The Nairobi Declaration: An African Appeal for an HIV Vaccine

A. Preamble

A consultation to discuss strategies to accelerate the development of HIV vaccines in
Africa was convened in Nairobi, Kenya, 12-14 June 2000, under the auspices of the
World Health Organisation (WHO), the Joint United Nations Programme on
HIV/AIDS (UNAIDS), the Southern Africa Development Community (SADC) and
the Society for AIDS in Africa (SAA). The consultation was attended by 40
participants from 15 African countries and representatives from the sponsoring
organisations.
The major outcomes of the meetings were:
1. The Nairobi Declaration: An African Appeal for an HIV Vaccine, a
policy/advocacy document urging major stakeholders in Africa and elsewhere to
support activities aimed at accelerating the development of HIV vaccines in
Africa, and
2. The African Strategy for an HIV Vaccine: an outline, described in the present
document.
The development and implementation of the African Strategy for an HIV vaccine
will be an evolving process, and it will be revised and refined periodically. Specific
activities will be identified, prioritised and implemented through consultations and
collaboration with multiple partners, in and outside Africa.
B. Situation Analysis
* Two decades into the HIV pandemic, sub-Saharan Africa continues to bear a
disproportionate burden of HIV infection. Two thirds of all people with
HIV/AIDS live in sub-Saharan Africa. In fifteen African countries, 10% or more
of the adult population is already infected with HIV.
* Whilst most countries in sub-Saharan Africa have established National AIDS
Control Programmes, interventions such as behaviour modification, condom
promotion and treatment of other sexually transmited infections have not been
sufficient to significantly reduce the incidence of HIV infections. From the
estimated 15.000 new HIV infections occurring every day in the world, 70 %
occur in sub-Saharan Africa.
* Whilst efforts to promote known interventions for HIV prevention must be
strengthened, preventive HIV vaccines remain the best long-term solution to
control the HIV pandemic.
* Global HIV vaccine efforts have started to receive renewed interest in the past
three years, and much progress has been made, including the development of
potentially more immunogenic candidate vaccines. Multiple clinical trials of HIV
candidate vaccines will have to be conducted simultaneously, to assess the safety,
immunogenicity and protective efficacy of different vaccine concepts, against
different HIV-1 subtypes, and in different populations.
* Whilst the vaccinological implications of different HIV-1 genetic subtypes remain
unresolved, there is consensus that given the current stage of HIV vaccine
research and development, efforts should be made to develop candidate vaccines
based on HIV-1 subtypes prevalent in different regions in Africa. It is also
recognised that HIV-2 candidate vaccines are not available at the present time.