Emily Donaldson

In this guest post, Emily Donaldson—program coordinator at AVAC—and Tom Harmon—senior policy analyst at the International AIDS Vaccine Initiative (IAVI)—write about the state of HIV prevention research funding as the first-ever conference devoted solely to HIV prevention research and development (R&D) takes place in Cape Town, South Africa, this week. Progress toward new tools to prevent HIV infection—including vaccines, microbicides, the use of antiretroviral treatment as HIV prevention, pre-exposure prophylaxis (PrEP), and a host of other options—is being presented and discussed at the inaugural HIV Research for Prevention Conference (HIVR4P) in Cape Town this week. While much progress has been made over the last few years, a four percent decline in funding between 2012 and 2013 speaks to the uncertain nature of the global environment in which that research is taking place. Such cuts hinder the ability of the researchers in Cape Town and across the globe to continue their work and could delay progress toward efficacy trials and eventual rollout of new prevention options. Investment data for almost every technology being discussed in Cape Town can be found in HIV Prevention Research & Development Investment in 2013: In a changing global development, economic, and human rights landscape—the most recent annual report by the HIV Vaccines and Microbicides Resource Tracking Working Group. The data show that the US government continued to fund more than 70 percent of HIV prevention R&D efforts in 2013. The combination of recent funding cuts across all US government budgets and declines in European investment in HIV prevention R&D led to the overall decline in funding from the previous year. Relying on such a small number of very committed donors is problematic when one or more of those donors is forced to reduce their support.The report also highlights funding declines in nearly every category of HIV prevention R&D, underscoring an urgent need to sustain and diversify funding sources through partnerships between governments, philanthropies, and the biopharmaceutical industry. The 2013 data provoke a concern that HIV prevention R&D is increasingly becoming a lower priority for public agencies funding international development, as portfolios and priorities within those agencies shift. Global health and development negotiations such as those around developing successors to the United Nations’ Millennium Development Goals take place far from the context of most HIV prevention clinical trials, but such international commitment at the highest levels can keep HIV and AIDS a priority for development agencies that can bolster support for science, technology, and innovation in endemic countries to end the epidemic. The report also compiles the number of volunteers taking part in HIV prevention R&D trials, which totaled almost 670,000 people in 2013. Most of these individuals are based in sub-Saharan Africa where the epidemic has its most profound impact and where several large-scale treatment-as-prevention and voluntary medical male circumcision trials and projects are underway. However, that balance doesn’t cut across all new prevention technologies—80 percent of volunteers in vaccine and PrEP trials reside in the United States and Europe. Ensuring that new HIV prevention options are appropriate and acceptable means testing them in partnership with those regions and those communities that need them most. Such communities are represented here at HIVR4P, and we’re excited by the opportunity to see them mingling with the experts working tirelessly to improve the state of HIV prevention R&D science and in turn hasten an end to the AIDS epidemic. However, they can’t do it without a diverse, committed investment base. Funding data show signals of vulnerability in support for HIV prevention R&D and support the need for policymakers and advocates to ensure that the state of the field remains a healthy one. The HIV Vaccines and Microbicides Resource Tracking Working Group consists of AVAC, IAVI, and the Joint United Nations Programme on HIV and AIDS. The report and summary materials are available at www.hivresourcetracking.org.

In this guest post, Emily Donaldson—program coordinator atAVAC: Global Advocacy for HIV Prevention—writes about an upcoming congressional briefing on November 18 that will highlight the latest in HIV and AIDS research and development. The world has made enormous strides in beginning to end the AIDS epidemic. Yet, there were still 2.3 million people newly infected with HIV in 2012. In order to continue to bring down new infections, it is essential to achieve high coverage rates of treatment and prevention methods, including voluntary medical male circumcision, male and female condoms, and harm reduction. In the long-term, new prevention tools, especially an effective preventive HIV vaccine, are critical for achieving maximum impact and ending the AIDS pandemic. Research to develop new prevention tools is critical for achieving maximum impact and ending the AIDS pandemic. Credit: PATH/Evelyn Hockstein. Since the Military HIV Research Program’s (MHRP) landmark RV144 trial first showed that an HIV vaccine was possible, MHRP, the National Institutes of Health (NIH), and partners have worked to build on those results. Additionally, US government-supported research in a range of new vaccine candidate strategies are moving forward in trials and in basic research for future clinical testing. At the same time, NIH and the US Agency for International Development (USAID) are developing new antiretroviral-based prevention options, such as treatment-as-prevention, pre-exposure prophylaxis, and microbicides. Through research programs like those at the MHRP, NIH, and USAID, the US can dramatically advance science and play a critical role in stopping the spread of the epidemic. Join us at a congressional briefing, Monday, November 18, as we call on Congress to invest in HIV prevention research. amfAR, The Foundation for AIDS Research AVAC: Global Advocacy for HIV Prevention Center for Global Health Policy International AIDS Vaccine Initiative In cooperation with Congresswoman Barbara Lee invite you to a Congressional Briefing The Role of HIV Research in Ending AIDS: New Developments in HIV Vaccine and Prevention Science Monday, November 18, 2013 12:00-1:30 p.m. Capitol Visitor Center, South Congressional Meeting Room Lunch will be provided Speakers include: Carl Dieffenbach, director of the National Institute of Allergy and Infectious Diseases’ Division of AIDS Margaret McGlynn, president and chief executive officer, International AIDS Vaccine Initiative Fredrick Sawe, associate director International Clinical Research, MHRP Christina Polyak, research physician, MHRP, Walter Reed Army Institute of Research Christine Lubinski, vice president for Global Health, Infectious Disease Society of America Kevin Fisher, policy director, AVAC: Global Advocacy for HIV Prevention, moderator For more information or to RSVP, please contact Emily Donaldson at AVAC at edonaldson@avac.org or 646-369-1476.