Salim and Quarraisha Abdool Karim with some of their many scientific awards for their work towards fighting HIV/Aids.
Salim and Quarraisha Abdool Karim with some of their many scientific awards for their work towards fighting HIV/Aids.

Finding a cure is their mission

By Liz Clarke Time of article published Nov 2, 2011

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Nine scientific awards in three months. It soon might require a separate room to store all those accolades.

“It’s overwhelming, but hugely gratifying,” says a delighted Professor Salim Abdool Karim, director of the University of KwaZulu-Natal’s Centre of Aids Programme of Research in South Africa (Caprisa).

“Even more important, though, than the awards themselves,” he says, “is that the world is recognising and appreciating scientific contributions from Africa. For us that is hugely encouraging – and frankly, critical to the ongoing success of our endeavours and research throughout Africa.”

To illustrate the point, the Abdool Karims will be travelling to Kenya next month to receive an award from the African Academy of Sciences for “their highly acclaimed discovery that the microbicide Tenofovir gel prevents HIV infection and genital herpes in women”. Since the breakthrough was announced last year, global health leaders have called the results “a game changer” and a “significant milestone for women in the 30-year history of the HIV/Aids pandemic”.

It was, they said, “set to alter the future trajectory of the HIV epidemic and become the turning point in the global HIV epidemic”. The journal Science ranked it among the Top 10 Scientific Breakthroughs of 2010.

In South Africa alone, it is estimated that the gel, once implemented, could avert 1.3 million new HIV infections and 800 000 Aids deaths over the next 20 years.

This week, the New York Times hailed the gel as a breakthrough for the prevention, not only of HIV, but also of herpes.

“We were pleasantly surprised to see such a potent effect,” Abdool Karim told the Times. A new international study provides an explanation for why Tenofovir gel prevents genital herpes, a lifelong incurable sexually transmitted infection. It shows that when Tenofovir gel enters human tissue, it is converted into a form that disrupts an enzyme that herpes needs to make copies of itself.

With these new discoveries, isn’t it time, then, for Salim and Quarraisha Abdool Karim to breathe a collective sigh of relief, sit back and say “we’ve done our work”?

Abdool Karim smiles knowingly. “Science is never like that. When you find one answer, a whole new set of questions arise. Scientific discovery is also a very slow process, requiring immense patience.

“You might have proven a point – and in this case, an important one – but the steps required to get a substance approved and licensed as a medicine, that’s a whole new chapter altogether. But we are patient people – we have to be.”

The new research that Caprisa will be doing follows two paths: one is to study how Tenofovir gel can be integrated into family planning clinics and the other is to find out how to make Tenofovir gel more effective in preventing HIV.

So what does it mean to make the gel more effective?

“We are studying the cells from the vagina and blood of the women who became HIV-infected despite using tenofovir gel during the Caprisa 004 trial,” says Abdool Karim.

There are some clues, he says. “It could be something to do with the body’s natural inflammatory responses. The cells that respond to the inflammatory signals have the CD4 receptor that HIV looks for to cause infection. This could be compromising the gel. We have several scientific teams looking at this right now.”

As he says – so many questions, so few answers.

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