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DR ADRIEL MOODLEY (RSA)LEAD RAPPORTEUR – TRACK A

RAPPORTEURS SESSION

TRACK A – Sciences (Biology and Pathogenesis)

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MEET THE TEAM

MR TINASHE CHIDEMO

(ZIM)

Biomedical Scientist UZ-CTRC

DR ALLEN MATUBU

(ZIM)

Biomedical Scientist Epidemiology; Immunology UZ-CTRC

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OVERARCHING TRENDS (THE THREADS)

  1. HIV and Infectious diseases

  • The widespread acceptance of SELF TESTING

  • VACCINATIONS and the need for African-based development

  • LESSONS FROM THE PANDEMIC and the STATE OF READINESS of Africa

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HIV & INFECTIOUS DISEASES – New findings

  • General decrease in the new HIV infection rate, however the burden of the effects remains high

  • Experiences shared from Zimbabwe in their HIV prevention cascades re-emphasise PREVENTION IS BETTER THAN CURE.

(SESSION: HIV Prevention cascades for routine program monitoring)

  • ALARMING results of the high incidence of DRUG RESISTANT HIV VARIANTS from two studies (Benin and Cameroon), which places emphasis on genetic monitoring + testing for resistance

(SESSION: A1 HIV co-infection with TB and other pathogens)

  • Study conducted in Kilimanjaro – 55% of women living with HIV co-infected with bilharzia (? Need for screening)

(SESSION: A2 HIV co-infection with TB and other pathogens)

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HIV & INFECTIOUS DISEASES – New findings

SESSION: Are vaccines capable of controlling STI’s? Bacterial STI Vaccines

  • Large study which reviewed the development of vaccines for the FOUR MAJOR TREATABLE STIs and their stages of testing.

  • Mathematically calculated: “Even a vaccine with limited effectiveness will have a significant decrease in incidence – some diseases can even be eradicated

  • HOWEVER: These trials performed in developed western nations: Africa needs to be involved with STI vaccine trials

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HIV & INFECTIOUS DISEASES – New findings

SESSION: Can vaccines control STIs? Viral STI Vaccines

  • HPV vaccinations rolled out in over 136 countries

  • Two dose regimen introduces complications.

  • Developing the vaccine wasn’t the problem: the logistics behind manufacturing, distribution and administration are.

  • RESULT: Several countries have changed to single dose

BE WARNED: limited evidence if single dose is enough to protect your people!

SESSION: mRNA vaccines

  • A South African based company has made available mRNA vaccine development technology
  • Marketed at low-middle incomes
  • Will allow local vaccine development – urgent need in Africa

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THE RISE OF SELF TESTING – New findings

SESSION: Give me a choice! Introducing blood-based HIV self-test kits

  • Blood based self-test kits have newly been introduced, alongside the more commonly used oral kits. They have widely been accepted by the consumers.

  • Experiences from Uganda and Nigeria:

-Be wary of cheaper unapproved test kits on the market

-Tests should ideally be more easily available – aim for supermarket shelves not just pharmacies.

-Price competitiveness is key to successful uptake.

SESSION: Accelerating viral hepatitis elimination by 2030

  • HepC rising in incidence esp. within the HIV population

  • DETECTION (screening) is the key to elimination – the development of new HepA + B + C self-test kits will improve this.

  • Screening and detection needs to be rolled out at the lowest possible level of care.

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VACCINATIONS– New findings

SESSION: Fast tracking pandemic vaccines: HIV vaccine development

  • A detailed South African review – Rapid development of COVID vaccines during pandemic

  • Analysed numerous efficacy and mortality studies vaccines and their boosters worked!

  • No effective HIV vaccine has yet been developed: the search continues – trials and testing need to be set in Africa.

SESSION: Empowering Africa in HIV vaccine development

  • HIV vaccine research hampered by inadequate funding from our own governments.

  • None of the analysed African countries met the 15% GDP allocation for health and R+D!

  • We have failed our promise to meet the Abuja and Bamako commitments

  • Domestic funding is critical to advance R+D in Africa – we should not be relying on handouts from other continents.

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LESSONS FROM THE PANDEMIC and the STATE OF READINESS of Africa

SESSION: Pandemic preparedness Framework: Implications for Africa

  • The Global Preparedness Monitoring Board has deemed Africa UNREADY for another pandemic (we failed to meet ANY of the criteria adequately).

  • Africa is not ready to deal with another pandemic: Need for address

  • The GPMB have identified a lack of accountability as the major reason
  • Recommendation: Target setting is an easy but effective first step (eg 95-95-95 goals)

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RECOMMENDATIONS

  1. Active monitoring and testing for resistant HIV strains, without neglecting prevention
    • Resistance to most NRTIs and NNRTIs are being identified
    • Need for the adoption of more preventative measures (prevention > cure)

  • Self-testing remains an effective tool for screening
  • Crucial for the goal to eliminate Hepatitis
  • Oral and blood-based kits are both widely accepted
  • Focus on consumer- develop and distribute an approved product to populations and places where it will be most effective.

  1. Africa needs to be the focus of vaccination development and trials
  2. Vaccines for STI’s proven to be effective – need to be adopted into African health systems.
  3. Self-made vaccine production
  4. mRNA vaccine development technology is available and is aimed to be affordable- this should not be left unexplored/invested into.

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THE RISE OF SELF TESTING – New findings

4. Africa is NOT PREPARED for another pandemic and has not fulfilled its mandate to the Abuja and Bamako commitments to free financial resources for R+D in HIV and healthcare.

  • Focus developing Africas ability to resource itself ie domestic funding (not depend on international partners)
  • Lack of strong leadership with accountable TARGETS
  • What if another pandemic occurs??

  1. Limited number of science and pathogenesis-based submissions this year.

- Direct need for more science-based studies to be performed or submitted for the next ICASA