Opening with a bold truth: a cure for HIV should not depend on where you live. That bold premise sits at the heart of a new international collaboration spearheaded by Western University, aiming to reshape how lifesaving HIV breakthroughs are designed, produced, and distributed so that everyone in need can benefit.
For Eric Arts, Canada Research Chair in HIV Pathogenesis and Viral Control, this isn’t just an ethical goal but an urgent one. After years of progress in HIV treatment and vaccine research, he has witnessed both remarkable scientific breakthroughs and the stubborn delays that keep them out of reach for many. “Where you live still determines whether you benefit from medical breakthroughs,” notes Arts, a professor in microbiology and immunology at Schulich School of Medicine & Dentistry. “In the HIV context, that gap is especially stark.”
Although modern antiretroviral therapy (ART) has transformed HIV from a fatal disease to a manageable chronic condition, access to the latest therapies remains uneven. In sub-Saharan Africa—the region bearing the heaviest HIV burden—people have waited for treatments and innovations familiar in wealthier nations, sometimes for years or even decades. Many programs depend on unstable international aid and government support, a fragility that imperils countless lives.
Today, about 40 million people live with HIV worldwide, and most require daily medication for life. Technically, a cure exists, but it’s not yet a universally usable solution.
IMMUNEQUITY is a newly formed, public-private international collaboration co-led by Arts along with Maria Drangova and David Holdsworth (medical biophysics), James Lacefield and Arghya Paul (engineering), Bassem Awad (law), and Ugandan partners at the Joint Clinical Research Centre (JCRC) and Makerere University, under the leadership of Dr. Cissy Kityo Mutuluuza. The team also draws on researchers from Université de Montréal, the University of Manitoba, and Western’s faculties and schools.
The initiative’s mission is to reimagine how HIV cures are developed, ensuring that scientific innovation, affordability, manufacturability, and equitable access are treated as inseparable goals from the outset. In simple terms: they want to pursue an equitable answer to the world’s HIV pandemic.
“The chance to help design a potentially curative HIV therapy with manufacturability, cost, and global accessibility built in from day one is incredibly compelling,” says Peter Zandstra, Canada Research Chair in Stem Cell Engineering and a professor at UBC. “If we can tackle manufacturing and distribution alongside biology, the impact could extend far beyond Canada to millions worldwide.”
Rethinking the design: from cure to scalable impact
Today’s most widely known cure approach for HIV involves hematopoietic stem cell transplantation (HSCT). It’s a complex, high-risk, and extremely costly process that can exceed $350,000 per patient for chemotherapy, hospital care, and specialized support. Scaling HSCT globally would be financially unsustainable and infrastructure-intensive, particularly in low- and middle-income countries where the HIV burden is greatest. This reality highlights a core flaw in how biomedical breakthroughs are typically developed: cures are created first, with access considered later.
IMMUNEQUITY flips this sequence, prioritizing scalability and affordability from the start.
At the project’s scientific core is a strategy known as “kick and kill.” HIV hides in dormant immune cells as a latent reservoir, evading treatment and immune detection. The “kick” reactivates these latent viruses, making them visible to targeted therapies that can then “kill” them. Rather than relying on harsh chemotherapies, the team emphasizes biologics—precision immunotherapies such as antibodies and virus-like particles designed to specifically target HIV-infected cells.
“These cutting-edge tools, when stripped of profit-driven pricing for low-income countries, can be produced far more affordably,” Arts explains. More importantly, biologics manufacturing is more feasible to establish in resource-limited settings than HSCT or some traditional chemical drugs, prompting a fundamentally new development approach.
Working under Western’s Frugal Biomedical Innovations program, researchers across Schulich Medicine & Dentistry, Engineering, and Science will rethink how biotherapeutics are designed, manufactured, and monitored. The aim is to ensure that eventual cures are affordable, sustainable, and suitable for widespread deployment.
Cost and deployment are built into early research decisions. As Drangova notes, new biotherapeutics cannot be developed in isolation from the realities of low-resource health systems. They must be designed in parallel with scalable manufacturing, reliable cold-chain logistics, affordable production methods, continuous monitoring capabilities, and regulatory-grade quality systems to guarantee safety, affordability, and accessible deployment where it’s needed most.
Grounding the plan in community realities
Equity is not an afterthought—it’s embedded in the project’s framework. The team will collaborate with people living with HIV in both Canada and Uganda to ensure that legal, social, ethical, and cultural considerations shape every step of the work.
Awad, who leads the Western Intellectual Property and Innovation Legal Clinic, will craft an IP and data governance strategy that removes legal barriers and accelerates deployment, manufacturing, and commercialization in sub-Saharan Africa and beyond.
Community engagement is a core, ongoing element of IMMUNEQUITY, aligning with the Frugal Biomedical Innovations program’s emphasis on real-world input. Arts emphasizes that community voices will steer planning, trial design, and implementation realities from the outset.
Ugandan collaborators bring essential local expertise
IMMUNEQUITY leverages Arts’ longstanding partnership with Kityo Mutuluuza, a renowned physician and epidemiologist at JCRC, and her team, to co-develop and test technologies. The collaboration grew from an MoU signed in 2022 between Schulich Medicine & Dentistry and JCRC, expanding to Makerere University College of Health Sciences and Mbarara University of Science and Technology.
Projects include Ugandan PhD work on HIV-virus-like particles under Arts’ supervision via the JCRC–Schulich graduate exchange, highlighting the hands-on, on-the-ground nature of the research.
Building capacity and sharing benefits
Canadian institutions and industry partners—SHC Therapeutics, the Centre for Commercialization of Regenerative Medicine (CCRM), and Western’s forthcoming Pathogen Research Centre—will contribute manufacturing expertise. The collaboration envisions a two-way flow of knowledge between Canada and Africa, aiming to expand capacity and create meaningful economic benefits.
SHC Therapeutics co-founder Andrew Farrow stresses that accessibility remains a priority, noting that more than 70 percent of people living with HIV reside in low- to middle-income countries. In contrast, ART costs in high-income countries can reach around US$30,000 per person annually when considering branded drug prices and clinical care. A one-time, affordable cure would offer global economic and health benefits, while building biotherapeutics capacity strengthens Canada’s biomedical sector and job creation, strengthening Canada’s role as a leader in equitable innovation.
Arts sums up the motivation: scientific breakthroughs alone aren’t enough. A cure that cannot be produced at scale and afforded in resource-limited settings is not a true cure. “The best cure in the world is meaningless if it cannot be produced at a large scale and affordable cost in resource-limited settings, because otherwise people cannot safely access it. And they will not trust it.”
A model for the future of infectious disease care
IMMUNEQUITY isn’t just about HIV. If successful, it could redefine biomedical innovation by embedding co-development, frugal engineering, local manufacturing, and community partnership into the core process. The framework could be applied to other infectious diseases and chronic conditions in low- and middle-income countries, potentially transforming global health outcomes beyond HIV.
The project’s overarching aim is ambitious but timely: ensure that every breakthrough has built-in pathways to real-world impact, especially where resources are scarce. If the initiative delivers, it could signal a pivotal shift in how science, industry, law, and communities collaborate to end the HIV epidemic—and perhaps reframe how we approach health innovations across the globe.
So, is it possible to reconcile the race for scientific breakthroughs with a truly universal access model from the very start? And if IMMUNEQUITY achieves its aims, will other health innovations follow suit, embracing equity as a default design principle rather than a afterthought? Share your thoughts in the comments: do you agree that access should steer research from day one, or should breakthroughs be pursued purely on scientific merit before tackling distribution?"
