Since the discovery of the Human Immuno Deficiency Virus (HIV) which causes Acquired Immuno Deficiency Syndrome (AIDS) , the world has been confronted with the consequences posed by the reality that no cure has been found for the disease. Although there have been claims and counter claims about the discovery of a vaccine, none has been approved by the World Health Organisation (WHO) . With the disease still ravaging, it is obvious that more needs to be done in the area of research and ethics. CHARLES KUMOLU& EMMANUEL ELEBEKE report.
Twenty years after the world recorded the first case of HIV in the United States of America, Nigeria cut the attention of the world.
From the hospital in the densely populated Gwagwalada, the news echoed beyond the shores of this country. The story on the lips of many was; Dr. Jeremiah Abalaka had found a cure for HIV.
“My serum named PABALAKS, is potent and passed through all known scientific measures in the preparation of serum and therefore fit for human consumption,”Abalaka reportedly said.
He further claimed that: “Unlike western scientists, who used humans as guinea pigs, I offered myself and members of my family to test the efficacy of my drug.
“What I did was to inject my serum into our system and thereafter I injected the virus which causes HIV into our blood stream and because of the potency of my serum, none of us contracted the virus”.
From relative obscurity, Abalaka suddenly became hot news, ‘the biggest thing to happen to Nigeria since Wole Soyinka won the Nobel’.
Although some had attested to the efficacy of Abalaka’s vaccine, but a lot of controversies led to its rejection by the federal government.
For instance, Abalaka reportedly, refused to patent his serum. But the Nigerian Academy of Science (NSA) investigated his claim and concluded that the serum did not posses the properties he claimed.
The panel said “any scientific feat all over the world is subjected to voluntary test, and investigations to verify claims. But Dr. Abalaka has refused on many occasions to submit his discovery for scrutiny, therefore we got the sample from a patient and after thorough scientific analysis we discovered that Dr. Abalaka, s claim was not true”.
Subsequently, the Federal Government banned the substance and Abalaka and his teeming patients who took the drugs went to court to challenge an assault on their constitutional rights to health and happiness.
In addition, it was gathered that the hurried announcement by Dr. Abalaka over his discovery, contravened the rules and regulations governing the Nigeria Medical Association (NMA), the umbrella body for medical doctors. The Federal Government also claimed that adequate access was not granted to the Federal Ministry of Health to ascertain the effects of the vaccine on an individual.
Beyond this, Vanguard Features, VF gathered that stipulation of a document on ethical research methodology may have contributed to the Abalaka’s travail.
A document titled: Ethical Considerations in HIV/AIDS Preventive Vaccine Research by the United Nations, states among others that HIV/AIDS vaccines must be conceived and manufactured in laboratories of developed world and tested in human populations in developing countries. This practically, gives the developed world the exclusive privilege to conceive and manufacture the HIV/AIDS vaccine.
Today, Dr. Abalaka’s claims belong to history, while HIV has continued to diminish humanity. And many cannot stop asking; what happened to Abalaka and his HIV vaccine? Was he a product of politics in his profession or did he contravene the ethical code for HIV research? These and other questions still begging for answers.
Perhaps, it was the need to have better research ethics that informed the current USAID report on Hiv in Nigeria.
According to the report, “The National HIV/AIDS and Reproductive Health Survey (NARHS) estimated the national adult HIV prevalence rate at 3.6 percent in 2007, the most recent year for which data are available.
According to the 2010 report, 2,980,000 people are living with HIV/AIDS. After South Africa, Nigeria has the largest number of people living with HIV/AIDS in Africa,” the report stated.
It further said, “Significant regional variation in the epidemic exists, with Ekiti State in the Southwest zone of Nigeria having the lowest prevalence (one percent), and Benue State in the north-central zone having the highest (10.6 percent).
Women are disproportionately affected by the epidemic: Prevalence among young women ages 15 to 24 is higher than the prevalence among young men (2.3 percent versus 0.8 percent, respectively).”
In addition, the report indicated that, “Among the three States surveyed , the average overall prevalence rate was 13.5 percent. The HIV prevalence was highest in Lagos, at 25.4 percent.
While there appears to be high levels of HIV prevention knowledge, consistent condom use was lower. Just one-quarter had been exposed to safe sex education from peer outreach workers. Sexual relationships with women were common, a potential means of HIV infection spreading to the general population.
“A good percentage are at high risk of HIV infection; Kano State had the highest prevalence rate of the three States surveyed, at 10 percent. Those people at risk in Kano State often injected drugs more than once a day, and less than 40 percent consistently used sterilized needles. About 20 percent of people reported sex, had low condom use. 60 percent of the surveyed had received HIV education within the 12 months preceding the survey.”
It further maintained that, “Nigeria has utilized numerous opportunities for collaboration and synergy across technical areas. Wrap around activities have linked family planning services with HIV counseling and testing, extended basic education programmes to orphans and vulnerable children, and included the provision of nutrient-rich local foods to people living with HIV/AIDS. A total of 1,043,000 HIV-positive individuals received care and support services.”
Regardless of these efforts to curb the scourge, VF gathered that the issue of research, especially research ethics, has remained contentious in the fight against the disease.
Revealing this, the Director of Institute of Human Virology, Professor Clement Adebamowo. told VF that the issue is not that Nigeria doesn’t have an existing research ethics on HIV/AIDs but that the country is lagging behind in the implementation efforts.
He said there is need to provide more protection guidelines for the people living with HIV/AIDS that be may be exposed to undue harm as after disclosing their personal information to researchers.
Though, research ethics is not yet a matured field all over the world, Prof. Adebamowo said Nigeria is one of the few countries in the world that has a functional national research ethics committee but wondered why Nigeria has not been doing very well in the area of implementation of research ethics, particularly as it concerns HIV/AIDS research.
“It is a growing field. In Ibadan for instance, we do not have a department for research ethics and this is the way it is in many other universities across the country. The text books and curriculum are just been developed. So, when you put it in that context, we are not too far behind the other part of the world. Even the United States, we are all learning together, ” he noted.
On why HIV/Aids has remained a contentious issue in Nigeria, Adebanmowo said though, Nigeria currently has an ethics code like any other country in the world, but the ethics code is general for all types of research not specific.
“Whether you are doing research on mental health issue, nutrition, whatever you are working on, there is a general guideline to the code that covered that. But in research ethics, we have identified that people require additional protection. These category of research participants we group them together and call them, vulnerable population.
This vulnerable population include children, pregnant women, prisoners, people living with HIV/Aids, unconscious people, people with mental health problem. Because they are vulnerable population, in the research ethics world, it is considered that they need additional protection, when they are being enrolled in health research. Not that they should not be enrolled in research or research should not be done on them.
“Studies have shown that about 80 per cent of drugs being used to treat children were not tested before usage. We just took results from adults and applied it to children population, and that is not good because children are unique, they are not small adults.
So, it is important for research to be done in this vulnerable population. That is why there is need to focus on HIV/AIDS. Additional workshops will be held for the other types of vulnerable population. Additional code like this will be developed also for the other category of the vulnerable population, pediatrics and all others but we have to take them one by one and the one we have taken this time,” he further stated.
Nonetheless, when VF sought the views of Adebayo Adejumo, on whether research ethics is constituting a challenge to the fight against HIV, Adejumo, who is a member of Health Ethics Committee of Nigeria and also