Q&A: Ugandan doctor honoured with Western University doctorate for work to end HIV/AIDS

One of Africa's leading voices in HIV/AIDS treatment and global health research is being awarded a doctorate from Western University this week.

Dr. Cissy Kityo Mutuluuza is a physician, epidemiologist, medical researcher, and the executive director of the Joint Clinical Research Centre in Kampala, Uganda. Western partnered with her and her research team in the summer of 2022 to strengthen global health research, medical education, and clinical care.

Dr. Mutuluuza joined London Morning host Andrew Brown to talk about the work she has been doing to treat and find a cure for HIV/AIDS.

The following interview has been edited for length and clarity.

Andrew Brown: It's great to have you. First off, congratulations. So, what does this honour mean to you?

Dr. Cissy Kityo Mutuluuza: Thank you very much. I'm really honoured to be awarded an honorary doctorate for outstanding work in medicine—specifically, for my work and my team's work on HIV.

This doctorate is a recognition of the work we have done, the changes we have made, and the improvements we've seen in the treatment of HIV in sub-Saharan Africa, but also in low-and middle-income countries. We've been involved in various research projects to improve HIV therapeutics and to make some inroads in prevention.

We've just concluded the first trial in sub-Saharan Africa, looking at long-acting anti-retroviral therapy, with the goal of bringing this treatment modality to the continent.

So, this recognition is an incentive to work even harder. We know that in order to control the HIV epidemic, we ultimately have to provide a cure. That's the direction our work is heading, and this honour energizes us to continue pushing toward that goal.

AB: This trial that you just finished—what kind of therapy is it, and how significant would you say it is?

CKM: We've come a long way—from taking many pills a day to taking one pill with three drugs just once daily.

HIV treatment is lifelong because we don't yet have a cure. So, that means a person has to take that pill every single day. Even though it's simplified from earlier regimens, it can still lead to treatment fatigue. We have children who begin treatment at one month old and stay on it into adulthood. Adults who start on treatment must remain consistent for life.

Some patients stay on track, but others struggle. That inconsistency can lead to an increase in viral load and, worse, to drug resistance. So, a lot of research is focused on simplifying treatment even further.

Instead of taking a pill daily, there are now drugs—already licensed in the U.S., Canada, and Europe—that allow for an injection of two drugs every two months. And there's even more research suggesting it may be possible to take some of these drugs every six months or even once a year.

LISTEN | Dr. Cissy Kityo Mutuluuza recognized for research and progress on HIV/AIDS:

This approach could reduce the frequency of medication, especially for people who struggle with daily adherence. But the trials that led to the licensing of these drugs were only done in high-income countries, and the populations in sub-Saharan Africa differ in many ways.

So our study—where I was the principal investigator, coordinated by the Joint Clinical Research Centre—evaluated whether these long-acting injections were not inferior to daily pills and whether they were acceptable to our population.

AB: Are the results promising?

CKM: The results are out. We followed 512 participants over two years, and the results are excellent. They're similar to what we've seen in high-income countries.

To adopt any new treatment modality, we need research-based evidence. That evidence is then reviewed and adopted by the WHO, which provides guidelines for individual countries to follow. So the results are very promising. We're now planning further studies that may allow injections every six months instead of every two.

AB: How close do you think we are to a cure?

CKM: We're close—as long as we get involved and start now.

Currently, cure research is happening mainly in high-income countries, yet the greatest burden of the disease is in sub-Saharan Africa, where much less research is taking place. That has to change.

One of the reasons I'm here is to contribute to a proposal to secure funding for cure research in sub-Saharan Africa. The populations are different, and we can't simply translate what's been done in the North to the South. We need resources to do this work locally.

There are new technologies and scientific advances that make us believe a cure is within reach—if we engage now. We already have proof of concept: nine patients around the world have been cured using bone marrow transplants. But that approach isn't scalable.

So we're exploring other strategies, like gene therapy. Some of these innovations have been developed by researchers like Eric Arts at Western University, and we're partnering with them to bring this research to the populations most affected by HIV.

Dr. Cissy Kityo Mutuluuza will be giving a public lecture titled Ending the HIV Epidemic: Next Steps and Innovations on Thursday at 11 a.m. in the Dental Sciences Building (DSB), Room 1002 at Western University. The lecture will also be streamed online.