Progress made in keeping HIV at bay

by with No Comment Health

While there is still no cure for HIV and Aids since it was first reported in the world, strides have been made in improving the lives of people living with the virus.

According to joint United Nations Programme on HIV/AIDS approximately 1.4 million Kenyans are living with HIV and with efforts to fight the disease, 1.2 million people are on treatment. The World Health Organisation says antiretroviral therapy reduces the viral load in patients to undetectable levels making it hard for them to spread the virus.

Testing and counselling services are now available all over including selftesting in one’s comfort. Jacque Wambui has lived with HIV for 17 years. She has reservations regarding the secret self- test method. Wambui says she’s not sure that would have worked for her when she tested HIV positive. “It took me six hours with the doctor who tested me because I had so many questions. How would self-testing have worked for me then?” she said, adding that on the other hand, when one tests themselves, then it remains strictly confidential.

She was speaking at a Media for Environment, Science, Health and Agriculture (MESHA) science café on HIV prevention, where Professor Kenneth Ngure, a researcher on HIV prevention, shared a raft of products ready for use to prevent HIV infection. All products were discussed at the recent virtual International Aids Conference (IAS 2021) in July.

Professor Ngure said researchers are coming up with a vaginal ring that can hit two birds with one stone by preventing both HIV and pregnancy. The ring are designed to last for three months, making it easier to be accepted by users who may not prefer changing it frequently. He was quick to caution that the ring doesn’t prevent other sexually transmitted transmissions. Professor Ngure also talked about other prevention measures including the oral Pre-exposure prophylaxis (PrEP).

Though findings on the efficacy of HIV prevention commodities are good, governments will be grappling with a number of issues to make the roll out successful in the near future. These include dealing with adherence stigma, barriers of accessibility to health facilities, affordability and ensuring commodities are discreet, especially for users who require consent from their partners/spouses. An example of adherence stigma is avoiding to swallow a pill when with people one may not be comfortable with. Some health facilities may be too far apart and with limited infrastructure.

De-medicalization of the commodities would make it easier for community health workers to deliver them to users at home. Prof Ngure also mentioned integrating commodities with other health services instead of standalone clinics such as the Comprehensive Care Centres will make it easier for people who may not want to be known for the services they are seeking at the health facilities. Researchers are also working reduce the burden of treatment by reducing the frequency of taking medication.

By Ann Mikia

Scientists now testing vaginal ring that can prevent HIV and pregnancy

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Seven months after the World Health Organisation (WHO) approved the dapivirine vaginal ring as a new choice for HIV prevention for women at high risk of infection, researchers are now testing a two-in-one method that can prevent both HIV and pregnancy.

The revelation was made during the 11th IAS Conference on HIV Science, which took place virtually from July 18-21, 2021, by Dr Sharon Hillier of the University of Pittburg. IAS Conference on HIV Science is the world’s most influential meeting on HIV research and its applications.

Presenting the IAS conference updates to journalists during a Mesha science café in Nairobi on August 27, Prof Kenneth Ngure, the Chair, Department of Community Health at Jomo Kenyatta University of Agriculture and Technology (JKUAT), said the new product being tested will be a 90-day dual-purpose vaginal ring, and is being developed by the nonprofit International Partnership for Microbicides (IPM).

According to him, high rates of HIV transmission and unintended pregnancy in some countries spurred the search for prevention methods that could prevent both.

Prof Ngure says the best thing about the ring, which contains dapivirine and levonorgestrel (contraceptive), is that results presented at the conference reported safety and
potential to offer women a discreet and long-acting product to simultaneously meet two major sexual and reproductive health needs, as well as offer greater convenience.

The ring builds on similar technology used for IPM’s monthly dapivirine-only ring, which is the first long-acting, self-initiated, female-only HIV prevention method that has
been shown to safely reduce the risk of HIV infection among sexually active women.

Though the ring currently lasts a month, IPM is also testing one that can last for three months, and results presented by Dr Hillier at the IAS meeting showed it had achieved 3-4 fold higher drug concentrations in the cervix, which could translate to even better HIV protection compared to the monthly ring.

“This milestone marks an important step towards expanding the number of biomedical HIV prevention and contraceptive options available to women. But be ready to wait a little bit longer before the products get to the market because research takes time,” she said.

The dapivirine vaginal ring is similar to Nuvaring, a contraceptive ring that many people are familiar with, which releases hormones to the female reproductive tract to prevent pregnancy. Women can insert the ring themselves and, for a month, it slowly releases dapivirine to protect against HIV infection.

Available information shows that whereas the monthly vaginal ring for HIV prevention only contains 25mg of dapivirine, the dual-purpose ring contains 200mg of dapivirine to allow for its extended release over three months, as well as 320mg of levonorgestrel, a synthetic progestin used in many contraceptives, either alone or in combination with estrogen.

Since the product is still in early-stage development, Ngure says people should expect it in the market in the next few years.

The dapivirine-contraceptive ring is not the only multipurpose prevention technology that is being developed. Other technologies are being developed to prevent unwanted pregnancy and a broad spectrum of STIs. For example, the Population Council is developing a vaginal insert to lower vaginal acidity (pH). This will inactivate sperm and bacteria.
A variant on this product also contains an agent that stops HIV from entering cells.

Altogether, 24 products are in development, most still in pre-clinical laboratory testing, according to the Initiative for Multipurpose Prevention Technologies.

 

By Njeri Murigi

No sufficient protection, findings say of HIV vaccine candidate

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Results from Phase 2B of the Imbokodo Study – carried out to test the efficacy and safety of a HIV vaccine candidate among women in five sub-Saharan African countries – shows that the vaccine candidate does not provide sufficient protection against HIV.

The study was conducted among 2,600 plus women in 23 sites across South Africa, Zambia, Zimbabwe, Mozambique and Malawi among women aged 18- 35 years at risk of acquiring HIV.

Discussing the findings at a Media for Environment, Science, Health and Agriculture (MESHA) briefing, Mitchel Warren, Executive Director of AVAC said that the efficacy of the vaccine was found to be at 25 percent.

“There was some hint that the vaccine was working very partially,” he said, “ but it is not strong enough to warrant the vaccine continuing in this trial because it is not good enough to get it licensed.”

Also known as the HVTN705/HPX2008, the study involved participants getting four different doses over the first 12 months of their participation.

“The first two were called prime, based on a cold virus, Adenovirus26. Then they received further boost- protein booster- to help stimulate the immune system. Half of the women received this combination, while the other half received four shots of a placebo, that didn’t have any active ingredient,” Warren explained, adding that the women were followed for 24 months after the final shot.

The Imbokodo study found that through 24 months of follow up, 63 of 1,109 participants who received placebo compared to 51 of 1,079 participants who received active vaccine acquired HIV.

In addition, it found that despite the low efficacy, the vaccine was safe and there was no adverse event reported.

There is a parallel trial ongoing dubbed the Mosaico trial being carried out on 3,000 men who have sex with men and transgender individuals in Latin America, US and Europe. The study uses a similar regimen with the same Adenovirus26 platform for the prime vaccine, but using a different form of protein boost.

“It is possible the vaccine could work differently because it is a different boost, addressing a different route of HIV transmission (anal route) or because it is in a different part of the world with different circulating HIV,” Warren said.

According to Warren, the Imbokodo study is a stark reminder of the need to develop a HIV vaccine and the need to scale up prevention products that are already at hand such as the condoms, Oral PrEP, injectable PrEP and vaginal ring among others.

“We have to go all in for the prevention products we have. We have to roll them out with urgency so that people can protect themselves today while we reorient the HIV research agenda,” he said.

The HIV vaccine was being developed in a public-private partnership by Johnson and Johnson in collaboration with National Institutes of Health, the Bill & Melinda Gates Foundation, and the HIV Vaccine Trials Network (HVTN) among others.

“HIV is a unique and complex virus that has long posed unprecedented challenges for vaccine development because of its ability to attack, hijack and evade the human immune system,” Paul Stoffels, Managing Director, Vice Chairman of the Executive Committee and Chief Scientific Officer at Johnson & Johnson said in a statement
during the release of the study findings.

“While we are disappointed the vaccine candidate did not provide a sufficient level of protection against HIV infection in the Imbokodo trial, the study will give us important scientific findings in the ongoing pursuit for a vaccine to prevent HIV.

We continue to stand in solidarity with people living with and vulnerable to HIV, and remain committed to furthering our research against this devastating virus,” he added.

Though it has been 37 years of existing with HIV, developing a vaccine for the virus has been an arduous task mainly due to the HIV strain diversity and the immune evasion strategies of the virus.

According to Ronald C. Desrosiers, Professor of Pathology, Vice-Chair for Research, University of Miami, in an article, the development of the vaccine is made difficult by the biological properties of HIV. This includes the ability of the virus to continuously replicate, to generate and tolerate many mutations in its genetic information as well as the ability to shield itself from recognition by antibodies.

Besides the Imbokodo study, there have been five other trials to find a vaccine for HIV. All of them failed since there was no protection against acquisition of the virus or lowering of viral loads for those infected.

Currently, the PrEPVacc studies are ongoing in Africa- Uganda, Tanzania, Mozambique and South Africa- to test efficacy of a two experimental combination of HIV vaccine regimen while also comparing the effectiveness of a new form of oral PrEP (Descovy) against Truvada. The study which includes both men and women aged 18-40 years at risk of HIV
started in 2018 and will end in 2023.

 

By Sharon Atieno

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Options now available for women to reduce HIV risk

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Experts in HIV prevention and treatment have laid bare how rapidly HIV prevention methods are evolving and particularly with a special focus on women, and more so adolescent aged 15 to 19 years.

This is especially important because in 2018, Kenya was flagged as having the third-largest HIV epidemic in the world, alongside Tanzania, with 1.6 million people living with HIV.

In that same year, an estimated 25,000 people died from AIDS related illnesses as per the National AIDS and STI programme (NASCOP) statistics.

Speaking during a media café held on August 27, 2021, Prof Kenneth Ngure of the school of public health, Jomo Kenyatta University of Agriculture and Technology said that particularly significant in broadening options for women is how disproportionately they have been affected by HIV/AIDS compared to men.

In 2017, NASCOP estimated that the national adult HIV prevalence rate was at 4.9 percent, with prevalence being higher among women at 5.2 percent than men at 4.5 percent by More so, NASCOP stated that “the national HIV prevalence among males and females aged 15-24 years was estimated at 1.34 percent and 2.61 percent in 2017 respectively,
and overall HIV prevalence was 1.98 percent, which means 184,718 young adults living with HIV in 2017.”

Prof Ngure, also a Governing Council member representing the Africa region at the International AIDS Society (IAS), said HIV prevention has come a long way.

“Before 2012, we only had two HIV prevention models the ABC (Abstinence, Be Faithful, and Use a Condom) and correct and consistence use of condoms,” he stated.

Informed by research into the limitations of the aforementioned methods, including research by the Joint United Nations Programme on HIV/ADS (UNAIDS) that revealed that “for many women in developing countries, the ABC approach is of limited value due to their lack of social and economic power. They cannot negotiate abstinence from sex, nor can they insist their partners remain faithful or use a condom.”

Within this context, HIV experts have emphasised that HIV prevention is critical in the fast-track strategy to end AIDS by 2030.

In a science media café by the Media for Environment, Science, Health and Agriculture (MESHA) attended by health journalists and experts in the field of HIV prevention and treatment, participants heard about options for intravaginal products, the relevant regulatory approvals, challenges with existing options and what the next generation of intravaginal products will offer.

Prof Ngure discussed how various studies are confirming that adolescents and young women can consistently use the dapivirine vaginal ring and daily pills for HIV pre-exposure prophylaxis (PrEP) when they receive adherence support. He said this evidence was presented at the 11th IAS conference held virtually on July 18-21, 2021.

He added that there were other studies that showed both the ring and oral PrEP were safe for pregnant women and that this was key as HIV prevention using the two prevention
methods was an understudied area.

Scientists say that biological and social factors contribute to high rates of infections among women. They add that the high number of infections among women does not mean they have more risky sexual behaviors compared to men.

In a landmark decision that put a stamp of approval on the vaginal ring, back in January 2021, the World Health Organisation (WHO) recommended the dapivirine vaginal ring as “a new choice for HIV prevention for women at substantial risk of HIV infection.”

Prof Ngure explained that the ring is a female initiated approach towards reducing the risk of acquiring HIV.

While issuing its recommendation, WHO stated that the ring is worn inside the vagina for a period of 28 days after which it should be replaced by a new one. HIV experts emphasise that recommended vaginal ring is made of silicone and therefore easy to bend and that women can insert the ring themselves.

Once inserted, the ring releases antiretroviral drug, dapivirine into the vagina slowly over a period of 28 days and thereby reducing the risk of acquiring HIV during vaginal sex. Experts emphasise that the ring should be used with other safer sex practices.

Jacqueline Wambui said this is nothing but good news for women. The health rights advocate, and a passionate advocate for HIV prevention and treatment spoke of the need to lower barriers in accessing existing HIV prevention models, especially with regard to both vaginal rings and oral PrEP.

Wambui further spoke of the need to create visibility around challenges in accessing HIV prevention methods that have been introduced or compounded by the ongoing COVID-19 pandemic.

She further waded into the U=U, a global campaign to raise awareness on the importance of HIV care and treatment in saving lives and prevention of new HIV transmission built on the premise that Undetectable (HIV viral load) = Untransmittable.

Wambui said as options broaden, there is a need to scale up and to integrate newer prevention models into “existing prevention and treatment programmes. The effectiveness of PrEP roll up strategies and the need for these programmes to reach the people who need them most cannot be overemphasised.”

She particularly hails the vaginal ring as a discreet option for women to reduce the risk of acquiring HIV on their own terms.

“What I would like to see as an advocate is increased awareness around the vaginal ring as a significant HIV prevention option. We have waited for the ring for a very long time because it has the capacity to turn the wheels of HIV prevention in very big ways,” Wambui said.

 

By Joyce Chimbi

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The search continues, say scientists after setback on HIV vaccine trial

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Scientists have played down fears that they may call off the search for a HIV vaccine after a recent study failed to reduce the overall risk of HIV acquisition among women
in five sub-Saharan African countries.

Noting that even though the study did not find the product under test effective as a HIV vaccine, hope still lies on other major trials still ongoing globally.

A major vaccine currently being tested at scale is the Mosaico trial, which is testing a vaccine among transgender people and gay men and other men who have sex with men in the Americas and in Europe.

The scientists were addressing journalists after Johnson & Johnson and partners announced that the Imbokodo study, a large-scale HIV vaccine proof-of-concept trial also known as HVTN 705/ HPX2008, did not significantly reduce the overall risk of HIV acquisition among women in five sub-Saharan African countries.

The report indicated that the vaccine trial, which was being conducted among 2,637 young women aged between 18 and 35 years in five countries (Zimbabwe, South Africa, Malawi, Zambia and Mozambique) did not provide sufficient protection, with a paltry 25.2 percent efficacy attained.

In a statement to the media, Paul Stoffels, Managing Director, Vice Chairman of the Executive Committee and Chief Scientific Officer at Johnson & Johnson thanked the women who participated in the trial and the company’s partners.

“We are extremely grateful to the women who volunteered for the Imbokodo study, and to our partners, including the people on the frontlines, all of whom are contributing every day to this enduring quest to make HIV history,” he said.

“While we are disappointed that the vaccine candidate did not provide a sufficient level of protection against HIV infection in the Imbokodo trial, the study will give us important scientific findings in the ongoing pursuit for a vaccine to prevent HIV,” he added.

“We must apply the knowledge learned from the Imbokodo trial and continue our efforts to find a vaccine that will be protective against HIV,” added Anthony
Fauci, director of the US National Institute of Allergy and Infectious Diseases which co-funded the study.

Speaking during a media science café by Media for Environment, Science, Health and Agriculture (MESHA), AVAC Executive Director Mitchell Warren said the HIV vaccine trial was not a total failure. Warren said the trial is important for science research as it directs the next step in learning because it gave quick results and clues that can be used in the other ongoing vaccine trials.

“The Imbokodo study was a beautifully designed study that was safe and well conducted even with the disappointing results,” he said.

Warren said HIV remains a global threat, and a safe, efficacious and accessible HIV vaccine is still needed to contribute towards preventing new infections and
providing a durable end to the scourge. He said there is still hope in the fight against HIV, with two other major trials still ongoing in Africa.

“This is in no way the end of the search for a HIV vaccine. We still hope for a positive outcome from the ongoing Mosaico and PrEPVacc studies,” he said.

The AVAC director further noted that now more than ever, the vaccine field needs diversity and creativity and even more collaboration interns of research and product delivery.

He said there was a need to scale up the delivery of available, safe and effective HIV prevention options, including male and female condoms, voluntary medical male circumcision and daily oral PrEP.

“Other additional prevention options are nearing availability, including the dapivirine vaginal ring and injectable cabotegravir, and several next-generation PrEP options are now entering advanced clinical trials,” he added.

His sentiments were echoed by Ntando Yola, a health advocate, who called for collaborated efforts by all stakeholders in coming up with correct messaging in communicating the science of health.

“How effective we are in sending science health messages to the public will help in curbing misinformation on vaccines not only HIV related,” said Yola.

For 40 years, scientists have been searching for an effective HIV vaccine in vain, given the mutating nature of the disease and the various strains circulating in different regions globally.

In February last year, the United States National Institutes of Health announced that its HVTN 702 clinical trial of an HIV vaccine, also known as Uhambo, had been stopped. While
no safety concerns were found during the trial, the independent data and safety monitoring board found that the vaccine was ineffective in preventing HIV transmission.

The trial, conducted at 14 sites across South Africa, followed more than 5400 HIV-negative 18–35-year-olds over 18 months.

The participants received six injections during the six-month period, either the vaccine or a placebo. An analysis undertaken after at least 60% of the participants had been in the study for more than 18 months showed that there were 129 HIV infections among the people who had the vaccine, while 123 people who had the placebo became infected.

 

By Christine Ochogo

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Journalists need to debunk health information to save lives

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Debunking misinformation in health reporting

By  Christine Ochogo I christawine@gmail.com

Information is power, as the saying goes. However correct and factual information in health reporting is what should be consumed in a bid to save lives.

It is therefore important to be cautious when handling information because as much as it is meant to enlighten people on a particular health subject matter, it that can also be used as a weapon for driving various agenda that is not for public good.

With the emergence of coronavirus that has caused Covid-19 pandemic, journalist have turned to health journalism to keep up pace in reporting its development since major stories being carried in the news media today is on COvid-19.

However, most journalist are not endowed with proper training on matters health and have been endowed with public health concepts but are forced to report on Covid-19.

This has created room for misinformation since people are coming up with their own views in regards to the novel coronavirus pandemic that has affected the globe.

In a write up published in forbes, dated August 09, 2020, a contributor mentioned that it is therefore necessary that journalist be taken through epidemiology training to be able to handle stories on covid-19 in a bid to fight misinformation.

By definition, epidemiology is the study and analysis of the distribution, patterns and determinants of health and diseases and other factors related to health.

Most often we journalist are bombarded with too much information that is not necessary yet what we are looking for is the missing facts that is not available at our disposal.

In dissemination of information there are three types of information disorder which include misinformation, disinformation and mal-information.

Misinformation has been described as false information shared with no intent to harm. It is usually spread unknowingly and it contains viral messages that are shared quickly without fact checking.

Disinformation on the other hand has been described as deliberate false information that is misleading and knowingly shared to cause harm.

Mal-information is when genuine information is shared to cause harm to a person, social group, organization or a country to a person, so, often by moving private information into the public sphere.

Journalist covering health should be fast in spotting and debunking health misinformation by questioning the content and not just consuming information at face value.

Take an example of a recent statement by a USA based doctor, Dr. Stella Immanuel , who come out to claim that  hydroxychloroquine, which is an anti-malaria drug, can cure Covid-19 yet there is no scientific approval to that effect.

Erick Mugendi, Communication Managing Director at PesaCheck, an organization that fights against misinformation, stressed that false information in health reporting can lead to death if mishandled or not debunked in time.

In his explanation during a media online café organized by Media for Environment Science Health and Agriculture (MESHA) he mentioned that fact checking helps in increasing the availability of factual information for under resourced health topics such as Neglected Tropical Diseases, Reproduction Health among others.

 “Debunking misinformation can be done by countering the false information with proper and factual content that can help save lives,” Mugendi stressed.

Sometimes people loose trust because of evolving rereign in information and therefore journalist should develop a tentative tone when doing reporting. This will keep the public on track and be well informed.

“Initially when covid-19 pandemic broke, the public was being told not to wear facemasks, however as the virus evolved, World Health Organization approved the usage of face mask saying it has the ability to prevent the spread of the virus,” Mugendi said.

The writer is a freelance journalist based in Nairobi, Kenya.

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Why Africa must participate in COVID-19 vaccines trials

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By Darrel Bosire I info@meshascience.org 

Africa could benefit from lower prices by participating in the ongoing COVID-19 vaccine development efforts, experts have said.

There could also be cost trade-offs for countries taking part in vaccine trials because they are co-investors or partners in the projects, says Dr Borna Nyaoke-Anoke, Manager, Clinical Trials at the Drugs for Neglected Diseases Initiative/Global Antibiotic Research and Development Partnership (DNDI/GARDP). Dr Nyaoke-Anoke said countries that opted out of vaccine trials will likely buy them at higher prices once they are developed.

“It does not make economic sense for pharmaceutical firms in the north that includes Europe and America, to test and develop a vaccine in their home countries at very high costs and then sell it here at a price similar to the one in their home countries. It is even harder to expect them to give discounted rates on the vaccines to African countries,” she said.

Dr Nyaoke-Anoke said the reasons pharmaceuticals prefer Africa for medicine and vaccine trials are purely scientific, and not racism. “Africa has the richest genetic variety and this makes it an ideal location for clinical trials involving vaccine and drug candidates.

That will result in more effective medicines and vaccines for people from the region and beyond,” she said. She was speaking at a recent virtual pre-conference hosted by the Media for Environment, Science, Health and Agriculture (MESHA), and attended by experts and science journalists from all over Africa.

Prof Kenneth Ngure, a lecturer at Jomo Kenyatta University of Agriculture and Technology (JKUAT), said Africa has scientific and moral reasons to participate in vaccine trials, so that when the vaccines are discovered the findings can also be generalizable to African populations.

Prof Ngure added that populations that participate in trials are usually the ones that are prioritized to receive the vaccines once they become available.

“We should avoid double speak. On the one hand we do not want to participate in vaccine trials and on the other we are demanding to get the vaccines,” he said.

“Remember most of the vaccines and drugs that we use in Africa today had the trials conducted in the west, it is only recently that Africa is getting more requests to conduct these studies because it has built its human, regulatory and infrastructural capacity.”

Dr Nyaoke-Anoke urged African countries to invest more in boosting research capacity in their labs as well as increasing the number of testing sites to attract interest from pharmaceutical firms developing vaccines and medications for various medical conditions.

She said not all medicines and vaccines developed in foreign countries were as effective for local populations, adding that the only way for African nations to overcome this was to take part in the research using local volunteers.

Data from the website www. clinicaltrials.org shows that there are 166 COVID-19 trials taking place in Africa, as compared to 710 in the United States alone, and 107 in Canada. South America has 162, China 60 and India 181.

Out of the 1,056 COVID-19 drug trials going on globally, DNDI indicates that Africa is the site for 56 trials. Uganda, Kenya and DRC are currently participating in trials for one drug each, as compared to Egypt with 36 trials, and South Africa with eight. Dr Nyaoke-Anoke rooted for more funding for research efforts into medication and vaccines on the continent.

“There is a real and urgent need for governments and other stakeholders in the continent to increase funding for research so that they can benefit from credible data from such efforts on home soil. By becoming partners in the research, it will put them in a good position to access drugs and vaccines developed specifically for their populations’ genetic makeup,” said the researcher and academic.

all are visited by tourists, so they are all potentially at risk. Apart from the more solitary orangutans, all species of great apes are highly sociable, living in close-knit social groups with physical interactions between them such as grooming and play occurring throughout large parts of every day. Transmission of any disease would Dr Nyaoke rooted for more funding for research efforts into medication and vaccines on the continent.  

“There is a real and urgent need for governments and other stakeholders in the continent to increase funding for research so that they can benefit from credible data from such efforts on home soil. By becoming partners in the research, it will put them in a good position to access drugs and vaccines developed specifically for their populations’ genetic makeup,” said the researcher and academic.

Responding to a question on why pharmaceuticals preferred Africa as a location for medicine and vaccine trials, Dr Nyaoke said science, and not racism, was the real reason for the choice.

“Africa has the richest genetic variety and this makes ideal location for clinical trials involving vaccine and drug candidates. Even though a few insensitive statements have created the impression in people’s minds that Africans are perhaps viewed as guinea pigs in some quarters, the main goal of the trials is to get comprehensive data from the wide genetic variations in the African populations. That will result in more effective medicines and vaccines for people from the region and beyond,” she said.

“Most trials are taking part in high-income countries. Very few trials are planned in Africa, South Africa, Central and South America, South and Southeast Asia.

Dr Nyaoke said many of the trials currently taking place are too small to be conclusive.

“COVID-19 trials need to be large, well designed and adequately powered to generate authoritative, concrete evidence,” said Dr Nyaoke.  

She lamented that “research to date has mainly been focused on advanced cases of the disease while COVID-19 cases in Africa have mainly been mild.”

Dr Nyaoke said the trials should look into better ways to care for patients in view of the worryingly low levels of ICU and hospital bed capacity on the continent.

“Limited hospital and ICU bed capacity and exposure of health workers require urgent investigation. Large, well-conducted clinical trials are urgently needed to support guidelines on prevention and clinical management in resource poor settings,” she said.

According to Dr Vincent Muturi-Kioi, a medical director at the International AIDS Vaccine (iavi), different people will respond differently to drugs and vaccines because of many factors including human genetics and environmental exposures.

For scientists to develop vaccines and other biomedical products that are optimized for African populations and are meant to address public health problems that may disproportionately affect people in Africa and other low-income regions of the world, it is important that the clinical trials provide data which accurately represents the way these products work in the target populations.

Global research on coronavirus disease gets a boost

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By Christine Ochogo

Scientists, physicians, funders, and policy makers globally have launched a COVID-19 Clinical Research Coalition to accelerate research on the prevention and treatment of the pandemic in low- and middle-income countries.

This coalition formed by 70 institutions from over 30 countries aims to accelerate desperately needed COVID-19 research in those areas where the virus could wreak havoc on already-fragile health systems and cause the greatest health impact on vulnerable populations.

According to World Health Organization (WHO) Coronavirus disease (COVID-19) is an infectious disease caused by a new virus.

The disease believed to have originated from Wuhan, a small market in China, has continuously been spreading globally from when it first broke out in November 2019.

The members of the coalition argue that international research collaboration and coordination is needed urgently to support African, Latin American, Eastern European, and certain Asian countries to respond effectively to the worsening pandemic and speed up research adapted to resource-limited settings.

“The coalition brings together an unprecedented array of health experts, including public-sector research institutes, ministries of health, academia, not-for-profit research and development organizations, NGOs, international organizations, and funders all committed to finding COVID19 solutions for resource-poor settings,” read in part a comment recently published in The Lancet.

One important research response to COVID-19 has been launched already, the World Health Organization (WHO)-led SOLIDARITY trial, an unprecedented global effort. However the authors found that out of almost 600 COVID-19 clinical trials registered, very few trials are planned in resource-poor settings. The authors commit to sharing their technical expertise and clinical trial capability to accelerate COVID-19 research in these settings.

The scale of the challenge is clearly beyond the scope of any single organization and therefore the coalition will facilitate a coordinated approach, so that all data from all regions can be collected in a similar fashion, pooled and shared in real-time. This will help countries and the WHO to make rapid evidence-based decisions on policies and practice.  

“We welcome the launch of this coalition, which takes advantage of existing multinational and multidisciplinary expertise in running clinical trials in resource poor settings, and will help the World Health Organization (WHO) in its coordinating role in the global response to COVID-19,” said Dr Soumya Swaminathan, Chief Scientist, World Health Organization.

“Although the epicenter is today elsewhere, we must prepare now for the consequences of this pandemic in more resource-constrained settings or we stand to lose many more lives,” added the doctor.

Members of the Coalition call for specific commitments to ensure access, so that effective new treatments are made available as soon as possible in resource-poor settings and are affordable and readily accessible.

Even though more than 70 organizations have joined this coalition, a call has been made to other organizations ready to contribute existing capacity to also join.

COVID-19 disease causes respiratory illness with symptoms such as cough, fever and in more severe cases victims who have been infected may have difficulties in breathing and even cause death.

The disease spread primarily through contact with infected person when they cough or sneeze. It is also spread when a person touches a surface or objects that have the virus.

In trying to control the spread of the disease, one is advised to wash their hands frequently using soap and running water, use sterilizers, avoid touching one’s face and keep social distance with people (1 meter or 3 feet).

The pandemic has so far affected over a million individuals globally, causing over 600,000 deaths. Different countries are trying to take various preventive measures in the help to curb its spread.

 In Kenya, the government has come up with measures among them asking people to stay at home and avoid social places, a daily 7.00 pm to 5.00am curfew and making use of masks.

Expert: Journalists must stay out of harm’s way while covering COVID-19

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By Christine Ochogo

NAIROBI – SATURDAY, APRIL 10, 2020 – Journalists have been cautioned against using traditional ways of news gathering when covering the coronavirus pandemic.

Just like all other humans, journalists are not an exemption and are equally at risk of contracting and spreading coronavirus disease given the nature of their day to day work.

Internews Global Health Media Adviser, Ms Ida Jooste is advising journalists globally to protect themselves fully if they have to leave home which she discouraged. For now she said everyone should stay at home and adhere to social distancing. “No story is worth your life hence staying safe during this unprecedented time is paramount,” she warned.

Ida was speaking during a cross border science café conducted online where over 70 science journalists from Kenya, Uganda, Zambia, Zimbabwe, Rwanda, Madagascar, Ghana and Nigeria participated.

The science media café was organised by the Media for Environment, Science, Health and Agriculture (MESHA) from Kenya, Humanitarian Information Facilitation Centre (HIFC) from Zimbabwe and Health Journalists Network in Uganda (HEJNU) whose team leader, Ms Esther Nakkazi, moderated the session. On board was also Zambia Institute of Mass Communication (ZAMCOM).

She mentioned that it was high time journalists embraced use of information technology such as, zoom, skype, WhatsApp among other social media tools.

The media advisor highlighted the importance for journalists to also adopt more revolutionary ways to gather news and information such as maximizing phone-in formats and voice recording for interviewees to avoid physical contacts with them, maintaining online production of unfolding story in credible and impactful way so as to keep audience.

She also advocated for use of protective equipment and adhering to the evolving guidance about best practice for safety such as wearing of face masks, keeping social distance, these among others.

During the café the Executive Director, International Community of Women Living with HIV, Kenya Chapter, Ms Inviolata M’mbavi, said lack of information flow from government has stifled access to medication and health services for persons living with HIV. 

She added that all the attention is now focussed on COVID-19 at the expense of other ailments. However she noted that some facilities had devised ways of serving them such as providing ARVs for three weeks per visit.

 “The COVID-19 situation is complicating lives of majority of HIV patients and this has increased their stress levels since they are unable to access antiretroviral therapy (ART) and other medication,” she added.

Search for an AIDS vaccine lands me my first ever media science café

by with No Comment Health

A message on my phone from Aghan Daniel, the secretary of MESHA (www.meshascience.org) on Wednesday, February 5, 2020 awakened my thoughts about the future of the world without a HIV vaccine.
Aghan was inviting to me to attend a two hour media science café at a Nairobi Hotel. In the invite, he simply stated that the meeting had been called to discuss vaccine research in the context of the halt of HVTN702 clinical trials.
As I sat in my university room, two things came to my mind. One, what is a media science café? Two, will I understand what the scientists will talk about given that they used complex terms?
Anyway, I conjured up courage and arrived at the venue 30 minutes before time. Then the introductions were done – and I was happy because I was seeing big names that I had only got to meet through bylines in the newspapers or heard their voices on radio! There was Angela Oketch of the Nation, Ann Mikia,a renowned radio personality in Kenya, Mike Mwaniki, a veteran journalist and Violet Otindo, whom I had only seen on TV, among others.
When the presentations started, Dr Kundai Chinyenze, Executive Medical Director, IAVI stepped forward and showed very simple slides using ordinary language in most of her talking points –she was very conscious of what could be technical and she explained them using a language that me, a non-science student easily understood.
Her topic was simple, HIV vaccine research efforts and IAVI’s role in the search for a safe, effective, affordable and globally accessible vaccine.
Then came Professor Omu Anzala from Kenya AIDS Vaccine Initiative (KAVI-ICR), University of Nairobi spoke on their roles in HIV vaccine research and prevention in Kenya.
These included clinical trials, research in communicable diseases, non- communicable diseases and the knowledge translation through public forums and targeted events like the science café, that I was privileged to attend for the first time. Prof Anzala spoke simple things off head without any presentation. He was in his element in his simplicity.
Mrs Rosemary Mburu, Executive Director, WACI Health talked on the need for the HIV vaccine. “We can end HIV without a vaccine but we cannot sustain the virus without a vaccine,” she said. She also urged for meaningful engagement of local communities for successful research and clinical trials.
To wind it up, a HIV champion, Ms Inviolata Mmbavi, Executive Director, International Community of Women Living with HIV – Kenya Chapter narrated her story of living with the virus for the last 30 years. “When you test HIV positive life will never be the same again,” she told us. She noted that the first drugs that were administered to her, almost killed her.
“That drug was a monster,” she said looking at Prof Omu Anzala whom she noted had started her on ARVs nearly three decades back and yet the two had never met again till today’s science café brought them together.
“Ladies and gentlemen, I have hope that a vaccine, to be only administered once in a human being’s life, will be found,” she said, almost tearfully.
She said that taking drugs daily is not a walk in the park and urged the researchers not to tire in their search for an AIDS vaccine. I gained a lot from this café and learnt that a lot of research is still being done in the quest to find an AIDS vaccine. This will definitely bring smiles back on the faces of those who are distraught because HVTN stalled.
The trials that are on-going include Imbokodo (Phase 2B/3) trial HVTN 705 which is a Mosaic Vaccine Aiming at Protection Against wide variety of global HIV strains. Dr Kundai said that HVTN 705 is a trial in women in five African countries of South Africa, Malawi, Zambia, Zimbabwe and Mozambique. The trial results are expected in 2022. Besides, up next is the PrEPVacc Trial Phase 2b trial which is testing 2 vaccines regimens to prevent HIV infection and compare a new kind of daily pill for pre-exposure prophylaxis (PrEP), Descovy vs the currently used Truvada. Importantly, this trial tests 2 vaccines regimens to prevent HIV infection and compare a new kind of daily pill for pre-exposure prophylaxis (PrEP), Descovy vs the currently used Truvada. Dr Kundai told us that this is the first efficacy vaccine trial that includes daily oral PrEP in its design in both men and women.

She added that it is planned to start later this year in Uganda, Tanzania, Mozambique and Kenya.
As I walked back to the university that day, not only was my fear of scientists slayed but I also felt tantalized by a few statements made at the café. 1. “Without HIV vaccine, we will not end AIDS.” – Dr Kundai Chinyenze. 2. “Can we end AIDS without a vaccine? Yes! But we cannot sustain HIV without a vaccine.” – Mrs Rosemary Mburu and 3. “When you test HIV positive life will never be the same again.” – Ms Inviolata Mmbavi, HIV champion.
The writer is a first year journalism student at the University of Nairobi.