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World AIDS day 2019: Clinical research that reaches key populations

2 December 2019

According to World Health Organization (WHO) statistics, in 2018 an estimated 1.7 million people were newly infected with HIV and there were 0.8 million HIV-related deaths. Most of these deaths are in low and middle-income countries, particularly in sub-Saharan Africa, where the burden of infectious diseases is highest and where vulnerable populations, such as adolescents, children, women and co-infected individuals, remain difficult to reach.

The UNAIDS Report 2019 states that ‘in 2018, more than half of all new HIV infections were among key populations. Globally in 2018, 6000 adolescent girls and young women became infected with HIV every week. Current demographic trends in Africa foresee increasing numbers of young people at risk of HIV exposure. Moreover, in sub-Saharan Africa, four in five new HIV infections among adolescents aged 10–19 years are among girls.’ In order to reduce the burden of new HIV infections, the high at-risk groups and communities need to be involved in research and clinical studies.

“The EDCTP programme is committed to support research that helps local and global efforts’ to fight HIV and it’s interaction with other diseases. Our current and future research and innovation strategies therefore promote people-centred and community-oriented approaches that facilitate timely diagnosis, ensure long-term retention in care, and achieve effective integration with other services.”

Dr Michael Makanga, EDCTP Executive Director

EDCTP portfolio of projects by disease, 2014-2019

CHAPS project: Reducing HIV infections in adolescents

The EDCTP funded CHAPS project involves the community and especially adolescents between the age of 13-24 through social science studies in South Africa, Uganda and Zimbabwe to: identify barriers and motivators towards the update of pre-exposure prophylaxis (or PrEP), describe the characteristics of adolescents willing to take daily versus on-demand PrEP and to describe the role of gender dynamics in HIV prevention implementation.

The CHAPS project also includes a clinical trial and evaluates a range of prevention strategies adapted to adolescents including a version of PrEP, the use of antiretroviral drugs to prevent infection. Daily PrEP clearly reduces the risk of HIV infection, but it remains costly and has some side effects, while adherence among adolescents is reduced. The project aims to overcome these challenges by evaluating the impact of a less toxic drug combination (tenofovir alafenamide and emtricitabine), and ‘on-demand’ PrEP, the use of PrEP just around the time of sexual activity.

On 8 July 2019, the European Commission Director-General for Research and Innovation, Jean-Eric Paquet, visited the Emavulandleni Research Centre in Cape Town, South Africa together with colleagues from the European Commission and representatives of the Department of Science and Technology of South Africa, the South African Medical Research Council and EDCTP. During the visit

members of the Adolescent Community Advisory Board and participants in the adolescent study shared their experiences and voiced challenges facing the adolescents in their community.

EDCTP at ICASA 2019

On Wednesday 4 December 2019, EDCTP will host a satellite symposium on: ‘EDCTP: Milestones, new platforms and strategies for HIV and TB vaccine research: an EDCTP overview‘, at the 20th International Conference on AIDS and STIs in Africa (ICASA 2019). The session is chaired by Prof. Tandakha Ndiaye Dieye (Centre National de Transfusion Sanguine, Senegal) and Mr Roger Tatoud (International AIDS Society, Switzerland).

This symposium will highlight the specific challenges, opportunities and strategies for developing HIV and TB vaccines and demonstrate how EDCTP-funded research is trying to address these together with international partners, including through locally developed solutions.

The session will also discuss common areas with other infectious diseases of relevance to sub-Saharan Africa and explore possibilities for cross-cutting coordination, knowledge sharing and learning through established networks and platforms.

This session aims to generate discussion on how future collaborative HIV and TB vaccine research can address the challenges and needs identified. It will also discuss how best to engage the relevant actors in order to build on progress to date and ensure the development of practical, accessible and affordable vaccines for sub-Saharan African populations.

EDCTP portfolio 2014-2019: HIV & HIV-associated infections

EDCTP’s strategic research agenda addresses treatment, prevention, and product-focused implementation research with prioritisation of the following needs:

  • Optimised treatment regimens and drug formulations for key groups such as children, pregnant women and adults with co-infections and co-morbidities;
  • Increased access to proven interventions; and
  • Novel HIV prevention strategies such as pre-exposure prophylaxis and vaccines.

 

EDCTP’s grants portfolio on HIV & HIV-associated infections comprises 78 projects on collaborative clinical trials and clinical studies (total investment €489.38 million). As of November 2019, EDCTP invested in 84 grants (total investment €526,04 million) of which 16 HIV & HIV-associated infections grants (total investment of €96,74 million).

Collaborative clinical studies and clinical trials: HIV and HIV-associated infections 2014-2019

Country participation in EDCTP-funded research on HIV and HIV-associated infections

The below map shows participation in EDCTP-funded HIV studies by country. For more detail, please download a PDF here.

More information on the EDCTP portfolio

The EDCTP2 programme is supported under the Horizon 2020, the European Union’s Framework Programme for Research and Innovation.

EDCTP’s public Project Portal provides an up-to-date view on the projects supported as our portfolio grows and gives details of each project’s aims and objectives. Search “HIV” or “Co-infections” in the “classification” box to see current HIV projects.

The portfolio of projects supported under the first EDCTP programme can be viewed here.