How HIV researchers overcame setbacks and kept a vaccine trial going

0:00During his first term, President Trump made this bold proposal during a State of the Union address. My budget will ask Democrats and Republicans to make the needed commitment to eliminate the HIV epidemic in the United States within 10 years. We have made incredible strides. For decades, eliminating AIDS has depended in part on the development of a vaccine. The Trump administration's goal of eliminating the virus in the U.S. led to a swell of research into a vaccine and funding for AIDS relief both in the U.S. and around the globe. HIV research has been in place since the discovery of the virus as the cause of advanced HIV disease, which we used to call AIDS.

0:48That's John Brooks, former chief medical officer to the CDC's Division of HIV Prevention. We are now at a place, due to consistent funding through mostly federal support, that's discovered amazing drugs that can help us both treat HIV to keep a person healthy, but also to prevent HIV. Then, during his second term, President Trump slashed thousands of public health jobs and gutted funding for scientific research, including grants and funds for developing an HIV vaccine and treating AIDS. The administration also suspended funding for global AIDS relief programs, leaving scientists around the globe worried for the future of their research.

1:32A vaccine would be incredible if we could have it. Enormous public health impact, gigantic economic benefits, as well as the scientific advancements it will provide and has provided in the past. Ditto for an HIV cure. Consider this. An ambitious and promising vaccine trial in Africa was supposed to launch a year ago. When the Trump administration cut funding, researchers like infectious disease specialist Linda Gale Becker had to pivot. This matters too much to not finish the work. Now a pared-down trial is getting underway.

2:07From NPR, I'm Juana Summers.

2:21It's Consider This from NPR. Scientists say research into a vaccine for HIV is further along than it's ever been. But Trump administration cuts to scientific research have set that effort back, including a promising trial for an HIV vaccine in Africa, which was shut down altogether. NPR's Ari Daniel has the story of how researchers there refused to give up. Penny Moore leads me into a room at the National Institute for Communicable Diseases in Johannesburg. It's arrayed with half a dozen large green and white freezers. These are the freezers that contain the samples that are the basis of everything we do in the lab.

3:05Moore is a virologist at the University of Witwatersrand. She cracks open the lid of one of the freezers and pulls out a tower of frosty tubes. It's heavy and hard for me to lift. So this is blood and cells. All samples that have been donated over and over again for two decades by the same group of 117 South African women. They live in the communities that are most ravaged by HIV, and they donate their samples because they hope to see an end to an epidemic that is really, really real for them. These samples have helped Moore and her team piece together a detailed portrait of the virus over the years, how it infects, how it hides, and how much it changes across different parts of the world and even within a single individual.

3:55The amount we have learned from these freezes, it's just astonishing. And yet Moore spent much of last year worrying that it might all amount to nothing. Because just when she and her colleagues were on the brink of something audacious, an innovative HIV vaccine trial across Africa, the bottom dropped out. To explain, let me rewind to early last year, to a meeting in Zanzibar. The famous Zanzibar trip. Zanzibar is a tropical archipelago off the east coast of Africa. Penny Moore says it was crazy hot. One of those places where you just consider standing up and you break out in a sweat. The gathering took place in a hotel perched on the edge of a brilliant blue ocean.

4:37There were researchers and clinicians from across Africa, and then there were the international scientific advisors. They grueled us to within an inch of our lives to make sure that we were doing the very best cutting-edge science we could do with the amount of money we had. That amount was$45 million, awarded by the United States Agency for International Development, to create a state-of-the-art vaccine to prevent HIV. The grant was intended to get teams across the continent to collaborate on developing a vaccine that would work in different African communities. The virus that they have in Kenya is not the same as the virus that we have in Botswana.

5:16It's not the same as the virus that they have in Senegal. And so understanding how these vaccines will work for the local virus is what makes it relevant. At the meeting in Zanzibar, there was a real feeling of momentum. The excitement was through the roof. This is Penny Moore's colleague. Nono Mkize. We were at the beginning of something big. But just as the meeting was about to wrap up, Penny Moore says the mood darkened. From the number of Americans particularly checking their phones all of a sudden and talking to one another in little huddles. Something was wrong. Newly inaugurated President Trump had just signed an executive order freezing all foreign aid.

5:56Suddenly, it seemed, everything was up in the air. I remember at the end of the meeting, USAID colleagues saying to me, I'm not sure if I'll see you again. I completely underestimated how much it would gut the program. But Moore and her colleagues would soon find out. After returning to Johannesburg, she says the official stop work orders arrived from Washington. Just weeks before the trials were to begin, everything came to a sudden halt. All the money was gone. In many ways, we've kind of had our legs cut off, even as we're beginning to run the sprint. Infectious disease specialist Linda Gail Becker is based at the University of Cape Town.

6:35When the funding collapsed, she says she cycled through the stages of grief. There's disbelief in the first instance. Then there is emotion that basically is angry because we'd worked damn hard, we'd won this grant, and we were doing what we had said we would do. But gradually, Becker and her colleagues started saying, This matters too much to not finish the work. A period of frantic grant writing began. We brought up the begging bowl to say, This is important. Can you help us in some way? Finally, they got funding from the South African Medical Research Council and the Gates Foundation. But it was a fraction of the original USAID grant and only focused inside South Africa.

7:21meaning they had to sacrifice studying how the vaccine might work against different versions of the virus within different African populations. Penny Moore. It's a bare-bones version. We will still get the answer, but it's going to cost us time, years, which is not trivial because people are getting infected with this virus constantly. Despite having to scale back, Moore says HIV vaccine research is farther along than it's ever been. She takes me back into that freezer room in her lab, which contains an embarrassment of scientific riches, thanks in no small part to those 117 women and the samples they've donated over the years.

8:03These samples have taught us everything we know about HIV. And have revealed a veritable pot of scientific gold, a unique kind of antibody that showed up in the blood of a few of these women. something called a broadly neutralizing antibody. A broadly neutralizing antibody could stop my virus and could stop your virus and could stop an HIV virus from any other person. But it's difficult to coax the human immune system to produce these antibodies. This vaccine trial is trying to figure out how to do that more easily. At last, after nearly a year of delays, the pared-down trial is getting underway.

8:43On the outskirts of Cape Town, a large brick building rises above Felipe Village, an impoverished township where HIV is rampant. A few levels up, I spot Amelia Mfiki, the community liaison officer for the vaccine trials. This is a great opportunity for South Africa to prove that we can do things in South Africa, for South Africa, with South African financing. Mfiki makes her way to a room where 20 or so young women from the community are gathered to hear about participating in the trial. 25-year-old Nandip Hamongo listens attentively. She says her community struggles with rape, sex traded for favors, unplanned pregnancies.

9:31Most of us are scared of getting HIV. Which is why she'd happily be involved in the research. Yo, I'm over the moon, man. I'm over the moon, yes. Because she's proud to be making a difference. Yes, a big one, a big difference. So I ask her, if this team of researchers are able to find a vaccine, what would a world without HIV be like? Living free, yeah. The first shots of the new vaccine trial started going into participants' arms this week. For NPR News, I'm Ari Daniel, Cape Town, South Africa. Ari's reporting for this story was supported by a grant from the Pulitzer Center. The Gates Foundation is a financial supporter of NPR.

10:15This episode was produced by Mallory Yu and Kira Joachim. It was edited by Rebecca Davis and Courtney Dorning. Our executive producer is Sammy Annigan.

10:28It's Consider This from NPR. I'm Juana Summers. Thank you.