IAVI began working in Rwanda in 2003, when it launched a partnership with Projet San Francisco (PSF), in Kigali, to conduct research related to the development of AIDS vaccines. IAVI and PSF established a clinical research center to support clinical trials and epidemiology studies.
 

Together, we conduct early stage clinical trials of candidate AIDS vaccines and epidemiology studies to prepare the ground for future, large-scale vaccine trials. We also support existing efforts to reach out to communities and civil society, and to cultivate political support for AIDS vaccine research.

We work with the following institutions in Rwanda:

• Clinical Research Center (IAVI-PSF CRC): PSF conducts HIV-related research and provides clinical care and counseling to people infected with HIV. Its research team pioneered couples’ voluntary counseling and testing (CVCT). CRC harnesses these assets to conduct HIV epidemiology studies that are crucial to the design of large scale vaccine trials. The center is home to one of the largest and longest running discordant couple (in which one partner is HIV positive, while the other is not) cohort studies in Africa. In November, 2005, in collaboration with IAVI, the United States National Institutes of Health and KAVI, the research center enrolled 57 volunteers in Rwanda’s first AIDS vaccine trial 

In 2005, along with research centers in Kenya, Uganda and Zambia, PSF participated in a study to examine the medical criteria for including African volunteers in AIDS vaccine trials. Before the results of this study were released, researchers had generally relied on laboratory reference ranges that, developed for Western populations, were not locally applicable.

BUILDING TECHNICAL CAPACITY

IAVI stresses the development of technical capacity in countries where it conducts vaccine trials, financing the construction of state-of-the-art laboratories and clinics, and supporting the training of local technicians and scientists. To ensure that the vaccine trials in which we participate are conducted at the highest scientific and ethical standards, we have overseen the training of researchers at CRC in Good Clinical Practice and Good Clinical Laboratory Practice (GCLP).

We also fund screening for HIV, sexually transmitted infections, and pregnancy at three of PSF’s community-based referral points in Kigali.

IAVI and PSF have also worked together to support infrastructure improvements at the Central Hospital Kigali and at the Gitega Health Center. 
 

In 2004, IAVI began providing support for the ongoing recruitment and follow-up of HIV discordant couples to estimate the rate of HIV transmission in this population. Data from the study will help in the design of future large-scale vaccine trials, in which discordant couples will be asked to enroll as volunteers. We have also recruited volunteers newly infected with HIV to study the early course of infection.

IAVI has supported the establishment of PSF’s Community Advisory Board (CAB) and helped to train its members. CABs advise researchers on elements of clinical trials design, and keep communication open and clear between researchers and the community at large. IAVI also provides opportunities for members of the CAB to participate in training and exchange programs with CAB representatives from other IAVI- sponsored research centers.

We have, further, supported PSF’s development of a network of local leaders and peer educators who teach their communities about the basics of HIV prevention and AIDS vaccines, and help to generate public interest in volunteering for vaccine trials.
 

REACHING OUT

The AIDS vaccine effort would not be sustainable without the widespread support of communities where clinical trials are conducted. IAVI systematically cultivates that support in the countries in which it operates by:

• Working with PSF to advocate for AIDS vaccines and sustain support for their clinical development in Rwanda

• Sponsoring workshops for journalists in Kigali to encourage accurate and consistent reporting on vaccine efforts in Rwanda

SUSTAINING POLITICAL SUPPORT

High-level political support and sound policy are also essential to the AIDS vaccine effort. IAVI partners with government agencies, policymakers, and researchers to formulate public policies in service of the swift development and future distribution of AIDS vaccines.

IAVI and PSF have won the active support for AIDS vaccine development from the president and first lady of Rwanda, and have been working to engage other political leaders in the effort.

Along with the World Health Organization and the African AIDS Vaccine Program (AAVP), among others, IAVI is playing an active role in updating Rwanda’s National AIDS Vaccine Plan.