AVAC is excited to launch the Advocacy Navigator, an extension of our Advocacy Fellows program, which has involved more than 90 advocates and dozens of civil society organizations in 15 countries to drive groundbreaking advocacy on HIV prevention research, rollout, and human rights. AVAC now seeks applications from early-career professionals from Eastern and Southern Africa interested in strengthening their skills in HIV prevention advocacy. Applications for the Advocacy Navigator program are now being accepted through 13 February 2023.

Find details about the Advocacy Navigator program and application process here.

The Advocacy Navigator combines training and mentorship to young and emerging advocates in the field of HIV prevention advocacy. The program will mobilize a cohort of ambitious individuals and empower them with the knowledge, skills, and confidence to meaningfully advance HIV prevention advocacy. The program includes online coursework, personalized mentorship, and opportunities to directly apply learning through a community advocacy project. The program begins with three months of coursework and project development, followed by three months of implementation, when advocates implement their plans.

Since 2009 and the beginning of the Advocacy Fellows program, AVAC has recognized the imperative to invest in mobilizing a growing cadre of HIV prevention advocates. They represent a global movement of seasoned veterans and passionate newcomers, who call out neglect, insist on equity, monitor commitments and identify solutions. This movement has been and will continue to be absolutely essential to the fight against HIV and progress in global health. See the 2019 evaluation of the Fellows program and highlights of what the current class of Fellows did last World AIDS Day.

Now the Advocacy Navigator Program is leveraging the strength of this extraordinary alumni community to sustainably expand this model to a larger number of people, continue to support and engage mentors, and prepare future Fellows for long-term projects.

Find the application and additional information at AVAC.org/navigator.

At AVAC we saw tremendous work to accelerate HIV prevention and invest in global health resilience in 2022, and the year ahead will require critical advocacy to keep the field on track. What does this mean?

Our year-end letter, HIV Prevention and Equity in 2022 & Beyond, explores in depth the many initiatives, resources and collaborations that powered advocacy in 2022 — a historic juncture for HIV and global health. The field is facing a turning point where the right commitments in funding, policy and programming in 2023 could put the world on track to hit 2025 targets, end HIV as a public health threat by 2030, and lay a solid foundation for global health security against future pandemics.

The world finds itself at this moment because of the convergence of the approval of two new biomedical options for HIV prevention—the dapivirine vaginal ring (DVR, or the ring) and injectable cabotegravir for PrEP (CAB for PrEP)— with the launch of critical new strategies to advance HIV prevention from PEPFAR, the Global Fund, the Global HIV Prevention Coalition, and The Coalition to Accelerate Access to Long-Acting PrEP. All this in the context of a growing consensus and commitments to invest in pandemic preparedness and strengthening health systems.

In 2023, advocacy must meet the moment. Here’s just a sample of what AVAC’s preparing for in the weeks and months ahead.

Access Access Access

• Accelerated planning and engagement with the Coalition to Accelerate Access to Long-Acting PrEP and pushing key action steps for comprehensive and effective delivery of injectable CAB everywhere it’s needed.

• Taking action across our partnerships to establish the policies, budgets and programs that will deliver the ring to women who need it and want it.

Funding: Innovation and Expansion

• Defining a robust advocacy agenda for PEPFAR’s multi-year reauthorization starting in 2023.

• Supporting partners to help shape priorities for the Global Fund, the Pandemic Fund, PEPFAR country operational plans (COPs).

The Research Pipeline

• Tracking the trials on injectable lenacapavir as PrEP and the Dual Prevention Pill, and engaging in the development of next-generation PrEP options.

• Translating developments in research on and HIV vaccines and broadly neutralizing antibodies, including possible results from the Mosaico vaccine trial, the application of mRNA technology and new approaches to research and trial design.

• Advancing a research agenda for the prevention of other sexually transmitted infections (STIs), including greater investment in STI vaccine development.

People Centered Advocacy

• Advancing the reach of the GPP guidelines by compiling a body of evidence on GPP’s value, impact, and best practices as a key resource for partners and for clinical research broadly.

• Watch-dogging the status of the HIV research agenda for: trans and gender diverse people, pregnant and breastfeeding populations, and other key populations.

• Engaging with new leadership at the National Institutes of Health and National Institutes of Allergy and Infectious Diseases to deepen collaboration with civil society, community and advocacy leadership.

Key Dates for January and February

Pull out your calendars for the first three months of 2023, these convenings will help shape your advocacy for the rest of the year.

● Jan 26: The Choice Agenda webinar: Trans Inclusion: Charting HIV Research into the Future: A Manifesto and Scorecard for Advocates and Researchers, at 10 am. Register

● Feb 13: CROI is coming! Join The Choice Agenda and partners for the February 13 webinar “Ready, Set, CROI 2023 – Prepare for the 30th Year of CROI”

● Stay tuned for the Margarita Breakfast Club series of three webinars highlighting the latest in science presented at CROI, open to all, held during the CROI conference, Feb 20 – 22.

● Feb 19-22: Whether or not you are attending CROI, AVAC will have you covered as we track the research and the advocacy. Plus, we’ll have recordings from the Margarita Breakfast Club, for a curated discussion with CROI researchers.

Buckle up and lean in, let’s make 2023 an unforgettable year of collaboration and solutions.

This year was an incredible one of reflection, engagement, opportunity, and action. More than 40 years into the HIV epidemic – and in the midst of multiple other pandemics and persistent inequities – AVAC and its partners continue to reshape, reimagine and fight for effective HIV prevention.

We began 2022 with a new strategy reflecting an evolving field and critical opportunities for HIV prevention and for global health:

• Research is accelerating, with more options available than ever before. But progress toward crucial targets has been far too slow, and these biomedical options are not yet real choices for the people who need them.
• COVID accelerated science, but significant gaps in access underscored the necessity for smart, equitable, and people-centered pandemic preparedness, prevention AND response.
• And a global movement for social justice continues to demand that we all reexamine critical questions of equity, including health equity.

As we close out the year, we’ve been asking ourselves, how have we done? And the answer, we hope, lays the foundation for bold action in 2023 and beyond.

Thanks to an incredible partnership network and committed donors and collaborators, I am proud to say that we’ve made significant progress. But, as Tony Fauci reminded us all last month when he and I had a chance to chat about history AND the future, “much accomplished; much more to do.”

In all that we do at AVAC, we keep three aims in mind. Track and translate the science so the research enterprise and the communities who need prevention most are working hand in hand. Advocate for evidence-based, high-impact, community-centered programs, products and policies. And catalyze the relationships, partnerships, coalitions, advocacy agendas, joint commitments and action plans that get it all done.

Here’s a look at just some of the work we’ve done to advance all three in 2022.

We served as a bridge between the scientific field and communities where research happens.

• Published new evidence on a wide range of critical topics:
  • Correlations Between Oral Pre-Exposure Prophylaxis (PrEP) Initiations and Policies that Enable the Use of PrEP to Address HIV Globally in PLOS
  • JIAS Viewpoint on HIV vaccines in 2022: where to from here?
  • Catalyzing action on HIV/SRH integration: lessons from Kenya, Malawi, and Zimbabwe to spur investment in Global Health Action
  • “It’s Almost as if Stakeholder Engagement is the Annoying ‘Have-to-do’…”: Can Ethics Review Help Address the “3 Ts” of Tokenism, Toxicity, and Tailoring in Stakeholder Engagement? in the Journal of Empirical Research on Human Research Ethics
  • Safety data needed for concurrent use of ARV-based PrEP in Lancet HIV
• Convened critical conversations to reframe and re-energize the search for an HIV vaccine; created a snapshot of Phase 1 mRNA HIV Vaccine Trials that are underway and a backgrounder on experimental medicine vaccine trials (EMVTs) that are driving the field forward.
• Spoke with advocates and global leaders on our PxPulse podcasts about all forms of HIV prevention and what needs to happen next to ensure equitable access.
• Redesigned PrEPWatch.org, a one-stop clearinghouse for the latest PrEP data on implementation and uptake, resources, and information on PrEP policies, programs and products, approved and in development.
• Created STIWatch.org, the first and only resource on all things STI vaccine development.
• Tracked and translated new developments: created and shared more than 17 accessible, up-to-date resources on the full spectrum of biomedical HIV prevention products from research to rollout and real-time analysis of emerging developments.

We deepened our investment in supporting the next generation of skilled and informed advocates with the belief that advocacy and action must be founded on principles of power-sharing.

• Developed and continuously track our Plan for Accelerating Access and Introduction of Injectable CAB for PrEP to ensure time is not wasted and opportunity is not squandered, and importantly, that civil society plays a meaningful role.
• Supported the African Women’s HIV Prevention Accountability Board and our CASPR and COMPASS partners in meeting with global leaders, including Winnie Byanyima of UNAIDS, Amb. John Nkengasong of PEPFAR and Atul Gawande and Han Kang of USAID, to make the urgent case for faster and more equitable access to both the dapivirine vaginal ring (DVR) and injectable cabotegravir – and to listening to and engaging with civil society before making decisions.
• Welcomed the 12th class of the flagship Fellows Program with 8 new Advocacy Fellows working on access to the DVR, U=U campaigns, and integrating SRH with HIV services.
• Established CureROAR to support a cadre of advocates to gain knowledge in the science and process of cure research, and to develop an advocacy agenda to ethically advance cure research.
• Introduced The Choice Agenda (TCA), a global forum for advocacy on HIV prevention, with agenda-setting conversations, deep-dive webinars on key issues in the field and moderated passionate, highly-informed discussions with 1,000 advocates and experts across the field.
• Launched an advocacy campaign with PrEP4All and other partners to ensure the US National PrEP Program reaches those who need prevention most – with a huge year-end victory this week when the US Congress included as part of its fiscal year 2023 budget a call for the Centers for Disease Control and Prevention (CDC) to expand equitable national PrEP access in order to end the HIV epidemic!

We expanded our work to cultivate and sustain dynamic partnerships that set a bold and innovative agenda for HIV prevention.

• Launched The Coalition to Accelerate Access to Long-Acting PrEP, a new initiative to ensure an accelerated, equitable, sustainable and collaborative approach to making longer-acting PrEP options accessible as quickly and as equitably as possible.
• Co-hosted the first Africa Health R&D Week and launched the Domestic Resource Mobilization (DRM) Learning Collaborative.
• Joined a wide range of partners in urging a comprehensive approach to Pandemic Preparedness, Prevention and Response, outlining a funding agenda for the Pandemic Fund and articulating key needs for future global health governance.
• Hosted 20+ virtual and in-person think tanks and consultations to update and gather feedback on the latest developments related to the Dual Prevention Pill (DPP) market introduction, injectable CAB for PrEP, and the MATRIX pipeline of new HIV prevention and multipurpose prevention options.
• Hosted with Wits RHI and CASPR a GPP Symposium exploring innovation in Good Participatory Practice (GPP) and strategizing for expansion of GPP in 2023.
• Convened 3,000+ participants on 28 webinars to explore issues key to the future of the AIDS response, HIV prevention and global health equity.

Yes, together we’ve been able to do so much this year. But there remains a long, unfinished agenda for all of us in 2023 and beyond, that no one organization can address alone. The challenges ahead can only be defeated by building global solidarity, sharing responsibility and accountability, and mobilizing a response that leaves no one behind.

Thank you to all of our partners, AVAC staff, board, donors, and the remarkable individuals and organizations around the world who allow us to continue this critical work as part of a comprehensive and integrated pathway to global health equity.

In solidarity and with enormous gratitude,

Mitchell Warren and all of us at AVAC

P.S. We are grateful for all forms of support and partnership. If you can, please do consider a financial contribution to AVAC to help keep this work moving, together.

World AIDS Day is a day to remember and reflect, but it can also be a day to intensify advocacy, which was the case for many of our 2022 AVAC Advocacy Fellows.

From broadcast interviews, to an open forum on religion and sexuality, to a symposium attended by the Prime Minister of Lesotho, AVAC Fellows took World AIDS Day to task with a day of conversation and advocacy. Check out highlights from the day below.

Ruth Akulu, who is hosted at ICWE/EA in Uganda, took on several broadcast interviews including Radio City and UBC TV to share perspective as someone living with HIV and to discuss the latest advances and opportunities in HIV prevention. These media appearances were supported by the Uganda AIDS Commission.

Pictured: Ruth Akulu and Radio City staff.

Onward Chironda, hosted by GALZ in Zimbabwe, organized a media cafe to launch a series discussing religion and sexuality, featuring religious leaders and members of the LGBTQ+ community. Read more about the event here.

Pictured: Reverend Maxwell Kapachawo in “Digital Conversation on: RELIGION, SEX & SEXUALITY”

Catherine Madebe participated in a panel discussion with the US Ambassador to the United Republic of Tanzania, Donald Wright, as they discussed youth priorities and challenges in HIV prevention and gender-based violence. Catherine offers perspective on where prevention is in Tanzania here.

Pictured: Catherine Madebe (second in on right) with Ambassador Wright and community members and PEPFAR leaders.

Prince Mikel Juao, hosted by Lesbians Intersex Trans and other Extensions (LITE) in Malawi, organized an event in Mzuzu to educate communities on new HIV prevention technologies such as injectable CAB for PrEP, the dapivirine vaginal ring, and HIV self test kits.

Pictured: A healthcare worker demonstrating how to use an HIV self-test kit.

Natasha Mwila and her host organization, The Network of Zambian People Living with HIV/AIDS (NZP+), commemorated World AIDS Day by distributing condoms and sharing information about additional HIV prevention strategies.

Pictured: Natasha Mwila (second in on right) and The Network of Zambian People Living with HIV/AIDS (NZP+) staff.

Pictured: Clever Chilende (2012 fellow), Esnart Sikazindu (2020), Chilufya Hampongo (2016 fellow), and Natasha Mwila (2022)

Peter Katleho Ntheri and his host, Lesotho Network of AIDS Service Organization (LENASO) collaborated with the National AIDS Commission and other AIDS-service partners for a World AIDS Day symposium in recognition of the community’s progress in ending the epidemic. Lesotho Prime Minister Sam Matekane attended this event!

Pictured: Lesotho King Letsie III and Prime Minister Sam Matekane attending the Lesotho Network of AIDS Service Organization symposium with LENASO Executive Director Mamello Makoae.

Elizabeth Atieno Onyango, who is hosted by the Coast Sex Workers Alliance in Kenya (COSWA-Kenya) collaborated with organizations such as Reachout Center Trust and HIV/AIDS People Alliance (HAPA-Kenya) to voice concerns around the lack of HIV prevention options in their communities. Their main message was saidia usiadhibu which means “support, don’t punish” in Swahili.

Pictured: Elizabeth Atieno Onyango at a World AIDS Day event in Kwa Khanyayo, Kenya.

Liyema Somnono hosted by Passionate Unlimited Peers in Action (PUPA) with the help of both government and non-governmental organizations hosted a World AIDS Day event in a hard-to-reach rural area called Kwa Khanyayo where community members were offered clinical services and HIV education. Liyema shared information on the dapivirine vaginal ring and held a Q&A session on PrEP.

Pictured: Community members in Kwa Khanyayo receiving HIV-related services and education.

To learn more about the AVAC Advocacy Fellows program and the work and achievements of our 2022 class as well as the past 11 years of Fellows, visit the AVAC Fellows page.

The Choice Agenda (TCA), a global forum for advocacy on HIV prevention, is just a few new sign ups away from the 1,000 member mark!!! It’s a milestone reminding us of what the TCA has achieved in such a short time, with agenda-setting conversations and deep-dive webinars on key issues in the field and a full program to come in 2023.

Since its launch earlier this year, The Choice Agenda has hosted monthly webinars and moderated passionate, highly-informed discussions with advocates and experts across the field. The Choice Agenda program, and all of its participants, representing over 40 countries, takes on a wide range of topics. Together, the TCA community drills into critical choices, including the need for short acting, non-systemic, user-controlled options, and a wide range of tailored implementation strategies that must define advocacy, the HIV response, and global health equity at large. Participants are also provided with links to a curation of exceptional resources to support further education and advocacy.

All these conversations and resources are here for you to follow, in the TCA archive of listserv discussions and webinar recordings, including:

● “PEP Needs Some Pep! Addressing PEP Neglect in HIV Prevention Research, Programming and Uptake” (Recording/Resources)

● “Doxycycline for STI prevention: Evidence and Current Research” (Recording/Resources)

● “RINGing the Bell for Choice: Actions and Solutions on Dapivirine Ring Access” (Recording/Resources)

● “Faster, Smarter and More Equitable – Accelerating Roll Out and Uptake of CAB for PrEP” (Recording/Resources)

● “The Research Says Yes, YES, YES – Just Like That”(Recording/Resources)

● “Efficacy is Not the Only HIV Prevention Attribute that Matters – Lessons from Contraception” (Recording/Resources)

Join the listserv to access the archive and participate in the discovery and debate of ongoing and emerging topics. And don’t miss the final TCA program of the year: More than Vessels: Pregnant people deserve inclusion in HIV prevention clinical and implementation research on Wednesday, December 14, 2022 at 9:00am-10:30am ET; 1:00pm-2:30pm GMT. Register Here

We’ll be announcing the 2023 TCA kickoff webinar shortly, which will include a series of convenings and webinars before and during February Conference on Retroviruses and Opportunistic Infections (CROI), including the beloved Margarita Breakfast Club offering daily research updates, all available whether you are attending the conference or not.

You won’t want to miss a thing!

Coming off World AIDS Day, we are reminded of the importance of robust domestic investment in all aspects of the HIV response, including research and development (R&D), to see an end to the epidemic and build sustainable systems for health. This Thursday, December 8 at 15:00 PM EAT / 14:00 PM SAST/ 13:00 PM WAT / 7:00 AM EDT marks the launch of the inaugural Domestic Resource Mobilization (DRM) Learning Collaborative.

The collaborative builds on work with our partners in both the COMPASS and CASPR programs and will be a facilitated virtual space that brings together global health advocates, civil society organizations and other key stakeholders from Africa to engage in peer-to-peer learning and collaboration. We will explore priority topics, including: local investments in HIV services and other health infrastructure; pandemic preparedness; and research and development (R&D). And we will use the time to explore opportunities and frame what questions must be answered to develop a unifying advocacy agenda. This comes exactly a month after Africa Health Week where over 80 community members and leaders came together online each day to reflect on lessons learned and best practices in health R&D.

You won’t want to miss this opportunity to build on what was learned and brainstorm with community leaders and advocates on ways to advance health R&D investment in Africa.

Save the date and register here!

Funded by USAID, the MATRIX consortium is seeking applications to advance research applications for development of new HIV prevention approaches, including novel drugs, delivery devices, and diagnostics. Applicants from a wide range of US, Kenyan, South African, and Zimbabwean institutions are invited to apply to this request for applications. Proposals ($150,000 for 18 months) are being collected from now until March 2023.

Each World AIDS Day is an opportunity to reflect, remember and, hopefully, reenergize. This year is no different, but, more than 40 years into this epidemic – and in the midst of multiple other pandemics and persistent inequities – this could be the year that marks a fundamental reshaping and reimagination of HIV prevention, if everyone does their part.

This week alone, we heard global leaders – including PEPFAR Ambassador Dr. John Nkengasong on AVAC’s PxPulse podcast, Dr. Anthony Fauci, Director of NIAID on our webinar, WACI Health director and CASPR partner Rosemary Mburu at the African Union and APHA director and CASPR partner, Yvette Raphael, on IAS’s HIV Unmuted podcast – all remark on this once-in-a-lifetime opportunity to accelerate access to new prevention options and prepare for future ones.

Let’s start with long overdue conversations about a new approach to delivering proven products (see AVAC’s plan for accelerating access to injectable cabotegravir for PrEP), and doubling down on investing in HIV prevention. At AVAC, we’ve long called for tailored, community-led prevention programs that integrate sexual and reproductive health, and most importantly, offer choices at scale. This means a range of products offered across a spectrum of programs. It means investment that will deliver these products and programs at a scale that will reach everyone who needs prevention. Global leaders, confronting heartbreaking rates of HIV infection that have been stalled at about 1.5 million new diagnoses a year for several years, are calling for bold new initiatives.

In the latest episode of AVAC’s PxPulse podcast, New Products are Needed and a New Paradigm is Essential: A new era in prevention?, Ambassador Nkengasong issued a call to action for an for an aggressive strategy to scale up combination prevention, including injectable cabotegravir for PrEP (injectable CAB). As the Ambassador said, “Imagine if we did this in five high incidence countries, what will happen in two years? That is where we are going to begin to break the backbone of this vicious cycle. As I said, the most difficult thing is making that decision to act. The rest is tenacity.”

Listen to the full podcast for the details.

Also in this podcast, Executive Director of HEPS-Uganda, current COMPASS partner and former AVAC Advocacy Fellow and Kenneth Mwehonge, talks about the commitments needed from a range of stakeholders to bring Global HIV Prevention Coalition’s new roadmap to life, and hit 2030 targets for ending the epidemic. Chief among the priorities: leadership must come from donors to fully invest in coordinated planning, and expanded roles for civil society leadership in the design and execution of these plans. And Lilian Benjamin Mwakyosi, the Executive Director of DARE in Tanzania, another former AVAC Advocacy Fellow and current COMPASS partner, explains why choice, programs and products, and community leadership are essential to overcome the real-world barriers that have stalled and frustrated prevention efforts to date. As Lilian said, “Sustainability is guaranteed when communities are engaged. So that’s one thing…to strengthen immediately.”

Embracing these priorities now is a once-in-an-epidemic opportunity to end the public health threat of HIV, and prepare for future ones. This week, South Africa has become the fourth country in the world to approve injectable CAB for PrEP, the dapivirine vaginal ring (DVR) is approved in a growing number of countries, and oral PrEP use is on the rise, passing the mark of three million initiations earlier this year. For the first time, the world has multiple biomedical interventions to offer choice, and it’s essential to develop the programs that bring the fruits of science to the communities facing public health threats.

During AVAC’s conversation with Tony Fauci earlier this week, he said it clearly: “We’ve got to get user-friendly PrEP to [people]. That’s going to involve implementation that integrates itself into the health care delivery system. Otherwise, we’re going to have highly effective interventions that are not being maximally utilized, and that would really be a big mistake.”

AVAC has been spearheading efforts to advance these priorities across our programs. In Montreal, at AIDS 2022, The Coalition to Accelerate Access to Long-Acting PrEP launched, with AVAC as the secretariat. As part of COMPASS and CASPR coalitions, we are joining civil society partners to lead key initiatives for stakeholder engagement on programs and projects delivering injectable CAB and DVR. These initiatives must be part of truly comprehensive and integrated prevention programs that link biomedical options with structural and behavioral programs. We championed the creation of the African Women’s Prevention Accountability Community Board and the Key Population Advisory Group. These two groups, representing affected communities, are offering essential leadership to ongoing planning for the introduction of these new prevention options. This leadership is crucial to reaching the 2025 UNAIDS target of less than 370,000 new annual HIV infections. It’s a vital part of our work, which has pushed community leadership, global access to proven interventions and accelerated research and introduction from the very beginning. And now it’s crunch time, when all this work must come together and yield results.

Highly effective options now exist and new discoveries continue to improve on them; it’s up to all of us to marshall the will, the money and the innovative partnerships to put people at the center of programs so these biomedical options translate into actual choices and deliver impact.