India and the Netherlands to collaborate on a joint cohort study on HIV/AIDS

On the occasion of the visit of Dutch Prime Minister, Mr. Mark Rutte, to New Delhi, the two countries plan to expand their existing cooperation in the area of large scale patient cohorts with a Joint Cohort study on HIV patients in India. It is proposed that the joint cohort study will be executed by various partners in both India and the Netherlands including Erasmus University Medical Centre (Erasmus MC), Rotterdam, International AIDS Vaccine Initiative (IAVI), India, together with the other research institutions, with support from the Department of Biotechnology (DBT).

The initiative shall be focused on: 1) Establishing of a collaborative framework to facilitate learning and knowledge sharing for establishment of acute and chronically infected HIV cohorts 2) Conduct of preclinical & clinical studies and manufacturing of neutralizing antibodies (NAbs) to HIV-1 for their use in combination therapies, passive immunization, and/or for designing preventive vaccines 3) Facilitating characterization and validation of Biomarkers that will aid in evaluation of disease progression and management.

Giving momentum to the existing efforts under the bilateral science & technology agreement between India and the Netherlands, this multiparty research project comprising of both Government and non-Government institutes will be jointly executed under the auspices of The Department of Biotechnology (DBT) Ministry of Science & Technology (MoS&T – India) by Erasmus Medical Center Rotterdam (The Netherlands), research institutions of DBT and Indian Council of Medical Research (ICMR), Ministry of Health and Family Welfare India and the International AIDS Vaccine Initiative (IAVI). It has the ability to be a huge value addition to both, the ongoing efforts and those planned, in the countries for researchers, science administrators and policy makers.

HIV still remains one of the most challenging viral diseases worldwide and for India— despite substantial progress in reducing new incidence of HIV the country still houses with the third-highest number of people of people living with the disease at 2.1 million.  To reach ground zero HIV burden in the country it is critical to fill gaps in the knowledge of how humans can defeat the virus as well reenergize research efforts to understand factors responsible for prevention and control of HIV infection and to develop strategies for the same.

The Government of India has taken several initiatives over the years to reinforce the national response to the global fight against HIV/AIDS through the MoHFW and the MoST departments.  HIV research is an emerging program priority for India with a goal to help identify tools and methods for disease detection, intervention, control, prevention and subsequent eradication. Continued and ongoing efforts are expected to not only boost efforts for Biomedical tools of prevention like HIV vaccine but also accelerate R&D initiatives in the country.  In recent times in working with African nations, initiatives are underway towards a stronger understanding of HIV Virology and Host-Microbe interactions through key centers of excellence in India. Also under the leadership of DBT and ICMR there is a national program being structured for Chronic and Acute infection HIV cohorts, setting up of a National Biorepository and initiating studies towards HIV Virology and Host-Microbe interactions.

For HIV/AIDS, Netherlands has a national cohort, which comprises ~93% of all patients under care, amounting to about 20,000 patients. The Dutch HIV/AIDS cohort is currently part of 15 international research collaborations. The Dutch are also setting up acute infection cohorts, which should also be a priority in India as none exist so far.  Though the size of the Dutch outbreak is much smaller than the Indian outbreak (~2.5 million infections), we have much to learn from it in terms of cohort building and its accessibility to researchers.

India and the Netherlands share close relations especially in the area of Science and Technology and have already collaborated and set up a cohort study in the past. The study aims to assess the risk factors associated with stroke and Alzheimer’s disease, with All India Institute of Medical Sciences (AIIMS), New Delhi, as the partner on the Indian side and Erasmus MC, Rotterdam on the Dutch side. The project was officially launched in January 2014, in New Delhi, by Dutch Minister for Health Welfare and Sport, Ms. Edith Schippers and former Indian Minister for Science and Technology, Shri Jaipal Reddy. The project aims to follow a population of 10,000 people aged 50 and above, over a period of 10 years. The two sides have now decided to extend their cooperation in large scale cohorts with a study on HIV patients in India.

The scientists from both India and the Netherlands will come together with the help of a workshop, which will be organized in New Delhi, around third quarter of this year. It will serve as a platform for all the partner institutes to get together and brainstorm their ideas for development of the project.

Institutes & Organizations driving the initiative

Department of Biotechnology
The setting up of a separate Department of Biotechnology (DBT), under the Ministry of Science and Technology in 1986 gave a new impetus to the development of the field of modern biology and biotechnology in India. Driven by its mission, of attaining new heights in biotechnology research, shaping biotechnology into a premier precision tool of the future for creation of wealth and ensuring social justice – specially for the welfare of the poor, in over 25 years of its existence, the Department has successfully promoted and accelerated the pace of development of biotechnology in the country.   Through the Department’s several R&D projects, demonstrations and creation of infrastructural facilities, a clear and visible impact of this field has been evident, especially in the broad areas of agriculture, health care, animal sciences, environment, and industry that have culminated into products and processes. More than 5000 research publications, 4000 post-doctoral students, several technologies transferred to industries and patents filed including US patents, can be considered a modest glance at the Department’s achievements. DBT has been interacting with more than 5,000 scientists per year in order to utilize the existing expertise of the universities and other national laboratories. Through close interaction with the State Governments particularly through State S & T Councils efforts have been made towards developing biotechnology application projects, demonstration of proven technologies, and training of human resource in States and Union Territories. Programmes with the states of Gujarat, Rajasthan, Madhya Pradesh, Orissa, West Bengal, Haryana, Punjab, Jammu & Kashmir, Mizoram, Andhra Pradesh and Uttar Pradesh have been evolved. Biotechnology Application Centres in Madhya Pradesh and West Bengal have successfully been established.   A unique feature of the Department has been the deep involvement of the scientific community of the country through a number of technical task forces, advisory committees and individual experts in identification, formulation, implementation and monitoring of various programmes and activities.

Erasmus Medical Center Rotterdam
Erasmus MC is the largest and most authoritative scientific University Medical Center in the Netherlands and one of the 20 best research institutes worldwide. Almost 13,000 staff members work within the core tasks of patient care, education, and scientific research on the continuous improvement and enforcement of individual patient care and social healthcare. Erasmus MC has comprehensive facilities for undergraduate and postgraduate teaching & training, as well world-renowned Research Education programs (Research Masters, PhD and combined Graduate programs) to train the researchers of the future.

For more than 25 years the Erasmus MC conducts large-scale population-based cohort research as one of its top priorities. The goal is to further understanding of the causes of common diseases. The cohorts take a life course perspective and cover nearly all ages from fetal life to the oldest old.

Indian Council of Medical Research
The Indian Council of Medical Research (ICMR), New Delhi, the apex body in India for the formulation, coordination and promotion of biomedical research, is one of the oldest medical research bodies in the world. As early as in 1911, the Government of India set up the Indian Research Fund Association (IRFA) with the specific objective of sponsoring and coordinating medical research in the country. After independence, several important changes were made in the organization and the activities of the IRFA. It was re-designated in 1949 as the Indian Council of Medical Research (ICMR) with considerably expanded scope of functions. The ICMR is funded by the Government of India through the Department of Health Research, Ministry of Health & Family Welfare.

International AIDS Vaccine Initiative
The International AIDS Vaccine Initiative (IAVI) is a global not-for-profit organization whose mission is to ensure the development of safe, effective, accessible, preventive HIV vaccines for use throughout the world. Founded in 1996, IAVI works with private companies, academics, and civil society partners in 25 countries to research, design, and develop AIDS vaccine candidates. In addition, IAVI conducts policy analyses and serves as an advocate for the AIDS vaccine field. IAVI supports a comprehensive approach to addressing HIV and AIDS that balances the expansion and strengthening of existing HIV-prevention and treatment programs with targeted investments in the design and development of new tools to prevent HIV. IAVI is dedicated to ensuring that a future AIDS vaccine will be available and accessible to all who need it. IAVI’s work is made possible by generous support from many donors including: the Bill & Melinda Gates Foundation; the Ministry of Foreign Affairs of Denmark; Irish Aid; the Ministry of Finance of Japan in partnership with The World Bank; the Ministry of Foreign Affairs of the Netherlands; the Norwegian Agency for Development Cooperation (NORAD); the United Kingdom Department for International Development (DFID), and the United States Agency for International Development (USAID). The full list of IAVI donors is available at www.iavi.org.