The first clinical trial on African soil for a vaccine against Covid-19 began this week. About 2,000 people will take part in this trial in South Africa. France 24 could discuss this with a doctor who monitors one of the sites where the candidate vaccine will be administered to volunteers.
About twenty volunteers have already received an injection. They are the first participants in the very first clinical trial in Africa for a vaccine against Covid-19. Officially announced on Tuesday, June 23, this test conducted by Wits University of Johannesburg in South Africa can be an important turning point in the fight against coronavirus in a continent where the spread is still in an acceleration phase and where more 330,000 people have already been infected.
The vaccine used in this study is ChAdOx1 nCoV-19. Developed in April by the University of Oxford, it is considered one of the most promising of hundreds under development. Outside South Africa, clinical trials of this vaccine are being conducted in the UK, Brazil and another is planned in the US.
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A phase 2 study
This test is not yet intended to assess the effect of ChadOx1 nCov-19 on the disease. “The aim is currently to ensure that the vaccine is not harmful to patients [qu’il n’y a pas d’effets secondaires, NDLR] and measure the immune system’s response, “said Lee Fairlie, a pediatrician at the University of Wits who oversees one of the clinical trial sites, contacted by France 24.” This is called a phase 2 trial, during which we try to determine the dose of a vaccine that gives the best immune response, “specifies Pierre Saliou, vaccine specialist and chair of the Intervention Group in Public Health and Epidemiology (GISPE), contacted by France 24.
Altogether, about 2,000 South Africans are expected to participate in this phase, which is expected to last about a year. But for the moment, “we have recruited a first group of 50 volunteers on our site who will receive the vaccine and then there will be 50 new arrivals before they move up,” Lee Fairlie said. This is much smaller than in the UK where the test already involves 4,000 people and “should provide the first information about the immune response in the coming weeks,” the South African pediatrician added.
The volunteers selected in South Africa are “all between the ages of 18 and 65 and we made sure they were in good health and were not affected by chronic illnesses that require special medical care,” Lee Fairlie said. However, she realizes that the trial could be extended to less healthy people, “depending on what we will learn about the safety of the vaccine after the first tests.”
The importance of a clinical trial on the African continent
At a time when the World Health Organization (WHO) insists on the need to make a future Covid-19 vaccine available to everyone, the clinical trial in South Africa can be crucial. Tests performed in one country or just one continent are not enough to prove the effectiveness of a vaccine because “some populations may sometimes have different immune responses,” notes Éric D’Ortenzio, epidemiologist at Inserm, contacted by France 24. “Genetically, we have a very diverse population in South Africa and different from the UK or Brazil, so it is important to perform tests here, “Lee Fairlie specifies. She believes the South African trial makes it possible to assess the effectiveness of the vaccine across the continent, “although it would always be better to conduct further studies in other countries”.
South Africa also presents a very different health environment from a European or South American country, which makes the results of this clinical trial interesting. “There are a number of very specific diseases here, such as tuberculosis and the HIV virus. And it will be necessary to understand how people affected respond to a vaccine,” notes Lee Fairlie.
This is especially true for AIDS, “an important issue in South Africa almost there7.5 million people have been infected by the virus“recalls the South African researcher. She also hopes to include people with HIV in a voluntary group” if we can establish that there is no risk of taking the vaccine for this population. “In this regard, this clinical trial, in addition to South Africa and the continent, , proves to be rich in lessons for the entire world One of the central issues in the research of treatments for Covid-19 is about how people with weakened immune systems due to diseases like the AIDS virus can respond to a future vaccine.
Testing in Africa, still a sensitive issue
The significance of this first clinical trial in Africa also contributes to the highly controversial history of vaccine testing being conducted on the continent. Larger drug groups have been accused, such as Pfizer 1996, for exploiting the lack of information from local populations to perform tests under questionable conditions.
The violent reaction to statements by a French doctor who called in April to test vaccines in Africa shows how much these scandals have left traces. “The doctor’s remarks were blunt and had potentially racist overtones,” says Lee Fairlie.
The experts interviewed by France 24 all realize that efforts must be made to restore confidence in local populations in clinical vaccine studies. “The key is that people are properly informed about the tests and that through awareness campaigns we can engage people, that is, they really want to participate,” emphasizes Eric D’Ortenzio. Lee Fairlie hopes that the trial of the ChAdOx1 nCoV-19 vaccine, which follows international rules for obtaining informed consent, will help “deepen the fear that some may still have”.
Of course, researchers hope the Oxford vaccine will fulfill its promise. But at least the tests conducted in South Africa allowed erase the legacy of the past, it would already be a victory.