Toolkit HIV Vaccines.ppt
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  • Welcome Quiz If time, also talk about microbicides
  • When people are given a vaccine against a particular disease, this provokes responses from their immnue systems. The immune systems are the « on alert ». If these people are later exposed to the infectious agent that causes that disease, their immune systems are ready to protect them from infection. I recognize that!
  • 15th century, China, Turks, small pox lesions/postules, snort, blow up nose, skin graft England: Jenner in 1796 invents the small pox vaccine. About 100 years later, Pasteur Ask: Chicken pox, Hepatitis A, Hepatitis B, influenza, measles, mumps, polio Humoral (blood): attacks the infectious agent itself Cellular: attacks infected cells Ideal: effective regardless of nutrition, health status or ethnicity; protects against all subtypes; protects against any route of infection; inexpensive to manufacture; easy to transport and administer; stable under field conditions; provide long-lasting protection Therapeutic treats, does not prevent disease. Do not yet exist. Preventative does not cure
  • Dozen products now being tested in humans on six continents – a record number Two arms of AIDSVAX: North America and Netherlands / Thailand One trial in Thailand of ALVAC & AIDSVAX Canada: only Phase III, no phase I or II Research: CANVAC, CIHR
  • CANVAC (Canadian Network for Vaccines and Immunotherapeutics) is a CIHR-funded network focussed on development of vaccines for prevention and treatment of chronic diseases, primarily HIV, HCV and cancer. 83 researchers, 15 universities, 18 corporate partners and 21 government agencies, patient and consumer groups. Handful of Canadian scientists researching HIV vaccines: Jolicoeur, Wainberg, Plummer, Cohen, Kang, Lemay, Sékaly, Hiscott, MacDonald, Rosenthal, Tremblay and Angel Canada 3rd largest donor, was largest country donor, now US Subtype B, North America and Western Europe, rapidly changing to majority devl countries strains
  • 3-5 million children die each year from diseases with existing vaccines 250 million people with HBV Low vaccination rate among gay men, at high risk. 49% HBV in Montreal, only 3/5 have full inoculations (3 needed) Lack of licensing agencies in many countries, time delays, lack of infrastructure for manufacturing (cost, time), lack of mechanisms ond sources of funding for purchase, lack of delivery infrastructure in most affected regions
  • Higher impact among population with higher rate of infection Lack of licensing agencies in many countries, time delays, lack of infrastructure for manufacturing (cost, time), lack of mechanisms ond sources of funding for purchase, lack of delivery infrastructure in most affected regions Most likely low efficacy at first
  • In Canada, gay men, maybe IDUs, prisoners, Aboriginal communities? Sub-Saharan Africa: sexually active pop., pre-adolescents? How will that work? Gloablly: adults, not children. Little to no experience, and what has been done has not worked well! HAV & HBV for example Varying levels of awareness, experience and acceptance of vaccines will differ here, in developing countries. What of anti-vaccine lobby? Small pox bioterrorism scare? Will people trust an HIV vaccine? Need for awareness Will people be willing to be vaccinated or have their families vaccinated? Stigma attached to disease may compound the obstacles.
  • Will we have better rates than with HAV & HBV? Very real possibility that a partially effective vaccine, especially with low rate of coverage, could make things WORSE! Vaccine optimism: greater increase in risk behaviour than protective aspect of vaccine Perhaps intro of microbicides (partially effective also). Impact of rates of infection, impact on prevention. What kinds of campaigns will be needed? Prevention messages? Role of VCT, combatting stigma and discrimination, etc. No efficacy: but slows viral replication and disease progression
  • CANVAC is a Network of Centres of Excellence, funded by federal government and private sector 83 researchers, 15 universities, 18 corporate partners, 21 government agencies, patient and consumer groups 3 targets: HIV Prophylactic and therapeutic vaccines, HCV therapeutic and prophylactic vaccines, theraputic cancer vaccines 4 themes: New targets for change of immune response, Novel technologies for vaccine delivery, Novel technologies to measure the immune response, Clinical integration and social behavioural research in vaccine development
  • Correction du quiz

Toolkit HIV Vaccines.ppt Toolkit HIV Vaccines.ppt Presentation Transcript

  • Introduction to H IV Vaccines
  • Definition
    • A vaccine is a substance that teaches the body’s immune system to recognize and protect against a disease caused by an infectious agent.
  • A vaccine primer
    • 200 years of vaccines
    • Common vaccines
    • Types of immunity: humoral (antibody) and cell-mediated
    • An ideal HIV vaccine
    • Preventative or therapeutic?
    • Vaccine development stages
  • State of Vaccine Research
    • First trial in 1987
    • 30 products tested
    • 60 clinical trials
    • 2 phase III trials
    • 1% of global health R&D
    • In Canada, only AIDSVAX trial
    • $2.14 million in Canada on research
  • State of vaccine research
    • CANVAC
    • CIHR
    • CIDA grant to IAVI
    • Globally: a few pharmas, universities and governments
    • A narrow pipeline!
  • Vaccine Delivery
    • Build on experience of other vaccines now!
    • Hepatitis A & B in Canada
    • Issues of licensing, manufacturing, purchase and delivery
    • Questions, questions!!!
  • Impact on the epidemic
    • Even low-efficacy could have long-term impact
    • With highly-effective vaccine, would still take years
    • Plan for various scenarios (low-efficacy, high efficacy)
  • Impact on the epidemic
    • Low-efficacy:
    • Delivered to « high-risk » population
    • Level of awareness of vaccines
    • Level of trust of vaccines
    • Attitudes towards HIV/AIDS
    • Stigma & discrimination
  • Impact on the epidemic
    • Low-efficacy (2)
    • Rates of coverage
    • Vaccine optimism
    • Combination prevention
    • High efficacy
    • Very similar issues!
    • No efficacy BUT still OK!
  • International AIDS Vaccine Initiative (IAVI)
    • G lobal organization working to speed the development and distribution of preventive AIDS vaccines
    • F ocus on four areas:
      • mobilizing support through advocacy and education
      • accelerating scientific progress
      • encouraging industrial participation in AIDS vaccine development
      • and assuring global access
  • Canadian AIDS Society
    • IAVI’s Canadian partner since 2000
    • Advocacy: funding Canadian HIV Vaccines Plan
    • Communications: dissemination of resources, web site, newsletter, advocacy updates, media relations
    • Capacity-building: workshops, CANVAC project
    • Strategic alliances: Legal Network, ICASO, European partners
    • Links between vaccines and microbicides
  • Canadian HIV/AIDS Legal Network
    • Discussion paper and info sheets on Vaccines in Canada
    • Discussion Paper on vaccines in developing countries
    • Satellite at International AIDS Conference
    • Global advocates meeting: vaccines, microbicides and treatment
  • CAS and Legal Network
    • Joint advocacy on Vaccines Plan
    • Joint efforts around AIDSVAX results: background information, media relations
  • CANVAC
    • Canadian network of scientists in immunology, virology, molecular biology
    • Conducts research in bio-medical and social science
    • Therapeutic and preventative vaccines for HIV/AIDS, HCV and cancer
  • Becoming involved
    • Getting and disseminating information
    • Subscribing to IAVI Report or VAX
    • Advocating for vaccine development
    • Raising information in your community
    • Participating in development of Canadian HIV Vaccines Plan
  • Sources of Information
    • www. iavi .org IAVI Report, VAX
    • www. avac .org Handbook, reports
    • www. cdnaids .ca Basics, advocacy updates
    • www. aidslaw .ca Discussion paper, info sheets
    • www.icaso.org Primers
    • www.canvacc.org Vaccines, R&D