The United States Military HIV Research Program (USMHRP or MHRP) is a program initiated by the United States Congress in 1986. It is centered at the Walter Reed Army Institute of Research (WRAIR), and has established five international research sites in Africa and Asia (Tanzania, Kenya, Nigeria, Uganda and Thailand). Its primary focus is developing a globally effective HIV-1 vaccine, but the program also provides prevention, care, and treatment through the President's Emergency Plan for AIDS Relief (PEPFAR).
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International vaccine research
One of the program's largest projects was the RV 144 vaccine study of 16,000 volunteers in Thailand. In September 2009, trial collaborators announced positive results indicating that the vaccine was safe and reduced the risk of HIV infection by approximately 31%. Although the efficacy is modest, this study represents a major scientific achievement that has important implications for HIV vaccine testing and development. MHRP provided study leadership and is working with researchers around the globe to dissect the results from the RV144 trial and to design future clinical trials to translate a scientific milestone into an eventual public health tool. MHRP scientists are also pursuing other global vaccine strategies, which include MVA vaccines developed by MHRP and NIAID researchers.
In addition to vaccine development and testing, MHRP also conducts therapeutic research, tracks the HIV epidemic in active-duty forces, assesses the risk of HIV exposure to deployed U.S. and allied forces overseas, and conducts all HIV-1 testing for the Army.
Prevention, care, and treatment
While MHRP’s primary focus is on developing a safe, globally effective HIV vaccine, the program provides prevention, care and treatment services in each of the communities where research is conducted. These services, funded through PEPFAR provide an ethical, non-coercive environment to conduct clinical research. MHRP leverages existing in-country technical expertise and administrative infrastructure to expand partnerships with local researchers, health care services and NGOs in Africa to implement PEPFAR activities.[1] It focuses on counseling, testing, prevention of mother to child transmission, full access to antiretroviral therapy, home-based care, and care for orphans and vulnerable children.
MHRP is distinct from the Defense HIV/AIDS Prevention Program, which was instituted in the late 1990s to address the spread of HIV in African military personnel in more than 30 countries. DHAPP deals primarily with military-to-military relationships, while MHRP supports both military-to-civilian and military-to-military PEPFAR programs.