March 12, 2025
“HIV is an incredibly diverse pandemic. Getting three quarters of all people living with HIV on this planet access to treatment is the greatest achievement of equity in global health. We all did that together. We can’t give it up and we are not going to.”
– Chris Beyrer, CROI 2025 plenary session
Defeating HIV has demanded heroics since the first report of a deadly new syndrome in the 1981 Morbidity and Mortality Weekly Report of the Centers for Disease Control. People devastated by AIDS, advocates putting their lives on the line to demand care, doctors and researchers struggling to find options—all facing down a plague that meant certain death.
Those gathered at the Conference on Retroviruses and Opportunistic Infections (CROI) 2025, which is ongoing in San Francisco through March 12, are taking stock of a grim new reality that will once again demand heroics of us all. Today the science is on our side with better solutions than ever before to control the epidemic (stay tuned for a roundup of the science). But the HIV response, from basic science research to community service providers, is now practically paralyzed by a despotic U.S. government, newly in power, that is attacking every aspect of scientific enterprise, global health, and foreign aid. Voices across sessions at CROI joined in calling for courage and solidarity.
Rebecca Denison, found of WORLD and a 42-year HIV survivor, opened the conference (slides here) with a stark assessment of the policies of the new US Administration as “going beyond persecution” and demanded action from us all.
“Silence ensures the abuse of power will continue… Now is the time for moral courage.”
Denison said too few Americans understand the dividends HIV research and development has paid out to them over the decades, accelerating technology from testing to vaccines. Communicating the impact and value of these historic investments is essential.
“Many Americans don’t know that the world waited four years for a test for HIV, which made possible the development of a COVID test in a matter of weeks.”
Chris Beyrer of Duke Global Health Institute at the Monday plenary address (slides here) put a spotlight on the historic achievements of U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), now in jeopardy. Before PEPFAR, Gross Domestic Product (GDP) and life expectancy were in decline. After 20 years of PEPFAR investment, GDP is on the rise, 25 million lives have been saved and 5.5 million at-risk babies were born HIV free. It took diversity, inclusion and equity to achieve these results.
The staggering impact of withdrawing PEPFAR supported programs has been recently estimated in a JIAS publication: “Each day of the funding freeze about 220,000 including over 7000 children, will be unable to access their needed treatment.” For the latest on the foreign aid freeze and the AVAC vs, Department of State lawsuit, visit our frequently updated webpage.
Beyrer called for restoring PEPFAR, sustained support for community partners especially those serving key populations, restoring the functions of the National Institutes of Health, the Centers for Disease Control and Prevention, and the US Food and Drug Administration, and for safeguarding human rights.
At Tuesday’s Community Breakfast Club, where advocates met with CROI researchers, Chilufya Kasanda Hampongo of TALC in Zambia said advocacy must be unswerving in protecting the gains in HIV prevention. “We got here, as Rebecca Denison reminded us, by building coalitions, using our voices, and demanding inclusive dialogues. We cannot abandon equity, inclusion and diversity.”
The calls for researchers to be in solidarity with advocates and communities that benefit from their research spilled out of the Mascone Center and into the streets of San Francisco on Monday as well. Several researchers and activists addressed a crowd of hundreds at the Save Our Sciences Rally to Protect HIV Research. The rally, organized by the San Francisco AIDS Foundation demanded restoration of cuts to research and implementation programs that have been gutted at USAID, PEPFAR and NIH. Speakers called for the kinds of activism necessary to create the infrastructure for HIV research and programs, as well as the impact that HIV researchers have had on other issues, including vaccines and therapies now widely used to treat, cure or prevent Hepatitis B & C, COVID-19 and other disease areas.
The latest science presented at CROI represents a stunning achievement, built on 40 years of advocacy, coalition, toil and discovery. As we wrote in a recent newsletter, “These are immensely challenging times for all of us, and it is easy to be paralyzed, overwhelmed and depressed. But we’ve all come too far for that to be the new normal. Lives, economies and democracies depend on our collective ability to stand up and fight back.”
Stay tuned for our round up of HIV prevention research and development at CROI including exciting new data on a one-year injection of LEN for PrEP, on-demand PrEP protocols for women, LEN for PrEP among adolescents, a monthly oral PrEP pill, the impact of DoxyPEP, the latest on cure, and so much more.