Our work in South Africa runs the gamut of HIV-related research, communication and advocacy. We have, since 2003, collaborated with our partners in the country to conduct two AIDS vaccine trials. We support epidemiological research and build local capacity for future, large-scale studies of AIDS vaccines. We are also deeply engaged in community outreach, vaccine education and the generation of political support for AIDS vaccine development at every level of society.

In June 2006, we opened a regional office in Johannesburg to coordinate research and other activities across southern Africa. We have also awarded, through IAVI's Innovation Fund, a research grant to the South African biotechnology company Elevation Biotech. Elevation applies its proprietary technology to the design, generation and early evaluation of HIV antigens that, when included in a vaccine, might elicit antibodies capable of neutralizing a wide range of HIV strains.

We collaborate with the following research centers in South Africa:

• Perinatal HIV Research Unit (PHRU): Based at the University of Witwatersrand, at the Chris Hani Baragwanath Hospital, in Soweto, PHRU established its AIDS vaccine division in 2001 with funding from IAVI and the South African AIDS Vaccine Initiative (SAAVI). The unit recently completed its second IAVI-sponsored trial of a candidate AIDS vaccine. PHRU also partners with IAVI on observational studies of HIV transmission in South Africa, helping with the collection of data, and sample storage and monitoring
   
• Desmond Tutu HIV Foundation (DTHF): Based at the University of Cape Town, DTHF’s Vaccine Trials Unit participated in the second IAVI-sponsored vaccine trial conducted in South Africa. IAVI works with DTHF at the Health Center of Uluntu Township on studies focused on HIV epidemiology and the clinical profile of acute HIV infection. The center in the township of Masiphumelele, meanwhile, participates in IAVI’s global effort to identify and study naturally occurring antibodies that neutralize HIV
   
• Aurum Institute for Health Research-Rustenburg (AIHR): IAVI is collaborating with AIHR to identify suitable populations for AIDS vaccine research in the mining town of Rustenburg, in North West Province. We also seek in this collaboration to optimize volunteer recruitment and retention strategies in preparation for upcoming epidemiology studies, and have to that end already completed social mapping of the community. The site has established a community advisory board (CAB), and will build an AIDS vaccine unit. It will also continue community mobilization activities and its efforts to strengthen local HIV prevention and treatment services
   
• Contract Laboratory Services (CLS): Based in Johannesburg, at the University of the Witwatersrand Faculty of Health Sciences, CLS has worked closely with IAVI to get the most out of the work done across its vaccine trials network. Specifically, it has helped to standardize the assays used at each research center to ensure that data generated by each lab is comparable to that generated by every other. It has also helped establish rigorous quality assurance and quality control systems at research centers. This is vital to ensuring that data from all sites can be pooled to create a safety database of a standard and size required for the ultimate regulatory approval any AIDS vaccine developed in the network.

 

BUILDING CAPACITY

Because vaccine development is a long term enterprise, IAVI stresses the cultivation of technical capacity in the countries in which it operates. Where required, we upgrade or construct laboratories and clinical facilities.

We also help to train local technicians and scientists in Good Clinical Practice(GCP) and Good Clinical Laboratory Practice (GCLP), and ensure that voluntary counselling and testing (VCT) services are up to date and consistently of the highest international quality. 

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SUPPORTING TRIALS

IAVI actively establishes effective mechanisms for community participation in the planning and implementation of vaccine trials. We have, to that end, partnered with various organizations in South Africa to educate communities about AIDS vaccines.

We also work with closely with CABs, whose members advise researchers about the needs and concerns of volunteers and the communities from which they are drawn, and play a direct role in the design and conduct of vaccine trials. IAVI, for instance, field-tested its CAB toolkit in South Africa in 2008. The toolkit provides guidance on how to form a CAB, outlines the roles and responsibilities of researchers and CAB members and helps to define—among other things—how a community might best be represented on the board.

We provide support and capacity building to CABs working with researchers at DTHF, AIHR and a rural research center we helped PHRU set up in Agincourt, a community located 500 kilometers from Johannesburg.

We have also collaborated with the SAAVI Social Behavioral Working Group to bring together social scientists, CAB members, and staff from research centers to identify areas for social science research that might enhance community participation in AIDS vaccine trials.

To inform large-scale efficacy trials of candidate AIDS vaccines that might be conducted in South Africa in the future, IAVI is working with AIHR on a number of social science research projects in Rustenburg. These projects are devised to gather a detailed portrait of the social dynamics of communities—in terms of HIV prevention, treatment and care—from which volunteers for such trials might be recruited.

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REACHING OUT

The AIDS vaccine effort would not be sustainable without the widespread support of communities where clinical trials are conducted.

IAVI cultivates and sustains that support in the countries in which it operates. We regularly hold open forum meetings with people interested in or affected by our research and development efforts. We also consult frequently with community leaders and other influential people in the areas around research centers in South Africa, and support accuracy in reporting by providing updated information about AIDS vaccine research and development with media professionals.

IAVI collaborates with NGO partners, such as the Gender AIDS Forum and Positive Women’s Network to integrate vaccine literacy training in their advocacy and educational programs.

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High-level political support and relevant policy are essential to the sustainability of the AIDS vaccine effort.

IAVI generates support in South Africa through the Global Political Advocacy Initiative (GPAI), which advocates for sound public policies to accelerate the development and distribution of AIDS vaccines. GPAI supported, in 2006, the inclusion of AIDS vaccines and microbicides in a Southern African Development Community (SADC) Resolution on Women and Girls and HIV and AIDS at the Commission on the Status of Women.

We also work with the Joaquim Chissano Foundation, established by the former President of Mozambique, to improve government support for AIDS vaccines in the Southern Africa region.

Our efforts in the arena of global advocacy also build on the India-Brazil-South Africa (IBSA) trilateral agreement, a partnership that encourages the three countries to tap, among other things, their growing biomedical and manufacturing capabilities for vaccine development.