Earlier this week the Medicines Patent Pool (MPP) announced the granting of three sublicenses to manufacture generic versions of injectable CAB for PrEP. All three manufacturers are based in India, and one of them (Cipla) is also planning to manufacture CAB for PrEP in South Africa. Join us Thursday, April 6 at 9:00 EDT for a webinar, Global PPPR Equity: Why do we need agreements on IP and Tech Transfers?, that will focus on the role of intellectual property, licensing agreements and tech transfer in the development and delivery of health interventions including vaccines, diagnostics or therapeutics. And we’ll explore how these issues fit into the ongoing negotiations of the Pandemic Accord that will be part of a new global architecture for Pandemic Prevention, Preparedness and Response (PPPR).

These new generic agreements for CAB for PrEP are an important step in accelerating affordable and equitable access to long-acting PrEP in low- and middle-income countries, but as history has shown, licenses are just one step.

HIV advocates know their history-making role of effectively fighting for more equitable access to prevention and treatment of HIV. It’s a legacy that has instilled equity as a guiding principle across global health. It’s a legacy that must be continually defended, and now it must be extended to agreements that will establish a global architecture for Pandemic Prevention, Preparedness and Response (PPPR), including the Pandemic Accord. Negotiations related to Intellectual property rights (IP), commitments on technology transfer and knowledge sharing are central to these agreements.

How quickly generic manufacturers can develop their capacity, how much investment it will take to do it, and at what price they might sell their finished products are all huge questions and the next steps in our advocacy.

And perhaps the biggest question for all stakeholders and new products is what will it take to build a sustainable market and deliver public health impact?

For background on the issues check out the Advocates’ Guide for Pandemic Preparedness and Response (PPPR) in 2023 and our podcast PPPR Advocacy 101: Find out what it means to you.

A new ruling by a US federal judge in Texas strikes down a provision of the Affordable Care Act that required insurance coverage of many preventive services, including HIV testing and the prevention drugs use for Pre-exposure prophylaxis (PrEP), and doubles down on the judge’s previous ruling in a separate case that PrEP provision violates some individuals’ religious freedom. The current ruling will not only affect HIV prevention services, but endangers access to contraception, vaccinations, routine health screenings and a wide range of prevention services.

“This ruling expands on last year’s shocking decision on PrEP and religious freedom and further undermines the right to health for an even larger group of Americans. It is the latest blow in a campaign to roll back bodily autonomy and human rights for a wide swathe of the population and will degrade the quality of life for all Americans by denying life-saving preventive care,” said Mitchell Warren, AVAC’s executive director.

“At a time when science has given us the tools to advance towards the end of the HIV epidemic and rational evidence-based public health policies and programs can implement those tools to save millions of lives around the world, one judge’s continued biased and discriminatory decisions endanger programs and lives far beyond northern Texas,” Warren added. “As advocates, activists and citizens, we at AVAC stand in solidarity with all those whom this decision affects. We firmly believe that the ruling must be called out as a dangerous infringement of the rights of individuals to determine their own healthcare needs with their healthcare providers and that every effort must be made to ensure that it does not stand.”

To help navigate it all, we’re delighted to launch our newest PxPulse podcast episode and a new Advocates’ Guide for Pandemic Preparedness and Response (PPPR) in 2023.

Over the coming months, global leaders will make key decisions about several initiatives to prepare for the next pandemic. What they commit to and how much they will spend, and how well these plans incorporate equity as a principle across all of these initiatives, is in question.

Deadlines for civil society to influence these decisions are coming up. Among these initiatives are the Pandemic Fund, the Pandemic Accord, several UN High-Level Meetings, and there’s also the Medical Countermeasures, or MCM, platform. The MCM platform would coordinate drugs, vaccines, diagnostics and other equipment for health emergencies.

In our last podcast, we spoke with Chris Collins, President of Friends of the Global Fight Against AIDS, TB and Malaria about all these efforts. He talked about how ultimately these decisions will build a new architecture for Pandemic Prevention, Preparedness, and Response, or PPPR.

Chris and the HIV community have been calling for stronger health systems and expanded domestic funding for health and have been pushing for a rights-based approach to pandemic prevention, preparedness and response—one that builds on the decades of advocacy that has shaped the response to HIV.

But it’s not clear whether planning for the next pandemic is heeding these lessons. Karrar Karrar, who heads up Health Policy at Save the Children, and Samantha Rick, who leads AVAC’s PPPR policy advocacy, have been tracking these efforts closely. They explain exactly what commitments for equity are needed and who needs to hear this advocacy and when.

Be sure to check out our Advocates’ Guide for PPPR in 2023, for a breakdown on all the moving parts, the organizations and initiatives to track, and key timelines for the year ahead.

Other helpful resources include:

–The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action, Px Pulse podcast with Chris Collins
–Prevent, Prepare, and Respond: An analysis of global health architecture for pandemic preparedness, AVAC
–We Have Cutting-Edge Science to Make Vaccines, But Will Everyone Benefit?, New York Times commentary from Barney Graham
–The World Health Summit: Hitting the target, or missing the mark?, AVAC
–Leveraging the HIV response to strengthen pandemic preparedness, PLOS Global Public Health

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

This week, Ugandan Parliamant took steps toward implementing an anti-gay policy change that would further criminalize and endanger the lives of LGBTQIA+ people. AVAC condemns the proposed legislation and stands in solidarity with the LGBTQIA+ community in Uganda who face threats to their lives, draconian prison terms, and even the prospect of death sentences if this legislation goes forward.

“This new legislation is a direct violation of the health, rights and humanity of the LGBTQIA+ community, and we urge President Yoweri Museveni not to sign it into law,” said Angelo Kaagwa-Katumba, Senior Program Manager at AVAC. “As LGBTQIA+ people and allies, we’ve been tireless in our work to change attitudes and policy – in Uganda and around the world – because we’ve seen the direct link between criminalization and stigma and the devastating impact both have on HIV incidence. This new legislation duplicates and expands on a previous attempt to legislate hate and oppression of the LGBTQIA+ community in Uganda nearly a decade ago. That legislation was overturned by the Constitutional Court, and we hope to see justice upheld again.”

This “Anti-Homosexuality Bill 2023”, passed earlier this week by the Uganda Parliament, makes it a crime to even identify as lesbian, gay, bisexual, transgender and queer, and gives authorities sweeping power to crackdown on any form of LGBTQIA+ advocacy. This new bill, criminalizing same-sex relations between consenting adults, is a harsher revision to Uganda’s 2014 Homosexuality Act, which outlawed the “promotion of homosexuality,” but was struck down. Ugandan President Yoweri Museveni now has a 30-day window to either approve the bill, return it to Parliament for reevaluation, or veto it – or, by not acting, the bill will be considered approved.

“We are seeing a tsunami of discrimination and oppression of basic human rights around the world right now,” said Mitchell Warren, AVAC executive director. “The proposed anti-gay bill in Uganda is the latest in a wave of anti-LGBTQIA+ actions in several countries, from arrests in Zambia to a backlash in Kenya, to anti-trans laws in several US states and elsewhere, all of which threaten lives and livelihoods, and our ability to connect key populations with the resources they need and deserve to prevent and treat HIV and to live their fullest lives. If we don’t deal with the fundamental reality of stigma, discrimination and criminalization, we will never end the epidemic.”

In Zambia, police arrested leaders of an approved demonstration condemning violence against women in observance of International Women’s Day. Authorities claimed the protest was promoting LGBTQIA+ rights. Same-sex sexual acts have been prohibited under Zambia law since the British colonial period. In Kenya, a February decision by its Supreme Court to bar discrimination on the basis of sexual orientation when it comes to registering LGBTQIA+ organizations has been followed by intense homophobic backlash. The uproar comes as a high court decision that criminalized same sex relationships is being appealed. The US is similarly swept up in a period of terrorizing legislation dismantling the rights of gender diverse populations and threatening their well being. Overall, 2023 has seen a record number of bills in states across the US that target LGBTQIA+ people.

“We stand ready to support the LGBTQIA+ community and their allies in every way that will not only help them survive this moment, but overcome these challenges to turn the tide from hate and fear to global health equity for all,” Warren added.

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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 www.avac.org and www.prepwatch.org.

Whether you are tracking PrEP initiations or cure research, pandemic preparedness or mpox news, emerging advocacy for the inclusion of pregnant people in research, or looking for an overview of prevention research and more from CROI, we’ve got you covered. Below is a roundup of important resources and upcoming webinars you won’t want to miss!

Pandemic Prevention, Preparedness, and Response: AVAC’s position on PPPR

Read AVAC’s, Prevent, Prepare, and Respond: An Analysis of Global Health Architecture for Pandemic Preparedness, a policy position on the future architecture of global health.

And be sure to listen to the latest Px Pulse podcast episode, The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action, featuring Chris Collins, the CEO and President of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.

Sign up for Pandemic Watch! AVAC’s expanded weekly round up of pandemic news

AVAC is broadening the coverage of our COVID News Brief and folding it into the new Pandemic Watch, a weekly round-up of news on COVID, pandemic preparedness, mpox and more. Check out our first issue and subscribe here.

An Action Plan for HIV Prevention Research Among Pregnant and Lactating People

The Coalition to Accelerate and Support Prevention Research (CASPR) jointly released with PHASES a new action plan, Advancing HIV Prevention Research in Pregnant and Lactating People (PLP), which identifies priority goals to advance the responsible study of HIV prevention in PLP, a population that must be better served by the research enterprise.

A Look Back at CROI

The 30th Conference on Retroviruses and Opportunistic Infections (CROI) showed an energized field—with scientific advances galvanizing research across a host of disease areas. The highlights in this round up and on our webpage, offer a look at standout research and advocacy from CROI.

Upcoming Webinars

The Choice Agenda, Been There, Did That – Research Reflections from CROI 2023
Thursday, March 23, 10:00–11:30am ET
Featuring Monica Gandhi and CROI 2023 Community Educator Scholars. Co-moderated by Devan Nambiar, Gay Men’s Sexual Health Alliance and CROI 2023 Community Educator Scholar.
Register

The Choice Agenda, Mpox – Sexual Networks, HIV and Activism
Wednesday, March 29, 9:30–11:00am ET
Featuring Keletso Makofane, Harvard University & Chloe Orkin, Queen Mary University of London.
Register

When Cure Means Control: An Introduction to Viral Control Off Therapy
Tuesday, March 28, 9:00-10:00 am ET
Featuring Jon LI, Harvard University; Marina Caskey, Rockefeller University; Ann Charoudi, Emory School of Medicine.
Register

We are delighted to launch two new publications: Pandemic Watch, our updated and rebranded curated news digest on pandemic prevention, preparedness, and response (PPPR) and a new AVAC position paper on PPPR and the evolving global health architecture.

For nearly three years, AVAC and partners have been tracking the pipeline of COVID-19 research and development, documenting COVID-19’s profound effects on the AIDS response, calling out the need for stronger health systems and expanded domestic funding for health, and pushing for a human rights-based approach to pandemic prevention, preparedness and response—one that builds on the decades of activism and engagement that has shaped the response to HIV.

Early on in the COVID-19 pandemic, AVAC created the COVID News Brief as a way to share vaccine developments and urgent questions surrounding equity, misinformation, social justice and the research enterprise with our community.

Three years on, the world has witnessed remarkable achievements in research and development only to see the benefits of those advances hoarded by rich countries as COVID-19 rages on. Global health leaders and advocates are studying how the HIV and TB responses struggled and adapted in the midst of COVID-19, and lessons that can be applied to PPPR.

Today, as we continue our work in HIV, in COVID and among multiple pandemics in a changing global health architecture, we are delighted to expand our news brief to Pandemic Watch, a new, weekly round-up of pandemic-related news. Pandemic Watch folds COVID-19 news into a curated digest that expands beyond COVID to reflect the evolving field of PPPR. If you already received the COVID News Brief, you’ll automatically begin to receive Pandemic Watch. If you’d like to sign up to receive Pandemic Watch, click here.

Major decisions are coming about the architecture of global health, as priorities for new structures and principles, such as the Pandemic Fund, the Pandemic Accord, and the UN Declarations on Universal Health Coverage and PPPR, among others, are set.

The future depends on a global understanding that pandemics are borderless. As Chris Collins and colleagues wrote in PLOS Global Public Health, “Leveraging the HIV Response to Strengthen Pandemic Preparedness, and shared on our Px Pulse podcast, “The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action”, the HIV response has given the world a platform to integrate, expand and adapt to new pandemics. This requires investing in resilient healthcare systems; incorporating a central role for community engagement and community leadership; and drawing on lessons learned from decades of negotiations on access to medicines. All of these elements are essential to achieve equity and impact when the world responds to pandemics. Ongoing planning must also prioritize recognition of the unique role of the WHO and its trusted evidence-based guidance, which position it to be the best candidate to coordinate pandemic responses.

We hope you’ll continue to read Pandemic Watch, and check out more background and resources on PPPR.

Resources

• Prevent, Prepare, and Respond: An analysis of global health architecture for pandemic preparedness
• US-based Advocacy Organizations Share Priorities on FIF for Pandemic Preparedness
• Global Fund and PEPFAR’s Essential Collaboration
• The Shape of Pandemic Preparedness is Being Decided, Now is the Time for Collective Action
• How COVID-19 Must Transform US Global Health Strategy

International Women’s Day is on March 8 and its 2023 #EmbraceEquity campaign put the question of justice and inclusion first and foremost. AVAC is right there to champion the call. At the just-concluded Conference on Retroviruses and Opportunistic Infections (CROI), the sessions were filled with data showing the urgency to meet the needs of women and gender diverse populations for their health and wellness. See our CROI round-up, especially the section Women and Choice: The data say yes!

While incidence of HIV and other health threats, social and economic barriers, and gender-based violence have destructive effects on women around the world, research is making strides in developing interventions that can and should offer women powerful choices for HIV prevention and the protection of their overall health (be sure to check out the updates from the DELIVER and B-Protected studies!). But critical gaps remain.

Pregnancy and the post-partum period are times of heightened HIV risk. Cisgender women are two to three times more likely to acquire HIV during pregnancy per exposure and four times more likely post-partum than otherwise. People who acquire HIV during pregnancy have an 18 percent chance of transmitting HIV to their newborn, which goes up to a 27 percent chance if they acquire HIV while breastfeeding.

Yet, HIV prevention options for pregnant and breastfeeding/lactating people and populations (PLP) are limited, and their inclusion in research inadequate—hence evidence gaps can be seen across the research landscape for new prevention products.

The Coalition to Accelerate and Support Prevention Research (CASPR), AVAC and partners are proud to jointly release with PHASES, our latest effort to take aim at one of these gaps and close them. Advancing HIV Prevention Research in Pregnant and Lactating People (PLP): Think Tank Report & Action Plan identifies priority goals to advance the responsible study of HIV prevention in PLP, a population that must be better served by the research enterprise. Realizing these goals requires sustained multi-stakeholder collaboration, including a central role for advocates and community voices at every stage.

The action plan includes calls for using a reproductive justice framework to work collaboratively in advancing the research agenda, implementing Good Participatory Practice in trials that center PLP, greater resources to support ethics bodies and for the harmonization of regulatory frameworks to support a research agenda for PLP. It is building on a growing consensus and evidence that safe, inclusive and ethical research among PLP is imperative.

It’s time to move from exclusion to fair inclusion. We hope you’ll join us in supporting this action plan. Reach out to AVAC to share information on relevant initiatives and stay tuned for opportunities to learn more and engage!

2022/23 fellow, Liz advocates for the inclusion of female sex workers in every space where decisions are being made. “Still the biggest challenge that we face as sex workers is the criminalization of sex work. It is the biggest barrier [to] accessing health and legal services. As sex worker activists, when we say sex work is work, we are not blind to the fact that every job has risks associated with it. But other workers enjoy labor protection that sex workers don’t.”

Check out Liz’s piece published on International Day to End Violence Against Sex Workers, and stay tuned for another in March.

And follow her weekly Twitter space, Thursdays with Liz$Lee at 7:30 PM EAT.

Tune in to the newest episode of our Px Pulse podcast: The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action.

Health leaders and advocates around the world are in the midst of creating a new architecture to deal with pandemics. This means new structures, systems and financing for pandemic prevention, preparedness and response — PPPR, for short. A lot is being discussed, and a lot more is riding on the decisions.

Chris Collins, the CEO and President at Friends of the Global Fight Against AIDS, Tuberculosis and Malaria and an AVAC co-founder, has been tracking this work. He’s warned of the risk of multiple, siloed systems for global health, and was a co-author of the recent PLOS Global Public Health article, Leveraging the HIV response to strengthen pandemic preparedness, which describes many parts of the HIV response that have been, and must continue to be, central to a bolder vision for this new architecture and for global health at large.

In this episode of Px Pulse, Jeanne Baron talks to Chris about what’s at stake, which policy-makers get it already, why this year matters so much, and what advocates can do about it.

Below are key articles shaping the conversation:

• Leveraging the HIV Response to Strengthen Pandemic Preparedness, PLOS Global Public Health
• Human Security and Universal Health Coverage: Japan’s vision for the G7 Hiroshima Summit, by Japanese Prime Minister Fumio Kishida, Lancet
• Trust Made the Difference for Democracies in COVID-19, Lancet
• The World Health Summit: Hitting the target, or missing the mark?, AVAC

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