage for stories on the subject.

Participation

The media breakfast was attended by media owners and managers (editors) from key media houses in Uganda, including print, radio Television and social media.

Speakers

• Prof. Pontiano Kaleebu: Director, Uganda Virus Research Institute (UVRI).
• Dr Francis Kiweewa, Head of Research and Scientific Affairs, Makerere University Walter Reed Project (MUWRP).
• Prof. Pontiano Kaleebu, Director, Uganda Virus Research Institute (UVRI) kicked off the media engagement by giving an overview of some of the ongoing and planned HIV vaccine trials globally.

Highlights

• Prof. Kaleebu said that while advances in treatment had helped improve the lives of people living with HIV, the disease will not be eliminated without a vaccine. According to Prof. Kaleebu, viruses such as smallpox have been successfully eliminated because of vaccines.
• In the case of HIV, the complexity of the virus has been a big hurdle in finding an effective vaccine, three decades after the disease was first developed.
• Prof. Kaleebu noted that several approaches are being used to develop the different vaccine concepts that are currently under trial.
• These approaches include the use of active immunization, broadly neutralizing antibodies (passive immunization), non-neutralizing anti-bodies, DNA, T-cells, and among others.
• He explained in detail the hope in passive immunization, Mosaic studies and the time lines that increase our hopes for success
• He noted that Uganda will soon be part of another large efficacy trial called PrepVacc, which will use a combination of a DNA and the Thai vaccine. The study will be conducted among HIV negative high-risk individuals in Uganda, Tanzania, Mozambique and South Africa involving 2500 volunteers. In Uganda it will be conducted among fishing communities in Masaka.
• Dr Francis Kiweewa on his part started his presentation by explaining that vaccine development is often a long process, conducted in different phases.

“Most start with a lot of promise in animals and create a lot of excitement. Then we go into phase I and II and realize they are inducing an immune response but which is not strong enough to prevent HIV infection.” - Dr Kiweewa.

• He added that to date there have been five vaccine candidates that have reached phase III trials, and all except the Thailand study were a failure.
• As a result, the vaccine concept that is driving much of the research happening globally today is based on the Thai study.
• Currently four phase III vaccine trials are on-going. Dr Kiweewa said these trials are being studied with a lot of hope and optimism that one of them could be effective.
• The results from these trials, which are taking place in South Africa, the Americas and Europe are expected to be out between 2020-2021.

Challenges in HIV Vaccine Research

The scientists noted that despite the hope and optimism that finding a vaccine is possible in the near future, HIV vaccine research still faces several challenges;

For example, the diverse nature of the virus continues to affect development of an effective vaccine. In Uganda for instance, Prof. Kaleebu noted that50 per cent of the viruses are recombinants. On top of diversity, the virus also mutates very fast, creating an even bigger challenge for researchers. The declining HIV incidence also makes it difficult to enroll to enroll large groups of volunteers for trials. Part of the work researchers are currently working on in the lab is to see how to address the issue of recombinants and mutation. Another challenge, according to Prof. Kaleebu is the fact that most of the research on HIV vaccine development is concentrated on the HIV sub type C, which is prevalent mostly in South Africa. Part of this is because on top of having a high HIV prevalence, South Africa is also investing heavily in terms of financial resources to undertake HIV research.

Countries, for instance those in Eastern Africa which have a different strain of the virus therefore need to invest more in vaccine trials that address their sub types of the virus. Dr Kiweewa noted that despite commitments made by African governments to invest at least 2% of their GDP on research, many have not lived to these commitments. Except for South Africa which has invested heavily in HIV research, much of the work on HIV going on in high burden countries is being funded through external donations.

Media, Advocacy and Challenges

One of the key areas for advocacy that the scientists hope the media can focus on is to advocate to governments to invest more in medical research generally. It was noted that South Africa had attracted many of the clinical trials because they have heavily invested financial resources in HIV research. Hilary Bainemigisha, the convener of the meeting, highlighted the importance of mobilizing media owners and managers because they are the planners, policy makers, gateway controllers and can set the agenda of their media houses. He said that these press bosses need to be aware of the HIV vaccine development updates in order to plan publicity, manage the science, identify the mistakes and help reporters to break down the science to the audience. Mr Bainemigisha says once the media owners get interested in HIV vaccine updates, the managers will fall in line and so will the reporters and that will increase the coverage of HIV vaccine stories. While several journalists have been trained on reporting on HIV, editors have not had the same training. When editors don’t understand the stories or have no interest in them, they don’t give them priority in the story competition for space.

Discussion of the issues

“There are unfair demands placed on us by activists. The HIV industry is well funded but when they want the media as partners, they don’t want to share the resources. Yet communication is one of the vital deliverables donors give HIV advocates.” – Participant and media house owner

 

• Media owners asked scientists to budget for publicity. They said it was acceptable for them to be partners in the fight against HIV but it was unfair for scientists to expect the media to do it free of charge while researchers cannot carry out their work free of charge. Let everybody do their bit and be paid for it.
• Media owners referred to the upcoming HIV Vaccine Awareness Day saying donors must have funded awareness activities. But many said the media did not get any money for adverts/airtime to do awareness yet the scientists still expect media to do it for free.
• Media managers and owners appreciated a partnership that was not selfish and based on the knowledge that the media industry needs money/income/profits to survive
• Media owners and managers said while scientists are privileged in their role of research, the media is also privileged in its skills of communication and available audiences. In the fight against HIV, the two important roles need to be respected, equally funded and supported
• Another issue raised was the fact that most stories on HIV/AIDS are often not well written or too complicated to be released to the audience. The editors and managers sometimes stop these stories because goofing affects the reputation of the media house. So a story rather not runs.
• They appreciated and called for protracted training of journalists in HIV reporting.
• Media managers also raised the issue of ethics. For instance, when dealing with stories of children or people living with HIV, who have not disclosed, they are required to block their identities and often this makes their stories unbelievable.
• Competition has also made it difficult for HIV stories to get space in the media. Because media houses are dealing with balancing how to make revenue and informing the public, often times, they are most likely to publish a story that gets more revenue than an important story on HIV vaccine.
• Journalists, editors and media owners need to be trained to see that HIV is a community problem that requires partnerships. In reporting on HIV, journalists therefore need to take on an advocacy role as part of their social corporate responsibility.

VARG at the High-Level Dialogue on Domestic Health Funding

On June 12, a high-level dialogue was held with Parliamentarians and other stakeholders in research, academia, and advocates on how to improve domestic funding to health research. Convened by the Ugandan National Health Research Organization (UNHRO) and supported by IAVI, different presenters gave their arguments justifying the need for improved funding. Health research in Uganda is financed from a variety of sources but mostly from external funders.

The total health research investment in Uganda for 2014/2015 was USD 116.84 million out of which the share of domestic financing was USD 11.08 million. Therefore, 90.51% of the financing for health research was generated from external sources and only 9.49% was from the domestic sources. The ratio of total health research financing to the total GDP of Uganda stands at 0.41%. However, the ratio of domestic financing for health research to the total GDP is as low as 0.04%. (EAHRC, 2018)

It was decided that instead of the different research organisations lobbying individually, an umbrella body is formed and costed. Members of Parliament gave advice on the strategies that could be used for potential advocacy initiatives and UNHRO was nominated to lead the main process. The VARG also participated in the Vaccine Interest Group (VIG), a high-level dialogue on HIV vaccine research with Parliamentarians organized through the Parliamentary Forum on Quality Health Care Service Delivery. This platform served as a networking mechanism between advocates, researchers, funding agencies and other stakeholders.