HIV Research Program Has Global Reach
By Cheryl Pellerin
American Forces Press Service
WASHINGTON, Dec. 1, 2010 In its effort to protect troops everywhere from HIV infection, the U.S. Military HIV Research Program in Rockville, Md., also works to reduce the disease’s global impact through work performed in regions heavily impacted by the virus.
A U.S. Military HIV Research Program scientist at work. MHRP photo
(Click photo for screen-resolution image);high-resolution image available.
The program, initiated by Congress in 1986, has contributed to recent successes against the pandemic that kills 5,500 people a day, and the promising work there continues, the director of the institute’s retrovirology division told the Pentagon Channel.
“The epidemic has taken some major hits recently,” Army Col. (Dr.) Nelson Michael said. “But even in this country, 20 percent of those who have HIV infection don’t know it and continue to spread that disease. Worldwide, the problem is much worse.
“For every two individuals that we can identify in Africa who require antiretroviral drugs,” he continued, “three more people are becoming infected. So even though we’re beginning to make strides … it’s not time to relax.”
Advances include using antiretroviral drugs to control HIV infection; prevention tools as different as barrier methods like condoms, microbicides as a tool to help women prevent HIV infection, using circumcision to reduce infection risk to men for heterosexual sex; and, most recently, in a study announced Nov. 23 in “The New England Journal of Medicine,” the use of a daily antiretroviral pill to protect men who have sex with men from infection.
MHRP provides prevention, care and treatment through PEPFAR, but its primary focus is developing a globally effective HIV vaccine.
In September 2009, a six-year clinical trial involving more than 16,000 mostly heterosexual adults in Thailand showed a vaccine candidate to be safe and to have a modest 31 percent effective rate in preventing HIV infection.
The study was sponsored by the MHRP in collaboration with the U.S. National Institute of Allergy and Infectious Diseases, Sanofi Pasteur and a U.S. company. The vaccine was based on HIV strains that commonly circulate in Thailand.
It was the first time scientists received a positive signal in any HIV vaccine trial but 31 percent is not effective enough to distribute the vaccine widely.
“For the Thai work, we have continued to push forward to understand why this vaccine showed the result it did,” Michael said.
Several hundred investigators from around the world, he said, are involved in the effort to discover why the vaccine worked and how to improve it. Researchers will then work to create new vaccines for southern Africa based on the HIV viruses that circulate there, he added.
Clinical research conducted at six sites in the United States, Africa and Asia is a key component of MHRP’s global vaccine research strategy.
For more than 10 years, the Walter Reed Project has worked in Kenya to help accelerate HIV research, prevention, care and treatment efforts in that nation. The project operates at the U.S. Army Medical Research Unit–Kenya on the campus of the Kenyan Medical Research Institute in Nairobi, where the Defense Department has had an infectious disease research program for nearly 40 years.
A field site has been based in Kericho, in the Southern Rift Valley, since 1999.
Dr. Fredrick Sawe is a physician from Kenya who leads HIV research, prevention and treatment in his community. He is the deputy director of the Kenya Medical Research Institute, which collaborates with the Walter Reed Project.
“One opportunity we’ve got by working with the U.S. military is that they give us the opportunity to transfer science and technology to Africa,” Sawe said in a Pentagon Channel interview.
“We were sitting there in Africa, we had the problem with HIV/AIDS and we knew exactly what we were supposed to do, but we didn’t have the means or the ability to do it,” he said. “The presence of the U.S. military in Kericho has transformed Kericho.”
Sawe said he and his colleagues are working with the Army and through PEPFAR to find better technologies for HIV prevention and treatment.
As in Kenya, MHRP international research projects involve collaborating agencies, institutions, commercial manufacturers and affected countries, all of which contribute to the effort. These include coordinated projects between the Defense Department and the National Institute of Allergy and Infectious Diseases, which helps fund MHRP.
The synergy between MHRP and NIAID has helped drive recent progress in HIV research and vaccine development in Africa and Thailand.
The program also works with the U.S. Centers for Disease Control and Prevention, the Department of State, U.S. military treatment facilities and other academic, government and nongovernmental organizations.
“Yes we’ve had success,” Michael said, “but HIV is still a worldwide killer of unspeakable proportions and it’s time for us to rededicate ourselves to getting the job done and finishing this beast off.”
Tackling the deadly AIDS pandemic requires a shared response that builds on each hard-won success, President Barack Obama said in a document proclaiming today as World AIDS Day.
“As as we approach the 30th year of the HIV/AIDS pandemic, we reflect on the many Americans and others around the globe lost to this devastating disease, and pledge our support to the 33 million people worldwide who live with HIV/AIDS,” Obama said.
“Globally,” he added, “tens of millions of people have benefited from HIV prevention, treatment and care programs supported by the American people.”
Through the President's Emergency Plan for AIDS Relief; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and now the Global Health Initiative, the United States is a leading funder of programs to fight HIV/AIDS around the world.