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The world of HIV and AIDS research and development (R&D) is changing dramatically, and sessions this week at the XIX International AIDS Conference have examine how R&D advocates need to adapt and adjust their strategies in this new environment. The global financial crisis is at the forefront of many people’s minds, along with issues like increasing demands on already strapped country-level budgets and the possible shift from the Millennium Development Goals to the Sustainable Development Goals. At a session on Tuesday to discuss persuading policymakers to invest in tuberculosis (TB) R&D, Richard Horton from the Lancet said that TB advocates have recently recognized the need for a different approach that involves going directly to policymakers, as well as bringing TB scientists and researchers together with national decision-makers in order to create a collective will to address the leading killer of HIV-positive people worldwide. Two members of parliament from the United Kingdom—Cathy Jamieson and Pamela Nash—stressed that in addition to making their evidence and arguments simple and understandable, advocates need to connect their issues to a politician’s constituents, as constituents are always a policymaker’s top priority. “My job as a politician is to listen to the evidence and expertise that you bring, and then make sure funding is available to address those priorities,” Jamieson said. (from left to right): GHTC Director Kaitlin Christenson, IAVI's Prince Bahati, Henriette Laursen of AIDS-Fondet, Christine Lubinski from the Infectious Diseases Society of America, and Chamunorwa Jefrey Mashoko from AVAC. Photo credit: PATH Later that afternoon, the GHTC and several coalition members—Aeras, AVAC, the International AIDS Vaccine Initiative (IAVI), and the International Partnership for Microbicides—hosted a session to discuss how advocates can adapt their advocacy to meet today’s challenges. Four main themes emerged—the first focused on taking a community approach to R&D advocacy that includes a range of diseases and products. “Policymakers are tired of vertical advocacy,” Prince Bahati of IAVI said, adding, “We as advocates have the opportunity to create a platform of integrated advocacy, comprised of advocates, and scientists. We need to adapt to the transition that is happening and create one voice.” Chamunorwa Jefrey Mashoko, an AVAC advocacy fellow, added that a key part of this effort will involve scientific collaboration between African and American researchers. Panelists also discussed the need to engage new voices in their advocacy, including researchers working on new HIV and TB tools, as well as the people and communities who will ultimately benefit from these new products. Christine Lubinski from the Infectious Diseases Society of America said that some of the most successful project she’s worked on involved taking members of Congress to African countries in order to see first-hand TB and HIV research projects and clinical trials, and to meet African scientists. She added that it’s vital to show policymakers that there is a domestic constituency who believes in global health R&D, comprised of academic institutions, scientists, and researchers. “We have game-changing tools in the pipeline,” Lubinski said, adding, “We have a real opportunity with some of these new products, and I believe that’s our biggest weapon as advocates.” Additionally, the panelists talked about how there is a great need to recognize investments that have been made in global health R&D from donors, as well as how to engage new donors from countries such as Brazil, Russia, India, and China. Finally, the panelists stressed the importance of advocating for new tools as well as increased access to existing and proven tools. “There really isn’t a division between advocating for R&D and advocating for existing tools,” Henriette Laursen of AIDS-Fondet said. She added, “We can look at the historical successes of R&D and recognize that they are both part of the package.” Kim Lufkin is the GHTC’s communications officer.

The following guest post from International AIDS Vaccine Initiative (IAVI) President and CEO Margaret McGlynn, AVAC Executive Director Mitchell Warren, and UNAIDS Executive Director Michel Sidibe comes on the release of Investing to End the AIDS Epidemic: A New Era for HIV Research & Development, a report from the HIV Vaccine & Microbicides Resource Tracking Working Group. This post originally appeared on Science Speaks. Close to 25,000 scientists, policymakers, and advocates from around the world are gathering here in Washington, DC, this week for the 2012 International AIDS Conference, where much of the discussion will be about how we can end the AIDS pandemic. The fact that these conversations will be based not just on hope but on real scientific progress proves how far we’ve come and how much we’ve learned in the struggle against AIDS over the last decade. Unprecedented public and private commitments to HIV prevention, treatment, and care over the last 10 years have saved the lives of millions of men, women, and children. Now more than ever we can see the path that leads to the end of the AIDS pandemic. Researchers, policymakers, funders, and advocates alike have long understood that new prevention options need be developed and made widely accessible to truly turn the tide on AIDS. Recent years have brought amazing breakthroughs in HIV prevention research. If prevention research were a business, now would be the time to invest. A decade ago our organizations launched the HIV Vaccine & Microbicides Resource Tracking Working Group in response to a call in the 2001 UN Declaration of Commitment on HIV and AIDS to track investments toward new tools and strategies for HIV prevention. Our data show that donors have remained committed to advancing research and development of new prevention tools to support a broader and more effective response to the HIV pandemic. The Working Group’s latest report, Investing to End the AIDS Epidemic: A New Era for HIV Research & Development, documents 2011 research investments in preventive and therapeutic HIV vaccines, cure research, microbicide development, pre-exposure prophylaxis (PrEP), and operations research to support implementation of such evidence-based interventions as the prevention of vertical transmission, voluntary medical male circumcision, and the use of antiretroviral therapies for HIV prevention. The report also looks back over a decade of mostly increasing investments that have made a number of key scientific advances possible and continue to fuel progress toward more effective biomedical approaches and improved implementation of existing prevention tools. Most of the $1.24 billion invested in new HIV prevention tools in 2011 came from dedicated public sector donors, especially the United States government. While funding for HIV prevention research and development saw a slight drop from the previous year, we acknowledge that difficult economic times have shrunk many public sector budgets. We laud funders and advocates for acknowledging the potential value of these tools through continued support and long-term vision. The prevention of HIV contributes to healthier populations and can save precious funds for other vital health and development needs. We are excited about how far HIV prevention research and development will go over the next decade, and we’re grateful for the continued support of committed donors in difficult economic times. Yet, capitalizing on exciting science will require stabilized funding to be supplemented as new breakthroughs move us toward effective new tools. We are concerned that staying the course might not be enough. The field will need sustained support for research across the development pipeline—from the basic scientific research that underpins new approaches to HIV prevention, to the translation of that research into candidate products and new strategies, to the costly large-scale trials that evaluate the safety and efficacy of promising products. Ending the AIDS pandemic requires us to think big and to think strategically. Join us in supporting the exciting science that will help make ending the AIDS pandemic a reality.

On the second day of the XIX International AIDS Conference, the need for a host of new tools to prevent and treat HIV and AIDS has already made it to the forefront of the agenda. Of particular note has been the resounding call for a vaccine to prevent HIV, with leading policymakers, scientists, and advocates saying that the world will never reach the end of AIDS without this powerful tool. In a session that focused on improving the effectiveness and efficacy in the HIV and AIDS response, Senator Lindsey Graham (R-SC) said that a vaccine is desperately needed to help make a sizable dent in the pandemic. Graham’s call for a vaccine was echoed by Bill Gates from the Bill & Melinda Gates Foundation. The “ultimate tool” in the fight against HIV and AIDS “will be a vaccine,” Gates said, adding that the US government has been the largest supporter of efforts to develop and vaccine “by far.” He also said that microbicide gels and rings will be powerful prevention products. Without a number of these new tools, the world cannot “talk seriously about moving toward the end” of the pandemic. “We will get these tools, but only if we stay the course.” Later in the afternoon, National Institutes of Health (NIH) Director Francis Collins and Jon Cohen from Science magazine chaired a panel that looked at what lies ahead in HIV and AIDS science. Gary Nabel, director of the NIH’s Vaccine Research Center, said “we’ve never been in a more exciting position” in the search for an HIV and AIDS vaccine. He added that recent discoveries related to broadly neutralizing antibodies over the past two years have made HIV vaccine research “like a phoenix rising from the ashes.” When sharing their hopes for the status of HIV and AIDS research, several panelists also stressed the urgent need to develop new HIV prevention and treatment options. Nabel said that by 2020, he expects researchers will be “in the midst of efficacy trials for an HIV vaccine candidate.” Robert Siliciano of the Johns Hopkins University School of Medicine stressed that by 2020, scientists will be leading clinical trials for new drugs that attack HIV reservoirs. And Dawn Averitt-Bridge of the Well Project said that by 2020, she hopes the world has effective microbicides to prevent HIV, a functional cure for the disease, and that “research makes it into the lives of the people and families we all care so much about.” Cohen ended the session with a call for young people to become the “next generation of scientists” leading HIV and AIDS research. “I’m looking to the young people, because that’s where the revolution is going to happen.” Kim Lufkin is the GHTC’s communications officer.

In this regular feature on Breakthroughs, we highlight some of the most interesting reads in global health research from the past week. The US Food and Drug Administration has approved the first over-the-counter, self-administered HIV test. Developed by OraSure Technologies, the test is 92 percent accurate and will cost less than $20. A recent article in IRIN News highlights the serious need for new antibiotic drugs worldwide, and discusses the potential of public-private partnerships to boost antibiotic discoveries. The United Nations (UN) is urging countries to impose various innovative financing mechanisms in an effort to raise money to offset cutbacks in development aid. The UN hopes that coordinated taxes on carbon emissions, air traffic, currency transactions, and other taxes could raise more than $400 billion a year. Global Health Initiative (GHI) leaders announced last week that the GHI office will be phased out at the State Department. According to GHI Executive Director Lois Quam, the GHI office will be replaced by the State Department’s new Office of Global Health Diplomacy.