Advocacy Fellow Ntando Yola at AIDS Vaccine 2013

On October 7, at the AIDS Vaccine 2013 Conference in Barcelona, AVAC Advocacy Fellow Ntando Yola gave a powerful speech on the continued and urgent need for an HIV vaccine. We hope you’ll all view the webcast here—and read on for highlights. Stay tuned to the Advocates’ Network for a conference wrap-up and webinar announcement.

Ntando worked at the Desmond Tutu HIV Foundation as a Community Engagement Coordinator prior to starting his 2013 Advocacy Fellowship hosted by the Networking HIV/AIDS Community of South Africa (NACOSA). In both of these roles, he’s participated in extensive dialogues with communities engaged in HIV prevention research. In the speech, he told the story of Grace, a South African woman living with HIV. “Brother, in ten years we’ll have a vaccine for HIV, won’t we?” she asked him. “At least when the vaccine comes, my son will be 15 years old and he won’t have to worry about HIV the way I have.” Using Grace’s story, as well as his own experiences growing up with—and witnessing the end of—apartheid, Ntando made a strong case for research and stakeholder engagement that reflects the realities of volunteers’ lives. “Trial participants who face everyday living realities in my country like flooded homes in the winter, may face township fires in the summer, live in shared ablutions, have high rates of unemployment. Yet in all these circumstances, they volunteer.”

Science Café in Nairobi

In July, AVAC and Internews in Kenya organized a journalists briefing on PrePex, a non-surgical device for voluntary medical male circumcision (VMMC) pre-qualified by the World Health Organization (WHO). (Click here for more on this process.) This was the first in a planned series of journalist “cafés” designed to spark conversation about VMMC and the role of non-surgical devices.

“Prequalification” is the process by which the WHO determines that a product meets required standards of quality, safety and efficacy for international use. This step paves the way for purchasing by international programs, such as PEPFAR and the Global Fund for AIDS, Tuberculosis and Malaria. PrePex is the first circumcision device pre-qualified by the WHO, and there are currently a range of evaluation studies underway to find out more about its acceptability, safety and feasibility.

Twelve journalists attended the conversation in Kenya—and they had a number of questions. “How will PrePex complement conventional VMMC surgery?” asked Thomas Bwire, an editor with Pamoja FM, a community radio based in the Kibera section of Nairobi. This is an essential question—and one that the evaluation studies described above are designed to address. As countries look at the information from these studies and decide if and how to introduce non-surgical devices alongside surgery, we will get a better picture of how these two options are viewed and sought by men as well as women, who play a key role as parents, partners and allies of men seeking circumcision.

Journalists also asked about the price of PrePex. The currently quoted cost is approximately US$20. There are ongoing negotiations that could bring the price down through bulk-purchasing agreements, but so far no new price has been set.

The journalists also emphasized the need to better communicate the partial protection message to men and their communities. Circumcision does not afford complete protection against HIV transmission and that must be made absolutely clear. VMMC is just part of combination HIV prevention—behavioral interventions, HIV testing, STI treatment, immediate initiation of ART, couples counseling and testing and condoms among others, as the local context dictates.

AVAC is collaborating with partners in South Africa, Uganda and Zambia to organize similar cafés in the coming months. Please contact us if you would like to be involved.

New GPP Tools in the Making

The Good Participatory Practice Guidelines continue to be rolled out in various contexts and are increasingly seen as an essential tool for engaging stakeholders in research. In recent months, AVAC collaborated with partners in Kenya, South African and Uganda for focused feedback sessions about several new GPP implementation tools that are in the works. The new tools take users through the process of developing a strategic community and stakeholder engagement plan. Participants are asked to develop a plan based on concrete goals and objectives such as working with local media to provide accurate information or increase participation of key populations throughout the trial life cycle. The end result is a clearly-defined set of GPP activities that can be evaluated in terms of their impact on research and communities.

AVAC worked with partners with expertise implementing GPP and stakeholder engagements. These include the Uganda Makerere University Walter Reed Program, Uganda Virus Research Institute-International AIDS Vaccine Initiative, Kenya Partners PrEP, Kenya AIDS Vaccine Initiative and the Wits Reproductive Health & HIV Institute in South Africa—all of which have extensive histories of engagement and GPP practices.

GPP is most often implemented in the context of randomized controlled trials. These sessions were especially exciting because they included teams involved in research with different types of designs, such as combination prevention studies and demonstration projects. Perspectives from these groups, including the Uganda Infectious Disease Institute and Liverpool VCT in Kenya, will help make the new tools widely applicable to a wide range of prevention studies. As the HIV prevention field increases in complexity, stakeholder engagement practices need to keep up! New tools, along with an online training course, will be available at