It can’t be easy being one of the key driving forces behind the race to find an AIDS vaccine for South Africa and it’s neighbours. “I’m very positive and I’m optimistic. However, even though the need for a vaccine is urgent, we are not going to take any shortcuts that can hamper the process in the long-run,” says Dr Tim Tucker, recently appointed head of the South African AIDS Vaccine Initiative (SAAVI). “The magnitude of the global disaster is one of the key factors that really inspired me to apply for this job,” he says. A medical doctor and clinical virologist with experience in researching new potential medications for liver diseases in laboratories at Groote Schuur and the University of Cape Town (UCT), Tucker recently took over the reins from Dr Walter Prozesky, who was responsible for the establishment of the SAAVI.

Always picturing himself ending up as “a rural GP administering to poor rural individuals”, Tucker’s new job and his previous job as a clinical virologist and laboratory scientist seem far removed from this reality. Not so, he says. “I think this is an opportunity to combine the two, in that I have a specialised role in co-ordinating the development of a very specific vaccine, but that vaccine eventually has to roll out in rural areas, to those most affected by HIV. “So, perhaps more that a decade later the two are combining.” SAAVI was set up by Government in 1999 and tasked with co-ordinating all scientific and clinical efforts aimed at developing an effective and affordable (cheap) AIDS vaccine within a decade (by 2009).

“We may not have the perfect vaccine within that time period, but we are optimistic that it will work to some degree,” Tucker cautions. Should South Africa achieve this feat, it would have been done in less than half the time usually needed to develop a vaccine. Tucker acknowledges that HIV research does provoke a lot of emotion and provokes a few people into believing that there are “territories”. “My job is to establish what is the factual component and what is the emotive component and then cut between the two. “We are making significant progress, due to the high levels of competence among the SA scientists and clinicians involved in driving this process,” Tucker says. He acknowledges the pressure that comes with the job. “The pressure is on to make and test a vaccine as soon as possible and this is appropriate in the setting of a global disaster, but we won’t let the pressure allow us to take shortcuts.

“All of us are aware of the fact that there is some urgency and we are full of belief that we can make and test a successful vaccine. There are huge hurdles to conquer as HIV is a clever virus, in that it evades the immune system by destroying that same the immune system. “I can’t put my head on a block that we will be successful, but we have history on our side,” says Tucker, referring to the small pox and polio epidemics that affected millions before vaccines were developed. In 1967, ten million cases were reported during the small pox epidemic, but after a vaccine was developed, the last field case was reported in India in 1975.

“There is scientific and clinical reason to believe that over time we will be successful,” he states confidently. And personally, how does Tucker escape the pressure? “I don’t find the pressures intolerable, but perhaps I am still in my honeymoon phase of the job and it will hit me later,” Tucker quips. “But one must be able to switch off,” he says. “For me, family life and getting out on weekends, that is the way I switch off. “Getting away on a weekend to a beach cottage and living on the beach, walking in the mountains and cycling is my preference. Getting out and being active.” Tucker acknowledges that the international competition to develop a vaccine is huge, but that there is a good balance between competing and sharing.

“This is actually one of the aspects of the job that I find most stimulating, as there is a good balance between competing and sharing. There is significant competition and everyone wants to be the first to produce an HIV vaccine that is successful, but people share their resources and information so we can all get to the endpoint more rapidly.” For example HIV genes characterised by SAAVI and UCT and included in the vaccine being developed by the university, the Medical Research Council (MRC) and a North Carolina company Alphavax, are being used in three other vaccines across the world.

Praising Government as an active force in driving the SAAVI process, Tucker points out that ESKOM has matched all money given by the state (about R10-m per year each). “As we enter the clinical trials phase we are going to need a lot more funding and I can only hope that big business will come to the table.” He said the entire SADC region would benefit from the successful development of a vaccine, as sub-type C is the overwhelming strain in the area. Praising his colleagues, Tucker says that they do not have unrealistic expectations, but that “I find the people very focused. There is huge enthusiasm, but it is tempered with realism”. UCT and the University of Stellenbosch are currently responsible for making the possible HIV vaccines, with phase I trials expected to take place sometime next year. Phase I clinical studies will involve between 40 and 50 people and will test the safety of each of the vaccines.

The testing of the first vaccine will probably take place in Durban with later studies at the Chris Hani Baragwanath Hospital and other sites under the guidance of the Universities and the Medical Research Council. The National Instititute for Virology in Johannesburg has been set up to run the laboratory tests to determine whether the vaccine does actually elicit an immune response or not. The University of Natal is developing the ethical protocols to make sure everything SAAVI does conforms to the highest ethical standards. SAAVI is also involved in co-ordinating the involvement and education of the media and the community aspects to make sure everyone is aware “of what we’re doing”. Almost 300 people are involved in these vaccine processes in SA, with SAAVI co-ordinating all the efforts.