Today, May 18 is HIV Vaccine Awareness Day, a day when the world celebrates the people, partnerships and science pushing ever closer to a safe, efficacious and accessible vaccine against HIV. 

What would you want the public to be aware of on this HIV Vaccine awareness day?

My personal wish is that they should know that HIV is still with us. And that there is no approved vaccine against it yet. But that there is an active fight going on and the struggle to get the vaccine has never been pessimistic. Vaccines are one way of containing pandemics. HIV now has treatments but the ARVs are expensive and lifelong. An HIV vaccine, when it comes, will be a good way to achieve the end of AIDS where there is 0 infections and 0 deaths. Researchers are not yet successful but every step takes us closer. UVRI has a mandate to continue trying to find the vaccine, while working with communities. We have had a good partnership so far and good things will certainly come from such a partnership.

This partnership you are talking about; as researchers, you bring skills, effort, time and lobby for funds; what do you expect from the community?

No research can succeed without the community. So, our community is already involved. We recognise the central role of the community in research and, for us, it is the people of Wakiso district. The community allows the researchers to interact with its members as stakeholders. We are committed to this partnership and to offer any information and service needed. We are hoping that the community stays as willing and welcome as they have been.

We depend on the community for interaction and feedback. From these we get to know their challenges, fears, knowledge and skills so that we plan effective interventions. We depend on the community for volunteers in research. For this, we pledge safety, willingness, openness and truth where HIV vaccine research is concerned.

There is an argument that for you to test your candidates effectively, you depend on the community’s promiscuity and risky behaviour.

That is an unfair assessment. Community risk behaviour is not our intention at all. Infact it is one of our mandates to fight it. One of our core engines is to achieve less and less HIV infections through prevention. Just because research looks for people who are at high risk of HIV infection, doesn’t mean we want them to be there. We look for high-risk individuals in order to protect them. Even in our informed consent forms, we explain how we have structured our prevention. Participants, who agree to join us as volunteers in research, are given low risk counselling, prevention information and tools. At every visit, risk reduction counselling is done. Participants are given counselling against multiple partners, drugs and other self-protection skills. For example, we offer condoms to everyone at every visit. We even intervene in alcohol dependency situations because alcohol increases risky behaviour. But humans remain autonomous with the way they decide to run their lives. They can still succumb to social pressures against our advice. But, that said, I can tell you that research sites have achieved behavioural changes in society. We have seen reduced risky behaviour, seen people get stable partners and a general improvement of HIV prevention knowledge.

We have seen the fast tracking in COVID 19 vaccines, which are already approved and in use while the HIV vaccine research is still trudging along before the finish line. Is that because HIV is no longer a problem to the rich countries?

My personal opinion is that it is not necessarily true. HIV is more stubborn and complex. I can say, it is cleverer than the coronavirus. It keeps mutating and changing. We have types 1, 2, 3 … and so no and even within these types, there are subtypes A, B, C, … and so on. Coronavirus also has variants but the ones of HIV bring new complex equations in the fight. This is why it has delayed the discovery of an effective vaccine. As you cover one entry point, you discover another. There are many hiding places for HIV. You have to be on top of the game all the time, which is not yet possible in the HIV vaccine research. That said, I am happy that research has come a long way and unearthed many new revelations about HIV. We have produced ARVs, made them better and even got an injectable version.

These ARVs have reduced the scare of AIDS as a life terminator, which may tempt people to stop considering HIV as an emergency.

The COVID 19 pandemic also engulfed every country in such a short time provoking international response that had to be aggressive. It was a kind of uprising to contain an international threat. We are still lobbying for funds for HIV vaccine research but the Coronavirus fight gets the money easily. Therefore, as the theme of the day suggests, we can’t afford to lose sight of HIV amidst the coronavirus pandemic.

Is there any hope for a vaccine soon?

There is hope. Hope has always been there. At UVRI, we are always optimistic. Even when a study doesn’t yield a vaccine, it gives us a lot of new information on which to build the next study. And we are ready for more studies. All we pray for is continued community support.

Today’s commemorations hails people who have been icons in the HIV vaccine research. For you, who are your heroes?

I won’t name names. But my heroes are, first and foremost, the community, whose members have received this research, supported us with volunteers and participants. The next heroes are the sponsors who keep investing their money in vaccine research in spite of its delayed production of a successful candidate. The third category of heroes are the researchers who never give up.

Anything you would like to add before we close?

I would like to hail Ugandans who have been there in this HIV vaccine research for a long time. We have provided new knowledge for the world about the HIV and the way it works, we have a lot of heroic participants who volunteered to work with researchers, when many of them were actually HIV negative. I pray that the HIV vaccine comes in our lifetime so that we celebrate our success together.