Trinidad and Tobago : Islands in Uproar over AIDS Vaccine Trial

By Peter Richards

It was supposed to be their moment of glory. After years of campaigning, the Trinidad and Tobago government this week finally gave the green light for local researchers to be part of an international campaign against the deadly HIV virus that causes AIDS.

But instead, the researchers and their supporters have been taking to the radio, television and other medium in a bid to assure the public that the HIV vaccine trials are safe and that participants will not end up contracting the deadly disease.

The vaccine is being developed through an alliance involving medical research centres in Brazil, Haiti, and Trinidad and Tobago with the Institute Pasteur, the Institut Merieux of France and Canada’s Connaught Laboratories.

The vaccine uses canary pox vectors to transport HIV genes to the host cells. Volunteers here would be participating in Phase Two of the trials which tests the efficacy of the vaccine.

In Trinidad and Tobago official figures show that 1,200 new cases of AIDS were reported last year and there are over 17,000 persons living with HIV/AIDS in the country.

But the controversy over the vaccine trial has come about as a result of a statement Health Minister Dr. Hamza Rafeeq made in Parliament this week while announcing that cabinet had agreed for the island to participate in the international effort.

In his prepared text, Rafeeq said that before cabinet had given its approval, it had sought clarification from a government-appointed committee on a number of specific issues including whether or not the vaccine would make those who receive it HIV positive.

According to Rafeeq some concerns took the form of the following questions, such as ’is the vaccine likely to cause the disease AIDS?’, to which the committee, made up of medical, church, trade union and university lecturers said ’no, highly unlikely’.

But when the committee was asked, ’Will the vaccine make those who receive it HIV positive,’ Rafeeq said the response was ’yes’.

"Immunization with these vaccines will result in HIV antibody positivity. However, tests are available and the Medical research Foundation of Trinidad and Tobago (MRFTT) has access to these biochemical tests which can differentiate between vaccine produced positivity and native infected positivity," the Health Minister said.

Further, he pointed out that the government reserves the right "to discontinue the vaccine trials in the event of any unforeseen circumstances that are highly disadvantageous or inimical to the health or well being of the volunteers or the larger society".

Rafeeq also said that the government was developing a policy to protect volunteers from discrimination should they become infected and that the researchers should provide "the best current available treatment in the world" for the infected person "for the remainder of his or her life".

But the researchers at the MRFTT say the Minister’s statements on the issue were far off the mark.

"It is impossible to become HIV positive from the vaccine," says Professor Courtenay Bartholomew who is leading the local research team. "What do they mean by the answer ’highly unlikely?’ " he asks.

He insists that the vaccine "is not made from a live HIV virus" and that since 1987, over 9,000 people have been participating in the trial in the United States.

He says should any volunteer became infected during the trials, it would not be as a result of the vaccine, but because of that persons "unsafe sex practices during the trial".

"We tell volunteers that they should not have unsafe sexual practices during the trial. They are told so at least three times on the form, we are testing the vaccine, we do not know whether it will be 100 percent or even 20 percent effective," he said.

The two-year old Trinidad and Tobago Community Advisory Board (TTCAB) said it too did not share the view that volunteers would become infected as a result of the trials.

The TTCAB, an independent group brings together a number of organisations including churches, the Registered Nurses Association, Artists Against AIDS and the Tobago Aids Society.

"We have access to all information available worldwide on the trials and other research, "says Bhuela Duke, its chairman. Duke added that the establishment of the TTCAB was one of the criteria for allowing this country to participate in the trials.

But not everyone is convinced.

David Mohammed of the Nation of Islam, who hosts a weekly radio show on AIDS, said there is "overwhelming, irrefutable evidence" that the vaccine does cause AIDS in individuals, saying the same vaccine being tested here had originally been tested in Kenya.

"Why did you send it to Africa to test to see if it is safe for human beings. It is not the intention of the Nation of Islam to stop the vaccine trial, but to merely provide all the information. The people should have the information from all sides," he said on radio.

Callers to other radio and television talks shows this week were raising the possibility of "human error" during the trial resulting in the volunteer becoming HIV positive, while others saw it as black people "who do not have a good track record with whites" being exploited once more.

"Every cabinet member, who voted yes, should become volunteers," said a woman caller, with another saying that "the third world countries were being targeted by the various drug companies".

But professor Bartholomew has dismissed such claims saying the safety of the canary pox vectors has already been assured in studies involving more than 800 people in the United States and France.

"These first world volunteers are truly the so-called human guinea pigs as they are the ones who tested the safety of the drug in a Phase 1 and also did Phase two trials," he said.