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Partnerships hold the key to making HIV history

Published on 20/11/17 at 12:42pm

Brian Woodfall, Global Head of Late Development, Infectious Diseases at Janssen, explains why a future without HIV can only be achieved if clinicians, academics, industry leaders and policymakers work together.

It’s not much more than three decades since the first cases of HIV/AIDS were catapulted into the global spotlight, and barely two decades since an HIV diagnosis was effectively a death sentence. Yet in the years since, we have seen extraordinary scientific and medical progress.

From the first antiretroviral therapy, AZT (zidovudine), in the late 1980s to the innovative treatments and therapy combinations of today, HIV has largely – in settings with adequate access to treatment and healthcare – evolved from a terminal illness into a manageable, chronic condition. In most parts of the world, we are also seeing considerably lower disease transmission.

 A problem changed, not solved

Yet while I’m proud to say Janssen has actively contributed to many of these developments, I’m acutely aware that a future in which HIV is treatable is very different to one in which it’s no longer a problem at all. The nature of the virus’s challenges may have evolved but they certainly haven’t disappeared.

You only need to look at the latest figures to see the scale of the problem that still exists. An estimated 36.7 million people are currently living with HIV globally, with 1.8 million newly infected every year and a million dying of AIDS. Those of us working in the field also know the infuriating complexity of HIV, thanks to its ability to rapidly mutate. This adds complication as it increases the risk of the virus becoming resistant to medicines – a problem exacerbated by poor adherence to treatment regimens.

What’s more, there are various socio-economic and political factors at play too, including poor and/or unequal access to treatments, restricted healthcare budgets and a general lack of education and awareness around HIV and its transmission. Most frustrating of all is the fact that people are continuing to become infected due to the lack of an effective preventative vaccine, the ultimate goal for many HIV researchers.

The power of partnerships

But that’s enough of the doom and gloom. Yes, challenges remain around patient care and long-term treatments, but my firm belief is that they can be overcome. For this to happen though, one thing will be key: collaboration, not just between scientists and clinicians but across the full spectrum of medicine, industry, academia, governments and NGOs.

The good news is it’s already happening, with several successful partnerships becoming established between industry partners. Most seek to uncover ways to reduce the negative impact of HIV on patients’ lives by limiting the number of pills they need to take. This has paved the way for numerous modern treatment regimens combining multiple HIV medicines in a single tablet.

At Janssen, for example, our ongoing research and development efforts are focused on pursuing a shift in the way we treat HIV, and striving to find a functional cure for the disease, for which collaborations and partnerships are critical.

Two of our ongoing collaborations focus on developing single-tablet regimens to simplify previously complex treatment programmes. Both demonstrate the progress achievable when we harness the expertise, energy and experience of multiple players across both the public and private sector. Why? The reason is that combining our collective power allows us to better address the wider issues around HIV, such as access to care in the developing world, especially among women, and the healthcare infrastructure needed to deliver HIV therapies.

Finding HIV’s Holy Grail

There’s another part of the world’s fight against HIV where the power of partnership is critical – the quest to find what some call the ‘Holy Grail of HIV’: a vaccine.

As the World Health Organization has stated, “a safe, effective and available vaccine is ultimately required to complement and enhance the effectiveness of existing prevention strategies to control the HIV/AIDS pandemic, especially in developing countries.” In other words, as important as treating HIV is – including from an HIV transmission perspective – we can’t rely only on a therapeutic approach. Eradicating HIV will require a vaccine.

Of course, this is far easier said than done. Due to the virus’s unique ability to mutate and global genetic diversity, finding an effective vaccine has so far proved elusive. It therefore follows that we can only expect to do so through a concerted, united effort between dedicated volunteers: the smartest scientific minds, the most knowledgeable medical practitioners and the most advanced technology.

At the IAS congress in Paris, we saw glimmers of hope emerging in this field. Among them were advances in research that investigates the potential of vaccines designed to protect against a wide range of the virus’s subtypes, utilising the genes of many HIV variants from around the world responsible for infection.

Working alongside a number of partner organisations including: Beth Israel Deaconess Medical Center (BIDMC); the United States Military HIV Research Program (MHRP) at the Walter Reed Army Institute of Research (WRAIR), with the Henry M Jackson Foundation for the Advancement of Military Medicine (HJF); the National Institute of Allergy and Infectious Diseases (NIAID), part of the US National Institutes of Health (NIH); the Ragon Institute; the International AIDS Vaccine Initiative (IAVI); and the HIV Vaccine Trials Network (HVTN), we hope to continue making dramatic improvements for patients with HIV.

Making HIV history

All of which brings me full circle. As with so many aspects of the battle against HIV to-date, the path to finding a vaccine is one that no scientist, academic, pharmaceutical company or policymaker can, nor should, expect to walk alone. Instead, sharing expertise, knowledge and progress will be crucial if we’re to stay one step ahead of this challenging virus and truly make HIV history.

We’ve come a long way in a relatively short space of time. But, in many ways, the most important steps of the HIV journey are still to come. We must take them together.

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