What’s New on AVAC.org and PrEPWatch.org

In case you missed it, this round-up of AVAC’s latest resources will keep your finger on the pulse of HIV prevention advocacy!

Planning for Rollout: Report

A new publication, The Dapivirine Ring: Key Learnings from Like-Product Introductions, from AVAC and the OPTIONS Consortium looks at the rollout of other public health interventions and how they overcame barriers to acceptance. Some of the cases come from interventions that offered partial protection, others from products that are vaginally inserted. The dapivirine ring shares both of these characteristics, and this report offers specific lessons to guide early planning for rollout.

Demanding Access to Data: Report

Hot off the presses, Data Watch: Data Accessibility from Global Funders of HIV, TB and Malaria Programming, published by amfAR and supported by AVAC’s COMPASS program, details which data are publicly available from each funder and which data are not. It focuses on the level of information available to grassroots advocates to monitor and understand how donor-funded programs for HIV, TB, and malaria are working in their own communities.

Designing Prevention That Works: Podcast

The latest episode of our Px Pulse podcast, Human-Centered Design and Prevention in the Real World, explores an intensive human-centered design project, Breaking the Cycle of Transmission, that is part of AVAC’s Prevention Market Manager program and is trying to better understand and design programs that help adolescent girls and young women chart a journey to HIV prevention.

Adapting for Impact at Scale: Event recording

On October 22nd, the CSIS Global Health Policy Center hosted an event on recent developments in HIV prevention and treatment technology and how to bring those interventions to scale. Speakers included ViiV CEO Deborah Waterhouse, PEPFAR leader Ambassador Deborah Birx, Elizabeth Glaser Pediatric AIDS Foundation CEO Chip Lyons, and AVAC’s Mitchell Warren. Watch the video to learn more about the successes and challenges in developing and delivering new products into existing service delivery, and how global programs, such as PEPFAR and the Global Fund, need to adapt. CSIS also launched a new report at the event: The Evolution and Future of HIV Prevention Technology: An HIV Policy Primer.

Getting PrEP to Everyone Who Needs It, F/TAF and Women in Trials: Webinar

Check out the webinar AVAC hosted, Advocates’ Debrief on the Science of Daily F/TAF vs. TDF/FTC as PrEP, for a review of the data and to explore questions about the safety profile of F/TAF. In early October, the FDA approved DESCOVY as PrEP for HIV-negative individuals (weighing 35kg or more), except for those who have receptive vaginal sex, which prompted outcry over Gilead’s failure to include women in clinical trials, among other questions related to F/TAF.

Keeping Up With the Pipeline of Prevention R&D: Infographic

Download the most recent update to our infographic that tracks the pipeline of non-vaccine HIV prevention products, including oral pills, vaginal rings, vaginal and rectal gels, vaginal films, long-acting injectable antiretrovirals, implants and more. Also featured are the range of multipurpose prevention technologies in development, which aim to reduce the risk of HIV and STIs and/or provide effective contraception for women. And checkout the newest version of the Global PrEP Tracker on PrEPWatch.org that provides the latest data on programs, number of enrollments by country, regulatory status and more.

Data Watch: New report out on funding data for advocacy

amfAR has released a new report, Data Watch: Data Accessibility from Global Funders of HIV, TB, and Malaria Programming, which analyzes data availability across four of the key funders of global HIV, TB, and malaria programming: The Global Fund, PEPFAR, the President’s Malaria Initiative, and USAID TB programming.

The report details which data are publicly available from each funder and which data are not. It focuses on the level of information available to grassroots advocates to monitor and understand how donor-funded programs for HIV, TB, and malaria are working in their own communities. The report evaluates the adequacy of the data by looking at what is funded in a community, who is funded and whether the services are being delivered as contractually specified. Recommendations are made for each funder on how to increase their data transparency to ensure advocates remain informed and equipped to address any issues that might arise. The adoption of these recommendations can only improve transparency and, in doing so, aid the fight against the global HIV, TB and malaria epidemics.

This project was developed as part of COMPASS Africa (the Coalition to build Momentum, Power, Activism, Strategy and Solidarity) by amfAR and supported by AVAC.

New Episode of AVAC’s Podcast, Px Pulse! Human-Centered Design and HIV Prevention in the Real World

Our latest episode of the Px Pulse podcast looks at Breaking the Cycle of Transmission, a human-centered design project that’s shedding new light on how to bring HIV prevention to adolescent girls and young women.

The task is imperative. Four out of five new infections among adolescents in sub-Saharan Africa are in girls. Young women aged 15-25 are more than twice as likely as their male counterparts to be living with HIV, based on the latest figures from UNAIDS. The challenge is daunting—stigma, gender-based violence and other forms of inequality persist as serious barriers to prevention.

To overcome these barriers, AVAC and CHAI’s Prevention Market Manager project is applying strategies for understanding the needs of adolescent girls and young women through an approach known as human-centered design, or HCD.

In this episode of Px Pulse, we hear from AVAC’s Global Marketing Manager, Anabel Gomez, about the HCD project in South Africa that is trying to chart a path that will better support girls and young women on a journey to HIV prevention.

We also hear from two members of the team—Lesego Taule and Mpumi Mbethe—who helped lead discussions with girls and young women to understand their needs, hopes and challenges in communities where HIV rates are high.

And Anthony Ambrose of NACOSA, an implementer in South Africa, tells us how the research can be applied to programs, and how it changed the way he thinks about HIV risk.

For the full podcast episode, highlights and resources, visit avac.org/px-pulse. And subscribe on Apple Podcasts to catch every episode!

Vaginas Deserve Better: Responding to recent F/TAF as PrEP approval

Yesterday, the US Food and Drug Administration (FDA) announced its approval of Gilead’s drug Descovy (also known as F/TAF) as daily oral PrEP for adults and adolescents, except those who have “receptive vaginal sex.”


AVAC and allies immediately decried the announcement, which lacked an acknowledgement of the gap in data on those at risk of HIV via vaginal sex. The announcement also failed to include any information about a funded plan and timeline for gathering the data necessary to understand if this drug prevents HIV infection among cisgender women.


The FDA has since posted its approval letter, which outlines a post-marketing commitment ON GILEAD to conduct a trial in cisgender women, with data expected in mid-2025. As Gilead plans and conducts this long-overdue trial, there’s vital work to be done around early and integrated Good Participatory Practice and community engagement starting now, not after the protocol is approved, and sustained throughout the life of the trial.


Join us and other advocates for the first of a two-part webinar series on F/TAF as PrEP. We’ll explore the science and research—and the community response to these developments.


Advocates’ Debrief on the Science of Daily F/TAF vs. TDF/FTC as PrEP


As always, please send any comments or questions.

A 15-Year Review of the PEPFAR Support to Malawi: How Has It Succeeded?

Maureen is the African Region Advocacy Advisor for AVAC. This post originally appeared in the Petrie-Flom Center at Harvard Law School’s Bill of Health.

Malawi was listed as one of the six locations that have made remarkable progress towards ending the AIDS epidemic in a recent report produced by amfAR, AVAC and Friends of the Global Fight. Being one of the poorest countries on the list, Malawi has proven that ending the epidemic is possible anywhere.

But one would want to know what has contributed to this success!

Well, there are many factors. And funding from donors is one of them. The HIV/AIDS response in Malawi is largely funded by the Global Fund and PEPFAR. But for the sake of this blog I will focus on PEPFAR, a US government program launched in 2003 by then President George W. Bush. In 15 years of support, PEPFAR has led the world in funding the global HIV response.

In Malawi, PEPFAR has invested nearly $700 million since 2003, which has brought significant improvements in the HIV/AIDS response.

But as you know, funding alone does not guarantee success. There are other factors that have played a role, such as increasing efficiency in the use of the resources, linking funding to performance and impact, having the right policies in place and widening stakeholder involvement, just to mention a few.

PEPFAR’s attention to geographical locations that carry a high burden of HIV incidence has resulted in funds going where they are needed most. PEPFAR has fought hard for the adoption of evidence-based policies, which in turn led to the implementation of the highest impact interventions.

PEPFAR’s strong recommendation to shift from paper to electronic medical records (EMR) has been another game changer for the HIV response in Malawi. Shifting to EMR improved real time access to data throughout the health care system.

Determined, Resilient, Empowered, AIDS-free, Mentored and Safe (DREAMS), a PEPFAR program meant to reduce HIV infections among adolescent girls and young women, has been another remarkable initiative rolled out to three districts in Malawi. The program has helped improved the socio-economic wellbeing of adolescent girls and young women, thereby reducing their HIV risk.

The HIV response took another important leap forward when PEPFAR opened up its doors to civil society organizations (CSOs). For me, this was proof of the principle that the best results come when funding and policy decisions are made in the presence of everyone who matters.

I remember attending the first country operational plan (COP) meeting where CSOs were invited. It was a revolutionary moment. Having CSOs in the room changed the course of the discussion. For the first time, we had everyone who mattered in the room. The following year we did it again and we are still doing it now.

But there have been challenges too! The first two years following PEPFAR’s inclusion of CSOs, civil society received limited access to PEPFAR data — it was shared late or not at all. This made it difficult for CSOs to effectively engage in the process. CSOs advocated for a change, and PEPFAR leadership has responded by making the data available, though not always timely. But we are getting there.

The other challenge has been getting policies fully implemented. A policy on paper alone is as good as no policy at all. This has been a big challenge for Malawi largely due to limited funding. Malawians can point to a full range of policies now in place, but yet some of them are live only on the books such as the Pre-Exposure Prophylaxis (PrEP) and the T=T/U=U campaigns, both of which have proven to be highest impact interventions elsewhere!

Moving forward a few things need more attention.

We all love the DREAMS program, but only focusing on three districts is not enough. It is time to scale it up!

As we get closer to epidemic control it’s important that we start thinking about how are we going to sustain the gains made so far. PEPFAR has committed to direct 70 percent of the funding to host country governments or organizations by the end of 2020 — this is highly commendable. However, this should not only be on paper, it has to be fully implemented. Lack of capacity should not be an excuse. Deliberate effort must be made to fill any gaps in capacity.

We need to embrace the model of differentiated service delivery to meet the diverse needs of the community members! To date we still have community members who travel a distance of more than 20 kilometers on foot just to get their ART refill! This is not acceptable! We need to get the services closer to them!

And, above all, policies must be fully implemented.

Advocates’ Debrief on the Science of Daily F/TAF vs. TDF/FTC as PrEP

Please join AVAC, the Treatment Action Group (TAG), The Well Project and the Women’s Research Initiative (WRI) on Monday, October 7 at 9-10am ET for an Advocates’ Debrief on the Science of Daily F/TAF vs. TDF/FTC as PrEP.


This webinar is the first in a two-part series, responding to advocates’ desire to better understand the research to date on F/TAF as PrEP, especially as it relates to its safety profile [compared to TDF/FTC] and the lack of robust data in cisgender women. This issue came into greater focus during an August 7 FDA advisory committee meeting at which Gilead’s regulatory submission of F/TAF for PrEP was discussed and debated.

On the webinar, AVAC, TAG, The Well Project and WRI representatives will be joined by researchers Andrew Hill (Senior Visiting Research Fellow in the Pharmacology Department at Liverpool University) and Monica Gandhi (Professor of Medicine and Associate Division Chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/San Francisco General Hospital). They will share their take on the latest research, contextualize the August 7 discussion, and help to inform an advocacy agenda for next steps.

For background, check out AVAC’s blog for a recap of the advisory committee proceedings, as well as TAG and PrEP4All’s joint comment to the FDA.

The webinar will be recorded and posted online shortly after its conclusion.

Have a question or comment? Please be in touch!