AILSA CHANG, HOST:
For four decades, researchers around the world have been trying to develop a vaccine for HIV without any luck. Recently, though, there has been some good news. Linda-Gail Bekker directs the Desmond Tutu Health Foundation in South Africa.
LINDA-GAIL BEKKER: The last five, 10 years has really shone a light on what is needed for an effective vaccine. So it's an incredibly exciting time.
CHANG: Well, one vaccine trial was hoping to build off of that excitement. It was supposed to launch a year ago across a handful of countries in Africa where AIDS has hit especially hard. But then suddenly, everything came to a stop. Reporter Ari Daniel has this story.
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ARI DANIEL, BYLINE: Penny Moore leads me into a room at the National Institute for Communicable Diseases in Johannesburg. It's arrayed with half a dozen large green-and-white freezers.
PENNY MOORE: These are the freezers that contain samples that are the basis of everything we do in the lab.
DANIEL: Moore is a virologist at the University of Witwatersrand.
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DANIEL: She cracks open the lid of one of the freezers and pulls out a tower of frosty tubes.
MOORE: It's heavy and hard for me to lift. So this is blood and cells.
DANIEL: All samples that have been donated over and over again for two decades by the same group of 117 South African women.
MOORE: They live in the communities most ravaged by HIV, and they donate their samples because they hope to see an end to an epidemic that is really, really real for them.
DANIEL: These samples have helped Moore and her team piece together a detailed portrait of the virus over the years - how it infects, how it hides and how much it changes across different parts of the world and even within a single individual.
MOORE: The amount we have learned from these freezers, it's just astonishing.
DANIEL: And yet Moore spent much of last year worrying that it might all amount to nothing because just when she and her colleagues were on the brink of something audacious, an innovative HIV vaccine trial across Africa, the bottom dropped out. To explain, let me rewind to early last year to a meeting in Zanzibar.
MOORE: The famous Zanzibar trip.
DANIEL: Zanzibar is a tropical archipelago off the east coast of Africa. Penny Moore says it was crazy hot.
MOORE: One of those places where you just consider standing up and you break out in a sweat.
DANIEL: The gathering took place in a hotel perched on the edge of a brilliant blue ocean. There were researchers and clinicians from across Africa, and then there were the international scientific advisers.
MOORE: They grilled (ph) us to within an inch of our lives to make sure that we were doing the very best cutting-edge science we could do with the amount of money we had.
DANIEL: That amount was $45 million awarded by the United States Agency for International Development to create a state-of-the-art vaccine to prevent HIV. The grant was intended to get teams across the continent to collaborate on developing a vaccine that would work in different African communities.
MOORE: The virus that they have in Kenya is not the same as the virus that we have in Botswana. It's not the same as the virus that they have in Senegal. And so understanding how these vaccines will work for the local virus is what makes it relevant.
DANIEL: At the meeting in Zanzibar, there was a real feeling of momentum.
NONO MKHIZE: The excitement was through the roof.
DANIEL: This is Penny Moore's colleague, Nono Mkhize.
MKHIZE: We're at the beginning of something big.
DANIEL: But just as the meeting was about to wrap up, Penny Moore says the mood darkened.
MOORE: From the number of Americans, particularly, checking their phones all of a sudden and talking to one another in little huddles.
DANIEL: Something was wrong. Newly inaugurated President Trump had just signed an executive order freezing all foreign aid. Suddenly, it seemed, everything was up in the air.
MOORE: I remember at the end of the meeting USAID colleagues saying to me, I'm not sure if I'll see you again. I completely underestimated how much it would gut the program.
DANIEL: But Moore and her colleagues would soon find out. After returning to Johannesburg, she says the official stop work orders arrived from Washington. Just weeks before the trials were to begin, everything came to a sudden halt. All the money was gone.
BEKKER: In many ways, we've kind of had our legs cut off, even as we're beginning to run the sprint.
DANIEL: Infectious disease specialist Linda-Gail Bekker is based at the University of Cape Town. When the funding collapsed, she says she cycled through the stages of grief.
BEKKER: There's disbelief in the first instance. Then there is emotion that basically is angry because we'd worked d*** hard. We'd won this grant, and we were doing what we had said we would do.
DANIEL: But gradually, Bekker and her colleagues started saying...
BEKKER: This matters too much to not finish the work.
DANIEL: A period of frantic grant writing began.
BEKKER: We brought up the begging bowl to say, this is important - can you help us in some way?
DANIEL: Finally, they got funding from the South African Medical Research Council and the Gates Foundation. But it was a fraction of the original USAID grant and only focused inside South Africa, meaning they had to sacrifice studying how the vaccine might work against different versions of the virus within different African populations. Penny Moore.
MOORE: It's a bare-bones version. We will still get the answer, but it's going to cost us time - years, which is not trivial because people are getting infected with this virus constantly.
DANIEL: Despite having to scale back, Moore says HIV vaccine research is farther along than it's ever been.
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DANIEL: She takes me back into that freezer room in her lab, which contains an embarrassment of scientific riches, thanks in no small part to those 117 women and the samples they've donated over the years.
MOORE: These samples have taught us everything we know about HIV.
DANIEL: And have revealed a veritable pot of scientific gold, a unique kind of antibody that showed up in the blood of a few of these women, something called a broadly neutralizing antibody.
MOORE: A broadly neutralizing antibody could stop my virus and could stop your virus and could stop the HIV virus from any other person.
DANIEL: But it's difficult to coax the human immune system to produce these antibodies. This vaccine trial is trying to figure out how to do that more easily.
UNIDENTIFIED PERSON: Don't get it (inaudible).
DANIEL: At last, after nearly a year of delays, the pared-down trial is getting underway. On the outskirts of Cape Town, a large brick building rises above Philippi Village, an impoverished township where HIV is rampant. A few levels up, I spot Amelia Mfiki, the community liaison officer for the vaccine trials.
AMELIA MFIKI: This is a great opportunity for South Africa to prove that we can do things in South Africa for South Africa with South African financing.
(Inaudible).
DANIEL: Mfiki makes her way to a room where 20 or so young women from the community are gathered to hear about participating in the trial.
MFIKI: The HIV vaccine (non-English language spoken).
DANIEL: Twenty-five-year-old Nandipha Mongo listens attentively. She says her community struggles with rape, sex traded for favors, unplanned pregnancies...
NANDIPHA MONGO: Most of us are scared of getting HIV.
DANIEL: ...Which is why she'd happily be involved in the research...
MONGO: Yo (laughter), I'm over the moon, man. I'm over the moon. Yes.
DANIEL: ...Because she's proud to be making a difference.
MONGO: Yes, a big one, a big difference.
DANIEL: So I ask her, if this team of researchers are able to find a vaccine, what would a world without HIV be like?
MONGO: Living free - yeah.
DANIEL: The first shots of the new vaccine trial started going into participants' arms this week. For NPR News, I'm Ari Daniel, Cape Town, South Africa.
CHANG: Reporting for this story was supported by a grant from the Pulitzer Center. The Gates Foundation is a financial supporter of NPR.
(SOUNDBITE OF J. COLE SONG, "FORBIDDEN FRUIT") Transcript provided by NPR, Copyright NPR.
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