HIV Prevention News Around The Globe

Africa: The Basket of HIV Prevention Options Needs to Be Filled

Recent research has confirmed the importance of choice. After using both the ring and oral PrEP for six months each, 67% of the participants chose the ring, 31% chose oral PrEP, and only 2% chose to use neither. Simply put, we need to make sure women have better access to the ring.

In Eswatini, access will be scaled up once the pilot projects there have concluded and we expect that the other five countries with pilot projects — Kenya, Lesotho, South Africa, Uganda, and Zimbabwe — will do so as well.

I'm encouraged to see that Botswana, Malawi, Namibia, and Rwanda have provided regulatory approvals for the ring, or authorisation for its use, through import permits. A South African pharmaceutical company plans on manufacturing the ring locally, which would lower the cost of the product.

It is also very exciting that, at the 25th International AIDS Conference, the Children Investment Fund Foundation (CIFF) and the Global Fund announced an initiative of US $2 million to purchase approximately 150,000 dapivirine vaginal rings for countries that implement the Global Fund’s grants.

We need more commitments to rapid and widespread implementation of the dapivirine ring beyond the pilot projects, from policymakers, governments, and global health organisations. The success of these pilots should trigger automatic scale-up plans in each country now especially that there is available funding. I urge health ministries to work closely with NGOs and community organisations to develop comprehensive rollout strategies that reach beyond urban centres into rural and underserved areas.

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U.S. biopharmaceutical giant Gilead blocks new 100% effective HIV drug from Global South

Activists and advocates are demanding universal access to a new life-saving anti-HIV drug with the potential to turn the tide against the epidemic in the Global South. The new drug has been found to have a 100% effectiveness rate at suppressing HIV, but the developer, U.S. biopharmaceutical company Gilead Sciences, is charging over $42,000 a year to get it.

Lenacapavir, sold under the brand name Sunlenca, was first approved for medical use in the U.S. in late 2022 to treat HIV infections. Lenacapavir is an antiretroviral medication delivered by injection every six months. A study published last month in the New England Journal of Medicine found a 100% effectiveness rate for the drug in a study of 2,134 women in South Africa and Uganda.

Dr. Andrew Hill of Liverpool University, who led the research, told the UK Guardian: “You’ve got an injection somebody could have every six months and not get HIV. That’s as close as we’ve ever been to an HIV vaccine. [emphasis added]”. Human Immunodeficiency Virus is a virus that kills its victims by destroying their immune systems, making even a small infection into a potentially deadly one. In this state of immune vulnerability, the disease is called Acquired Immunodeficiency Syndrome. Multiple medications exist that can prevent HIV from progressing to AIDS and even reverse the process, but no vaccine or cure has been found.

Since it was first clinically observed in 1981, HIV has killed between 35.7 million and 51.1 million people around the globe. Development of treatments took more than a decade due to rampant homophobia and racism, since it was stereotyped as a disease that primarily affected gay men, transgender women, and oppressed minority groups such as Haitian-Americans. However, as the virus spread across the Global South, it rapidly lost its association with the LGBTQ community and became a problem faced by all populations.

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Bold new strategy to suppress HIV passes first test

More than 15 years ago, University of California San Francisco biophysicist Leor Weinberger proposed an audacious new strategy to beat the AIDS virus: giving already infected people an engineered version of HIV. The variant, stripped of nearly all its genes and designed not to cause disease, might outcompete and suppress the natural version, he thought. The therapeutic interfering particle (TIP)—his bland term for the defanged HIV—could even spread person to person, reducing AIDS prevalence globally.

This week brings proof of principle for the first part of Weinberger’s vision. A single injection of TIPs into monkeys already infected with a simian version of HIV knocked down their virus levels 10,000-fold for prolonged periods, he and colleagues report today in Science.

Plans are already underway to test this fight-fire-with-fire approach in humans. If it proves safe and effective, Weinberger imagines it could be offered to everyone who learns they are infected with HIV. Many people living with the virus have difficulty accessing antiviral drugs or taking the pills every day, he notes. “I think we need to try something new.”

“This is an exciting paper,” says Nobel laureate David Baltimore. He and his wife Alice Huang, both virologists at the California Institute of Technology, in the 1970s described similar disabled versions of poliovirus and vesicular stomatitis virus (which sickens livestock) that naturally emerge in cell cultures and interfere with the intact virus. “We never put in the effort to make it a reality,” says Baltimore, who is excited that now, “There is a chance that the therapeutic potential of defective interfering particles will be realized.”

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Researchers develop a new vaccine additive that creates a stronger, tunable immune response

Researchers at Stanford Engineering have developed a nanoparticle platform that could make existing vaccines more effective, including those for influenza, COVID-19, and HIV. In addition to helping vaccine candidates produce stronger, longer-lasting immune responses, the platform will allow researchers to elicit and test different types of immune responses to determine what is most effective for protecting against specific pathogens.

"These nanoparticles elicit stronger, more robust immune responses, and the breadth of our platform allows us to readily tune the type of immune response in a way that just was not feasible with previous technologies," said Eric Appel, an associate professor of materials science and engineering and senior author on the paper published Aug. 7 in Science Advances. "This can be a tool to understand how different types of immune responses give rise to better or worse protection—it was impossible to even ask that question before."

Most modern vaccines teach our immune systems to recognize and fight off infections by introducing only a piece of a pathogen—such as the coronavirus's now-infamous spike protein—instead of the whole virus. On their own, these fragments may not cause much of a reaction, so vaccines also contain adjuvants—additives that help stimulate and shape the body's immune response. But there are currently only a handful of adjuvants available for clinical use and their effectiveness can vary widely.

"We wanted to create as potent an adjuvant as possible," said Ben Ou, a doctoral student in Appel's lab and first author on the paper. "We combined two different adjuvant technologies to create a nanoparticle platform that will activate different immune pathways and improve vaccine responses."

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The world is making steady progress tackling HIV-AIDS – but challenges remain

In health care, we tend to spend a lot more time bemoaning failures than pondering successes. We too often lose sight of the fact that, while progress often comes gradually, the cumulative effect can be impactful.

HIV-AIDS is a case in point. With 88.4 million people infected with human immunodeficiency virus over the past four decades, and 42.3 million of them having succumbed to AIDS, it remains one of the worst pandemics in history. But new infections are down a remarkable 60 per cent since the peak – from 3.3 million in 1995 to 1.3 million in 2023. Deaths have dropped ever more sharply, 69 per cent, from 2.1 million in 2004 to 630,000 last year.

An astonishing 30.7 million people – 77 per cent of those of the 39.9 million living with HIV worldwide – are accessing antiretrovirals, drugs that keep the virus from replicating, and essentially made HIV a chronic, manageable illness. Yet, much more remains to be done.

The campaign to rid the world of the scourge of HIV-AIDS by 2030 seems to be faltering. The other pandemic, COVID-19, took a lot of wind out of the sails, overwhelming public health in many parts of the world.

Still, glimmers of hope continue to arise. At the 25th International AIDS Conference, held last month in Munich, there were two noteworthy developments: News of another patient who has been cured, and a big improvement in how preventive treatment can be delivered.

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New hope in HIV treatment with affordable ‘vaccine-like’ drug

PARIS (AFP) – A new “vaccine-like” HIV drug that currently costs over USD40,000 per person a year could be made for as little as USD40, researchers estimated yesterday.

The antiretroviral drug Lenacapavir, developed by United States (US) pharmaceutical giant Gilead, has been hailed as a potential game-changer in the fight against HIV.

Early trials have found the treatment is 100 percent effective in preventing HIV infection. And it only needs to be injected twice a year, making the drug far easier to administer than current regimens requiring daily pills. “It’s like having a vaccine basically,” researcher Andrew Hill at the UK’s Liverpool University, told AFP.

The treatment currently costs patients over USD40,000 a year in a range of countries including the US, France, Norway and Australia. New research, which Hill presented at the International AIDS Conference in Munich yesterday, looked into how much the cost of making the drug could come down if Gilead allowed for cheaper generic versions to be manufactured. A year’s worth of the drug could be made for as little as USD40 – 1,000 times less than the current price – according to the research, which has not been peer reviewed.

This price was based on production volumes equal to treating 10 million people.

If the drug was given to people at high risk of contracting HIV, it could “basically shut down HIV transmission,” Hill emphasised. “We could actually control the epidemic.” There were 1.3 million new HIV infections last year, while 39 million people are living with the virus, according to the World Health Organization (WHO).

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Advocates Spotlight

WACI Health's youth leadership and advocacy program recently onboarded a new cohort of mentees. This program aims at creating a cadre of high quality and impact youth advocates. Our current cohort has young people from different African countries who meet online twice a week for mentorship. The program involves regularly bringing in mentors and experts to speak on and share their experiences. Meet Mariah Akinyi who is an HIV prevention advocate based in Kenya.

Mariah Akinyi is a Sexual and Reproductive Health advocate who works in the rural and urban community of Kenya. She is passionate about gender justice and holistically advocates for an intersectional and inclusive approach to the realization of these rights. She believes everyone has a right to their reproductive freedom thus wanting online space where adolescents’ reproductive rights are respected and protected while allowing them to interact freely from stigma, bullying and discrimination. She managed to run a successful campaign that promoted safe sex, HIV awareness, testing and counselling and VCAT training that involved using communication to influence and achieve Behaviour Change and Communication techniques (BCC) in her community. She believes in changing one life at a time.