One jab for millions

August 4, 2000

MP Evan Harris explains why he has volunteered as a guinea-pig in trials of a new Aids vaccine

My decision to volunteer as a human guinea-pig - in a trial of a new Aids vaccine - is neither brave nor heroic. The heroes are the scientists based in Oxford, Canada and Kenya who have developed this novel Aids vaccine approach. The bravery lies with the Aids patients in Africa dying from this modern-day plague.

It may seem strange that western scientists are experimenting on a British politician for the benefit of the developing world. Usually it is the other way round. But it is precisely because western pharmaceutical companies see no prospect of any financial return on a vaccine in the developing world that publicly funded bodies such as the Medical Research Council and the International Aids Vaccine Initiative have stepped in.

My last clinical job as a physician before being elected to Parliament was to work on the infectious diseases ward at the Churchill Hospital in Oxford where several gay men, haemophiliacs and drug users were dying from Aids.

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Although, as a junior hospital doctor, I had never seen so many young men die, I also knew of the disaster about to befall southern Africa - the birthplace of my parents. Coverage of the international Aids conference in Durban highlighted the extent of the epidemic in sub-Saharan Africa. For many it is too late. It is inconceivable that African health-care systems could afford the complex, potentially toxic and expensive triple combination therapies that are now available in the West.

Education programmes, the mainstay of prevention, are not proving effective enough. Prevention strategies then turn to vaccines, but scientists are faced with the problem of an ineffective antibody response to HIV.

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What the MRC group in Oxford - in collaboration with colleagues in Canada and Kenya - found was that about 5 per cent of Nairobi prostitutes were not infected with HIV. They discovered that these women have high levels of a special immune cell, a "killer T cell", which attacks proteins in the HIV virus.

The idea is that a safe vaccine will evoke this response in advance, priming the immune system against infection. Invaluable preliminary animal research have shown promising results and a similar vaccine is being developed in Oxford to try to tackle malaria.

This much theory I already knew from a visit of the All-Party Parliamentary Group on Aids to the MRC labs in Oxford last year. I also knew of the need for human volunteers for preliminary safety testing. In passing I mentioned that I would be prepared to help. My offer was taken up.

The announcement of the trial in Durban gave me an opportunity to stress the seriousness of the situation in Africa, to promote the trial and to plug British science.

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I have discovered that either my constituents do not care about my welfare or they recognise that receiving a vaccine against HIV is not the same as receiving HIV. Far from it in fact. If the vaccine does work at the preliminary dose schedule used, then I will be more protected from HIV than before.

Any mass-produced vaccine must be safe, and there is little risk of serious harm from vaccine components. Also I must, reassuringly, be assessed as healthy, HIV negative and "low-risk" to be included in the trial.

A few trips to hospital for injections and blood tests is a small price to pay for helping solve a very big problem.

After UK safety trials, there will be more extensive trials, mainly also in the UK. The critical phase-three trial will be in Africa, where the vaccine will be given to high-risk individuals, who will be monitored to see if their infection rate is reduced compared with those not vaccinated. It is hard to give a potential vaccine only to some in an experiment. But not to do proper clinical trials would be unscientific and unethical.

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It is ironic that making an Oxford doctor and MP more like a Nairobi prostitute may help find the answer to a devastating problem.

Evan Harris is the Liberal Democrat higher education and science spokesman.

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If you are interested in helping in the trial and are local to Oxford, please call Freephone 0800 1696978

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