New Delhi: UNAIDS states that 40.1 million people have died from AIDS-related illnesses since the start of the epidemic in 1981. Yet the world does not have a vaccine for the disease. It further adds that 38.4 million people globally were living with HIV in 2021, and an additional 1.5 million people became newly infected with HIV. But still, in the four decades since the HIV epidemic exploded, the world has not found the cure for the disease.
In a world where we are making strides in vaccine technology, COVID being the recent example for which a vaccine was built in a record time of just months since the virus was identified, we are still trying to outsmart the HIV virus, without a vaccine.
HIV is one of the most pressing health crises that still plagues the world today. To educate people and communities about the importance and need for HIV vaccine, World AIDS Vaccine Day is observed on May 18 every year. The day also recognises professionals who are working in the development of vaccine against AIDS. This day is also known as HIV Vaccine Knowledge Day.
In India, as per National AIDS Control Organisation’s last report, nationally, there were an estimated 23.48 lakh people living with HIV in 2019. Whereas, there were 69.22 thousand estimated new HIV infections the same year, which translates into 190 new infections every day and eight new infections every hour.
Also Read: “Protect, Don’t Neglect”: Dr. Tanaya Narendra Urges The Use Of Condoms To Prevent HIV/AIDS
About The World AIDS Vaccine Day
World AIDS Vaccine Day was observed for the first time on May 18, 1998, globally with the idea to emphasise the need for vaccination to eradicate HIV. The day was put forth by the then United States President Bill Clinton and it was inspired by his commencement speech at the Morgan State University in 1997.
Since then, the day has been observed globally to educate the public about preventive measures, offer encouragement to researchers and educate people on AIDS vaccination.
Also Read: “Need To Reach Out To Vulnerable Communities To Achieve Zero New HIV/AIDS Cases”: J.V.R Prasad Rao
About HIV Disease
World Health Organization quotes, ‘HIV is not an easy virus to defeat’. It defines HIV – Human Immunodeficiency Virus (HIV) as an infection that attacks the body’s immune system. WHO adds that HIV targets the body’s white blood cells, weakening the immune system. This makes it easier to get sick with diseases like Tuberculosis, infections and some cancers. Explaining about how the disease spread, WHO states that HIV is spread from the body fluids of an infected person, including blood, breast milk, semen and vaginal fluids.
Currently, HIV can be treated and prevented with Anti Retroviral Therapy (ART). WHO adds that untreated HIV can progress to AIDS, often after many years.
Why Making HIV Vaccine Is So Challenging?
According to International AIDS Vaccine Initiative Report, a scientific publication that provides comprehensive and editorially independent coverage of HIV vaccine and prevention research, the challenge in developing HIV / AIDS vaccine lies in the characteristic of HIV virus. It states that the virus’s rapid replication, furious mutation, immune system evasion, and creation of viral reservoirs fail the typical vaccine approach in which the aim of the vaccine is to make antibodies to fight different pathogens.
IAVI also states that when viruses such as polio, smallpox, influenza, and measles infect the body, the immune system recognises the viruses as foreign agent and white blood cells called B-lymphocytes differentiate into cells that produce antibodies specifically targeting the invading virus. This is also the reason why people develop long-term or even life-long immunity against subsequent infections.
Explaining the working of how vaccines work in one of the WHO’s Science in Five episode, Dr Katherine O’brien, Director, Department of Immunisation, Vaccines and Biologicals, from World Health Organization and Professor, Johns Hopkins Bloomberg School of Public Health states,
There is just one thumb rule for vaccines – whenever it is developed for a particular disease – to put a part of the germ or activate it in our body, which our body can recognise and develop and immune response.
However, with HIV the problem is that it turns this process upside-down. IAVI states that HIV hides from the immune system in different ways. It adds,
In most patients HIV eludes the immune system, which fails to generate an effective antibody response to the infection. Patients that do generate HIV-specific antibodies, which is very few, the antibodies are insufficient to limit the course of the disease.
IAVI also states that HIV infects, disables, and kills the very cells that are critical to the healthy functioning of the immune system – the white blood cells, which is why, as AIDS progresses, patients become increasingly vulnerable to life-threatening infections.
In earlier interview with NDTV, explaining the issues with HIV vaccine, Dr Rajesh Parikh, Director of Medical Research and Honorary Neuropsychiatrist at the Jaslok Hospital & Research Centre, Mumbai said,
The replication cycle of HIV is about 24 hours; it mutates so rapidly that their surfaces change shape before antibodies can lock onto them.
He said that there are over 60 dominants strains as well as the multitude of recombinant strains. “Thus, no person who has contracted HIV has recovered from it. There is no immune response that the vaccines can use to replicate.”
HIV Vaccine Development Efforts
According to IAVI Report, a scientific publication that provides comprehensive and editorially independent coverage of HIV vaccine and prevention research, till now, there have been more than 250 HIV vaccine trials, however, most of them stopped at an early stage, as vaccine was not proved safe and could not mount an immune response following vaccination. Very few vaccine trials —10 or so have advanced to the point of looking at efficacy.
COVID-19 Effect On AIDS / HIV
As per a research paper, published in 2022 on National Library of Medicine, the COVID‐19 pandemic led to significant decreases in HIV‐related service utilization among key populations in India. The research paper stated that the numbers of patients receiving HIV tests dropped to 13% of pre‐pandemic levels in April 2020.
Even WHO reported that seventy-three countries have warned that they are at risk of stock-outs of antiretroviral (ARV) medicines as a result of the COVID-19 pandemic. WHO stated that a failure of suppliers to deliver ARVs on time and a shut-down of land and air transport services, coupled with limited access to health services within countries as a result of the pandemic, were among the causes cited for the disruptions in the services.
NDTV – Dettol have been working towards a clean and healthy India since 2014 via the Banega Swachh India initiative, which is helmed by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the inter-dependency of humans and the environment, and of humans on one another with the focus on One Health, One Planet, One Future – Leaving No One Behind. It stresses on the need to take care of, and consider, everyone’s health in India – especially vulnerable communities – the LGBTQ population, indigenous people, India’s different tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically remote populations, gender and sexual minorities. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign will continue to raise awareness on the same along with focussing on the importance of nutrition and healthcare for women and children, fight malnutrition, mental wellbeing, self care, science and health, adolescent health & gender awareness. Along with the health of people, the campaign has realised the need to also take care of the health of the eco-system. Our environment is fragile due to human activity, which is not only over-exploiting available resources, but also generating immense pollution as a result of using and extracting those resources. The imbalance has also led to immense biodiversity loss that has caused one of the biggest threats to human survival – climate change. It has now been described as a “code red for humanity.” The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene. Banega Swasth India will also be taking forward the dream of Swasth Bharat, the campaign feels that only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and the country can become a Swasth or healthy India.
