African researchers are working to cure HIV, but the U.S. aid cuts range | Health News

Patrick Arbuthnot browsed his email in his lab in Johannesburg when he saw a strange notification pop up.

“Stop working,” it says.

Arbuthnot remembers what the U.S. official said in January in the text, but a line burned in his memory was enough, even if it was almost impossible to believe.

For two years, researchers have been working on developing an HIV vaccine to help end one of Africa’s deadliest diseases. His laboratory at the University of Witsland, South Africa has spent thousands of dollars on experimental funding. Now all critical work must be paused or worse, permanently stopped.

“It's all a waste, it's a waste. When I see the information, the words keep running in my mind,” Arbuthnot of director Wits' antiviral gene therapy research department told Al Jazeera a few months after the nightmare unfolds. “It seems like nothing is gone.”

Dozens of health trials across Africa were forced to abruptly stop after U.S. President Donald Trump pulled out millions of dollars without warning. His executive order suspends aid from developing countries through U.S. aid agencies, U.S. Agency for International Development and PEPFAR (U.S. President’s Emergency Plan for AIDS Relief), awaiting a three-month review period. Cutting has swept the plans for a number of deadly diseases in Africa, especially malaria and HIV.

Southern African countries with the highest number of HIV cases in the world tend to the United States to fight the pandemic. With the cuts, the HIV clinics provide services to sex workers and MSMS (men having sex with men), suddenly closed. Health workers are unemployed in thousands. People infected with HIV are not sure how to get key medications. In a poor country like Zimbabwe, the United States Agency for International Development (USAID) has funded about 80% of the HIV response, which has been severely hit and even the supply of condoms has been destroyed.

The timing couldn't be better for African scientists to compete for HIV under control.

A few days ago, Arbuthnot met with other researchers working on similar trials at a meeting in Zanzibar. They all make the breeze island positive.

“We have pasta in boiling water, we're just waiting (the chef). “There's still work to be done to prepare the pasta.” You still have to mix it with the sauce so it's not ready for meals, but we've already eaten the pasta in the water. We got there. ”

Progress has stopped

Since 2023, Arbuthnot has sequenced the genetic makeup of two “elite controllers”, the U.S. genetic makeup, a rare HIV-infected person who is able to live a normal life in some way without the need to use antiretroviral (ARV) to suppress viral load.

The two people in the Arbuthnot trial were anonymous – identified only as 255 and Cap 25 – but they form part of a group whose condition researchers viewed it as something of a superpower because they had no developmental symptoms or seemed to require medication.

Arbuthnot’s trial is part of a brilliant consortium project funded by the U.S., which features African researchers from seven countries including Nigeria, Zimbabwe and Kenya, all of which are working to develop vaccines and efficient HIV prevention or management treatments.

This gene sequencing effort in Africa is also crucial to help understand how disease affects people on the continent. So far, the human genome in Africa accounts for only 2% of the human genome sequencing.

Africa has the most HIV cases, and South Africa accounts for the most infections – nearly 8 million people. Experts say the toxic combination of labor and segregation policies in the era of apartheid, low income and distrust of Western healthcare institutions are blamed.

That's why HIV research is heavily concentrated in South Africa, not any other African country. Because HIV patients weaken the immune system that is prone to tuberculosis (TB), research on both diseases usually goes hand in hand.

World leaders pledged in 2016 to end AIDS by 2030, and African scientists seem eager to provide treatment.

But creating an HIV vaccine like Arbuthnot tries to do is very difficult because of how fast the virus mutations and once masked its own abilities in the host's DNA. Despite decades of research, progress has remained limited, partly due to funding restrictions.

With the crucial U.S. funding cuts, the industry has fallen into chaos, and experts say progress has retreated.

Since 2003, PEPFAR has donated a large portion of the $100 billion donated to African countries. In South Africa, it supports up to 18% of the HIV budget. Scientists found in a recent study that shutting down PEPFAR in South Africa alone would result in 600,000 HIV-related deaths and 500,000 new infections over the next 10 years.

“It’s not just the fact that the fund is cut, it’s the problem,” Esther Casas, an HIV-TB consultant at Medical Doctor, a medical non-governmental organization known as the French abbreviation MSF, told Al Jazeera. MSF does not rely on U.S. funds and is still operating its HIV center, but everyone in the full range is affected one way or another, Casas said.

“It's a sudden way (the US cuts funds). To do something like that, you have to be prepared. But it didn't happen, it was disastrous.”

Lenacapavir: Breakthrough Drugs

The United States has not only cut trials and experiments. Trump’s orders also impact actual, testing and more effective pre-exposure prevention (PREP) therapy, after years of trial.

PREP is to prevent people who have HIV exposure (such as the partner of an HIV-infected person) from getting infected. A common form of medication is a daily medication that some people may struggle to stick to, with effects ranging from 74% to 99%.

Last year, Lenacapavir was in rare form, a preparatory drug, tested 5,000 young women aged 16 to 25 in South Africa and Uganda. This is 100% effective. This is also more convenient: the patient only needs two shots every six months.

Although the trial was funded by US biopharmaceutical company Gilead Pharma, the U.S. Agency for International Development plans to step in to the next important step: helping bring Lenacapavir to generic drug manufacturers to generic drugs available on the market at affordable prices.

“Now, the pipeline has completely disappeared,” Nomathemba Chandiwana, chief scientific officer of the Desmond Tutu Health Foundation in Cape Town, told Al Jazeera. Her boss Linda Gail-Bekker, directing the nonprofit research center, is the lead researcher of the trial.

Some projects received their funds to be restored after the Trump administration's cessation order, but others, such as the Lenacapavir project, remain uncertain about their position.

“Can you imagine it? This is the biggest thing in last year's scientific breakthrough, and now we have no way forward.”

The scientist added that it is unrealistic to expect the South African government to bear the burden of Lenacapavir to go public. The drug is expensive and the Ministry of Health may have a hard time providing a budget, she said.

“Not all doom and depression”

Critics blamed African governments for over-reliance on aid after U.S. aid caused shock to Africa’s health system and HIV care response, noting the billions of dollars lost in the massive corruption scandal in two largest economies: Nigeria and South Africa. Until January, both countries received about one-fifth of their HIV response budget from Washington.

MSF Casas said turbulence is undoubtedly an awakening call for Africans, taking full responsibility for their health care, from research to drug development and treatment. However, it is to understand how deep the damage the U.S. can cause, she said, adding that it is too much power for any single external entity.

“We cannot allow access to health care, access to HIV and TB care, and other conditions that affect the most vulnerable communities to politicize. We must realize that solutions and responses may not come from any funder,” Casas said.

Arbuthnot is one of some lucky researchers who have successfully obtained other funding paths. Since the U.S. withdrawal, the U.S. charity Elma Foundation has stepped in to support his lab work. However, things are still uncertain because the funding is only six months old.

Despite having a real and instant impact on people’s lives, some African researchers say their work is starting to feel impossible. Chandiwana said other countries, including the UK, are backing down research funding, even as important research efforts are shut down due to internal politics and priorities.

“Our work is not abstract at all. It's not like, 'oh, whatever kind of work,'” Chandiwana said. “As a community, we're shrinking, but the health issues we're going to solve are getting bigger and bigger.”

Experts say the mission of African health scientists in the future will be how to participate in governments and how to use less money to deliver life-saving results. Some governments seem to have their journey ready: Nigeria released $200 million in February to immediately fill the funding gap. In South Africa, the health budget has increased by $1.5 billion.

Chadiwana said at the Desmond Tutu Foundation that one way she and her colleagues cope is to diversify focus and include obesity (such as obesity) in their research. This will help add more options to the funding basket, she said.

“These changes are frightening, but in the age of dragons, you need dragon killers,” Chadiwana said of how scientists should adapt. “I'm a timeless optimist, so that's not all doom and melancholy. We just have to stick with it.”