Statement in Response to the US Supreme Court Opinion in Dobbs v. Jackson Women’s Health Organization

Today, AVAC executive director Mitchell Warren issued the following statement in response to the US Supreme Court opinion in Dobbs v. Jackson Women’s Health Organization:

“As a global organization dedicated to health as a human right, to social justice, and to individual autonomy and choice, AVAC stands today and always for reproductive justice. We condemn the 6-3 decision by the US Supreme Court, which rolls back decades of protections for those seeking safe abortion services in the US and undermines other landmark rulings that safeguard fundamental human rights, privacy and personal liberty.

The court’s ruling harms public health, full stop. We know that access to sexual and reproductive health care, privacy, and bodily autonomy underpin not only abortion rights, but also our ability to combat HIV and end this epidemic. We are HIV and global health advocates and activists, and our work is fundamentally about intersectional social justice and human rights. We stand in solidarity with the reproductive justice organizations and leaders who are at the forefront of the fight for reproductive rights and with everyone whose lives will be fundamentally altered by this decision.

This is a sad and scary day, but it is not the end. We commit to working with our partners and allies to ensure that the right to abortion, and reproductive rights overall, are protected for all.”


About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of HIV prevention options as part of a comprehensive response to the pandemic. Follow AVAC on Twitter @HIVpxresearch and find more at and

Changing minds: Journalists see a universe of genders

Face-to-face contact is transformative for journalists.

Mandi is the vice-president, World Federation of Science Journalists (WFSJ) and President: Southern African Freelancers’ Association (Safrea).

Ida is a global health media adviser at Internews and Coalition to Accelerate and Support Prevention Research (CASPR).

In 2019 Anna Miti, a seasoned health journalist in Zimbabwe, founder of the Health Communicators Forum, and former AVAC Fellow, was looking at the media landscape and seeing both a problem and an opportunity. In Zimbabwe, like in many regions of the world, trans and gender-diverse (TGD) people cannot safely seek HIV prevention or treatment services because of myriad barriers; social, cultural and legal barriers. As a result, little is known about this community, even as national epidemics in across Africa become increasingly concentrated among marginalized populations.

Miti understood that the media could influence perceptions about gender. She had seen the media’s role in breaking gender stereotypes. Internews and International Media Support (IMS) have both developed strategy documents for how media can achieve this. (Internews Gender Equality and Inclusion Strategy (2022-2024) and IMS: The crucial role of media in achieving gender equality).

But many journalists themselves held stigmatizing attitudes, or had so little awareness of the issues that harmful or inaccurate assumptions were going unchallenged, even among those who regularly write about health issues. Anna had the idea to educate the journalists and harness the power of the media.

Cultural norms, taboos, rumors and old habits can all make it challenging to adopt ideal health practices. An informed media ignites conversations that change such norms over time. Local media, trusted by communities and speaking local languages, can be an especially powerful agent in changing social norms. To do so, reporters must understand many things: the history and politics, the facts and the evidence, the surrounding anxieties and aspirations, and most importantly, the real people found among the affected communities of any given health issue they report on.

For Miti, improving journalists’ knowledge of gender issues had to start with encounters. For the media to spark conversations that would reach transgender people, and win their attention, required building trust. Cisgendered reporters and transgender advocates needed a chance to get to know each other.

The HIV Connection

Zimbabwe has a high prevalence of HIV. UNAIDS data show almost 13 percent of the 15-49-year-old age group is HIV positive. Despite these high numbers, it’s an ongoing effort to get HIV onto the news agenda. Editors tend to spike stories as “not interesting or controversial enough”, said Anna.

As convener of media science cafés, which take place at the Zimbabwean NGO Humanitarian Information Facilitation Centre (HIFC), she and the team work to find ways of keeping HIV prevention issues on the news agenda. Focused on biomedical HIV prevention, the cafés bring journalists together to discuss issues they’re tackling in their work, and to learn from relevant experts, such as scientists working in the prevention field, civil society organizations and health advocates engaged in HIV prevention. Supported by AVAC and integrated into the multi-partner Coalition to Accelerate and Support Prevention Research (CASPR) program, these events have proven their value over time. The media café program, which is also active in Zambia, Kenya and Uganda, is a part of AVAC’s 25-year history of working to foster leadership by African organizations and to make sure science makes sense at the community level.

Gender dynamics are a significant factor in the HIV epidemic, and the cafés have already done transformative work in this area. For example, an exercise called “In His Shoes/In Her Shoes”, challenged gender role stereotypes with participants imagining themselves if they were a different gender. A follow up discussion explored the harm done when gender issues are framed as a “battle” between men and women. “That exercise resulted in a really intense but productive dialogue. The journalists and everyone else seemed to take away new perspectives” said Anna.

But now the plan was to go further.

Changing minds requires making connection. Ending AIDS depends on reaching communities that are often overlooked and even criminalized. Health issues of every stripe land most heavily among those with the least access to healthcare or the corridors of power that secure it. So it’s no surprise that gay, transgender and other communities of sexual minorites are at high risk of HIV infection. One study in 2020 in Zimbabwe showed that HIV prevalence among male and transgender sex workers was as high as for female sex workers. Although figures for the non-sex-worker TG population are not easy to come by, research by local organizations and anecdotal evidence suggest they are highly vulnerable to HIV as well. A recent global scientific review concluded, “Trans feminine and trans masculine individuals are disproportionately burdened by HIV. Their unique prevention and care needs should be comprehensively addressed.”

Could the work of media science cafés change attitudes toward gender-non-conforming people? Manju Chatani-Gada, Director of Partnerships & Capacity Strengthening at AVAC, has long experience of trying to change minds and engender inclusivity in societies. “It’s critical to be engaging with the media. At AVAC we have a long commitment to supporting the work of advocates, and as we’ve deepened our efforts to advance equity, it’s been very important to also work with ministries of health, program implementers and very much the media, too.”

Anna had heard journalists remark that there are none, or hardly any, transgender people in Zimbabwe and thus no need to focus on this community in HIV storytelling. But she knew it wasn’t true. She and the HIFC team began to work with Trans and Intersex Rising Zimbabwe (TIRZ) on a media café with journalists where they could introduce themselves to each other, explore the issues and begin an exchange. TIRZ Programs Director, Queen Bee Meki Chihera, played a crucial role. Queen Bee is deeply concerned about HIV infection rates, especially high rates her organisation’s research had revealed among young transgender men. Despite a previously adversarial relationship with media, driven by what she characterises as “distortions” in reporting, she well understands the leverage of journalism: “We need journalists to bring transparency, and to follow up on promises made by government,” she said.

“Something Clicked”

A date was set in October 2019 for an initial media science café, with a talk by Chamunorwa Mashoko of ACT (Advocacy Core Team, a collective of 20 civil society organisations working for access to decent health services for all in Zimbabwe and part of the Coalition to build Momentum, Power, Activism, Strategy & Solidarity (COMPASS) Africa), followed by Queen Bee, who spoke about the difficulties faced by trans people in negotiating life, from accessing health care to facing discrimination and violence. “Some of the journalists were shocked,” Anna recalls. “Others were really, really surprised and really not comfortable.” One journalist who is normally talkative went very quiet, she said.

Participants now say it was transformative. Face-to-face exposure to a person who is “different” is one of the most powerful tools available to change minds. The differences fade as people find the similarities.

“Something changed; something clicked for a lot of those present,” said Manju. “I was actually surprised at how big an impact it made. Queen Bee was the right person with the right message at the right time.”

Queen Bee has been a welcome and willing guest at several media science cafés since that seminal event in October 2019, answering questions and opening minds to the way gender dynamics and prejudices affect everything, from family relationships to risk of infection, to, crucially, access to health care. Transgender people are subjected to invasive questioning and casual cruelties when they seek medical care and it has been enlightening for journalists to hear from Queen Bee how such stigmatising treatment drive sexual minorities away from the health services they desperately need.

More Media Connections, More Shifts

And the information has hit home. Articles which have been published following these events have focused on “the difficulties in getting access to services, and how homophobia affects people seeking services,” said Anna. (Many of these stories appeared in local languages or on the radio, but these two examples can be read in english: Dreading To Go Home: The Plight Of Transgender People in Zimbabwe and Trans woman opens up on journey.)

“Before the face to face meeting with the transgender community at Transmart, I used to view the community or paint the community with one brush”, said Michael Gwarisa of the Health Times.

Gwarisa said he did not know the difference between a trans person or a gay person or lesbian. However, following the workshop where presenters from the transgender community shared their experiences, he came to a new realisation. “I started appreciating some of the challenges they face in terms of accessing basic services such as health, travel and even in terms of exercising their electoral right to vote”, said Gwarisa. He said awareness raising via the media should continue. And health care workers should also be engaged to ensure they do not deny the trans community any services based on their sexual orientation.

Catherine Murombedzi, a freelance journalist in Zimbabwe agrees: “I feel the workshops really helped me understand issues of transgender people; it’s difficult writing about them because we are very homophophic as a people due to culture and religious beliefs”, she said. “From a health journalist’s perspective it’s always important to look at different sides so that we leave no one behind.”

In another ground-breaking move, in a country where LGBTQ people face legal challenges, Queen Bee has appeared on Anna’s radio programme. As expected, it elicited some bigotry, but also opened a door to information that had before been taboo in the media.

TIRZ went on to hold a series of media trainings in partnership with Zimbabwe’s National Aids Council and others. In particular, TIRZ conducted training on sexual orientation, gender identity and expression, SOGIE, including for journalists in Chinhoyi and in Marondera, two towns out of Harare. Other trans advocacy groups are also raising their profile and expanding the perspective of journalists through the café. Transmart Trust held its first-ever media engagement, presenting at a media science café that was hosted by the Health Communicators Forum, a health journalism organization affiliated with the HIFC. Transmart works towards recognition and rights for transgender and intersex people.

The most recent media training with Queen Bee was in December 2021 where she highlighted how COVID-19 was also affecting sexual minorities. She said she is really pleased with the results of slowly but steadily building media connections and awareness. The narrative has changed.

Learn More About the Impact of Media Science Cafés in Zimbabwe

For more than a decade, AVAC and partners have been leading Media Science Cafés, a program connecting journalists, researchers and advocates to help expand and deepen accurate reporting of HIV science. The program began in Uganda, when a group of journalists were looking for ways to connect with research and better understand both the science of HIV and its impact on their communities. These Cafés began with a focus on HIV with support from the Gates Foundation and the USAID-funded Coalition to Accelerate & Support Prevention Research (CASPR) and have expanded over the years to cover research on sexual and reproductive health and other health issues and, more recently with support from the Rockefeller Foundation, to COVID-19, and are now running, in partnership with health media associations, in Kenya, Uganda, Zambia, and Zimbabwe.

In a blog, Changing Minds: Journalists see a universe of genders, South African journalist, Mandi Smallhorne-Kraft tells the story of how one Café in Zimbabwe, as part of the 2019 program to connect journalists with transgender people, made a critical connection that participants called transformational. It’s a must read. Follow this link to read more.

Welcoming Amb. John Nkengasong to PEPFAR, and 3 Priorities

Yesterday, Dr. John Nkengasong was sworn-in as the US Global AIDS Coordinator and Special Representative for Global Health Diplomacy overseeing PEPFAR, the largest funder of HIV/AIDS programming in the world. We are confident that with Ambassador Nkengasong’s ambitious leadership, vision and experience, PEPFAR and the global community can maintain the urgency and impact in ending the AIDS pandemic, continue responding to COVID, and build the sustainable health infrastructure that we so desperately need.

We also want to thank Angeli Achrekar for her steadfast commitment to end the AIDS pandemic and her terrific leadership over the past two years.

At AVAC, our eyes are on three major actions to help us get there these next few months – and urge Ambassador Nkengasong’s and PEPFAR to take immediate and bold actions to:

  1. Leverage new biomedical prevention options to re-boot primary prevention – and make sure these new options become viable choices for all people who can benefit from them. Accelerating access and introduction of injectable CAB for PrEP and ensuring political and financial support to also introduce the dapivirine vaginal ring provide an opportunity to build comprehensive, sustainable and integrated prevention programmatic platforms to deliver choice today and build for a future of even more options.
  2. Center communities in the prevention response. Generating deeper, more consistent community engagement in prevention requires restructuring community engagement. Community input must move beyond “consultation” on specific questions or challenges to a deeper, more meaningful, sustained, strategic engagement that supports the full navigation of challenges from research to rollout, in all their complexity.
  3. Imbed the AIDS response into the future of global health security and pandemic preparedness and response (PPR). The certainty of more complex and challenging health crises on the horizon demands rights-based public health approaches that focus on health systems strengthening, comprehensive integration of key health priorities including HIV, TB, malaria, sexual and reproductive health and non-communicable diseases and lay effective groundwork for addressing emerging health priorities in the future. And efforts to build a global pandemic response capacity must leverage the organizational capacities, investments, and reach of PEPFAR and the Global Fund to Fight AIDS, TB and Malaria.

There remain enormous challenges and opportunities ahead. We are very excited to welcome Ambassador Nkengasong back to PEPFAR and for his leadership in the global AIDS response. We look very forward to working with him toward our shared goals of ending the AIDS epidemic and ensuring global health equity.

Accelerating Access and Introduction of Injectable CAB for PrEP

Late last month, ViiV Healthcare, the maker of injectable cabotegravir (CAB) announced that it is “actively negotiating voluntary licensing terms” of CAB for PrEP to the Medicines Patent Pool (MPP) and is “committed to supplying” the product at a non-profit price for public programs in low-income and all sub-Saharan African countries until a generic is available. This announcement comes after months-long pressure from advocates and others, demanding that ViiV does its part to make good on the promise of injectable CAB for PrEP to advance HIV prevention and global health equity – see a number of important statements from advocates emerging from these discussions.

While this is an important step forward, and an example of advocacy at its best, this is only one piece of the puzzle that will make CAB for PrEP available to all who need and want it. Advocates have much more work ahead to ensure swift and equitable access to CAB.

And AVAC has a plan.

AVAC’s Plan for Accelerating Access and Introduction of Injectable CAB for PrEP provides a comprehensive view of all the moving parts involved in delivering this new PrEP option and identifies priorities for ensuring time is not wasted and opportunity is not squandered. The plan focuses on learning the lessons from the first ten years of delivering oral PrEP and how to move faster, more strategically, and with greater coordination to maximize the impact of injectable CAB for PrEP.

AVAC’s plan calls on ViiV, policy makers, normative agencies, donors, program implementers, researchers, civil society, advocates and communities to act on a range of key activities, which include:

  • A transparent commitment from ViiV, and a negotiated guarantee from donors, to a cost-effective and affordable price and volume of CAB for PrEP to support early launch, introduction and rollout.
  • Inclusion of injectable CAB for PrEP in WHO guidelines, which are expected ahead of AIDS 2022.
  • National programs in priority countries complete CAB for PrEP registration or secure relevant waivers.
  • Voluntary licensing from ViiV to select generic manufacturers, including technology transfer as required.
  • Donor investments in generic manufacturing capacity.
  • Market assessments and demand forecasts are updated with data from initial projects, to inform programming, manufacturing and cost.
  • Operational research and implementation science studies identify successful, scalable delivery channels; a testing algorithm that balances resistance risk with the needs of users and providers; ongoing engagement with communities and civil society; and a mechanism for independent coordination.

The plan also lays out advocacy priorities and calls on advocates to hold decision-makers accountable, for the rollout of CAB for PrEP – and on prevention generally. Is there clarity about next steps? Are there targets and milestones in place? Is there adequate funding to support strategic and accelerated rollout? How might decisions be made about who would get the product first, if it’s licensed and introduced through phased rollout?

In the days, weeks and months to come, advocates will continue to engage with ViiV, WHO, donors and other decision-making bodies focused on the future of CAB for PrEP and HIV prevention at large. Read our full statement here. AVAC hopes this plan will be the guide. As always, we will be tracking the progress, investing support, and keeping you informed.