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The Big Read: Searching for powerful antibodies to block HIV infection is like trying to find a needle in a haystack, says Professor Lynn Morris from the National Institute for Communicable Diseases (NICD) and Wits University.
But Morris and her team in Johannesburg together with their US collaborators at Duke University succeeded in the lab last year in identifying in HIV-positive women just such neutralising antibodies - proteins that bind to HIV and prevent infection.
"We've identified people with potent anti-HIV antibodies in their blood. Using sophisticated technologies we could isolate the cells, make the antibodies and test them," she says.
Morris, the head of the NICD's Aids unit, says that the broadly neutralising antibodies identified by the International Aids Vaccine Initiative and the Vaccine Research Centre are extremely effective and can "knock out almost every single virus when combined".
The discovery of these antibodies is a leap forward for HIV vaccine development, according to a scientific plan published in the journal Nature Medicine this week.
The 2010 scientific strategic plan of the Global HIV Vaccine Enterprise, developed by more than 400 experts in the field, outlines progress since the 2005 plan and a vision to speed up the development of a safe and effective HIV vaccine.
At the launch of the roadmap, its executive director, Dr Alan Bernstein, declared: "Last year the RV144 trial in Thailand provided the first evidence that a vaccine can prevent HIV acquisition. Powerful new technologies are significantly advancing our understanding of HIV infection and the human immune system."
Bernstein says these advances, combined with a "new spirit of global collaboration", herald a new era in the journey towards a vaccine, now in its 27th year.
The plan provides a framework to accelerate HIV trials by changing the way they are designed and implemented. Its authors recommend the better integration of clinical and lab research, taking advantage of advances in other biomedical fields and expanding the field to include new researchers and new funders.
They call for the development of a "robust pipeline of diverse vaccine strategies" and a system to make sure that trial data is compatible and accessible.
Strengthening research capacity in countries with high rates of new HIV infection as well as boosting community engagement and regulatory frameworks are also on the list of priorities.
"The plan rightly emphasises that developing countries must be full partners in HIV vaccine research and development," says Professor Malegapuru Makgoba, vice-chancellor of the University of KwaZulu-Natal.
"Involving developing countries in HIV vaccine research means more than simply conducting clinical trials here. It means conducting preclinical and clinical research in full and equal collaboration with developed country institutions and researchers."
South Africa - the country with the highest number of people with HIV/Aids in the world - makes a significant contribution to the HIV vaccine field by testing promising candidates and developing its own products.
Professor Glenda Gray, director of the Wits Perinatal HIV Research Unit at Chris Hani-Baragwanath Hospital, which has successfully completed clinical vaccine trials, says they have new vaccine trials lined up for testing next year.
"We have three in the pipeline and hopefully there will be a whole lot more Phase II(b) trials in 2013 - that will be a good year.
"Unfortunately we cannot just turn out a vaccine candidate for testing, it takes time."
Human clinical trials are conducted in three phases and proof-of-concept (II)b trials are smaller and less expensive to execute than large phase III efficacy trials.
Meanwhile, Dr Carolyn Williamson from University of Cape Town's medical virology department is at the forefront of developing two candidates for the South African Aids Vaccine Initiative, and these will be tested in clinical trials in the near future.

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