According to Dr. Rajat Goyal, the head of the International AIDS Vaccine Initiative’s (IAVI) India operations:
“The 32nd annual World AIDS Day is upon us and it serves as a reminder that while we have achieved great milestones in containing the disease a lot still needs to be done. Millions of the world’s most vulnerable people, families and communities are being left behind: those most affected face societal discrimination and stigma. Even with much better access to and use of existing tools to fight the epidemic, millions more in developing countries are likely to contract HIV in decades to come.
The disease continues to kill millions of people every year. A vaccine is a critical part of any long-term strategy to end the AIDS epidemic. Only then will we make serious inroads against HIV-AIDS, in the way that we successfully conquered polio and smallpox.”
What is the position of HIV-AIDS in India today?
You can easily understand the position of India by having a look at the given figures(Source: UNAIDS 2019)
- 2.1 million of Indians are living with HIV.
- HIV prevalence among adults was 0.2% (estimated).
- 88,000 new HIV infection cases were found.
- 56% of adults on antiretroviral treatment.
- 69,000 AIDS-related deaths(Source: UNAIDS 2018).
Why is an AIDS Vaccine important?
Vaccines are a powerful public health tool and have proven to be the world’s most effective and cost-effective preventive mechanism
- A 70% effective AIDS vaccine could reduce new infections by 40% in its first 10 years and 50% in its first 25 years.
- Globally, about 36.9 million people reported to be living with AIDS, in the year 2014. (Source: UNAIDS).
How is India positioned as part of global efforts to discover a vaccine?
- India’s strength lies in its rich pool of scientists and healthcare professionals who are globally competitive, competitive scientific infrastructure and a thriving bio pharma industry. Additionally, the Government of India is committed to this critically important cause.
Why is the making of a vaccine so challenging?
- HIV is a complex pathogen
- Part of what makes HIV such a difficult virus to combat is its ability to furiously mutate the trimeric envelope protein on its outer surface. This high mutation rate gives rise to multiple HIV subtypes that circulate around the globe, allowing the virus to escape the responses that human immune systems mount against it.
- That the virus could mutate and regain its pathogenicity has rendered approaches like using attenuated versions of the pathogens to immunize people or using a killed or inactivated virus adopted for making other vaccines like measles, polio and influenza, unsuccessful thus far. Scientists are learning to be as wily as the virus to discover new ways to combat it.
- There are other challenges unique to HIV. Quickly following transmission, the virus disseminates and establishes a persistent infection, including hidden reservoirs from which it can strike again at any time. The opportunity for a vaccine-induced response to prevent infection or to control the initial, limited infection is thus short-lived.
- Scientists still don’t understand how to elicit specific, durable, and protective immune responses against HIV.
Where are we today on the road to a viable AIDS Vaccine for humans?
Progress during the past five years is spurring creative and promising new approaches. Scientists have isolated and closely analyzed dozens of exceptionally potent antibodies that neutralize a broad spectrum of HIV variants circulating around the world.
In addition, several preclinical studies of novel vectors for HIV vaccine have produced promising results, far exceeding the performance in similar studies of candidates that are today in clinical trials.
Breakthrough discoveries are leading to more refined and targeted vaccine designs
Some scientists are making significant progress by employing reverse-engineering or structure-assisted vaccine discovery. This new approach starts with isolating broadly neutralizing antibodies from chronically infected HIV patients whose immune systems produce them.
Even the clinical trials with disappointing results are and will continue to be important. The lessons learned in HIV vaccine research are also helping to fight flu, malaria, cancer, Ebola
Another major advance has been the scientists’ ability to obtain an atomic-level image of the HIV envelope trimer, the principal target for broadly neutralizing antibodies
Collectively, these efforts are paving the way for nontraditional immunoprophylaxis that can protect against HIV infection without depending on the lengthy and complex antibody maturation process required to generate broadly neutralizing antibodies through immunization.
Source: IAVI; photo courtesy flickr.com/bastique
The International AIDS Vaccine Initiative (known as IAVI) is a global not-for-profit, public-private partnership working to accelerate the development of vaccines to prevent HIV infection and AIDS. IAVI’s work is centered around the needs of those regions and populations most in need of an AIDS vaccine. With more than 15 years of in-country experience, IAVI partners to expand the R&D capacity and leadership in India as well as Africa region.
IAVI continues to conduct and facilitate training, mentoring, knowledge sharing and technology transfer within regions and across regions globally. IAVI pioneered the Public-Private Product Development Partnership (PDP) model that brings together researchers from academia, the private sector, and government with the common goal of advancing the best vaccine candidates down the research and development pipeline.
Global HIV & AIDS statistics for 2019 (Source: UNAIDS 2019)
Global HIV Statistics
- 24.5 million [21.6 million–25.5 million] people were accessing antiretroviral therapy (end of June 2019).
- 37.9 million [32.7 million–44.0 million] people globally were living with HIV (end 2018).
- 1.7 million [1.4 million–2.3 million] people became newly infected with HIV (end 2018).
- 770 000 [570 000–1.1 million] people died from AIDS-related illnesses (end 2018).
- 74.9 million [58.3 million–98.1 million] people have become infected with HIV since the start of the epidemic (end 2018).
- 32.0 million [23.6 million–43.8 million] people have died from AIDS-related illnesses since the start of the epidemic (end 2018).
People Living With HIV
- In 2018, there were 37.9 million [32.7 million–44.0 million] people living with HIV.
- 36.2 million [31.3 million–42.0 million] adults.
- 1.7 million [1.3 million–2.2 million] children (<15 years).
- 79% [67–92%] of all people living with HIV knew their HIV status.
- About 8.1 million people did not know that they were living with HIV.
- retroviral medicines to prevent transmission of HIV to their child in 2018.
New HIV Infections
- New HIV infections have been reduced by 40% since the peak in 1997. In 2018, around 1.7 million [1.4 million–2.3 million] were newly infected with HIV, compared to 2.9 million [2.3 million–3.8 million] in 1997.
- Since 2010, new HIV infections have declined by an estimated 16%, from 2.1 million [1.6 million–2.7 million] to 1.7 million [1.4 million–2.3 million] in 2018.
- AIDS-related deaths have been reduced by more than 56% since the peak in 2004. In 2018, around 770 000 [570 000–1.1 million] people died from AIDS-related illnesses worldwide, compared to 1.7 million [1.3 million–2.4 million] in 2004 and 1.2 million [860 000–1.6 million] in 2010.
Women Suffering From HIV-AIDS
- Every week, around 6000 young women aged 15–24 years become infected with HIV. In sub-Saharan Africa, four in five new infections among adolescents aged 15–19 years are in girls. Young women aged 15–24 years are twice as likely to be living with HIV than men.
Also, read about: Most Common Sexually Transmitted Diseases in India