Keywords: HIV, AIDS, Vaccine, Microbicide, Mucosal, Network and Prevention
The successful development of preventative strategies against HIV-1 infection (microbicides, vaccines or their combined effects) would provide a pivotal turning point in global efforts to combat the pandemic spread of AIDS providing an incalculable impact on solving societal prob-lems associated with this disease. The principal aim of this project is to bring together EU scien-tists from the microbicide and vaccine fields to embrace a co-ordinated approach to HIV-1 infec-tion prevention research. Partners in the EUROPRISE consortium represent 13 projects funded by the European Commission from the sixth Framework Programme as well as four projects funded by the Gates Foundation.
These projects involve 132 institutions from 22 countries. EUROPRISE is, in this respect, the first consortium to purposely bring these groups together in a truly integrated fashion from both within Europe and internationally. EUROPRISE will offer an integrated programme of research; co-ordinate a wide portfolio of activities and encompass the whole pipeline of vaccine and microbicide development; from early discovery, through to early clinical trials. This unique approach places the Network at the international forefront, for understanding the interface between these two technologies; pursuing a critical path to the develop-ment of effective HIV-1 infection prevention strategies.
Although therapeutics for HIV infection and AIDS continue to improve and initiatives for mak-ing these products available in developing countries have been introduced, ultimately, the global incidence of HIV infection is critically dependent on the development of safe and effec-tive strategies to block and prevent HIV transmission.
The design and implementation of effective microbicide and vaccine strategies, individually and possibly in combination, will be key to achieving this goal. Ideally, microbicides will pro-vide chemical and vaccines immune protection respectively, at the mucosal surfaces of the va-gina and rectum, which represent the major portals of viral entry. The combination of these approaches may maximise potential synergy between both technologies.
It is now well established that under most circumstances, vaccines delivering non-replicating antigens fail to induce sufficient mucosal responses and immunological memory to provide protection against high viral challenge. In contrast, while it may be technically easier to develop microbicides that prevent transmission when applied before intercourse, their duration of protection is likely to be short-lived and their efficacy will be critically dependent upon user compliance. To date, both fields have been slow to work together in the development of products that provide multiple levels of protection. This network is focusing on the premise that microbicides and vaccines that target multiple stages of mucosal transmission will have the best chance of success. Since both target the same proc-esses, there is a clear overlap between the two fields.
Indeed, there are compelling reasons as to why the two fields should work together on develop-ing effective strategies to prevent mucosal vaginal or rectal transmission including:
The successful development of preventative strategies against HIV-1 (microbicides, vaccines or their combined effects) would provide a pivotal turning point in global efforts to combat the pandemic spread of AIDS providing an incalculable impact on solving societal problems asso-ciated with this disease. The principal aim of this proposal is to bring together EU scientists from the microbicide and vaccine fields to embrace a coordinated approach to HIV-1 preven-tion research.
Delivery of the goals will be achieved through the following scientific and technical objectives:
The potential strategic impact on solving societal problems for any project aimed at developing a preventative strategy against HIV infection /AIDS (microbicides or vaccines) is almost incal-culable. HIV infection /AIDS is a global issue and UNAIDS/WHO estimate that at the end of 2004, 40 million people globally were living with HIV, of which 28.5 million were in Sub- Saharan Africa. In Eastern Europe and Central Asia, a rapid increase in HIV infections resulted in 1.4 million people being affected. InWestern Europe, an estimated 610,000 people were liv-ing with HIV.
Globally, there are 14,000 new HIV infections per day, of which 95% are in developing coun-tries. Approximately 12,000 of these infections are in persons aged 15-49 years of age, of whom almost 50% are women, and 50% are 15-24 years of age. In S. Africa, 1 in 4 women are infected with HIV by the age of 22.
It has been estimated that a 60% efficacious prophylactic treatment, introduced into 73 low-income countries and used by only 20% of women, would avert 2.5 million HIV infections over a period of 3 years in women, men and infants.
In some countries, public health programmes have achieved modest results in reducing HIV rates of infection. Although the use of condoms has slowly increased in countries most severely affected by the HIV epidemic, many vulnerable women are unable to ensure routine use.
The development of new anti-HIV infection and AIDS vaccines and microbicides has been identified as key areas in FP6. This builds on past highquality research programmes on vac-cines and therapeutics supported by the EU, through the programmes FP4 and FP5. However, while significant progress has been achieved in understanding immune response to HIV-1 antigens and in the development of effective antiretroviral therapy, significant challenges to the development of effective preventative strategies still remain. The potential direct impact of this network, therefore, is multifaceted and broad in scope. There is a clear and urgent need to network European microbicide and vaccine research and provide a clear and coordinated strategy for the development of new prevention technology against HIV infection and AIDS.
Such an approach has obvious potential for direct health benefits that will translate into social stability and development. It will offer scientific benefits; by the creation of new knowledge as well as maintaining a strong science base in Europe. It is generally accepted that HIV vaccines and microbicides will have the most significant impact on the growth of this pandemic in both the developing world and within Europe. The potential to derive enormous health benefits, by itself, argues for a strong, integrated approach to the development of HIV-1 prevention strate-gies.
1 - Administrative Coordinator:
Centre for Infection Department of Cellular and Molecular Diseases
St George’s Hospital Medical School
Cranmer Terrace / Tooting, London
2 - Scientific Coordinator:
Hans Wigzell Karolinska Institutet
Stockholm - Sweden
3 - Co-Coordinator for Vaccines:
Novartis Vaccines and Diagnostics srl
Via Fiorentina 1
53100 SIENA - Italy
|Official Address||Other Information|
|4||R Shattock / Dr M Cranage |
J Ma / Dr D Lewis
|St. George’s Hospital University
of London |
|5||H Wigzell / Dr BWahren / Dr F Chiodi |
|Karolinska Institutet |
|6||R Rappuoli / Dr S Barnett |
G Del Giudice
|Novartis Vaccines and Diagnostics |
|7||D Medaglini / Prof G Pozzi||Universita di Siena |
|8||A Tagliabue||ALTA Siena IT|
|9||G Voss||GlaxoSmith Kline |
|10||H Katinger / G Steiglere||Polymun |
|11||C Kelly / T Lehner |
|Kings College London |
|12||G Scalae||Universita di Napoli |
|13||K Uberla||Ruhr Universitaet Bochum |
|14||H Holmes / N. Almond |
|National Biological Standards Board |
|15||R Weiss||University College London |
|16||F Gotch / S Patterson||Imperial College of Science, |
Technology & Medicine
|17||V Jespers||Prince Leopold Institute |
for Tropical Medicine
|18||S McCormack / A Nunn |
|Medical Research Council |
|19||G Scarlatti / G Poli / P Lusso||Centro San Raffaele |
|20||R Le Grand||Commissariat a l’Energie Atomique |
|21||B Verrier |
|Institut National de la Sante et de la Medecine |
University of York
|22||Q Sattentau||University of Oxford |
|23||P La Colla||Università di Cagliari |
|24||Christiane Stahl-Hennig||Deutsches Primatenzentrum GmbH
|25||Fenyö||Lunds Universitet |
|26||F Tangy||Institut Pasteur |
|27||H Schuitemaker||Sanquin |
|28||J Alcami / Prof R Najera||Instituto de Salus Carlos III |
|29||G Leroux-Roels||Ghent University |
|30||D Zipeto||Università di Verona |
|31||S Norley||Robert Koch-Institut |
|32||E Karamov||Ivanovsky Institute of Virology, |
Russian Academy of Medical Science
|33||K Nihlmark||Mabtech AB |
|34||N Dedes||European AIDS Treatment Group e.V |
|35||C Moog||Universite Louis Pasteur |