My dream is that before I die, we will have developed an HIV vaccine

Kundai Chinyenze was anxious to know her results, the culmination of four years of dedication and hard work at school, and her mother’s unfailing support.

More than anything else, she wanted to share her performance with her mother, who was unwell, and had been for a while. She fervently believed that her good performance would just be what would inject some life into the most important person in her life.

She was ecstatic with joy when she received her results. She had scored 11 straight A’s, placing her among the top five candidates in the entire country! She could not wait to share the good news with her mother and watch her face light up with joy.

 “There were no cellphones those days because I would have immediately called mum with the exciting news.”

However, when she arrived home later that day, she found many relatives seated outside their compound. Some were crying, and without having to be told, she knew that something terrible has happened to her mother.

BRUTAL NEWS

“When I stepped into the house, a relative took my hand and guided me to my mother’s bedroom. I walked in and found her lying still, on the bed. When I realised that she could no longer recognise me, my heart broke into small pieces.”

But she had to share the good news with her mother, and she did, only for her to stare at her with a blank expression.

“I would later learn that she had lost her mind - the pain of not being able to share the joy of my performance stayed with me for a long time,” says Kundai, who was only 15 then.

When her mother’s condition worsened, she was rushed to hospital. Kundai’s parents had earlier separated, and being an only child, she had to bear the sorrow of her mother’s illness alone, save for relatives, who would visit her in hospital.

Throughout her mother’s illness, no one told her what she was ailing from, no matter how many times she asked. She only found out during one of her many visits to the hospital. It happened in a brutal manner. As she walked past some nurses, she heard one whisper to the others;

“That is the child of the woman with AIDS”.

Kundai almost fainted.

“It was such a shock for me. It was as if I was day dreaming. I run to my mother’s bed and stood there just looking at her. I stood there until the doctor came.”

The first question she asked him was, “Is she going to die?”

But the doctor was non-committal, and retorted;

“We don’t talk about such things to children.”

She says that she felt as if someone had slapped her.

It was then that Kundai made a promise to herself. She would study medicine and learn everything about this disease that was slowly taking her mother away from her.

Two weeks later, her mother died, and two years after her death, her father succumbed to the same disease.

Today, Dr Kundai Chinyenze, at only 37, is coordinating one of the most complex research projects in medicine - that of finding a vaccine to tame HIV, a pathogen considered one of the most formidable in the history of science.

Dr Chinyenze, who comes from Harare, Zimbabwe, is charged with the task of ensuring the quality of research conducted by a team of researchers in Kenya, led by Prof Omu Wanzala of the University of Nairobi, and supported by the New York-based International Aids Vaccine Initiative (IAVI), matches international standards.

IMPORTANT WORK

“Our mission is to ensure the development of safe, effective, accessible and preventive HIV vaccines for use throughout the world. My role as Medical Affairs Director is to ensure the clinical research process is above board and that the researchers have all the material and technical support they require to conduct the trials,” she says.

Doctor Chinyenze is also overseeing similar research in Uganda, Rwanda, South Africa and Zambia.

She says,

“Watching my parents die due to Aids-related complications motivated me to become a doctor and to specialise in this field. My dream is that before I die, we will have developed a HIV vaccine. A vaccine that will be available to my children, my grandchildren and the generation after them. They will then not have to approach sex with trepidation, since it is now viewed as a possible death trap.”

Kundai, who arrived in Kenya in 2007, is a wife and mother of three boys. We ask her how she balances career and family.

“My work is important, and so is my family, so I find time for both. My work can sometimes take me away for days, and when this happens, I have to explain to my husband and children why I will need to be away from them. My hope is that what I am doing will benefit future generations.”

She adds,

 “My children know what I do, and every evening when I return home they ask me; ‘mom have you found a HIV vaccine?’ That one question makes me feel energized, and keeps me going.”

Besides her children, seeing many female researchers studying science also inspires her.

“I find it very inspirational to find the likes of Elizabeth Bukusi and Glenda Gray making impressive contribution through their research work, which is already influencing policies,” she says.

The two women are HIV and reproductive health top researchers in Kenya and South Africa respectively.

She points out that one of the major challenges facing African researchers is lack of access to resources, unlike their counterparts in the West.

“We don’t have access to the same quality of training that our colleagues in the West have, and this difference is seen when we sit around a table discussing scientific research and sometimes, we are unable to articulate them as well as other scientists, or to come up with critical questions that need to be answered, to make progress.”

However, this challenge is being addressed, thanks to IAVI, which is training investigators in the region to enable them to significantly contribute to the world of medical research in an equal footing as their counterparts in the West.

Kundai has advice for young doctors hoping to join the world of research.

PHASE ONE

“Be prepared to work hard, but note too that often, your contribution will not be recognised, since you will be working with a big team, and in most cases, it is the lead researcher’s name that is published,” she says.

She also warns that research takes time, so don’t expect instant results. When it comes to developing a vaccine for instance, think of a marathon, which requires patience and perseverance, rather than a sprint, which is quite fast.

“We’re not looking at a scenario where we will have a HIV vaccine within the next two years. It will take much more time, since there is a lot of work that is ongoing around the development, which goes through several phases of testing, and can take up to 12-15 years before being rolled out to the people,” she explaines.

Currently, there are several vaccines being tested, although majority of them are in phase one, while others are being tested in animals in pre-clinical tests, which take between two and four years.

Kundai credits her accomplishments to her mother’s unfailing sacrifice and support.

“My world revolved around my mother. She was one of my strongest pillars. She was  very dynamic, gentle and loving. She taught me to believe in myself, and often told me that there was nothing I could not do.”

After her mother’s death, it is this encouragement that nudged her to perform well in her A levels, where her high scores in pure sciences secured her a place at the University of Zimbabwe. She went on to study medicine, and after completing her degree, she joined the University of Leeds in Britain for her Masters qualification.

Thereafter, she got a scholarship with Canon Collins Trust, a United Kingdom sponsorship in collaboration with the Graca Machel Trust, to study public health.

When she graduated, Kundai returned home and went to work at the emergency ward at Harare Central Hospital, the equivalent of Kenyatta National Hospital.

At that time, many patients in their last stages of Aids were referred to her ward.

HUGE CHALLENGE

“I had been affected by HIV, so it was only natural to be very interested in my patients. I also asked fellow doctors lots of questions regarding the virus. My interest reached the director at the hospital’s HIV Clinic, who proposed me for training in the US. That is how I ended up in HIV vaccine development work, back in 2004,” she explains.

Doctor Chinyenze is optimistic that there is hope of getting a HIV vaccine. She refers to the outcome of the 2011 Thailand results that presented a vaccine that showed an efficacy of around 31 per cent.

“For a vaccine to be rolled out in the market, it must have an efficacy of between 80 and 90 per cent. The decision now is to go back to the drawing board and redesign the vaccine, improve it and then test it again. There are ongoing trials in South Africa to test the vaccine - we should have the results around 2020.”

Locally, trials are being conducted at one of the Nairobi City County government-owned clinics at the Kangemi Research Centre. They are sponsored by Oxford University, and supported by IAVI - five candidates have volunteered for the trials.

HIV/AIDS IS STILL A BIG HEALTH CHALLENGE, since hundreds of thousands of new infections are reported annually. In 2012, an estimated 1.6million people in Kenya were living with HIV, and nearly 60,000 people died from Aids-related illness that year, while more than a million children were orphaned.

According to IAVI and the Kenya AIDS Vaccine Initiative (KAVI), also spearheading the search for a vaccine, without an AIDS vaccine, and even with full scale up of AIDS treatment, prevention and care programs, new HIV infections will increase to 170,406 per year by 2050, due to population growth.