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HIV continues to be a major health problem, taking its most severe toll on developing
countries countries. The annual number of AIDS deaths globally stood at 2 million per year
in 2007. While this is an improvement on 2005 figures, a lot remains to be done to curb HIV
infection. In sub-Saharan Africa, HIV has reduced life expectancy by more than 20 years,
slowed economic growth, and deepened household poverty and the epidemic has orphaned
nearly 12 million children aged under 18 years. Representing only two percent of the world’s
population, the region has the world’s highest levels of HIV infection. In countries such as
Lesotho, Namibia, South Africa and Swaziland—HIV prevalence appears to have stabilized
at extraordinarily high levels. In real terms, AIDS deaths affect key sectors such as
agriculture, education, and health. The unprecedented loss of skilled and productive men and
women from the workforce has placed an enormous strain on the southern African economies
already facing development challenges before the epidemic peaked.
Current efforts to control HIV infection in southern Africa are focused on education and
awareness on condom use and various social behavioural education programs. Despite global
efforts, an effective vaccine against HIV is not imminent, and efforts to develop such a
vaccine have been hampered by the variability of HIV strains. Efforts to develop a vaccine in
the laboratories in developed countries focus primarily on subtype B viruses which are
prevalent in that part of the world, subtype C viruses are prevalent in southern Africa. In the
absence of an effective vaccine against the disease, other methods of infection control need to
be considered. Microbicides are a potentially effective tool against HIV infection. Currently
there are several microbicide clinical trials going on in the region, with all products under
study developed in western countries. BufferGel and Pro2000, some of the products in
human clinical trials in the region, are not amenable to the cost effective production
technology being proposed.
All governments in the Southern African region have policies on HIV infection control
(education, prevention and care) which invariably consists of HIV testing provided within the
context of voluntary testing and counselling, diagnostic testing (preventing mother-to-child
transmission, opportunistic infections and antiretroviral therapy) and blood safety, condom
use, social behavioural education programs promoting awareness and fidelity. This is then
complimented by the activities in managing disease in the infected population, which
includes the use of ARVs, home based care, immune boosting food programs and use of
traditional herbal remedies. Some of these policies are even finely tuned for the various
sectors (transportation, mining, education), because of the different dynamics that exist
within these sectors. The United Nations Development Programme (UNDP) has also
launched the Southern Africa Capacity Initiative (SACI) in March 2004 to support the
governments of the nine countries in developing innovative approaches to stop the erosion of
human resources and strengthen HIV/AIDS awareness initiatives and support mechanisms.
Microbicides to curb HIV infection are a recent addition to a paradigm aimed at preventing
the disease as compared to treating it. It is in this context that we are adding cost effective
microbicides as a tool in the fight against HIV infection.
In Southern Africa, cultures limit women’s autonomy and can leave them vulnerable to a
spouse's unsafe sexual practices. Currently available prevention options such as condoms
and mutual monogamy are not feasible for millions of people, especially women, who do not
have the social or economic power necessary to insist on condom use and fidelity. Clearly a
massively expanded prevention program that specifically targets women is required to curb
global HIV infection.
In this project we will establish technologies for expression of promising microbicidal
candidates in plant cells and in fruit. Successful expression of the microbicidal molecules
lays the foundations for a technology that can be adapted for GMP production of molecules
for early phase human clinical testing. In this project we will train two students from the
region and one from South Africa in molecular biology and plant based bio therapeutic
expression, and in immunology. We acquired the Griffithsin and Scytovirin molecules from
NCI Frederick, and should we establish viable expression, we will be able to license the
molecules for use for the humanitarian intention of HIV infection prevention.
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