Walking The Journey of Hope


Dr. Fatima Laher- PHRU, Durban, South Africa with contributions from the HVTN 702 Protocol Team

Uhambo Logo

Uhambo means journey, and this is the name being used for the journey of hope toward an HIV vaccine to prevent HIV in sub-Saharan Africa. There were 270,000 new HIV infections in 2016 in South Africa alone (UNAIDS, 2017). Uhambo’s journey is a series of research studies that will hopefully lead the region toward the safe and effective HIV vaccine that is so desperately needed.

The journey so far

Communities are engaged at grass-roots level in the streets of Kliptown.
Communities are engaged at grass-roots level in the streets of Kliptown.
  • 2009: The ancestor to our journey is the “Thai trial”, a study done in Thailand which showed that a combination of two experimental vaccines, named ALVAC + AIDSVAX B/E, was safe and could prevent people from getting HIV. It was the first time a study showed that vaccines to prevent people getting HIV are possible. It also showed that the vaccines had to be improved for more lasting immune responses and protection.
     
A presentation on Uhambo at a clinic Open Day in Durban by Community Liaison Officer Jason Naidoo of the eThekwini CRS.
A presentation on Uhambo at a clinic Open Day in Durban by Community Liaison Officer Jason Naidoo of the eThekwini CRS.
  • 2013: The journey moved to South Africa, where a small study called “HVTN 097” showed that the same vaccines that had been used in the Thai trial were also safe in South Africans. South Africans even had slightly better immune responses to the vaccines.
A community member, Phindile Mbolekwa, performs the ceremonial ribbon cutting with Dr. Neide Cossa at the opening of the Uhambo clinic at the Soweto-Bara site.
A community member, Phindile Mbolekwa, performs the ceremonial ribbon cutting with Dr. Neide Cossa at the opening of the Uhambo clinic at the Soweto-Bara site.
  • 2015: The vaccines were adapted for the southern African region. A study called HVTN 100 first used these adapted vaccines, and showed good safety and immune responses in South Africans. HVTN 100 also showed that giving a booster can extend how long the immune responses to vaccines last.
  • 2015: The vaccines were adapted for the southern African region. A study called HVTN 100 first used these adapted vaccines, and showed good safety and immune responses in South Africans. HVTN 100 also showed that giving a booster can extend how long the immune responses to vaccines last.
  • 2016: In October 2016, South Africa took another bold step forward in the journey of hope toward an HIV vaccine with HVTN 702. In this historic study, the adapted vaccines are now being tested in 5,400 participants across the country to find out if the vaccines are effective. In other words, the big question of HVTN 702 is: do these vaccines have the ability to prevent people from getting HIV? If the vaccines are successful, then in years to come the HVTN 702 results will be submitted to the South African Medicines Control Council to apply for registration in the country. It is possible this could lead to the first ever licensed preventive HIV vaccine regimen.

  • There are also other smaller studies that are happening in the southern African region that form part of our journey toward an HIV vaccine. Studies like HVTN 107, HVTN 108, HVTN 111, HVTN 120, and HVTN 126 will give us very important information about how to make the vaccines even better. These smaller studies ask questions about the effect of different adjuvants and about whether a DNA vaccine could have a role to play. 
Uhambo

A study that has been widely covered in the news, on television, in newspapers, on the radio, online and at community events is HVTN 702. This study tests a combination of two experimental vaccines aimed at trying to prevent people from getting HIV. One vaccine is a protein vaccine; the other is a vaccine made with a pox virus carrier. Neither of the vaccines use the real HIV virus, and the trial never exposes participants to HIV. 

Healthy women and men between 18 and 35 years of age who do not have HIV can be screened to see if they are eligible to join HVTN 702. A person must be willing to undergo medical check-ups and regular HIV counseling and testing in the study. Women cannot be pregnant or breastfeeding. There are also other criteria that must be met in order for a person to be eligible to join the study. 

The study opened in October 2016, is planned to enroll for at least 18 months, and is following up each participant’s health for 3 years. Throughout the study, participants are provided with regular risk reduction counselling and access to other approved HIV prevention methods.

Communities have been engaging with local researchers since the first HIV vaccine study in South Africa, and continue to be active. Prevention methods are for communities. Study participants and research staff are part of communities with the singular goal of improving health through vaccine research. Community stakeholders continue to engage with the research development and implementation process, ensuring research ties in with our South African community preferences, needs, customs, traditions, and beliefs.

We asked study staff to tell us their favorite things about working on the HVTN 702 study so far:

  • It’s a pivotal study that is aiming to find a safe and effective vaccine that will protect people from HIV – Counsellor, CAPRISA site
  • It unites us in the fight against HIV – Pontso Seithlamo, Kliptown site
  • The study includes women, heterosexual men and men who have sex with men, hence no-one is excluded in having an opportunity to participate and make their contribution toward finding a great HIV prevention method – Staffer, CAPRISA site
  • The potential to stop new HIV infections – Kingsley Nukeri, Kliptown site
  • The vaccines could be submitted for licensure in our country! – Bontle Modibedi, Soweto-Bara trial site. (Sr. Bontle is the first ever nurse to administer these vaccines.)

The journey continues – online…

*Dr. Fatima Laher is the Principal Investigator and Director of the PHRU Vaccines Research CRS in Durban, South Africa and is Co-Chair for the Uhambo Study.