CAPE TOWN, SOUTH AFRICA -- In the shadow of the mountains surrounding Cape Town, top scientists and others gathered Wednesday for the opening of a lab that will focus on developing a vaccine to prevent HIV infections worldwide.
Dr. Julie McElrath, principal investigator and director of the HIV Vaccine Trials Network Laboratory Program, based at Fred Hutch, said the opening of the lab marks a key moment in the effort to develop an HIV vaccine.
“We are here for one common reason, and that’s because we want to find an effective HIV vaccine,” McElrath said. “We believe that the fastest way to do this is to do clinical research with the most promising HIV vaccine candidates here in South Africa.”
Tshililo Michael Masutha, South Africa’s deputy minister of science and technology, said the lab will play a critical role in bringing together expertise that can help combat the region’s HIV epidemic, the most severe in the world.
“For us as a country, this is about survival,” Masutha said. “We need to produce a knowledge base (to help us) on the path to vaccine development.”
The opening of the lab coincides with a conference co-hosted by the HVTN and the South African Medical Research Council. It marks the HVTN’s first meeting outside of the United States. The network is partnering with the South African government as it moves forward on its efforts to expand HIV vaccine research in the region.
Everybody understands the stakes
The 10,000-square foot Cape Town HVTN Immunology Laboratory, built by Fred Hutch, will serve as a base for upcoming HIV vaccine trials in South Africa and throughout the region.
It is the first lab outside Seattle built for the HIV Vaccine Trials Network (HVTN), a Hutch-based international collaboration of scientists and educators working to finding a safe, effective HIV vaccine.
There may be no better place for that work than the legislative capital of the country most ravaged by HIV. South Africa has the highest number of people living with HIV in the world -- more than five million, according to Statistics South Africa and UNAIDS. Many people have lost close friends and family members, which makes them more likely to get involved in the vaccine trials.
“Everybody there understands the stakes and the lab represents another opportunity for collaborating with the extraordinary scientific community there," said Banks Warden, the HVTN's chief operating officer.
The lab will initially focus on two large clinical trials to test HIV vaccines in healthy adults. Slated to start in 2015, the trials will involve more than 12,000 participants and cost about $250 million, with roughly equal amounts of funding from the Bill & Melinda Gates Foundation and the National Institutes of Health.
Those trials ― and the lab built to carry them out ― were prompted by a groundbreaking six-year trial in Thailand of the only vaccine to show modest efficacy in protecting people against HIV infection. Participants who got the vaccine, known as RV 144, were infected at a rate almost one-third lower compared to those who did not receive the vaccine.
The trial involved more than 16,000 volunteers and was the largest HIV vaccine trial in history. Its results were released in 2009, a decade after the HVTN was launched, and offered the first glimmer of hope that HIV's insidious spread might be preventable.
"There was great excitement about the results of the trial," said Dr. Erica Andersen-Nissen, director of the Cape Town lab. "It was the first signal that an HIV vaccine was showing progress."
The mission of the Hutch is the elimination of cancer and related diseases as a cause of human suffering and death. Those with HIV can be several thousand times more likely to develop various types of cancer, according to the National Cancer Institute.
One of the upcoming trials will test different combinations of vaccines to look for common immune system responses. The other will focus on developing a vaccine that can be licensed in South Africa and will use the RV 144 vaccine modified to match the HIV strain present in the region. Known as Clade C, the strain is the most rapidly spreading subtype of HIV in the world.
Safety tests are currently underway to see how the vaccine used in the Thai trial affects those in South Africa. The trials will be carried out under the Pox Protein Public-Private Partnership, or P5, a consortium launched in 2010 to build on the Thai trial. The group includes the HVTN, the Gates Foundation, the U.S. Military HIV Research Program, vaccine manufacturers and others.
Safer, more efficient way to process samples
Because of the Cape Town lab’s proximity to the trial participants, it provides a more efficient, safer way to process blood samples. Previously, samples from HVTN trials have been stored on dry ice or liquid nitrogen and flown back to the network's lab at the Hutch, a labor-intensive and costly process that has occasionally resulted in ruined or lost samples.
"They will do the laboratory assays in South Africa exactly like we do them here, so the data will be a hundred100 percent comparable," Warden said.
The cost to renovate the lab space and purchase equipment was almost $3 million, and the project received key funding from the Gates Foundation and the NIH. It so far has two employees, Andersen-Nissen and a lab training manager, and there are plans to hire two local technicians and an administrative assistant over the next few months.
Located at Wembley Square, a three-building multiuse development with residential, retail and commercial space in Cape Town's City Bowl area, the state-of-the-art lab will host researchers from other countries and also train South African scientists in lab techniques related to diagnosing HIV and AIDS.
Though the upcoming trials will focus specifically on the HIV strain found in South Africa, the work done at the lab has the potential to advance the fight against HIV around the globe, Andersen-Nissen said.
"Anything we find out here is going to be translatable to elsewhere in the world," she said.
View a slideshow of Cape town Lab opening ceremony and South Africa
