(July 19, 2009): "South Africa tests HIV/AIDS vaccine" (AP, via SF Gate)

[CGP]

Full Article @ SF Gate (http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2009/07/19/international/i134655D63.DTL&tsp=1#ixzz0LlHqUZTA)


South Africa is launching clinical trials of the first AIDS vaccines created by a developing country, a feat by scientists who forged ahead even when some of their political leaders shocked the world with unscientific pronouncements about the disease.

Trials to test the safety in humans of the vaccines begin this month on 36 healthy volunteers, Anthony Mbewu, president of South Africa's government-supported Medical Research Council, said in an interview Sunday. Mbewu's respected organization shepherded the project.

A trial of 12 volunteers in the United States began earlier this year.

Mbewu said the vaccine was designed at the University of Cape Town with technical help from the U.S. National Institutes of Health, which also manufactured the vaccine.

Dr. Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Disease and a leading AIDS researcher, was in South Africa for the launch.

During nearly 10 years of denial and neglect, South Africa developed a staggering AIDS crisis. Around 5.2 million South Africans were living with HIV last year — the highest number of any country in the world. Young women are hardest hit, with one-third of those aged 20 to 34 infected with the virus.

In 1999, the ministries of health and of science and technology founded the vaccine initiative and poured 250 million rand into it over nearly 10 years.

Some 250 scientists and technicians worked on the project, along the way gaining scores of doctorates and producing work for professional publications as well as a model for continued biotechnology development in South Africa.

The government decided it was important to develop a vaccine specifically for the HIV subtype C strain that is prevalent in southern Africa "and to ensure that once developed, it would be available at an affordable price," Mbewu said.

"We have the biggest problem" in the world, Mbewu said on the sidelines of an international AIDS conference in Cape Town.

"Every emerging country is trying, wants to develop their own capacity to design and develop vaccines — Brazil, Korea," Mbewu said.

But the South Africans are the first to reach the clinical trial stage, though years of testing will be needed.

At the AIDS conference later, South Africa's Vice President Kgalema Motlanthe emphasized the clinical trials are being held "under strict ethical rules." The first trial may have been started in the United States to allay any criticism that the U.S. was collaborating in an AIDS vaccine that would use Africans as guinea pigs.

[CGP]

And this:

South Africa Is Seen to Lag in H.I.V. Fight (NYT, 7/19/09) (http://www.nytimes.com/2009/07/20/world/africa/20circumcision.html)


Young men have flocked by the thousands to this clinic for circumcisions, the only one of its kind in South Africa. Each of them lies down on one of seven closely spaced surgical tables, his privacy shielded only by a green curtain.

“I’ve done 53 in a seven-hour day, me, myself, personally,” said Dr. Dino Rech, who helped design the highly efficient surgical assembly line at this French-financed clinic for cutting off foreskins.

Circumcision has been proven to reduce a man’s risk of contracting H.I.V. by more than half. Yet two years after the World Health Organization recommended the surgery, the government here still does not provide it to help fight the disease or educate the public about its benefits.

Some other African nations are championing the procedure and bringing it to thousands. But in South Africa, the powerhouse country at the heart of the epidemic, the government has been notably silent, despite the withering international criticism the country has endured for its previous foot-dragging in fighting and treating AIDS.

“Countries around us with fewer resources, both human and financial, are able to achieve more,” said Dr. Quarraisha Abdool Karim, the first director of South Africa’s national AIDS program in the mid-1990s under President Nelson Mandela. “I wish I understood why South Africa, which has an enviable amount of resources, is not able to respond to the epidemic the way Botswana and Kenya have.”

Even without government involvement, demand for the surgery, performed free under local anesthetic, has surged over the last year here at the Orange Farm clinic. The men are counseled to continue using condoms since circumcision provides partial, though substantial protection.

Men waited nervously one recent chilly morning for their turn. Most were hoping the procedure would help them stay healthy here in the nation with more H.I.V.-positive people than any other.

But some said they were also drawn by a surprising, if powerful, motivation: They had heard from recently circumcised friends that it makes for better sex. You last longer, they said. Your lovers think you’re cleaner and more exciting in bed.

“My girlfriend was nagging me about this,” said Shane Koapeng, 24. “So I was like, ‘O.K., let me do it.’ ”

As new H.I.V. infections have continued to outpace efforts to treat the sick in Africa, there is growing concern about the ballooning costs of treatment for an ever-expanding number of patients who need medicines for the rest of their lives. Almost two million people were newly infected in 2007 in sub-Saharan Africa, bringing the total of those living with H.I.V. in the region to 22 million, according to United Nations estimates.

The major international donors to AIDS programs, including the United States and the Global Fund to Fight AIDS, Tuberculosis and Malaria, are ready to pour money into male circumcision, but the countries have to be ready to accept the help.

“You can’t impose it from the outside, particularly such a sensitive intervention,” said the Global Fund’s executive director, Dr. Michel Kazatchkine.

Public health doctors agree that circumcising millions of men will be no simple task. Africa has a severe shortage of doctors and nurses, and circumcision is potentially a political and cultural minefield in countries where some ethnic groups practice it but others do not.

Still, some countries are showing it can be done. In Botswana, circumcision was largely stopped in the late 19th and early 20th centuries by British colonial-era administrators and Christian missionaries.

But Festus Mogae, who was president from 1998 to 2008, provided a critical endorsement of male circumcision just before he stepped down.

Over the past year, the government has trained medical teams to do circumcisions in all its public hospitals and aims by 2016 to have circumcised 470,000 males from infancy to age 49, which is 80 percent of the total number in that group.

Public awareness is being raised through advertisements on radio and television. Billboards have sprouted across the country featuring a star of the national youth soccer team.

“Men have started to flock to the hospitals,” said Dr. Khumo Seipone, director of H.I.V./AIDS prevention and care in Botswana’s Ministry of Health.

In Kenya, where the Luo do not generally practice circumcision, Prime Minister Raila Odinga, himself a Luo, encouraged the procedure and lobbied elders. The H.I.V. infection rate among Luo men is more than triple that of Kenyan men generally — 17.5 percent versus 5.6 percent.

“Anything that could help save lives needs to be tried,” Mr. Odinga said, adding that he had been circumcised.

So far, more than 20,000 men in Kenya have been circumcised in hospitals, dispensaries, village schools, social halls and tents. Teams of doctors, nurses and counselors have even taken boats to islands in Lake Victoria to circumcise Luo fishermen.

[CGP]

Well it seems circumcision reduces the risk of transmitting/acquiring HIV, but hopefully people aren't seeing that as a reason not to use condoms!

[Laura Cereta]

Well it seems circumcision reduces the risk of transmitting/acquiring HIV, but hopefully people aren't seeing that as a reason not to use condoms!

True, there are so many other STD's out there. :eek:

Those volunteers who the vaccine is being tested on are very brave.