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Speeches / Lectures
Address during the inauguration of Symposium on Using
Health Research and Information Technology to address
Grand Challenges in Health
Accelerate research
through national mission
I am delighted to participate in the inauguration of the International Symposium on Accelerating India?s Response to Research for a Preventive HIV Vaccine
organized by Ministry of Science and Technology in partnership with the Ministry of Health and Family Welfare and Forum of Parliamentarian on HIV/AIDS at New Delhi. My greetings to the Political Leaders, Administrators, Policy Makers, Opinion Leaders, Scientists, Technologists and Educators participating in this symposium. Friends, I realize for our country the important current health mission is to combat TB, Water Borne Diseases like Diarrhea, and Vector Borne Diseases like Malaria apart from Cardiac diseases and Cancer. However, for the past decade, HIV/AIDS has been threatening to become a silent killer, since it takes nearly a decade to detect the infection to recognition of fatal disease symptom on an affected person.
When I am with you I would like to discuss on the topic "HIV Free India: A mission"
HIV/AIDS Control
Today in our country, all age groups put together have incidence of 2.39 million HIV
cases. 163 out of 611 districts in the country have high proportion of HIV cases. As per the UN report, India has halved the number of adults newly infected during the last decade by AIDS response through manufacture of generic anti-retroviral drugs. I congratulate NACO and other researchers for this unique effort. The scientific community has been continuously engaged in the task of determining the genetic nature of HIV that will lead to its cure. The genetic nature when studied had some surprises. The Retro virus is RNA based and not DNA. Most retro viruses have only three genes, whereas the HIV virus had nine genes, with 9200 base pairs. With this understanding of genetic nature, number of drugs have come in at least to control the HIV in as it is where it is condition. This intervention extends the life of HIV affected persons. The typical drug which has been developed and produced abroad are AZT, based on DNA synthesis. It halts the disease spread. Another medicine found is INDINAVIR with equally good results. One university abroad has tried a combination of AZT-INDINAVIR and 3TC, for some patients, which gave unique results fully suppressing the HIV AID virus. Of course research is continuing. However, the cost of medicine is still prohibitive. We have to bring down the cost of the drugs further, so that it will be affordable to all the needy patients. Let us now understand some of the global and national missions towards combating HIV. Development of Preventive Vaccine against HIV
Global y, it is estimated that more than 34 million people are affected by the HIV/AIDS
and every year roughly 2.7 million new infections are made. Moreover, over 10% of the HIV/AIDS affected people are children and it is estimated that over 16.6 mil ion children were rendered orphans in 2009 because of the disease which consumed their parents. So, HIV/AIDS is not only a global medical challenge but also affects social order and To find a permanent solution for preventing HIV/AIDS, we have to develop preventive vaccine against HIV at the earliest and lead it to commercial production. That should be the most important contribution of scientists and researchers spread across the country dealing with the development of preventive vaccine against HIV during the last decade. Normally vaccines are developed using the natural immunity against re-infection, protect against disease and not against infections and they protect against infection which are infrequently encountered. Vaccine for preventing HIV/AIDS has to have a new way of thinking since HIV/AIDS infection does not fol ow the normal routes. Trial results in India
Phase one clinical trial of an imported Adeno-Associated Virus based HIV vaccine was
initiated at National AIDS Research Institute, Pune in early 2005. The product was found the safe, but since it was moderately immunogenic at high doze, it was not taken up for further development. The second phase ?one trial on TBC-M4 sub type-C vaccine was tested at NITR Chennai during 2006. Based on the results of this trial, another phase one trial was initiated using TBC-M4 in a prime boost regimen with ADVAX in 2010 at NITR and NARI. Although the results of the studies showed comparable responses of the heterologous DNA ? MVA prime boost strategy to the homologous MVA strategy, the vector was found to be genetically unstable in simulation studies for large-scale manufacturing. Hence, additional studies were halted. However, these trials provided information on how HIV can evade the two major arms of the adaptive immune system: Humoral (anti-body mediated) and cellular (mediated by T-cells) immunity. This will Our scientists were in the search for new generation vaccine candidates simultaneously. Presently institutions like Indian Institute of Sciences Bangalore, NARI, AIIMS, International Centre for Genetic Engineering and Biology, Jawaharlal Nehru Centre for Applied Scientific Research, National Institute of Immunology, and now the newly established HIV Vaccine translational research laboratory at Translational Health Sciences and Technology Institute under the Dept of Biotechnology in partnership with Recently, there was a report a small group of patients with HIV in France who have been able to cease taking AIDS drugs without the resurgence of virus in their bodies which has given a new hope to the mission of humanity to cure HIV. The difference was that these patients were given anti retro viral treatment very early into their infection and after a routine of three years they developed the state of being "HIV Controllers" even when the treatment stopped. This has given a dimension of functional cure of HIV but it works only when complimented with early detection and regular treatment. Another international effort towards developing preventive vaccine against HIV was conducted when the much talked AIDSVAX vaccine of VaxGen was retested in Thailand in 2004 under the vaccine regimen cal ed RV 144. The Thai trial was the largest AIDS vaccine trial to date when it started. In 2009, the results of the RV 144 trial were published. The study involved about 16,400 participants who did not have HIV infection, about 8200 of whom were given treatment consisting of two experimental vaccines targeting HIV types B and E that are prevalent in Thailand, while the rest were given a placebo. The participants were tested for HIV every six months for three years. After three years, the vaccine group saw HIV infection rates reduced by more than 30% compared with those in the placebo group. Further analysis presented at a 2011 AIDS conference in Bangkok revealed that participants receiving vaccines in the RV 144 trial who produced IgG antibodies against the V2 loop of the HIV outer envelope were 43% less likely to become infected than those who did not, while IgA production was associated with a 54% greater risk of infection than those who did not produce the antibodies. This finding can be the basis for greater international and national effort towards creating an HIV/AIDS free India and the National programme for preventive vaccine for HIV/AIDS
Time has now come to integrate all the research and development activities on
preventive vaccine for HIV/AIDS in the country into a single umbrel a of a "national
programme for development of preventive vaccine for HIV/AIDS" with a
mandate to promote research, develop, carry out trials, and lead to commercial production of low cost highly effective public health product within the next five years. There should be an autonomous organization to integrate all the activities of the participating institutions linking with relevant departments of Govt of India with a common funding and a decentralized management structure. The apex body of the programme should be empower to carryout periodic review of all the constituent tasks being performed by different institutions, using experts in the field, select the best performing options and channel the financial, infrastructural and human resources to accelerate and realize the best possible options. This will facilitate appropriate channeling of resources to create healthy competition and accelerate research and development. If we can take this decision through this symposium after due deliberation, the entire country and the world can definitely see a viable vaccine in the near future which wil be a boon to the entire society. HIV / AIDS diagnosis and detection
Friends, it is essential our national laboratories to launch a programme for a cost
effective, diagnostic tool for HIV. Here let me share an Indian experience. NEVA-HIV is a test to detect HIV (AIDS) in a drop of blood within three minutes. It is a single step test in which a drop of blood is mixed with a drop of a reagent on a glass slide. If the blood sample shows clumping, it is positive for HIV. This clumping of blood can be easily seen with the naked eye. The test uses recombinant proteins consisting of NEVA-HIV is one of the very few tests in the world that can be performed on whole blood, even from a finger prick. Developed, keeping in mind the practical constraints of HIV testing in our country, NEVA-HIV is an instrument-free test. In addition, the simplicity and rapidity of the test, makes it suitable for use in a primary health centre of a village even in a remote part of our country. This novel scientific development has been carried out by the faculty members of Department of Biochemistry, University of Delhi in collaboration with the Department of Bio-technology and Cadilla Pharmaceuticals Ltd., Ahmedabad. I would suggest the scientists and technologists assembled here work on further improvement of such products and deliver it to the users. I would suggest the researchers who are developing diagnostic system and also working on the vaccine for preventing HIV/AIDS to take into account the fol owing socio-medical observation. a) Despite repeated exposure to HIV in breast milk. The majority of the infants who are exclusively breastfed (EBF) do not becoming infected. Why the HIV does not transfer from an-infected mother to her infant through breast feeding? This observation should provide a vital clue for the researchers. b) We need to research on research rare anti-bodies in people infected with HIV. These anti-bodies wil al ow for better understanding of the host?s ability to mount and immune response, that is capable of halting HIV transmission. Hence, we must enroll HIV infected people into our research. Conclusion: Combating HIV is a National Mission
Friends, discovering a preventive vaccine for HIV/AIDS throughout the world is
becoming a big challenge and many nations and health organizations have done research even world bodies like UN and WHO are bringing together different nations. We have gained a lot of experience by the research of different nations trying to find solutions. But a definite solution is not emerging whereas new patients are constantly being added. In such a situation, as a nation of bil ion plus people we have a responsibility to start a mission mode preventive vaccine against HIV development. While developing the vaccine for preventing HIV/AIDS, I would like to make the fol owing suggestions for reducing the incidence HIV/AIDS and also the pain of HIV/AIDS 1. Translation and Health Science and Technical Institute should have other research partners and particularly an empowered team from pharma manufacturers commencing from research to production of vaccine for preventing HIV/AIDS. This team should identify and characterized neutralizing anti-body (bNAbs) and develop a full vaccine and 2. Consider taking up control and prevention of HIV/AIDS through advocacy 3. The occurrence of HIV is found to be 83% among the adults in the age group of 15- 49 years. Considering this situation, political leaders in partnership with local educational institutions can organize awareness campaigns among al the people falling in this age group, so that they can take care of themselves from falling as a victim of this HIV/AIDS 4. Creating a mechanism in partnership with societal organizations, medical institutions and Government for testing the blood for any contamination and ensuring that contaminated blood is not stored in any of the blood banks. 5. Consider facilitating hassle-free availability of all the services such as schooling for children, rural employment, nutrition, health services, banking credit, training and employment to all the people living with HIV AIDS in their constituency. This will enable improvement of quality of life of people living with HIV AIDS and make them feel that they are an integral part of our society. 6. Consider creation of a HIV AIDS Foundation in partnership with philanthropists and NGOs in their constituency, which can provide financial assistance to the needy HIV AIDS patients for their treatment and sustenance. 7. There are many reports in the country with certain experiences where certain traditional medicines drawn from the herbal plants which have anti-HIV properties and cure. It is essential to identify such individual groups in the country and encourage their work to find out two or three herbal based solutions for cure of HIV and as a preventive With these words, I inaugurate the International Symposium on Accelerating India's
Response to Research for a Preventive HIV Vaccine. My best wishes to all the
participants of this symposium success in their mission of accelerating and bringing out an effective affordable preventive vaccine for HIV/AIDS at the earliest. I am sure, you will all be remembered for this important contribution by the humanity as Alexander Fleming is remembered even today for his work on Penicillin. By Dr. APJ Abdulkalam
www.abdulkalam.com

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