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Is there hope for an AIDS vaccine in our lifetime?
Publish Date: May 14, 2010
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By Hilary Bainemigisha
Today, 7,500 people will get infected by HIV, the virus that leads to AIDS, which has no cure. Over 300 of these will be Ugandans. That is, on average, around 13 people per hour.

Eight of these will most likely be women. These calculations are based on the 2010 statistics from Uganda AIDS Commission survey.

According to the data, of the 301 unfortunate citizens, only 178 people have a realistic chance of receiving free HIV drugs (ARVs), if the current situation remains as is. But all indicators show the situation is deteriorating.

Losing the battle
For every two people put on ARVs, five others get infected with HIV. And according to the Medicins San Frontiers’ report, many people living with HIV and on treatment are routinely turned away at major clinics because there are no drugs. Treatment programmes in many African countries are not enrolling more people on ARVs.

It could be the global recession, the change of focus to cheaper diseases which are killing more people, or donor fatigue. Whatever it is, Uganda will not manage the increasing HIV burden if the rates of infection are not curbed.

According to the head of the Uganda AIDS Commission, Dr. Kihumuro Apuuli, it is impossible to be effective mopping the floor if the tap is not switched off. Apuuli says there is need for an effective preventive technology to close the tap.

Stopping HIV
Dr. Patrick Ndase, Africa’s Regional physician in international clinical research on HIV, said infection can be stopped at three different spots. Before exposure, at the point of transmission and after infection.

Before exposure: HIV can be stopped using education and behavioural change, male circumcision, preventive vaccines and PrEP (pre-exposure prophylaxis) – taking ARVs before a sexual encounter.

Vaccines and PrEP are still being investigated. The science is impressive on paper and in animals. Trials to prove if PrEP and vaccines work in humans are going on in Uganda and other countries.

Education and behaviour change are being used but their effect is not yet good enough, while male circumcision posted a good 60% risk reduction rate. Swaziland, Kenya, Rwanda, Zimbabwe and South Africa have rolled it out to the public either on a large scale or pilot level.

Uganda is still dragging its feet in policy formulation as HIV infections continue to pile up Point of transmission: Ndase says condoms, prevention of mother to child transmission (PMTCT), post exposure prophylaxis and microbicides can be used.

Condoms must be used consistently and correctly but not everyone is following the advice, PMTCT programmes are challenged by lack drugs and medical personnel. Post exposure prophylaxis is limited to medical personnel at major hospitals but is still not readily available.

Microbicides, a gel that is inserted in the vagina or anus to kill bacteria and viruses on contact, are still on trial in Uganda and other countries.

After infection: Ndase mentioned ARVs, positive living and therapeutic vaccines. Uganda and most African countries have failed to put many people who need treatment and cannot afford it, on ARVs.

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