AVAC and partners are delighted to share two new reports showing investments for HIV prevention and cure research and development (R&D) that were launched this week at the IAS 2023 Conference on HIV Science. Both reports explore a variety of factors influencing investment and detail how investment trends are changing.
In its 17th annual report, the Resource Tracking for HIV Prevention R&D Working Group, a collaboration among AVAC, IAVI and UNAIDS, documents 22 years of investment in biomedical HIV prevention R&D, including HIV vaccines, PrEP, microbicides, voluntary medical male circumcision (VMMC), treatment as prevention (TasP) or undetectable equals untransmittable (U=U), female condoms and prevention of vertical transmission (PVT).
Key Findings and Analysis
- Overall, total 2021 investments (the latest data available) in HIV prevention R&D show an approximate 12% increase for HIV prevention R&D compared to 2020. Money for HIV prevention has not returned to the high-water mark seen in 2012, when total investment was US $1.31 billion, but the figures have inched back up, to $1.25 billion in 2023, from $1.09 billion in 2020.
- Investment in HIV vaccine research declined, but still represents a majority of all HIV prevention research. At approximately $794 million, it is 63.5% of total HIV prevention R&D.
- Funding for microbicides is down for the 7th year in a row, and by 20% from 2020. However, this is in part attributable to several funders shifting to consolidating the PrEP category to include all products using antiretrovirals, including topical microbicides.
- 2021 saw the launch of USAID’s MATRIX Consortium, supporting further research on microbicides and dual prevention options.
- Also launched in 2021, USAID’s MOSAIC program, focused on developing and accelerating women’s access to new HIV prevention products. MOSAIC investments, funded as part of USAID’s long-standing microbicide investments, will be recorded by the Working Group from 2022 onwards.
- PrEP investment saw a two-fold increase, the highest seen since the Working Group began tracking, hitting approximately $270 million in 2021.
- A 30% increase in VMMC in 2021 reversed a decline seen in 2020.
- Funding for PVT decreased from US$25 million in 2020 to US$14.3 million in 2021, the lowest level recorded by the Working Group.
- The ratio of public to philanthropic investment remained the same as 2020, at 81% and 12%, respectively.
- Global philanthropic funding levels increased 16% in 2021 to US$150 million.
- Though the US continues to shoulder the bulk of all funding at approximately $922 million, diversity by geography is on the up. European entities increased their investments by 40%, reaching $161 million. Diversifying the funding base is vital not only for the long-term sustainability of the field, but also to ensure that the research priorities are informed by a diversity of perspectives.
The 2021 report of the Cure Resource Tracking Group, a collaboration between AVAC and the International AIDS Society, showed an impressive 30% increase in funding for cure research. The report also provides an analysis of the cure research agenda and the scientific questions shaping investment decisions.
- Total funding went from $337 million in 2020 to $439 million in 2021. This increase represents a five-fold increase since tracking began in 2012.
- Approximately $362 million comes from public funders, approximately $40 million comes from philanthropy. Approximately $36 million is invested by industry.
- Only 6% of research sponsors report participant data derived from trials conducted in African countries, even though Africa is home to 68 percent of people living with HIV. There is a growing recognition that research needs to be done among affected communities and conducted in African countries. The establishment of the HIV Cure African Acceleration Partnership (HCAAP) aims to enable stakeholder engagement.
- The US NIH-funded Martin Delaney Collaboratories for HIV Cure Research expanded in 2021 and now include ten collaboratories.
- 2021 data show sustained geographic diversity in cure R&D, with several countries joining the US to increase their funding, including Canada, Switzerland and the Netherlands.
We hope these reports will serve as tools for advocacy and inform public policy. Funding priorities are instrumental to the decisions and commitments that allow scientific progress. All stakeholders need opportunities to understand these trends and advocate where change is needed.
A special thank you to trial participants everywhere. Without their time and dedication, scientific advance would halt, full stop. Also thank you to the individuals who contributed data to the report.
If your organization is a funder or recipient of HIV prevention or cure grants and we don’t know you already, please contact us at email@example.com!