#HVAD2018 Kenya – A four point agenda!

Celebrating Africa Day: HIV Vaccine Development – A four-point agenda

Each year on May 18, advocates all over the world commemorate the day to mark progress in the search for an AIDS vaccine. Also, the Africa Day is the annual commemoration of the foundation of the Organisation of African Unity OAU, on 25 May, 1963. The OAU is now the African Union (AU). As we recognize and celebrate the Africa Day, we also recognize the need to develop an Africa Agenda for HIV Vaccine Research and Development.

While vaccine development is always a long-term process, there have been unprecedented advances in recent years and several promising concepts are being tested in large-scale trials. For Africa, where a high burden of disease still persists, it is important that we find a safe, effective and affordable vaccine. It will be one of the most critically important tools to control the HIV epidemic in our region. Beyond controlling the epidemic, development of an effective HIV vaccine will likely be necessary to achieve a durable end to the HIV/AIDS pandemic. It is critical, therefore, to continue and accelerate a robust research effort to develop an HIV vaccine that is at least moderately effective, while also aggressively scaling up the implementation of current treatment and prevention tools.

I would like highlight four critical elements towards an AIDS Vaccine for Africa, with Africa in commemorating the day:

1. Increasing involvement of African researchers in the product development pathway

We have seen gold-standard HIV vaccine trials conducted in Africa, yet the leadership of the research is rarely African. In my view, this is less an issue of capability but more about perception regarding quality of research in Africa which then determines leadership in research projects. Without a doubt, African researchers have been performing cutting-edge research to contribute to finding an AIDS Vaccine and can play active and equal roles as their western counterparts. This dynamic can be shifted by encouraging research that reflects African realities and considers key regional priorities. HIV vaccine research in Africa should purposely consider developing research capacity by African researchers as that will ensure sustainability of research programs. This would also contribute significantly to developing and introducing an HIV vaccine where the greatest disease burden persists.

2. Ensuring good participatory practice in clinical trials

Ethical guidance documents generally stress community engagement as essential to the ethical conduct of trials. This involves various considerations including proper stakeholder identification through a broad, inclusive and multifaceted understanding of the context in which the trial is taking place. The process should not only help to empower and equip African community stakeholders to meaningfully engage in the research process but also to harness the expertise that community stakeholders can contribute to the design and conduct of research.

3. Strengthening African-led advocacy

African leadership in civil society is essential to sustaining support for HIV prevention research. Building advocacy for research across Africa both at national and regional levels will significantly contribute enhancing demand and backing of prevention research from civil society, communities, policymakers, and other key stakeholders. African led advocacy agenda and local ownership is critical for the realisation of regional research priorities such as calling for increasing domestic resources for research in Africa. However, civil society must be sufficiently capacitated to rise to the task. This includes the ability of both holding government accountable and to take on new responsibilities in the implementation and the monitoring of greatly expanded HIV R&D activities. The recently formed network, Africa Free of New HIV Infections (AfNHi), an Africa regional network for HIV prevention research advocacy is well positioned to provide the needed leadership.

4. Scaling up Domestic resources for research in Africa

Recent trends indicate a decline in key aspects of biomedical new HIV prevention funding. Changing funding dynamics and priorities in donor countries have shaped these trends and will continue to do so in years to come. Currently, neither national budgets nor regional commitments to health demonstrate adequate investment in new HIV prevention R&D. There is, therefore, a need for African governments to raise political will towards increased investments in HIV prevention R&D. This will serve, among other positive outcomes, to accelerate research and rollout of New Prevention Technologies (NPTs) and ensure that African nations can prioritise Africa’s research agenda. It is also imperative to raise the level of awareness on new HIV prevention R&D and the funding landscape among civil society leaders to scale up momentum for advocacy in Africa.