Now that Africa is turning the tide on HIV/AIDS, with most new HIV infections occurring outside the continent, the hunt is on for a cure, says Professor Thumbi Ndung’u, international HIV/AIDS expert and Director of Basic and Translational Sciences at the African Health Research Institute (AHRI) in KwaZulu-Natal.
World AIDS Day has been observed annually on December 1 since 1988, to remind society of the need for global solidarity in the ongoing fight against HIV/AIDS.
“We have made enormous progress. There are very effective HIV prevention and treatment methods, but almost 40 million people worldwide are living with HIV and it’s not easy. Most of these people live in Africa. We need new solutions,” says Ndung’u.
One of these new solutions is a vaccine against HIV, the other a cure. These new approaches to the pandemic show that while antiretroviral drugs (ARVs) have been extremely effective in preventing person-to-person transmission of HIV and prolonging the lives of HIV-positive people, their long-term use is burdensome and costly. People living with HIV, even when on antiretroviral therapy, also tend to have a higher incidence of comorbidities such as metabolic disorders and cancer compared to people without HIV infection.
In South Africa, ARV therapy has been provided free of charge by the public health system since 2004. ARV treatment is the main factor behind UNAIDS’ estimate that the number of new HIV infections in South Africa has declined by 50% between 2010 and 2021.
Globally, new HIV infections have declined by 60% since their peak in 1995, according to UNAIDS, and Ndung’u says that about 26 million of the nearly 40 million people infected with HIV in the world world live in Africa.
The third United Nations Sustainable Development Goal (SDG), which aims to achieve good health and well-being worldwide by 2030, aims to end the HIV/AIDS pandemic by that same year. This goal will be achieved if the number of new HIV infections and AIDS-related deaths declines by 90% between 2010 and 2030. The SDGs are a set of 17 goals which, if achieved, aim to ensure “peace and prosperity for people and the planet.”
According to Ndung’u, researchers are seeking a cure for HIV that could help eradicate AIDS and control the spread of the virus. However, decades of research into a vaccine against the virus have shown that finding immune solutions against the virus is not simple.
“We used to say that a vaccine was close to being developed,” he says. But it is difficult to predict when we will be able to develop one. That said, 30 years ago many would have been skeptical about the effectiveness of our medications. »
It is also difficult to find a cure. Only seven people worldwide have been cured of HIV, all after receiving a bone marrow transplant after developing cancer. But bone marrow transplantation is a radical, expensive and often dangerous procedure.
Ndung’u is participating in a treatment trial involving young women in KwaZulu-Natal, one of the populations most vulnerable to HIV infection in South Africa.
The study is ongoing, but Ndung’u is hopeful. As part of this study, AHRI is treating women with ARVs very early after contracting the HIV virus. This measure preserves their immune system. Women then receive powerful immune-boosting interventions that can directly kill HIV and wake up immune cells where the virus is hiding when the person takes antiretroviral drugs.
“We hope that this strategy will allow long-term control of the virus in the absence of ARVs and that we will also be able to better understand the mechanisms that can control the virus in study participants without antiretroviral treatment. This would be an important breakthrough and, in time, could lead us to a cure,” says Ndung’u.
It is essential that HIV/AIDS research continues in Africa because, although the incidence of HIV infection is declining, the situation could change at any time, says Ndung’u. To achieve the Sustainable Development Goal on HIV/AIDS, Africa must significantly reduce its infection rate.
Also in Africa, HIV is a disease that primarily affects young women, while in regions where HIV infection is on the rise – Asia, Latin America and Eastern Europe – infection most often affects men.
“We must continue to research, otherwise we will never make discoveries. Research gives us a chance,” he says.
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