HIV, art and serendipity: fighting COVID-19 circulation in Sub-Saharan Africa

The Developing Excellence, Leadership and Training in Science in Africa (DELTAS Africa) programme, funds Africa-based scientists to amplify the development of world-class research and scientific leadership on the continent while strengthening African institutions. DELTAS Africa is implemented through the AESA Platform. AESA (Alliance for Accelerating Excellence in Science in Africa) is a funding, agenda-setting, programme management initiative of the African Academy of Sciences (AAS), the African Union Development Agency (AUDA-NEPAD), founding and funding global partners, and through a resolution of the summit of African Union Heads of Governments. DELTAS Africa is supported by Wellcome and the United Kingdom Foreign, Commonwealth and Development Office (FCDO formerly DFID). The ongoing DELTAS Africa is a USD 100 million programme, funding eleven consortia spanning 54 institutions from Africa and 24 European institutions.

DELTAS Africa’s goal is to produce researchers with the capacity to publish and lead locally relevant and high-quality research to impact health science, policy and practice in Africa. To achieve this, the DELTAS Africa Theory of Change (TOC) is predicated on building research leadership through supporting growth of excellent research environments, scientific citizenship, research training and scientific quality.

This blog series explores how the eleven DELTAS Africa funded consortia were able to leverage on the TOC and pivot in real time to support an Africa-wide response to COVID-19, influencing research and policy across the continent and beyond.

SANTHE (the Sub-Saharan African Network for TB/HIV Research Excellence) is a research-led network with a cutting edge, globally competitive scientific programme focussed on HIV/AIDS and tuberculosis (TB), as these two diseases pose the most substantial public health challenges in Sub-Saharan Africa. When COVID-19 emerged, we were serendipitously already set up with the expertise, networks and well-established research infrastructure we needed to address this emerging pandemic, we felt both a professional and moral obligation to take action. Our sites in Botswana, Cameroon, Kenya, Rwanda, South Africa and Zambia immediately went to work attracting funding and establishing group-based laboratory studies while the SANTHE secretariat focused on what we could do as a network to contribute to the fight against SARS-CoV-2 circulation in Africa.

The impact of HIV on the antibody responses in COVID-19

An example of the research in which SANTHE scientists are involved is a crucial study being conducted at our lead site – the Africa Health Research Institute (AHRI) in Durban, South Africa –co-led by one of our Post-doctoral Fellows. It aims to establish how antibodies against SARS-CoV-2 - the causative agent of COVID-19 - could be useful in limiting viral replication, preventing re-infection and conferring protection upon vaccination. Some diagnostic tests also rely on antibodies to detect prior exposure to the virus, and antibodies are important for surveillance. However, extensive variation in the antibody response has been observed in COVID-19 patients, suggesting significant modulation by various patients’ and environmental factors. One such possible patient factor is HIV infection, which has been shown to inhibit antibody responses to other pathogens, such as measles and influenza.

Notably, there is contradicting evidence on whether HIV infection increases the risk of death from COVID-19. Considering that a significant proportion of the South African population is infected with HIV, understanding the impact of HIV on antibody responses against SARS-CoV-2 could have important implications for effective immunity against SARS-CoV-2 as well as for accurate diagnostic and surveillance algorithms.

The researchers are aiming to characterise the effect of HIV infection on SARS-CoV-2 immune responses, under a protocol known as the “Mechanisms Study”. Some of the participants recruited into the study are individuals living with HIV, among other diseases that have been shown to affect COVID-19 severity - such as diabetes and hypertension - thus enabling assessment of the effect of these factors on anti-SARS-CoV-2 immune responses. We are measuring various immune parameters induced or modulated by SARS-CoV-2, including antibodies. This work has the potential to inform understanding of why the disease course in COVID-19 patients is highly variable and the information is also relevant for development of effective vaccines against SARS-CoV-2.

Preliminary data suggests that antibody responses are similar between HIV-infected and HIV-uninfected individuals, despite differences in other underlying immunological factors. However, work is ongoing to determine whether HIV-infected individuals have different anti-SARS-CoV-2 antibodies or other immune functions and durability following infection, which may help predict  the effectiveness of vaccination to control the infection in HIV-infected people, as well as informing other preventative, diagnostic, therapeutic, and surveillance approaches.

COVID-19: where art and science meet

As the COVID-19 studies at SANTHE sites were quickly set up and embarked upon, the SANTHE Secretariat undertook an exciting community and public engagement project bringing scientists and young African creatives together to workshop thoughts and feelings around the pandemic.

Through these interactions, it was hoped that the artists would gain a greater appreciation of the science surrounding the COVID-19 pandemic as well as a greater interest and understanding of science and its role in society.  Furthermore, the team envisioned creating an impactful collection of art that would stimulate further discussions with the wider public via social media.

It was also hoped that the scientists would gain an insight into lay perspectives of the science of COVID-19 and potentially use this information to influence future research as well as science and policy communication efforts. A further aim was for the scientists to gain increased confidence and interest in participating in community and public engagement efforts.

We received awe-inspiring artwork and very positive feedback from the participants throughout this exercise, with many very interested to take part in future projects combining art and science. The online exhibition was also very popular with the public with over 3500 individuals voting for their favourite pieces of art. The virtual exhibition can be accessed here: https://artandscience.santheafrica.org/entries/

COVID-19 collaborative grants

The SANTHE Secretariat has also responded to the pandemic by offering two pilot collaborative research grants of $40,000 USD across the African continent to SANTHE-affiliated scientists.

The applications, which are currently under review, are for one-year collaborative grants for research projects that address critical challenges posed by the COVID-19 pandemic on Africa in the fields of clinical, social/behavioural and biomedical science. Priority will be given to projects that add value to existing skills and initiate a programme of study that is likely to be competitive for external funding. The projects are also being evaluated based on scientific quality, feasibility, and likelihood to generate preliminary data for external funding. In line with SANTHE’s mission to nurture young leaders in science, early-career researchers were encouraged to apply.