“There are more than 38 million people still living with HIV in sub-Saharan Africa,” Dr Omolara Baiyegunhi, a research associate from the Africa Health Research Institute (AHRI), told a media briefing in Johannesburg on Tuesday morning. She said that of that 38 million, 60% were women and girls, showing the disproportionate nature of how the disease affected the region. 

Baiyegunhi said research by the institute had shown that while there were various tools available — including male and female condoms, daily oral pre-exposure prophylaxis (PrEP), antiretrovirals and medical male circumcision — to act against infection and the spreading of the virus, more needed to be done. 

She said some people did not have the financial resources to access these tools, and that people already taking medication for comorbidities were reluctant to take more medicine. An HIV vaccine could prove more attractive as it did not need to be taken daily. 

Professor Thumbi Ndung’u, the director of basic and translational science at AHRI, focused on why the HI virus was able to infect human cells and how to stop it. He told the briefing the current tools were difficult for resource-limited communities to use on an ongoing basis and stressed that a “vaccine offers long-term prevention against infection”.

Ndung’u conceded that the multiple strains of the virus made it difficult to develop just one vaccine that could tackle all the strains. He said that “government, multidisciplinary scientists and communities need to come together” and that there had to be a buy-in from communities, particularly because of the vaccine hesitancy during the Covid-19 pandemic. 

He said the big mistake that was made when developing the Covid-19 vaccine was that there wasn’t a clear explanation of how it would work.  

Six HIV vaccines are in research and development stages globally, in the US, Rwanda, South Africa and Kenya, Dr William Brumskine from the Aurum Institute told the gathering. He said that the research was trying to target antibodies that would be responsive to all the strains of HIV. He also spoke of an African-led clinical trial under way into what he referred to as a PrEPVacc which would be a combination of PrEP and a vaccine, the results of which were anticipated at the end of 2023 or early in 2024. 

The International Aids Vaccine Initiative’s community engagement manager, Zandile Ciko, emphasised that the organisation had identified that “community engagement is not a good-to-do but is a must-do”.  

She said the failure of a Covid-19 vaccine community buy-in was an example of the need for full stakeholder engagement so that communities could understand the need for an HIV vaccine.  

“Communities know what they need,” said Ciko. It was essential that scientists understood community struggles first before proposing solutions. She said greater care needed to be taken to ensure a legacy of community engagement from design to trials, to licensing and distribution, to combat issues of hesitancy. DM