Apr 2 Webinar—Pandemic Vaccine Development and Lessons for COVID-19

[UPDATED: Recording now available.]

Please join an upcoming webinar on pandemic vaccine development, scheduled for Thursday, April 2, 10am EDT.

In the second installment of AVAC’s webinar series on COVID-19 and its relationship to HIV, Dr. Mark Feinberg, CEO of IAVI, shared experiences and lessons from Ebola and HIV vaccine development that might be applied to COVID-19 vaccine development. Dr. Feinberg was joined by Dr. Helen Rees of Wits RHI to discuss the history and role of the Coalition for Epidemic Preparedness Innovations (CEPI), which supports vaccine development against emerging infectious diseases, including COVID-19.

Access the recording, listen to excerpts or read the transcript.

The first webinar in the series featured a range of voices on COVID-19 and HIV. Dr. Carl Dieffenbach, Director of the Division of AIDS (DAIDS) at the US NIH answered questions about risk for people living with HIV, the impact of COVID-19 on HIV research, and the status of research into treatments and vaccines for COVID-19. Lillian Mworeko of ICW-EA and Yvette Raphael of APHA framed issues that must be incorporated into a robust advocacy agenda for sub-Saharan Africa, a region bracing for a tide of COVID-19 cases already seen in Asia, Europe and North America. The advocates also shared their Call to African leaders to accelerate action on COVID-19.

Additional Resources

Our partners at the Global Health Technologies Coalition (GHTC) have a COVID-19 R&D Tracker. It summarizes the latest updates on:

AVAC maintains a Resources for Advocates sheet that provides links to the latest COVID-19 information on prevention and transmission, the research pipeline and a growing list of country-specific resources.

Also a work in progress, AVAC has a table of Ongoing Studies for 2019-nCoV Prevention and Treatment tracking the development of COVID-19 diagnostics, therapeutics and a potential vaccine.

While there is anxiety and uncertainty right now, we take great comfort in our relationships, knowing we have each other for support, solace and motivation. Thank you, as ever, for your partnership and commitment to our important work together.

Resources you need for COVID-19 and HIV

There’s much we do and don’t know about COVID-19 and the virus that causes it, SARS-CoV-2. The effort to stop this new virus also has implications for the still imperative effort to stop HIV. The global response to COVID-19, which is evolving rapidly, can and must benefit from lessons learned in the fight against HIV.

AVAC is committed to data-driven, evidence-based advocacy, and we hope these resources help us all stay up-to-date on the facts, share experiences and make sure interventions for COVID-19 and HIV reach those who need them the most.

  • Use these Resources for Advocates for the latest COVID-19 information on prevention and transmission, the research pipeline, and a growing list of country-specific resources.

In the weeks and months ahead, while we all maintain physical distance, we’ll be reaching out—because now more than ever it’s vital to connect. We will be organizing additional webinars and other virtual platforms for information-sharing and action; please do stay tuned. Together, we can get out the facts, demand data, set milestones and call on global leaders to bring solutions that work to the people who need them.

Global Advocates’ Teleconference: COVID-19 & HIV update

As we watch COVID-19 spread across the globe, we see a virus that must be stopped. Drawing from decades of work on HIV, we know that confronting this novel virus demands the same data-driven, evidence-based advocacy that has been at the center of our work with all of you for 25 years.

There are still a lot of unknowns—and many myths circulating—but the scientific community is working to advance our understanding of COVID-19 and develop potential treatments and vaccines. Understandably, this new disease also raises many questions about the implications for HIV research and the global communities of people affected by HIV.

On Monday, March 23 we were joined by Dr. Carl Dieffenbach, Director of the Division of AIDS (DAIDS) at the NIH, Lillian Mworeko of ICW-EA and Yvette Raphael of APHA, to answer questions about what we do and don’t know about COVID-19 and HIV, how to track research developments on the HIV front, what this new pandemic might mean for ongoing HIV research, and how the HIV community can contribute to the fight against COVID-19.

The recording can be found here.

The HIV advocacy community has a unique role to play in countering myths, developing an advocacy agenda that brings solutions to the people who need it most, and demanding those solutions be data-driven, evidence-based and centered in human rights.

In the weeks and months ahead, we encourage you to sort the myths and facts on COVID-19 with these resources, and to keep watching this space to engage with crucial developments.

Activism in Action: Week 2 reporting from the frontlines of the PEPFAR planning process

In late February, we reported back from week one of the Regional Planning Meetings (RPM) in Johannesburg where representatives from programs under the US Government’s President’s Emergency Plan for AIDS Relief (PEPFAR) meet to make plans, set targets and define approaches, ultimately captured in Country Operational Plans (COPs) for more than 50 countries around the world. At the RPMs, PEPFAR country staff, PEPFAR Washington staff, national ministry of health representatives, national and international civil society organizations (CSOs), WHO, UNAIDS and Global Fund gather for three weeks to lay out the priorities for the PEPFAR program for the next year, which starts the following October.

Week two, which wrapped up the last week of February, focused on Angola, Botswana, the Dominican Republic, Haiti, Namibia, Mozambique, South Africa, Zambia and Zimbabwe. AVAC was there, along with civil society partners from the Advocacy Core Team—the Zimbabwe country team from COMPASS as well as GALZ and other activists from Zimbabwe. Here are some highlights, issues and what was won in week two.


COMPASS in Action in the Zim Room

COMPASS partners came to the RPMs with a list of community priorities, reflected in the Community COP20 Zimbabwe. These demands were informed by over 50 Zimbabwean CSOs. The final version of the Zimbabwe COP, adopted in week two, reflected many of the Community COP priorities, including:

  • Increased staffing and scale-up of viral load testing, and new approaches to connect clinics and laboratories to improve the coverage of viral load testing from the current 44 percent coverage to 85 percent.
  • Increased PrEP targets by 177 percent by delivering PrEP to 28,600 people in 22 districts with a focus on key populations and adolescent girls and young women with supporting communications and PrEP literacy efforts to increase demand, normalize PrEP and improve continuation.
  • Commitment to continue funding human resources for health, such as lab technicians, community adolescent treatment supporters (CATS), data clerks, peer and lay workers, nurses and pharmacists in PEPFAR priority districts.
  • Elimination of all formal and informal user fees for HIV and related services in the public sector by September 2021.
  • Increased Community ART Refill Groups (CARGS) as an option in up to 50 percent of treatment facilities to increase retention of treatment among PLHIV.
  • A buddy-system as a model for key and vulnerable populations to access HIV related services, and the expansion of drop-in centers.
  • Beginning scale-up of 3HP, the more tolerable and preferred TB preventive therapy, as the current TB therapy, is expanded cover to 100 percent of PLHIV by end of COP20.
  • CSOs won US$1m for community-led monitoring of services at 200 facilities in 40 districts in Zimbabwe. The focus will be on services for young people and key populations.
  • Rollout of electronic medical records to over 500 sites.

Coverage for viral load testing was a top priority for civil society. Last year, COMPASS partners worked with PEPFAR staff to develop a US$6.8m plan to expand coverage. Power outages greatly impact the stable functioning of the labs that are critical to measure viral loads. Activists pushed for staff hirings and backup solar power to avoid lab processing delays. Since it had no funds this year to commit, PEPFAR agreed to request those funds from Global Fund, and the Global Fund agreed to consider the request at the country level in the next few weeks. Activists will follow up on this.

Wither Testing?

This year’s PEPFAR Country Operational Plan (COP) Guidance, an annual statement of PEPFAR priorities and requirements used by country teams to develop their COPs, continued ambitious scale-up of index testing. In week two, AVAC and other civil society continued to voice their concern about harm from index testing. See recent Call to Action. Current index testing in the Guidance still stands, but there’s movement to allow community monitoring of index testing programs, funded by PEPFAR, to test compliance with WHO testing guidelines. Still, the continuation of high targets for index testing remained. As Naïké Ledan from Haiti said at the closing plenary, “Failing on targets [should be] more acceptable than failing on human rights.”

In 2018, PEPFAR tested 95 million people in provider-initiated testing centers (PITC) such as hospitals or clinics, and through modalities such as self-testing and index testing. According to PEPFAR leader Ambassador Birx, PEPFAR programs have significantly overspent on testing with an investment in COP19 of US$401m against a budget of US$285 million. (In contrast, PEPFAR underspent on prevention by 10 percent, spending US$475m from a budget of US$520m.) As countries approach over 80-95 percent of PLHIV on treatment, those testing positive for HIV from provider testing have fallen. The implication of these data came to the fore in different country plans as index testing was scaled up and funding for PITC testing was signficantly cut. COMPASS partners voiced concerns about the 90 percent reduction in PITC testing in Zimbabwe in COP20. PITC testing repesented half of all of new HIV positive diagnoses in Zimbabwe, so advocates pushed for and were able to retain PITC testing targets in the final COP plan.

Another Virus Steals the Spotlight

In week two, another virus was consuming public attention, and Ambassador Birx was appointed to be the White House Coronavirus (COVID 19) Response Coordinator, in addition to her PEPFAR role. The PEPFAR program, and the US$900m in labs that PEPFAR has built across Africa will help prepare the continent from this new threat. As Birx noted, COVID-19 represents a challenge that PEPFAR understands, surveillance, finding asymptomatic patients and working with community.

Zambia Moves on Prevention

As a number of countries approach their 90-90-90 targets, they have been encouraged by PEPFAR to look to investments in treatment retention and HIV prevention. For Zambia, discusions focused on how to push PEPFAR funded programs beyond the 90-90-90 fast track targets set by UNAIDS, which have now been met. Zambian CSOs, along with COMPASS partners AVAC and amfAR, pushed for communities to lead the way on closing long-standing gaps in primary prevention. A strategy of pushing an agenda early in the week worked well, getting changes included before budgets were locked down. By the end of the week, PrEP targets for the Zambia program went from 44,000 to 110,000, including increases for KPs.

Stay tuned for week three! We’ll provide updates on Tanzania and Malawi, where COMPASS Africa worked to implement the Malawi Community COP.

Want to learn more about the issues above and engaging with PEPFAR? Check out these resources:

Spotlight on HVTN 702: AVAC’s Latest Podcast Episode

The latest installment of AVAC’s podcast, , is up. In this episode, AVAC puts a spotlight on HVTN 702, or Uhambo, one of the most anticipated HIV vaccine efficacy trials in the field. Data show the vaccine tested is safe, but vaccinations were stopped early after a scheduled review showed it did not offer protection.

The news delivered disappointment to local communities, to the thousands of South Africans who participated in the study, and to the field worldwide. Meanwhile, the trial team will continue to follow participants over the next year to monitor safety and gather data to help answer urgent questions raised by the trial results. While the vaccine in the trial did not work, the trial was extremely well-conducted and got an answer quickly.

In this episode of Px Pulse:

  • HVTN 702 Protocol Co-chair and AVAC Board Member, Linda-Gail Bekker, explores what the trial team hopes to learn during the follow-up period and how these answers might impact the ongoing pursuit for an HIV vaccine;
  • AVAC’s Regional Stakeholder Engagement Advisor, Nandisile Luthuli, also joins the conversation to shed light on the trial team’s plans for continuing community engagement;
  • and AVAC’s Director of Research Engagement, Stacey Hannah, talks about the successes of the trial.

For more resources on the issue go to AVAC.org’s HVTN 702 Updates and Next Steps.

For the full podcast episode, highlights and more resources, visit avac.org/px-pulse. And subscribe on Apple Podcasts, Spotify or wherever you get your podcasts!

CROI Goes Virtual: Next steps for advocates’ sessions and more

As many of you may have heard, next week’s Conference on Retroviruses and Opportunistic Infections (CROI) is now going to be a virtual meeting. The CROI organizers will be updating their site with additional details and opportunities to participate virtually in the conference next week.

AVAC and partners had a range of events planned for the in-person meeting that will now not be taking place. We will be working over the coming days to reprogram those events virtually. Please stay tuned for details and looking forward to continuing the conversation!

CROI 2020 Preview: Follow from near and afar

[UPDATE: CROI 2020 is now a virtual meeting. More information from CROI is available here. AVAC will continue updating our event page.]

The annual Conference on Retroviruses and Opportunistic Infections (CROI) kicks off this coming Sunday, March 8, in Boston. Whether you’re en route to Boston for the four-day meeting or following the proceedings from afar, this update is for you.

As limitations on travel related to COVID-19 may continue to change, CROI will be offering additional ways to share information virtually. AVAC will provide updates on our 2020 CROI page. But, whether you come in person or follow remotely, AVAC will be there and looks forward to connecting with you however you join the conversation!

This year’s program covers a range of topics of interest to advocates including new data from early-stage prevention trials, additional data on F/TAF for PrEP, long-acting treatment data, a symposium on contraceptives, a workshop on clinical trial design, a special session on the HVTN 702 vaccine trial, and more!

Saturday, March 7, AVAC and partners will host an all-day, pre-conference community workshop on cure research that will offer updates on current studies such as HIV gene therapy and discussion of complex issues in cure research. Come in person (RSVP here) or join remotely!

AVAC is also pleased to invite you to join a special session on Monday evening, The Future of HIV Prevention Research: How to do trials in the era of oral PrEP, co-organized by AVAC, Fenway Health and The Forum for Collaborative Research. During the session we’ll explore and discuss next-generation trial designs for biomedical HIV prevention research, including design, regulatory and ethical considerations, and mechanisms for community engagement. Join us in person at Fenway Health or register to watch a livestream of the event.

Check out the CROI website for a look at this year’s program, search abstracts, view sessions via webcast and follow the conference hashtag on your favorite social media platform at #CROI2020. And be sure to subscribe to AVAC’s social media updates.

Daily CROI press conferences will be webcast live and available for playback. Download the press conference schedule here, which includes information on how to view the webcasts.

Stay tuned for more from Boston!

Diversifying PrEP delivery models—what about DSD for PrEP?

Help us collect examples and evidence that supports differentiated service delivery (DSD) models for PrEP—fill out this survey!

As part of an effort by The Differentiated Service Delivery Initiative of the International AIDS Society (IAS), AVAC and CHAI’s HIV Prevention Market Manager project and PATH are reaching out with a survey to better understand DSD models currently being piloted and implemented for oral PrEP. The survey should take approximately 10 minutes to complete.

Responses will help inform guidance and development of DSD models, which we hope will ultimately help improve access to oral PrEP and new interventions on the horizon. All data will be kept confidential and will be aggregated to inform a planned satellite session at AIDS2020.

This effort will collect and share what countries are doing to diversify PrEP service delivery models, what models are moving beyond the clinic to reach PrEP users, and what DSD models can be borrowed from treatment and family planning programs to significantly increase oral PrEP use now and for next-generation HIV prevention options as they become available.

Thanks in advance for your time and please send on to relevant networks and colleagues!