A Swedish Vaccine for HIV
November 2009

by Åke Ericson

A vaccine protecting against the HIV disease sounds intriguing, to say the least. It would be a medical breakthrough saving the lives of thousands of people.

Over the last three years medical reporter Gunilla Eldh and I had tried to persuade Swedish professor Eric Sandström to let us come to his medical research facility in Tanzania. Time after time he had said no, but our persistence eventually paid off and finally we got permission to join him on his next trip. We left Stockholm in September for Dar es Salaam, Tanzania's largest city and the country's economical center, with an estimated population of three million.

© Åke Ericson/Aurora Photos
At the research center at the Muhimbili University Hospital, "Professor Erici," to the right, is well known to everyone in the vicinity. Here, Eric Sandstrom is seen with the chief nurse, Mary Ngatoluwa, the medical officer, Suleiman Choum, and a visitor (to the left). The medical personnel are part of the HIV vaccine trials conducted by Professor Sandstrom in Dar es Salaam, Tanzania.
It is a pretty long trip by air from Sweden to Tanzania: 14 hours with a stopover in Amsterdam. It was a relief to leave the airplane when we arrived for the hotel and instant sleep.

Early in the morning Eldh and I were prepared to meet the day, heading for the Muhimbili University Hospital which is one kilometer from the hotel. I noticed people in need of care standing in endless lines at a gate outside the one hospital building. Becoming disoriented, we accidentally entered the HIV and AIDS nursing ward. Emaciated people were lying in beds in the corridor. Said a man in a white coat, "You must have gone in the wrong direction."

In distress, we walked away from the horrifying sight of these very weak and sick people, beyond hope of recovery. But then – there he was again! Eric Sandström greeted us with a big smile and invited us to his office to meet his staff. Here we were briefed about the situation and introduced to two police officers, Mr. Ben Friday and Ms. Dafroza Kibirit.

© Åke Ericson/Aurora Photos
Dafroza Kibirit, in the foreground, and Ben Friday, left, are two of a total of 60 police officers participating as volunteers in the Swedish-Tanzanian HIV vaccine study by Prof. Eric Sandstrom. Forty have received the vaccine and 20 received the placebo.
Both of them have been important in the vaccine trials because they are among the 60 volunteer healthy men and women from the country's police force to take part in the trial. Ben Friday said, "I have seen many people die of AIDS and that is why I am engaged." His colleague agreed: "My uncle and aunt died of the disease and they felt it was so shameful they kept quiet about it." Both Friday and Kibirit are looking forward to a change of attitude in people who are HIV-positive or have contracted AIDS. Neither regrets participating in the study, saying, "We have learned an immense amount and now we can influence others in the areas where we are working."

For Ben Friday this was his 24th visit to the hospital. He has received five vaccine injections, left blood samples and has been answering the nurses' many intimate questions. The injections are either the test vaccine or a harmless 'placebo' to support the results. In order to see if the vaccine was able to trigger the immune defense, the scientists measured the amount of certain immune cells. These immune cells are destroying the HIV-infected cells in the human body.

© Åke Ericson/Aurora Photos
The patient was concerned about fever and boils. A test indicated he was HIV-positive but the test will be performed again to mÅke sure. The man promised to let his wife join him next time so she can be tested as part of the HIV vaccine study, conducted by Swedish professor Eric Sandstrom, in Dar es Salaam, Tanzania.
The scientists also examined if the participants in the study developed the correct antibodies. Every one of the people exposed to the vaccine developed both more immune cells and antibodies. This was very good news for the researchers trying to create a vaccine against the lethal disease.

The Muhimbili hospital compound consists of some 100 houses, connected by dusty roads. In the vicinity of where the small research offices are located, Eric Sandström has become an institution in his own right. He is greeted with, "Habari gani professor Erici," by people in the hallway. In Kiswahili, the local language, it means, "How are you doing?" He replies, "Mzuri," or "fine." His office is only the size of a large closet and the computer is … slow. Regardless of the evident lack of computer power, the research results have been dramatic recently.

Photographing was quite restricted because of the bureaucracy. But on day five we finally got access to the laboratory and were able to see some of the positive results visible through the microscope and on the data scanner. Now we really felt that out story about the new vaccine was even more interesting than we anticipated or imagined before we left Sweden.

Professor Eric Sandström has been in Tanzania 75 times. The first time was16 years ago when he was a physician for the AIDS project, "Tanswed." He saw the grim effects of AIDS then and he was disgusted about the lack of resources in Tanzania compared to that in Sweden and other rich countries.

© Åke Ericson/Aurora Photos
Technicians Zacharia Mtulo and Emmanuel Salala are pleased with how the immune cells have been reacting with the "Hivis" vaccine. The traditional microscope today is only a complement to the computerized analysis in the HIV vaccine study, conducted by Swedish professor Eric Sandstrom, in Dar es Salaam, Tanzania.
The project name for the Swedish-Tanzanian vaccine is "Hivis." Professor Sandström does not want to reveal anything publicly until he is absolutely positive about his scientific research. But he looked very content later that night when we joined him at a restaurant where we could watch the sun descend into the ocean. In the African twilight the rapid, irregular flight of bats against the sunset made them look like strange flakes of soot against the sky.

As yet it is too early to state that "Hivis" can protect against HIV and AIDS. Hopefully this will be confirmed in the upcoming "phase three" of the tests.

A month ago there was another news report that American and Thai researchers had developed a vaccine giving some protection against HIV for the first time. This vaccine helps reduce the risk of being contaminated 31 percent. Both the American-Thailand vaccine and the Swedish "Hivis" are combination vaccines, meaning that they consist of two different formulas. The Swedish "Hivis" is made up of DNA of three different viruses. The American-Thai vaccine consists of DNA pieces from yet another virus placed within a cowpox virus.

The Swedish vaccine might be more effective compared to the existing vaccine from Thailand because it consists of several more types of viruses "and, therefore, it gives a broader protection."

Åke Ericson is a Swedish photographer located in the capital of Stockholm. Over the years he has been working and traveling in many Eastern European countries like Russia, the Balkans, and especially in Kosovo where he did a 10-year photo documentary story about the most demolished village in the region, Loxha. But Åke Ericson also has been on assignment in places like North Korea and Sierra Leone. He earned the title "Photographer of the Year 2008," and was also awarded "Picture of the Year" and "Best of Journalism" in the U.S. Åke Ericson is affiliated with Aurora Photos in New York, and he has been published in Stern, The New York Times, Le Observateur, Paris Match and Newsweek.

[Thanks to Lars-Gunnar Gustafsson for translation and other assistance.]

© Åke Ericson

Web site: www.akeericson.com

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