African governments have shown increasing levels of commitment to HIV and AIDS vaccine research, driven both by the need for more effective methods of HIV prevention and by the recognition that Phase III trials must be carried out in Africa. This has led to increasing levels of international collaboration among African countries and scientists as well as with public and private sector partners based outside Africa.

Uganda has sustained a very strong political commitment to vaccine research alongside other responses to the epidemic. The first Phase I clinical trial began in 1999, using a canarypox recombinant vaccine from Aventis Pasteur, to look at cross-strain immune responses (Kebba 2000; Serwanga 2000).

Dr Edward Mbidde of the Uganda Cancer Institute has observed that the vaccines used against childhood diseases in Uganda were in the past always bought for the country and donated by UNICEF. Uganda is therefore breaking new ground as an active participant in this area of medicine (Mbidde 1996).

The Kenyan national HIV strategy (Baltazar 1999) now incorporates vaccine research as a national priority, reflecting strong political support for the partnership between the University of Nairobi and the Medical Research Council researchers at Oxford University to develop and evaluate a vaccine which has been adopted as IAVI’s lead project.

In March and June 2000, there were consultative meetings sponsored by WHO, UNAIDS, AfriCASO, the Southern African Development Community and Society on AIDS in Africa in Pretoria and Nairobi which led to the launch of ‘The Nairobi Declaration: An African Appeal for an HIV Vaccine’ at the Durban conference, with forty African scientists as signatories. This has led to the formation of an African AIDS Vaccine Programme as a network of researchers working through a series of thematic groups.

The most substantial African commitment to vaccine development has now been made by the South African government, which is backing an ambitious South African AIDS Vaccine Initiative (SAAVI) led by the Medical Research Council of South Africa, providing a framework for a number of international partnerships. Intensive preparatory work has been undertaken in a number of sites for Phase III vaccine trials as soon as credible vaccine candidates based on local subtype C HIV isolates can be produced.

The overall aim of SAAVI is to develop as many as eight different candidates into trials, which would make it one of the biggest programs of its kind anywhere. The first clinical trials are likely to begin in 2003.

Botswana is preparing for HIV vaccine trials in partnership with Harvard University, which is helping to set up the trial infrastructure there and will be testing one or more vaccine candidates developed for South Africa.

Cote d'Ivoire, Nigeria and Tanzania have held national consultations with a view to establishing HIV vaccine programmes.