Real People, Real Progress

Wednesday 18 May 2004 marked the seventh HIV Vaccine Awareness Day. This celebration is held annually following former US President Bill Clinton?’s 1997 challenge to scientists to develop "the 21st century's first great triumph": a vaccine to prevent HIV infection. This year's theme "Real People, Real Progress" embodied a tribute to the thousands of volunteer participants and researchers involved internationally in the search for effective preventive HIV vaccines. The focus of this cross-country event was education and information-sharing.

In South Africa, the South African AIDS Vaccine Initiative (SAAVI) and its partner organizations convened events in the four cities with vaccine clinical trial sites, being Cape Town, Durban, Soweto and Orkney. The awareness event provided an excellent opportunity in Durban for members of the Medical Research Council (MRC), the Durban Community Advisory Board (CAB) and trail participants to interact with and engage members of the public. For the second year in a row, the day was commemorated with a ?“twist on a familiar symbol of AIDS awareness?”, the red ribbon.

The convenors converged on Durban City Hall wearing their AIDS ribbons upside-down to symbolize a "V" for vaccines and a vision of a world without AIDS. This theme was chorused by the Sinikithemba Choir. Onlookers, attracted by hub of activity and the street theatre performed by Yabantu Productions on the hall steps, engaged in information-sharing and question-and-answer sessions regarding eligibility criteria to participate in trials and on trials currently underway.

Councilor Nomusa Dube from eThekwini municipality supported the need for vaccines to complement prevention interventions focusing on behavioural change. Speaking openly about their experiences in Phase One vaccine trials, two participants encouraged members of the community to attend educational sessions on Tuesdays and Thursdays at the MRC where potential volunteers are exposed to more detailed information. The vaccine trials were also supported by traditional healers from kwaMashu.

A clear message was communicated by MRC and CAB spokespersons: Preventive vaccines are given to people who are uninfected with HIV. Healthy volunteers can be recruited to three types of vaccine trials. Phase One safety trials assess responses of trial participants to low doses of candidate vaccines. These trials require few participants. Phase Two trials encompass further investigation into immune responses with higher doses and larger numbers of participants. Phase Three trials assess the efficacy of vaccines among thousands of trial participants.

It is also clear that HIV vaccine testing has assumed impetus since 1999. As at 2004, about thirty (30) vaccine candidates are being tested across nineteen (19) countries in Africa, Europe, Asia, Australia, North and South America. Today, a record number of pharmaceutical companies, academic laboratories and government institutions are involved in the global effort to develop an AIDS vaccine.

Major challenges exist, however. The majority of trial vaccines are still in the early stages of human testing. Only two vaccine candidates have advanced to efficacy trials. A challenge in this regard is to recruit healthy participants to the trials that have been initiated in South Africa. This requires active involvement of the Durban and Soweto CABs in education of communities regarding the trials and in supporting participants in existing trials.

Durban CAB secretary, Nirmala Gopal had the following to say about the awareness event: ?“The day made us aware of our successes and our limitations. Engagement with the audience alerted us to the complex nature of enrolling civil society in the vaccine trial dialogue. We were alerted to the increasing support we as CAB need to provide to the site in recruiting trial participants. We were also alerted to the notion of choosing different public venues to recruit heterogenous trial participant populations. We were also aware of those individuals who indicated no interest in the event. This may perhaps have been fuelled by time constraints or, simply, ignorance.?”

For more information contact the SAAVI Vaccine Info-Line 080 VACCINE. See also the SAAVI website for further information on progress in vaccine development in South Africa - http://www.saavi.org.za