HIV Research Program Has Global Reach

WASHINGTON, Dec. 1, 2010 — In its effort to pro­tect troops every­where from HIV infec­tion, the U.S. Mil­i­tary HIV Research Pro­gram at Fort Det­rick, Md., also works to reduce the disease’s glob­al impact through work per­formed in regions heav­i­ly impact­ed by the virus.

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.

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

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