Last week a study published in The Lancet highlighted the astonishing progress that has been made through the use antiretroviral therapy (ART) to address HIV: young people on the latest drugs now have near-normal life expectancy and are projected to live ten years longer than those who first used ART in 1996.
While some may consider research and development a dry topic, this study clearly illustrates its importance to improving health outcomes. Newer drugs have fewer side effects and appear better at preventing the virus replicating, allowing people to live fuller, longer lives.
Nevertheless, AIDS remains one of the leading infectious killers in the world – second only to tuberculosis – and starting treatment for HIV early is crucial to achieving a long and healthy life. The simple truth is that of the 36 million people living with HIV, only 18 million are on treatment.
This is of particular concern in developing countries, where access to treatment can be limited; nearly two-thirds of all AIDS-related deaths and new HIV infections occur in sub-Saharan Africa. Women and girls, young people and other vulnerable groups such as men who have sex with men, sex workers and transgender people are hit hardest. These key populations often face social, cultural and economic barriers to accessing treatment.
Notwithstanding advances in treatment, the number of new HIV infections remains stubbornly high. There are still 1.9 million new infections every year and progress in reducing new infections has stalled for the last five years.
This is timely as today marks HIV Vaccine Awareness Day. There are, of course, an abundance of days to mark different issues and occasions. Today, however, is a crucial and sombre reminder that there is so much more to do.
No infectious epidemic has been ended without a vaccine and the development of preventive HIV vaccines appears to offer the best chance of bringing a sustainable end to the HIV epidemic. Indeed, modeling data from IAVI, AVAC and Avenir Health shows that a vaccine is needed to deliver a comprehensive end to the HIV epidemic.
While the need for a vaccine has been noted, there have been concerns about the apparent deprioritization of HIV and AIDS within the global health agenda. Moreover, developing the necessary tools to end the epidemic is not a short process – scientists have been working on HIV vaccines for over 30 years - and this process certainly doesn’t fit within political cycles. This, however, is a reason for resolve not retreat.
Universities and institutions across the world and in the UK (including Imperial College and Oxford) have developed expertise on HIV vaccines at the same time as engaging communities most affected, particularly in developing countries where they have also built local research capacity.
This expertise has achieved some remarkable results in recent years; with new vaccine concepts getting ready for clinical testing, with some about to enter late-stage studies and further promising new approaches in earlier stages. There may be new challenges, but we cannot turn our backs when 1.1 million people continue to die each year.
Last week’s Lancet study reaffirmed the potential of research and development: life chances for people living with HIV have been improved; but detection, prevention and access remain as obstacles to securing a sustainable end to the HIV epidemic. Standing steadfast with vaccine research and development must be a key component of reaching that goal. Our response to HIV and AIDS must be comprehensive and for that we need the right tools.