How prevention research helps stall new HIV infections
Dr James Anenih is the head of Research at the National Agency for Control of AIDS (NACA). In this interview, he spoke on the status of Pre-Exposure Prophylaxis (PrEP), a demonstration study in Nigeria, how prevention research will help improve the health of the populace and the challenges, among others. Excerpt: About two years […]
Dr James Anenih is the head of Research at the National Agency for Control of AIDS (NACA). In this interview, he spoke on the status of Pre-Exposure Prophylaxis (PrEP), a demonstration study in Nigeria, how prevention research will help improve the health of the populace and the challenges, among others. Excerpt:
About two years ago the Pre-Exposure Prophylaxis (PrEP) demonstration study was launched in Nigeria, what is its stage today and how has it helped reduce new HIV infections?
Pre-Exposure Prophylaxis (PrEP) is simply drugs that people take to prevent them from getting HIV infection. It is a procedure for people who do not have HIV but who are at substantial risk of contracting the virus; to prevent HIV infection they take a pill daily.
PrEP is used worldwide and it is more than 98% effective. The Bill and Melinda Gates Foundation gave us the grant to carry out the PrEP demonstrations study. The primary objective of the study is to find a model that will be cost effective, available and efficient to introduce in Nigeria.
So even though we already knew that PrEP is effective worldwide, we needed to find out the best way for Nigeria to introduce it for people that need it. At the end of the study, we will find out the best model to present to government which will in turn put in resources to make it available to those that need it.
The study is taking place in three states, Plateau, Anambra and Cross River. It will come to an end in September this year. At that time, we will be able to start talking about data analysis to provide the necessary information to enable government make an informed decision when it wants to roll it out.
PrEP has now been included in the National Prevention Plan so immediately after this demonstration study, government will have the information it needs to make it available.
Aside PrEP, what are other key areas of biomedical HIV prevention research that are currently been undertaken?
HIV prevention research, just as the name indicates, is research around prevention strategies that we use in Nigeria and globally. Prevention research or interventions involve condoms, gels, microbicides, and drugs. So researches around these prevention interventions are primarily to make them more available, more effective and more efficient.
HIV biomedical research involves research around things like condoms, microbicides, HIV drugs that are used for prevention, that is Anti Retroviral Therapy (ART), and PrEP among others.
Another area of biomedical research is vaccines. About six years ago, we initiated a road map for HIV vaccine research. I led the team, but it has not been implemented as far as research goes. However, over the last few years, emphasis has been more on treatment as prevention because all the vaccine trials across the world have failed so far, which is why we don’t have HIV vaccine till date.
Why was the HIV vaccine research road map not implemented?
It requires a lot of resources. The Nigerian situation is a little bit different in the sense that first of all we don’t have the resources to continue to support vaccine research. Secondly, Nigeria depends largely on donor support, more so, globally, the emphasis now is not so much on developing a vaccine but more on looking for a way or alternative ways of controlling infection.
It is has been very difficult to get a vaccine because of how the organisms replicate.
At this point, there is no vaccine that works but there are still active researches going on as far as vaccines are concerned but not in Nigeria.
In what ways will prevention research tackle the HIV burden in the country?
We are doing the very best we can under the available resources we have; luckily a lot of western countries are collaborating with us on prevention research.
We have had challenges conducting researches ourselves locally in Nigeria because of resources but, like I said, the western world and donors have been supportive.
A healthy country is a wealthy country; the lower the number of people with new HIV infections the better it is for the country. It will not only improve the economy of the country but the general health of the populace.
All of these innovations will help to reduce new infections, help keep those infected under control and as a result improve the general health of the populace.
I am very confident that in the near future, we will be able to reduce new infections, reduce the national prevalence rate and keep in control those that have been infected because HIV is a major part of the health sector. Keeping it under control obviously translates to a healthier country.