Source: Johnson&Johnson
From the newsletter
The International AIDS Vaccine Initiative (IAVI) has started the first vaccinations of an experimental HIV vaccine in South Africa. The vaccine approach is trying to train the immune system to make very powerful antibodies that can block many different strains of HIV, a goal that scientists have chased, to reduce the burden of treatment and preventive drugs.
According to Mark Feinberg, the President of IAVI, fewer resources are currently going into HIV treatment and prevention because of the recent aid cuts, making the launch of this trial essential to sustaining the fight against HIV.
While promising, the trial could take six to ten years to complete, even as HIV services across Africa are already strained and millions of lives remain at risk.
More details
The IAVI G004 Phase 1 clinical trial is testing three experimental HIV vaccine immunogens developed by IAVI and Scripps Research, delivered via Moderna’s mRNA platform. The study will determine the safest dose that triggers an effective immune response. Scientists hope this approach will guide certain B cells to produce broadly neutralising antibodies, which could protect against multiple HIV strains.
The trial involves 96 healthy adult participants across six South African clinical sites, including the Perinatal HIV Research Unit in Soweto and Groote Schuur Hospital in Cape Town. Researchers are using a dose escalation model to identify the minimum dose that produces an immune response while reducing side effects, such as skin reactions observed in previous studies. The Gates Foundation is funding the study through the Collaboration for AIDS Vaccine Discovery
HIV treatment in Africa has long depended heavily on international funding. In 2024, an estimated 40.8 million people were living with HIV across the continent, with over 11 million unsuppressed viral loads. Much of the annual expenditure on antiretroviral therapy and prevention relied on donor contributions, including US foreign assistance and multilateral funding from organisations like the Global Fund.
Recent funding cuts have created a gap in Africa’s HIV response. The US paused foreign aid in January 2025, reducing resources for life-saving medicines and prevention services. The Global Fund raised $11.34 billion in November 2025, short of its $18 billion target for 2027–2029. This shortfall leaves many programmes underfunded, threatening treatment continuity and HIV prevention efforts.
The cuts have put frontline services under severe strain. Dr. Limpho Ramangoaela, a HIV Clinician in South Africa, says, “We’ve lost the community health workers who did home tracing and brought people into care early. In some instances, we have had to turn patients away.” Tabita Ntuli, UNAIDS Equality and Rights Advisor, adds, “These cuts will widen existing inequalities in HIV response.” While promising, the trial could take six to ten years to complete and materialise into an actual vaccine.
Our take
The IAVI trial is one of the most credible HIV vaccine strategies to date but overinvesting in this rather than current care can reverse the hard-won gains in the fight against HIV.
While scientifically promising, the vaccine’s six-to-ten-year timeline collides with immediate funding gaps that need immediate and sustained investment.