Advancing Choice in HIV Prevention

In recent weeks, important new resources for advancing choice in HIV prevention have been announced. Don’t miss these highlights from the field. They point to an HIV response in transition, and help to define the role advocacy must play. As policy, practice and budgets strive to keep up with advances in research, advocacy around choice becomes a cross-cutting priority—so that the promise of new options in HIV prevention won’t be squandered in siloed programs, or by poorly-planned supply chains, or because of disconnected policy decisions. People have diverse needs and face complex challenges; ending HIV depends on finding the option that works best for each individual.  

The Choice Manifesto 

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The African Women’s HIV Prevention Community Accounability Board (AWPCAB) launched the HIV Prevention Choice Manifesto, calling for increased political and financial support to ensure every proven method of HIV prevention is integrated into the HIV response, so that all women who need prevention will have access to the options that will make prevention possible for them. At the launch event in Kampala, UNAIDS Executive Director Winnie Byanyima gave a keynote address in support of the Manifesto’s call for all stakeholders to commit to the budgets and strategies that will make choice possible.  

“I congratulate you for the HIV Prevention Choice Manifesto. It’s about pushing everyone towards people-centered, women-centered and women-led approaches to HIV prevention. You have fought with your lives to get here. You are fearless feminists. Women must lead for themselves.” – Winnie Byanyima, UNAIDS Executive Director

Learn more about the HIV Prevention Choice Manifesto and other advocacy resources for choice in our latest AVAC blog, Reclaiming Choice: The launch of the HIV Prevention Choice Manifesto and what that means.  

The Dual Prevention Pill (DPP) 

The DPP Consortium created a multiyear strategy to frame priorities and next steps in the development and delivery of the dual prevention pill (DPP), which is being developed to prevent HIV and unintended pregnancy. This multipurpose prevention technology (MPT) combines oral PrEP with an oral contraceptive. The updated strategy consolidates two years of progress toward preparing the field for new MPTs. The strategy addresses additions to the MPT pipeline, the potential role of the private sector in delivering a future DPP, recommendations for provider counseling on the use of the DPP, market research on potential DPP users, the latest analysis on cost, and more.

Stay tuned for more resources and updates to come on the DPP, the Choice Manifesto, and tools for connecting choice to HIV prevention, ending the epidemic and the role of choice in global health equity in HIV, and beyond.

Reclaiming Choice: The launch of the HIV Prevention Choice Manifesto and what that means

The African Women’s HIV Prevention Community Accountability Board (AWCAB) launched its HIV Prevention Choice Manifesto in Kampala, Uganda on September 8, 2023. This document, and the advocacy behind its development and release, marks a historic milestone in the power of community-led leadership and prioritization of choice in HIV prevention.  

“The toolbox for HIV prevention products is still falling short. More options are needed to suit everyone at different stages of their lives including an effective, accessible, and safe HIV vaccine if we want to see an end to the epidemic”. – Joyce Ng’ang’a, WACI Health, Accountability Board Member and Communications Lead

The AWCAB is a coalition of women and girls living and working in Africa who are united in calling for continued political and financial support for more choice in HIV prevention through the HIV Prevention Choice Manifesto. This comes at a time when political will and financial investment are critical to deliver new prevention options such as CAB for PrEP and the dapivirine vaginal ring to meet the needs of women and girls in Africa. In 2023, over four decades in the epidemic, a vast array of biomedical tools to prevent HIV acquisition exist, but these tools are only effective in their purpose if there is universal access, if communities know they exist and are able to choose from all the available options. The manifesto serves as a declaration of what could happen if African women and girls not only had a seat at the table, but led the response and advocacy efforts that shape healthcare for HIV prevention.  

“We have come a long way in the fight to secure choice in HIV prevention for women and girls. We are at a watershed moment to ensure we close the gap for new infections among women and girls. The launch of the Choice Manifesto is the beginning of the work ahead of us as we call on key players to sign onto the manifesto and become part of the change.” – Yvette Raphael, Advocacy for Prevention of HIV and AIDS (APHA), Accountability Board co-chair

Most notable was the presence of UNAIDS Executive Director, Winnie Byanyima, who delivered the keynote address and publicly endorsed and signed the Manifesto. Key stakeholders in HIV prevention participated in the launch and affirmed their commitments to choice. This included leadership from UNICEF, UN WOMEN, ViiV, PEPFAR, USAID, Global Fund, Ministry of Health, Uganda, Population Council/ IPM, Aidsfonds, FHI 360 and other civil society organizations. The commitments leadership and key stakeholders signed were focused on elevating national and global dialogue, ensuring resources to prevention options were accessible and sustainable, and bolstering support for local manufacturing of prevention products. Following the launch of the Manifesto, UNAIDS released a feature story on its website HIV Prevention Choice Manifesto for Women and Girls in Africa launched, highlighting the commitment to choice. 

Explore resources, tools, and takeaways from the launch including the full HIV Prevention Choice Manifesto.  

“The Choice Manifesto is an important and timely advocacy tool. It will help advocates lobby for resources and political will towards making HIV prevention options available for women and girls in Africa. We need commitment and actions from all stakeholders including funders and governments towards CHOICE-based HIV Prevention Programming”. – Grace Kumwenda, AVAC, Accountability Board Member

AVAC stands in solidarity with the Accountability Board, and congratulates the group on this major advocacy win! AVAC reaffirms its ongoing commitment to support the Accountability Board as part of the Coalition to Accelerate and Support Prevention Research (CASPR) and to champion the cause of ensuring choice in program implementation, access to and procurement of prevention options; and to advocating that the prevention agenda is shaped by women and girls who seek and want these essential tools. 

“We are not asking for much! Let us stop being comfortable with shameful statistics of alarming new HIV infections among adolescent women and girls and start providing options for HIV prevention that meet their needs. Their lives matter!” – Lillian Mworeko, International Community of Women living with HIV Eastern Africa (ICWEA), Accountability Board co-chair

As advocates continue to track and translate HIV prevention tools on the horizon, including already existing and revolutionary long-acting medications, it is important to listen to those who are leading the fight for equity and center choice in all of our implementation efforts.  

For more information on the Manifesto, please reach out to Yvette Raphael (yvette@apha.org.za), Lillian Mworeko (lmworeko@icwea.org), or Joyce Ng’ang’a (joyce@wacihealth.org).  

PEPFAR at 20: Keeping the promise

Our latest episode of Px Pulse is out, PEPFAR: Keeping the promise.  

PEPFAR is one of the greatest US foreign policy and global development achievements of the century. The program has saved upwards of 25 million lives since it launched in 2003. But as PEPFAR marks its 20th anniversary, it’s also fighting for its future.  

The US Congress needs to reauthorize PEPFAR for another five years by September 30 and reaffirm its commitment to this lifesaving program. Until a couple of months ago, most in global health and development expected smooth sailing for a five-year reauthorization of the program, as has happened throughout the past 20 years. PEPFAR has enjoyed deep and broad bipartisan support since its founding. Evangelical Christians, staunch conservatives and progressive liberals, Democrats and Republicans, HIV activists, civil society advocates and public health leaders have all championed PEPFAR, year in and year out. But a handful of Republicans, including past PEPFAR allies, are pulling reauthorization into high-stakes partisan politics. 

In this episode, Px Pulse talks to some of the people who put PEPFAR dollars into action and to global health leaders who explain why PEPFAR’s approach has been so effective, and what’s at stake in this debate. 

Tune in to hear: 

    Ilda Kuleba from Mothers 2 Mothers talks about the impact of PEPFAR on their work across 10 countries, training and employing HIV positive mothers as peer healthcare workers. 

    Dr. James Mukabi of World Vision’s Kenya program talks about how this Christian relief organization has changed the lives of thousands of orphans and other populations who are vulnerable to HIV.  

    Tom Hart, President of the ONE Campaign, which was co-founded by the rock star Bono, to be an early champion of PEPFAR and other poverty fighting efforts talks about PEPFAR’s accomplishments at the global level and what’s next as Congress debates reauthorizing the program.

    PEPFAR’s supporters have a job to do, to make sure everyone understands that the world has a lot to lose if PEPFAR is weakened and so, so much to gain if US policymakers unite in their support. We hope you will listen and pass on the episode, download the resources and, most especially, add your voice in support of PEPFAR.

      Announcing the New AVAC.org and Digital Resources

      We are delighted to share the new and improved AVAC.org! On our new site, you can easily access all the great data, policy analysis, tools and resources that you’ve come to expect from AVAC, including our much-loved infographics, podcasts, Weekly NewsDigest and Pandemic Watch, webinars, research literacy materials and so much more! 
       
      The updated AVAC.org also reflects the expanded vision and practice of our dynamic programs. AVAC will always work to accelerate ethical development and equitable delivery of effective HIV prevention options. But, we also know that responding to HIV and preparing for future pandemics requires a comprehensive, integrated, and sustained response that is rights-based, people-centered and evidence-informed.
       
      To AVAC, this means connecting the dots between HIV prevention, sexual and reproductive health and rights, pandemic preparedness, strengthened health systems, research engagement and community leadership. It means recognizing that resilience in global health requires us to confront the threats posed by disparities in access, entrenched stigma, discrimination, criminalizing key populations and inadequate responses to other sexually transmitted infections.

      Visit the new AVAC.org for resources, tools and analysis that make these connections as we continue to track and translate the field, including:

      • Information on the entire pipeline of biomedical prevention strategies being investigated today
      • Our projects, which showcase the incredible partnerships and collaboration that underpin everything we do
      • Our podcast, PxPulse, which will deepen your knowledge and help you “check the pulse” of this fast-paced field and the urgent challenges still ahead
      • PxWire our quarterly update on where we are in biomedical prevention research
      • Our HIV clinical trials database, where you can find details on all biomedical prevention trials and our broader resource database containing fact sheets, infographics, blog posts and more on HIV prevention and the broader issues surrounding global health equity
      • Links to our newsletters—Pandemic Watch, Weekly NewsDigest, and our Advocates Network

      And be sure to check out three vital AVAC resources that give you all the information you need on PrEP access, STI vaccine and diagnostics R&D and HIV prevention R&D funding.

      We are immensely proud to share these resources with you. We hope these tools and analyses will help to power your advocacy, accelerate ethical development and equitable delivery of effective HIV prevention options, and advance global health equity.