HIV prevention research under spotlight

The audio is in isiZulu. See the English summary below.

MABUTHO: Ungqongqoshe wezempilo kuzwelonke, uDr Manto Tshabala-Msimang uthi sesifikile isikhathi sokuthi kelufakelwe izibuko udaba lokuhlolwa kwamakhambi ahlolelwa ukuvikela igciwane le HIV kuleli. Lesisitatimende sika Tshabalala-Msimang sifika esikhathini esifushane lapho kusanda kumiswa amakhambi ahlukene abehlolelwa ukuvikela igciwane le HIV ngenxa yesizathu sokwehluleka ukuvikela leligciwane. Okunye okukhombisa ukubayinkinga ukuthi sekubonakele ukuthi amanye alawamakhambi aholele ekutheneni labo ahlolwa kubona babe semathubeni okuthola igciwane le HIV. UTshabalala-Msimang uthi ososayensi abahlola lamakhambi kuzomele baqinise ukuphepha kwalamakhambi kubantu ahlolwa kubona. Lokhu kuphepha kungabakhona uma kukhuphulwa izinga lolwazi olunikezwa abantu abangenela ukuphenywa kwalamakhambi.

DR MANTO TSHABALALA-MSIMANG: Many participants, particularly women from disadvantaged backgrounds seroconverted into HIV while they were participating in these trials… What is of concern to us is not just the failure of these studies, but it’€™s the citizens of this country who participate in such trials and the subsequent implications. Are the participants in these trials made to fully understand what the participation means? I have a report from KwaHlabisa which indicates otherwise. Are they fully aware of the negative and the positive consequences of such participation? There is a need’€¦ to respond to HIV infection without putting more lives at risk.

MABUTHO: Ngonyaka owedlule kuye kwamiswa ukuhlolwa kwekhambi elingumjovo, iHVTN 503, ebelihlolelwa ukuvikela igciwane le HIV kuleli kanye nasemazweni angaphandle emva kokuba kuvele ukuthi alikwazi ukuvikela iHIV. Ngonyaka ka 2006 kwamiswa ukuhlolwa kwekhambi iCellulose-sulphate microbicide,  okuwuketshezi olugcotshwa esithweni sangasese sowesifazane, nalo elabe lihlolelwa ukuvikela igciwane le HIV. Lokhu kwaba  semva kokubaphezulu kwezibalo zabathola igciwane le HIV kulabo elalihlolwa kubona. Ngonyaka ka 2000 kwamiswa ukuhlolwa kolunye uketshezi olwaziwa nge Nonoxynol-9 emva kokuba abesifazane olwaluhlolwa kubona kwabonakala ukuthi nabo basemathubeni amakhulu okuthola igciwane le HIV. UTshabalala-Msimang uthi okubakhathaza kakhulu ukuthi ingabe lababantu ababa yingxenye yokuhlolwa kwalamakhambi bayachazelwa yini ngobuhle nobubi bokuba ingxenye yokuhlolwa kwalamakhambi. UProf. Glenda Gray ungumqondisi wesikhungo esicwaninga amakhambi egciwane le HIV iPeri-natal HIV Research Unit (PHRU), yasenyuvesi iWits. Uthi uyahambisana no Tshabalala-Msimang ukuthi kuqiniswe ezokuphepha uma kuqhutshekwa nokuhlolwa kwalamakhambi kubantu. Kodwa uthi ukuhlolwa kwalamakhambi, anjengemijovo, kumele kuqhubeke ukuze kuzosizakala izizukulwane ezizayo. Uthi kuzobayingozi enkulu kakhulu uma lemizamo ingaqhubeki.

GLENDA GRAY: I do agree with the Minister of Health that if we are to go ahead with future human clinical trials we have to optimize safety’€¦ But to stop an HIV vaccine program will be very devastating for the future generations of Africans and of everybody who are heavily burdened by HIV.

MABUTHO: Ingaphezulu kwamashumi amabili iminyaka latholakala igciwane le HIV emhlabeni. Kanti yonke imizamo esenziwe yokuthola ikhambi lokuvikela igciwane isalokhu yehluleka. Kwesinye isikhathi lemizamo ishiya imibuzo kwabaningi njengoba ibuye ibeke engcupheni izimpilo zabantu lamakhambi asuke ehlolwa kubona. UProf. Lynn Morris oyinhloko yophiko olubhekele igciwane le HIV kwisikhungo seNational Institute for Communicable Diseases (NICD), eGoli, uthi kufuneka kwazeke ukuthi kuthatha isikhathi eside ukuthola ikhambi lanoma isiphi isifo. Uthi isibonelo salokhu akhuluma ngakho ikhambi lesifo iPolio athi kuthathe iminyaka engu 47 ngaphambi kokuba litholakale. Uthi abacwaningi balo lelikhambi bake babhekana nobunzima obufanayo nalobu ababhekene nabo bokuthi kuthiwe abame ukulihlola ngenxa yobungozi obungadeleka ebantwini. Uthi ukuba akuqhutshekwanga nokuba lihlolwe ngabe nanamuhla alikho ikhambi lalesisifo.

PROF .LYNN MORRIS: It is very important to see HIV development in the broader context of vaccine development… It took 47 years from the time of identifying polio to actual making a vaccine… And along the way there were also these stumbling blocks like we are facing now with HIV. In fact, there were two trials where people became infected with polio.   They were called to stop the polio vaccine program. Of course it did n’€™t. Thanks goodness it didn’€™t, because if it did, we would n’€™t have a polio vaccine today.

 MABUTHO: Kunokuvumelana ukuthi kunesidingo sokuthi kuqhutshekwe kuhlolwe amakhambi okuvikela igciwane le HIV. Kodwa okuyikhona okuhlalukayo ukuthi abacwaningi balamakhambi kumele benzengcono ezokuphepha. Lokhu bangakwenza ngoku khuphula imfundiso kulabo abasetshenziswa ukuhlolwa kwalamakhambi ngobungozi obukhona kanye nokuthi bangazivikela kanjani ukuthi bangatholi igciwane le HIV.

English summary.

HIV prevention research under spotlight

The failure of several clinical trials to find an effective HIV prevention mechanism has prompted the Minister of Health, Dr Manto Tshabalala-Msimang, to call for a review of research trials. Speaking at a meeting with HIV researchers, Tshabalala-Msimang   raised concern over the risks involved in participating in the trials.

‘€œMany participants, particularly women from disadvantaged backgrounds seroconverted into HIV while they were participating in these trials… What is of concern to us is not just the failure of these studies, but it’€™s the citizens of this country who participate in such trials and the subsequent implications. Are the participants in these trials made to fully understand what the participation means? I have a report from KwaHlabisa which indicates otherwise. Are they fully aware of the negative and the positive consequences of such participation? There is a need’€¦ to respond to HIV infection without putting more lives at risk,’€ Tshabalala-Msimang said in her opening address to the meeting.

Over the last few years, the scientific research front has experienced failure after failure of efforts to find effective measures to prevent HIV infection. The HVTN 503/Phambili vaccine trial was prematurely aborted last year because interim results indicated that the vaccine would not be effective in preventing HIV infection. In 2006, a cellulose-sulphate based microbicide clinical trial  was also stopped after it was discovered that participants using the gel had an increased risk of HIV infection. Prior to that another microbicide, Nonoxynol-9, was also stopped for the same reason years back, in 2000. Professor Glenda Gray, Director of the Peri-natal HIV Research Unit (PHRU) at of the Witwatersrand University, agreed with Tshabalala-Msimang that the issue of safety aspect of clinical trials should be increased. But she argued that there is no need to stop scientists from carrying out trials aimed at finding preventative tools, such as a vaccine, against HIV infection.

‘€œI do agree with the Minister of Health that if we are to go ahead with future human clinical trials we have to optimize safety’€¦ But to stop an HIV vaccine program will be very devastating for the future generations of Africans and of everybody who are heavily burdened by HIV,’€ said Gray.

It is more than 20 years since HIV was first discovered. But attempts to find an effective prevention method against the virus have largely failed. Professor Lynn Morris, head of the HIV Unit  at the National Institute for Communicable Diseases (NICD) also supports the call  for the continuation of vaccine clinical trials. She said getting an effective vaccine can take several years, citing the polio vaccine as an example.

‘€œIt is very important to see HIV development in the broader context of vaccine development… It took 47 years from the time of identifying polio to actually finding a vaccine… And along the way there were also these stumbling blocks like we are facing now with HIV. In fact, there were two trials where people became infected with polio.   They (scientists) were called to stop the polio vaccine program. Of course it did n’€™t (stop). Thank goodness it didn’€™t, because if it did, we would n’€™t have a polio vaccine today,’€ she said.

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