June 13, 2005
By Andra Stevens*
MUTARE, Zimbabwe (UMNS)--Researchers from St. Jude Children's Research Hospital in Memphis, Tenn. say Africa University and Zimbabwe are good potential partners in an initiative to test the effectiveness of an HIV vaccine on people in Africa.
"This would be a first for Africa," said Dr. Karen Slobod, co-leader of the HIV Therapeutics and Vaccine Development team working at the Children's Infectious Disease Center at St Jude.
Slobod and her colleagues have been working on the vaccine for a number of years. Described as bold and ambitious in terms of what it hopes to accomplish, the vaccine is designed to cause the immune system to respond to multiple strains of the virus from different parts of the world. It is also to offer protection against infection from those strains and others that may develop as the virus mutates.
Researchers have completed much of the phase one testing â€” safety trials to determine how well people tolerate the component drugs. They are now ready to move to phase two: investigating whether or not the vaccine actually protects people who are at risk from becoming infected with HIV. The research team wants to run simultaneous vaccine trials with volunteers in the United States and in Africa.
"The clock is ticking, so why not now and why not Africa," said Slobod. "We believe that human trials in Africa that look at vaccine effectiveness, even when done with much smaller groups and over a shorter time period, can be very useful."
The three doctors, Slobod, Pat Flynn and Julia Hurwitz, visited Zimbabwe from June 1-4. Their visit was part of a three-country trip to identify the best testing site for the vaccine in Southern Africa.
Before arriving in Zimbabwe, the team evaluated proposed vaccine trial sites in South Africa and Malawi. Their last stop was Mutare, Zimbabwe's fourth largest city, and United Methodist-related Africa University.
The team toured local counseling and treatment centers to determine if there was a large enough pool of people who are HIV negative and who might volunteer to participate in the proposed vaccine trial. Team members also assessed the facilities and community support for the trial and came away impressed by what they had encountered.
"It's certainly more developed than Malawi," said Flynn." At the Old Mutare Hospital, (a 68-bed facility located on the United Methodist Church Mission across the road from Africa University), the wards that we saw were cleaner and more organized. The other thing that impressed me is that in this country, more so than in any other place where we went, it was Africans taking care of Africans and Africans running things."
During the visit, the St. Jude team met with health officials as well as provincial and municipal leaders. More than 75 physicians, nurses and pharmacists met with the research team from St. Jude. Many pledged to support the vaccine trial if Mutare is chosen as the site.
"We want to do all that we can to make this project a success," said Dr. Akinjide Obonyo, a family physician. "The people here are doing so much with very little by way of resources, because they are committed to making a change in the outlook of this disease."
Africa University is spearheading the push to bring the St. Jude vaccine trial to its home community of Mutare, where current estimates are that about a quarter of the population is HIV positive.
"The way we put it to the City of Mutare is that 25 percent of the people have HIV, and this vaccine is for the 75 percent who don't have it and are at risk," said Dr. Abigail Kangwende. "We need to concentrate on those people, as much as we are on those who are infected, if we want to stop the disease from devastating this continent."
Through its health sciences faculty, Africa University hopes to be at the center of the study as the local collaborating institution. The university already has outreach programs dealing with HIV/AIDS prevention and education, impact mitigation and primary health care. It is offering access to computers, office and laboratory space in its new health sciences building for the vaccine trial.
Other potential partners in Mutare include the provincial hospital, city and suburban clinics that do voluntary testing and counseling, and the United Methodist hospital. All are keen to participate.
Public health physicians like Kangwende are a key element in the case for staging the vaccine trial in Mutare. Kangwende, along with leading Zimbabwean experts such as Dr. Exnevia Gomo, the principal medical research officer in the HIV unit of the National Institute of Health Research and Paul Ndebele, the national coordinator of the Medical Research Council of Zimbabwe, are building support for the research in the community.
"A healthy person who volunteers to participate in a research study of this kind may not benefit personally, but their participation and what results from it are really a gift to humankind," Ndebele said.
The proposed vaccine trial is the most recent development in a long-term collaboration between Africa University and St. Jude Children's Research Hospital, which has included faculty and staff exchanges, training and capacity building.
Four health professionals from Zimbabwe visited St. Jude through a fellowship that offers training and exposure to new knowledge. Visiting faculty members from St. Jude
have done short-term teaching at the university and are assisting the health sciences faculty in equipping its new building.
*Stevens is director of information and public affairs at Africa University.
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