As the world gets ready to commemorate AIDS Day on 1 December, there is a question in everybody’s mind whether mankind will be able to find a cure to this dreaded disease or invent a vaccine to prevent its occurrence. India, with about 2.1 million HIV/AIDS patients, is the third largest country in the world after South Africa and Nigeria. Worldwide, serious research efforts are going on and India, with such a large number of cases, is not behind in terms of research to find a cure. In fact, there has been tremendous progress in this field and Indian experts are part of this exercise. RAJAT GOYAL, the Country Director of International AIDS Vaccine Initiative (IAVI), a global organisation working to accelerate development of effective AIDS vaccines, is quite optimistic about the exercise. Speaking to The Sunday Guardian, Goyal said that there has been significant progress and that “we are getting closer to a vaccine for AIDS”. It will happen soon and India will be a major contributor to this achievement, he said, elaborating on the current status of research in this direction and its future in India.
Q. What is the current status of HIV/AIDS in India?
A. According to estimates of the National Aids Control Organisation (NACO), there were 21.17 lakh HIV/AIDS cases in 2015. About 40.5% of total HIV infections are among females. Moreover, 68,000 more become infected each year.
Q. Research is going on in different parts of the world to come out with a vaccine. What is the status of such research?
A. There was a successful experiment in Thailand with “RV144” vaccine candidate in 2009. However, the success rate was low, about 34%, but it established that HIV vaccine was possible. But after that, a lot of effort has gone into further research, especially for the “Clade C” strain of the virus which is prevalent in India and African countries. A modified version of the “RV144” candidate is all set to go for trial. We are now in a much better position to understand the disease. Today, the situation is not like in the 1990s when a vaccine was “unthinkable”. I cannot give you an exact time frame, but we are getting very close to a vaccine for HIV/AIDS.
Q. Why is the process of getting a vaccine taking so much of time? What are the challenges?
A. The problem with HIV is that it is one of the fastest evolving viruses known to man. HIV virus uses its outer casting to bind with and infect healthy human cells. The human body takes a while before it recognises the presence of the virus and creates antibodies which bind with its outer casting to neutralise it and block infection. Meanwhile, HIV mutates multiple times in the body and the antibodies produced by the immune system are unable to track and neutralise the mutated forms. Thus, it attacks the immune system badly and hides, waiting to emerge and strike at any time.
However, scientists are now trying new strategies to target the virus. There are a few sites in the HIV casting which do not change despite rapid mutation. Reseachers at IAVI and other institutions are working to identify such sites and design immunogens which can elicit antibodies to bind to these specific sites, thereby successfully neutralising the virus before infection takes root.
Q. What is the role of IAVI in facilitating research and studies in India towards achieving the goal of an AIDS vaccine?
A. There are two nodal agencies in the field of HIV/AIDS. While the National AIDS Research Institute at Pune, under the Indian Council for Medical Research (ICMR), is pioneering research activities in this field, the National AIDS Control Organisation (NACO) coordinates the disease control part. IAVI collaborates with both, along with the Department of Biotechnology, Department of Science & Technology, ICMR and other stakeholders to facilitate research and studies, keeping in mind that prevention is the best way to end this disease. Worldwide, IAVI has developed and tested 26 AIDS vaccine candidates, including 15 trials in Africa and India. In India, we have conducted three phase I clinical trials of novel HIV vaccine candidates, implemented community research in Maharashtra and established an HIV Vaccine Laboratory with the Department of Biotechnology at Faridabad.
Q. How is the response of the government and the community towards research activities?
A. The government is making a lot of effort. As a result, India is moving forward in this direction. There is greater engagement of industries and academics. There are plans to open new research institutes. In the next one year, India will achieve significant milestones in the field of research and treatment of AIDS and will be one of the leaders in the world.