Africa accounts for about 68% of the global HIV burden. While the rate of HIV infection appears to be falling in some countries, overall, it is still a significant cause of morbidity and mortality in the region. In most African countries, despite their efforts, governments have been unable to provide anti-retroviral treatment to all those who need it. Where ARVs are provided, 2 - 3 new infections still occur for every one person commenced on ARVs. Thus prevention remains the mainstay of HIV control. The potential positive impact of an effective HIV vaccine, even with an efficacy as low as 30%, is tremendous. Unfortunately, HIV vaccine research has faced and continues to face several challenges. The current global discourse on the possibility of ending the HIV epidemic with the use of proven effective tools, and the recent exciting HIV prevention research outcomes makes the discussion and the drive for investment in HIV vaccine research more challenging. For Africa, HIV vaccine remains a main hope for addressing the epidemic. The feasibility of use of antiretrovirals on a large scale for HIV prevention has its challenges both for implementation and sustainability. Cheap and effective prevention tools are critically needed. The development of a HIV vaccine is one such tool that would have tremendous significant impact on the epidemic in sub-Saharan Africa. This discussion will highlight some of the challenges facing HIV vaccine research with particular reference to Africa, critically appraise the need to stay on course in the search for an effective vaccine, and suggest some measures that might be required to move the HIV vaccine research and development agenda forward.
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