FOUR decades ago, the HIV virus was discovered and since then, millions of lives have been lost as a result. With no cure in sight as yet, a number of innovations have been developed to either prevent and or reduce chances of getting infected with the HIV virus.
By Michael Gwarisa
This has seen cases of new HIV infections and deaths reducing and now more than ever, People Living with HIV (PLHIV) live long and fulfilling lives just like anyone else. The number of children being born with HIV has also declined owing to Prevention of Mother to Child Transmission of HIV (PMTCT) interventions.
The HIV prevention package has over the years included behavioural change programs at the individual level. Such interventions include educational, skills-building, counselling, HIV testing among others. HIV prevention has also amplified the uptake of biomedical HIV prevention tools with focus largely being on the three primary biomedical HIV prevention tool namely Treatment as Prevention (TasP), Pre-Exposure Prophylaxis (PrEP), and Post-Exposure Prophylaxis (PEP). These tools utilize antiretroviral therapy (ART) to not only treat HIV infection, but also to prevent transmission.
Just recently, Zimbabwe approved use of the Long-acting Injectable PrEP using Cabotegravir-LA and also use of the Dapivirin or Vaginal Ring as additional HIV prevention methods.
To further expand HIV prevention options for women, in 2021, the USAID Microbicide Program launched the a Microbicide Research and Development to Advance HIV Prevention Technologies through Responsive Innovation and Excellence (MATRIX ) consortium, a $125 million five-year cooperative agreement, funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
Unlike previous researches and innovations where Zimbabwe and Africa would be by standers, waiting to receive an already finished product from the Global North, the MATRIX allows for equal participation and collaborations between Global North and Global South where all key activities are led by North-South partnerships, pairing United States (US) based investigators, with investigators based in SA, Zimbabwe and Kenya.
This is like decolonizing research and development of innovations around HIV. The whole idea of the MATRIX is to advance the research and development of innovative HIV products for women,” said Dr Nyaradzo Mgodi one of the lead researchers in the MATRIX.
“Previously, it was more of a top-bottom situation whereby the Global North would innovate while the Global South was not doing much. But now, we are making it an Africa initiative, by Africans for Africans. This is what the MATRI is all about, we want to decolonize research, and we want home-grown solutions by our investigators, for our people.”
MATRIX is currently partnered with four Product Developers working on nine novel products at various stages of development. MATRIX will provide fiscal and administrative oversight through the Prime, and additional support to Product Developers’ R&D efforts through five cross-cutting Activity Hubs.
“We have got nine products that we are working on and we are working with product developers. As you are aware, we were using the dapivirine in ring form but now we are saying lets introduce new forms for example, we are introducing the dapivirine film.”
She added that there are various vehicles of delivery of drugs being explored under the MATRIX with the aim of measuring acceptability of the products by women. She also said plans were underway to develop a multipurpose devise that will prevent against HIV infection, STI infection and also prevent pregnancies at one go.
There are two types of films, the other one is square in shape and the other one has round edges. This is a film that one inserts in the vagina using a finger. The film dissolves and won’t give any environmental problems as there be any need to dispose of it.
Tendai Mamvura, a behavioural social scientist working on the MATRIX project said the initiative empowers local scientists and academic institutions in the field of HIV research and development.
“As you are aware, previous studies were mainly being driven by the Global North. But in this instance, the Global South will actively be involved in these projects. We have the likes of Dr Mgodi and local institutions such as the University of Zimbabwe working together with the global north institutions to come up with innovative products.
“The aim is to develop a range of HIV prevention products that are acceptable, affordable, scalable and deliverable by providing a platform for efficient, benchmark-driven portfolio management. It is a Collaborative initiative designed to positively accelerate early research and development (R&D) for new HIV prevention products,” said Tendai.
The MATRIX will also provide additional support to product developers through five cross cutting activity hubs.
“This is now quite interesting because instead of just doing clinical trials, we have got different arms which include the Technology Accelerator, Design to Delivery (D2D), Business, MArket Dynamics and Commercialization Hub (BACH), Capacity Strengthening, Engagement and Mentorship (CaSE), and Clinical Trials hub.
“For Zimbabwe, we are actually working on three hubs. We have got the clinical trials hub which is being led by Dr Nyaradzo Mugodi. We also have the CaSE and the D2D which PANGAEA AIDS Trust is leading. So when all the institutions and different stakeholders come together, they can then come up with solutions.”
MATRIX is designed to expedite R&D of products for prevention of HIV by supporting innovative and equitable collaboration among institutions, scientists, implementers, industry partners, and other stakeholders worldwide.
Meanwhile, Wanzirai Makoni, a Project Coordinator at Pangaea Zimbabwe Aids Trust said the MTRIX was a multi stakeholder initiative.
“In HIV prevention, what we are doing is that MATRIX is at the beginning, that’s is where the new products are being made, being thought about and being brought to life. We as PZAT are in the D2D hub. It’s a working group that is coordinated to engage different stakeholders. These stakeholders include the women themselves who are going to use these HIV prevention products, men, service providers and healthcare providers, pharmacies, policy makers, key influencers among others.
“The purpose is to provide insight into the uptake of products, the rollout and then the acceptability. We also leverage to inform and advance the research and development. We want to inform and we also want to move them along. It’s all about choice, and increasing the number of HIV prevention products that a woman should be able to choose whenever they want to use at any particular time,” said Wanzi.
MATRIX collaborators have deep inter-disciplinary product R&D-related experience in women-initiated HIV prevention methods, and they have support from SAGScientific Advisory Group: The SAG is an external, neutral, cross-cutting, multidisciplinary committee that provides expert data review and consultation services to inform the MATRIX stage-gating process.
