The South African Aids Vaccine Initiative has received another crippling blow: two government bodies have failed to provide promised funding since early last year.
The Sunday Times reported last week that cash-strapped Eskom had withdrawn R15-million of funding for the flagship project.
It has now emerged that the Department of Science and Technology, which has been supporting the research work to the tune of R15-million a year, has agreed to pay its 2007/08 commitments only up to the end of September last year, leaving a shortfall.
In addition, the department has refused to commit itself to future funding until there is a restructuring of the vaccine project, which falls under the management of the Medical Research Council.
This means the initiative is about to enter a new financial year — starting on Tuesday — with just R10-million of committed funds. This comes from the Health Department, which has also agreed to pay its commitments for the current financial year.
In total this year the initiative will disburse about R39-million, but three-quarters of this is in the form of back-payments.
Acting vaccine initiative head Elise Levendal said the science department had at one stage demanded that the project become a public-private partnership. However, this was not feasible.
After accepting this in January, the department refused to make future funding commitments until there had been a one-day workshop with the department of health to discuss the structure and control of the initiative. That meeting has not been held and might not take place for some months.
Meanwhile, the project is having to rein in researchers because of the funding shortfall. Despite its lean annual budget, it has produced two vaccines ready to be injected into human volunteers.
Approval for this first phase human safety trial in the United States and South Africa is still outstanding from the South African regulatory body, the Medicines Control Council. However, the United States Food and Drug Administration has given its approval.
Levendal said the project’s remit goes far beyond supporting laboratory and clinical research to include community involvement, the training of scientists and development of research infrastructure.
South Africa has been at the forefront of HIV vaccine testing and is the only developing country to have such a significant national development strategy.
The initiative has concentrated on the ”clade C” strain of HIV most prevalent in South Africa, rather than ”clade B”, which is most common in the US and has been most widely researched.
Most at risk from the funding shortfall is the basic scientific investigation of the virus and immune responses to it, identified at a high-level summit in the US this week as crucial for a successful vaccine.
The Summit on HIV Vaccine Research and Development in Washington, hosted by the US National Institutes of Health, highlighted the unpleasant truth that after a quarter of a century of research no HIV vaccine is in sight.
As a result, there have been calls for greater basic research into the virus and for the intensification of small-scale human trials as the only reliable method of understanding human immune responses.
Understanding, for example, what makes some people ”elite controllers” — capable of living with HIV for decades without falling ill or requiring antiretroviral therapy — could provide guidelines on which functions of the immune system a vaccine should try to stimulate.
The so-called ”transmitter virus” — the strain of HIV that makes it into a human body — might have unique properties that help it evade the body’s defences and are then discarded once infection is established.
It is widely accepted that a vaccine against HIV is key to stopping the epidemic. Other biomedical prevention efforts are in disarray, with recent news that diaphragms, treatment of herpes and the most advanced microbicides are ineffective in cutting HIV transmission. To date, the only successful intervention has been circumcision.
Glenda Gray, head of the perinatal HIV research unit at the University of the Witwatersrand, reportedly told the Washington summit that ”any call to halt vaccine funding is like abandoning Africa”. Her plea was heard by US researchers — and funders — who said that they would continue supporting the continent.