It’s Day 2 of the daily updates… and the conference has just barely begun with the official opening on Monday evening. Nevertheless, delegates have already covered a lot of ground—taking to the streets for a vibrant, sun-baked, song-filled March for Health.

Not everything is in motion, though. Long queues to undergo security screening are keeping people standing in place or, at best, shuffling along. While shuffling ourselves, we overheard an activist wondering why there wasn’t a “fast track” lane for people living with HIV. Perhaps the queue slowed down for US Global AIDS Ambassador Debbi Birx, who participated in the march—and raced into a press conference 15 minutes late. The security lines do have an upside though… they’ve provided our theme for today: “Hurry up!”

Hurry up, Part I

Two consecutive sessions on voluntary medical male circumcision (VMMC) started the day off. The first introduced the new UNAIDS Strategic Framework for VMMC—which recommends positioning VMMC in the context of a comprehensive platform of services for adolescent boys and young men. This shifts VMMC away from a campaign-based model that provided a basic package of services at the time of the procedure—but didn’t seek to use the procedure to anchor people to a broader health platform. Given the absence of youth-friendly health services for adolescent boys and girls (not to mention those individuals who don’t fit into gender-binary categories!)—this is a welcome recommendation. But it’s not clear what this shift will cost or how it will impact the goal of roughly doubling VMMCs annually from 2.5 million to five million in order to meet the global target. The sole presenter who addressed cost indicated that Swaziland’s approach to providing VMMC within a program of comprehensive services for young men cost about US$180 per procedure, compared to less than US$100 for a standard approach. Moving to the UNAIDS-recommended model is going to cost money, and the money is not on hand. At the same panel, a representative from the GFATM reported that six VMMC priority countries requested a total of US$9 million for VMMC from dedicated funds during the last round. However, an additional US$65 million for VMMC was in the “above allocation” wish-list—e.g., money they wanted but weren’t likely to get. So—the model is changing, costs could be rising, and the money is missing. That’s the challenge for delivery of the most effective HIV prevention available for HIV-negative men today. It needs to be resolved. Fast. Hurry up.

Hurry Up, Part II

A lively discussion took place in an afternoon session on HIV prevention for pregnant and breastfeeding women. Participants considered PrEP, including daily oral TDF/FTC, which is available today, as well as emerging strategies like the vaginal dapivirine ring and perhaps long-acting injectable ARVs. At issue was the best way to offer PrEP to HIV-negative women in antenatal settings. Does additional safety information need to be gathered even though there are years and years of experience using TDF/FTC-containing regimens in pregnant women living with HIV? Or should daily oral PrEP be part of antenatal services offered to women who are at substantial risk? Opinions were heated and diverse. Could over-crowded, under-resourced and under-staffed antenatal clinics accommodate the required counseling associated with PrEP initiation and successful follow-up? Was it ethical to hold off on offering PrEP for women who would definitely receive ART if they returned with an HIV-positive result? “There is some deep level of inequity, of sexism…” one participant opined. “If men could get pregnant this would be a really different discussion.” The questions standing in the way of routine provision of PrEP for women at risk in ANC clinics need to be addressed ASAP. Hurry up.

Hurry Up, Part III

The session on fast track prevention targets also got our attention. As seen in the Lancet HIV, global targets will fail to control HIV if the rate of new infection continues to march along at current levels. There’s been too little investment, focus and commitment on prevention. The scale of the effort has been too small and the quality of implementation uneven. The UNAIDS–Lancet Commission on Defeating AIDS—Advancing Global Health reported that updated UNAIDS targets to reduce new infections below 500,000 by 2020—a 75 percent reduction from 2010 requires a full complement of prevention and treatment strategies scaled to reach a significant percentage of high-risk populations. Prevention advocates are pushing program targets for a worldwide plan that could spell the difference between success and failure. Hurry Up!

If you don’t want to read the whole the Lancet HIV piece see how Peter Piot and Mitchell Warren cast it here.

Hurry Up, Part IV

AVAC has been closely following the development of DREAMS, the PEPFAR-led, public-private partnership focused on adolescent girls and young women. AVAC was present in force and cheered on former AVAC Fellow Anna Miti, who served as the moderator at today’s update on the DREAMS partnership. One highlight, PEPFAR and DREAMS Partners announced the winners of their Innovation Challenge Fund, which is handing out a total of US$85 million to 56 groups. The call for applications encouraged groups to cover priority areas not fully addressed in the ten country work plans. The news is in and some of it is exciting: of those awarded, nearly half have never received PEPFAR funding. The organizations cover six main focus areas, including community capacity strengthening and keeping girls in school. Just four of the grants (7 percent of the total) are focused on PrEP—and it is not clear that all of these four are involved in providing services. The majority of the organizations are in Kenya, South Africa, Uganda and Tanzania. While 36 of the organizations are small in revenue, several on the list are large international NGOs and it remains to be seen what resource allocation will look like across the 56 organizations. DREAMS has an essential goal—reduce the incidence of HIV in adolescent girls and young women by 40 percent in 2017. Nothing could be more important and we support it 100 percent. Hurry up!

And here’s a look at some of what tomorrow will bring:

Tuesday at the Research Literacy Networking Zone

In addition to having a Help Desk (have a question about prevention research or looking for a resource—stop in!) and a comfortable space to rest your feet, come check out all the programming in the RLNZ (Global Village, Booth 606). See Tuesday’s schedule below:

• 11:00 – 11:45 – Understanding HIV Prevention Research and Clinical Trial Process (WRHI)
• 11:45 – 12.45 – Breaking Down Silos-Implementing GPP Across Diseases and Research Phases (AVAC, WRHI)
• 13:00 – 14:00 – CUREiculum & Gene Therapy (Martin Delaney Collaboratory CAB)
• 14:45 – 15:45 – Ask the Researchers: Antibodies for Prevention & Treatment (HVTN, PxROAR)
• 16:00 – 16:45 – A Conversation about HIV with Emilio Emini, Director of HIV, Gates Foundation
• 16:45 – 17:45 – PrEP Prepositions 4 Prevention (DTHF, WRHI)
• 17:45 – 18:30 – AVAC Advocacy Fellows Info Session (AVAC)

A Few Sessions We’ve Starred

See below for a highly selective list of sessions for all the data geeks out there! Check them out in-person or find them on the webcast archive the following day.

• 11:00 – 12:30 – PrEP: New Drugs, New Questions, Session Room 11, Data on maraviroc as PrEP, dapivirine ring and rilpivirine long-acting injectable
• 11:00 – 12:30 – Progress in HIV Vaccines and the Road to the Clinic, Session Room 5, Review of P5, the AMP Study, Janssen’s ad26/MVA and new HIV vaccine concepts
• 13:00 – 14:00 – Late Breaker Session, Data from the HVTN 100 vaccine trial, SAPPH-IRe PrEP demonstration project in FSWs in Zimbabwe, ATN 113 PrEP demonstration project in young Black men in the US and Truvada as PrEP utilization data in the US
• 14:30 – 15:30 – New Evidence: Why Do Young Women in Africa Have High Rates of HIV Infection?, Session Room 1

Follow along in real-time on Twitter, and look for the next update in your inbox tomorrow!

On the eve of the Durban International AIDS conference, European AIDS Treatment Group and a number of partners launched a global Community Consensus Statement on Access to HIV Treatment and its Use for HIV Prevention, available here and now for endorsement. The Statement places the right of the person with or at risk of HIV to access ARVs for treatment or prevention in the way they want and in a way that enables them to use it successfully.

This is an updated Statement and shows the evolution in knowledge around the use of ARVs for both treatment and prevention. Since the first version, launched two years ago, there is further evidence showing that:

• Treatment improves health outcomes for everyone living with HIV regardless of CD4 count
• People with HIV who are on ART and virally suppressed are non-infectious
• If HIV-negative people take ARVs approved for prevention (PrEP) consistently, they are protected from virtually any risk of HIV infection

In addition to the progress in science around ARVs for treatment and prevention, activism and policy advances over the last two years is also reflected in the Statement. In particular, the sections on ARV access and PrEP are new.

Sections include:

• The right to ART for people who are HIV-positive
• Access to ART for people who are HIV-positive
• Preventing HIV transmission
• PrEP for people who are HIV-negative
• Prevention policies for all

This final version was shaped by global community input with more inclusive, wider authorship than the original. As a result, it is shorter and less technical, with the aim of easier engagement and uptake.

The end goal is to see this final Statement included at the core of every HIV treatment guideline and program with the potential to become a cornerstone of patients’ rights. The more people who authorize it, the more likely it is to be adopted. Many thanks for individual and organizational sign-ons.

Another brief update in the run-up to Durban (you can find our previous resources on navigating prevention research and activism here). In this one: how to find AVAC—which we hope you’ll do to amplify messages, add experience and share the work of bringing prevention to the forefront of the meeting.

A full run-down of AVAC at Durban 2016 is here—this includes our presentations, satellites, workshops, booth and Global Village work (and for the full prevention roadmap, click here). We will also be providing daily updates on prevention activism and developments at the meeting—with a guide to what to watch out for the next day. These will be via the Advocates’ Network and also tweeted out from @hivpxresearch.

Below is a very brief selection of highlights by strategy and issue. Scroll down for some key places to find and learn more about AVAC and partners, and let your voice be heard!

Advocacy in Action

• July 18, 12:00 – 3:00 PM: Look for us at the March for Quality Treatment for All – come raise your voice for prevention and signal a “code red” for the HIV response.
• July 19, 17:45-18:30 (Research Literacy Networking Zone): AVAC Advocacy Fellows Info Session – come learn more about this fellowship opportunity for emerging and mid-career advocates.
• Ongoing: “Truth Booth” (Booth 572 in the Global Village) – a recording booth to capture diverse voices of the conference.

Combination Prevention and “Ending AIDS”

• What will it take to reach the Fast Track Prevention Targets: What, Who and How, Monday, July 18 14:45-16:45 (Session Room 5)
• Right things, right places, right now: Setting the right targets, Tuesday, July 19 11:00-12:30 (Session Room 10)
• Oral presentations in the Financing the Response to HIV: Show Us the Money session, Thursday, July 21 11:00-12:30 (Session Room 1)

Cure

Towards an HIV Cure: Engaging the Community, Saturday, July 16 9:00-12:10 (Session Room 11)

HIV Vaccines

• Vaccines are Needed to Conclusively End HIV/AIDS and TB, Monday, July 18, 8:00-10:00 (Session Room 1)
• Ask the Researchers: Talking About the Use of Antibodies for HIV Prevention, with the HVTN, Tuesday, July 19 14:15-15:45 (Research Literacy Networking Zone, Global Village booth 606)

Hormonal Contraception and HIV

One Woman, Many Choices, Monday, July 18 11:15-12:15 (Research Literacy Networking Zone, Global Village booth 606)

Key Populations

• Adolescents at Risk and in the Lead, featuring Micheal Ighodaro as Plenary Speaker, Wednesday, July 20, 8:45-10:55 (Session Room 1)
• Lived Realities, Imagined Futures: Meeting the HIV Prevention Needs of African Gay Men, Monday, July 18 10:150-12:15 (Session room 5)

Long-acting Injectable ARVs for Prevention (and Treatment)

Marketplace for Rings, Pills, Jabs and Other Things: Understanding new biomedical interventions to reduce HIV risk from development to delivery, Wednesday, July 20, 14:30-17:00 (Session Room 3)

Microbicides

HIV Prevention Landscape for Women: A look at new & emerging prevention options including PrEP, vaginal rings and new products in development, Wednesday, July 20, 13:00-14:30 (Global Village Session Room 1)

PrEP

• PrEP Implementation Meeting, Sunday, July 18 9:00-17:15 (Hotel Elangani, Tugela room, Maharani Tower)
• What do we need to do to access and deliver PrEP?: Tapping into unheard voices of end-users and providers to support country level advocacy and equitable access, Tuesday, July 19, 14:30-17:00 (Session room 7)

Prevention Options for Women

HIV Prevention for pregnant & breastfeeding women: Long overdue. But is it time to deliver?, Monday, July 18 14:45-16:45 (Session room 12)

Research Literacy

Throughout the Conference at the Research Literacy Networking Zone in the Global Village, click here for complete program.

VMMC

Voluntary Medical Male Circumcision as Primary HIV Prevention: Maximizing Our Investment and Considerations for Sustainability, Monday, July 18, 10:15-12:15 (Session Room 11)

With less than a week to go until the International AIDS Conference, here’s the next in AVAC’s series of brief updates to prepare. In this one… prevention activism at Durban. What, where, why and how. We hope you’ll find this useful and thought-provoking whether you’re coming to an IAC for the first time—or whether this is familiar ground.

What does prevention activism mean in 2016?

As it was in 2000, access to antiretroviral treatment for people living with HIV will be one important theme for this year’s meeting. That 35 years into the HIV epidemic, less than half of the 37 million who need ART are on treatment means that access continues to be a major issue.

Prevention activism starts with this premise and adds loud, specific, targeted demands for funding, programs and research for the things we know, and need, as combination prevention. This means male and female condoms and condom-compatible lubricant, comprehensive harm reduction, PrEP, VMMC, structural and rights-based interventions, and R&D for additional options. The world won’t end AIDS without targets, accountability and action around these interventions—and action won’t happen without activism.

Why is activism needed?

Because there are major, glaring gaps in HIV prevention worldwide. UNAIDS just took a stand on this with its first Prevention Gap report that highlights numerous places where we are failing. Just 2 percent of the people who need PrEP, according to UNAIDS’ target of 3 million by 2020, have access to it today—a situation similar to ART access around the last Durban conference. Also this week, WHO reported that the number of voluntary medical male circumcisions performed in 2015 declined by 20 percent from 2014. A month ago, UNAIDS put out its annual progress report which noted that there has been no decline in the number of new cases of HIV worldwide in the past five years.

This because public health systems are broken; there are not enough health workers; prices of new medicines and technologies are still high; and supportive policies and funding for community-led programs should be priority for any program implementation but this is hardly the case.

How should it happen at the meeting?

Anywhere that there is a conversation about ending AIDS, prevention activism is needed. You can do it by sporting a message—look for AVAC’ers and allies with prevention “red alert” stickers like the one in this message. You can also do it by speaking up.

Here are some questions to ask specific speakers and stakeholders?

• UNAIDS leadership: How will you help lead the world to less than 500,000 new infections per year by 2020 and fill the gaps in your new report?
• PEPFAR leadership: What will it take to get PrEP offered to adolescent girls and young women in all of the countries where you are implementing your DREAMS program, and how will you ensure that the newly-announced initiative for key populations has true impact?
• National leadership: How are country targets and budgets aligning with global targets – for prevention, for key populations and for human rights?
• Session chairs: Where are the voices of the people leading the fight? Those most highly burdened and underserved, including young women, should be front and center of the conversation, leading with their voices and not being talked about from the podium.

Where should it happen?

• See below for a list of marches, activist strategy sessions and ideas for actions.
• To strategize messages and share timely updates on events, join the Health GAP-led Activists at Durban Listserv and/or join the WhatsApp Group by sending an email with your name and phone number (don’t forget to include your country code!) to [email protected].
• Join the March for Quality Treatment for All Facebook page here.

It’s time activists shaped the International AIDS Conference to ensure these issues are raised and rhetoric matches action. Community needs to set a new global agenda in its response. Activists could start by showing up, grabbing a sign, marching, demanding answers of decision-makers, meeting with media, blogging and being counted. See you in the streets!

Activities

• Activist Strategy Session: An all-day strategy workshop led by MSF, TAC, ITPC and Health GAP to strategize treatment for 30 million people with HIV by 2020; Sunday, July 17 at 8:30am – 4:00pm; The Royal Hotel, 267 Anton Lembede St, Durban, 4001

• Activist Meeting: Join TAC, Health GAP, SECTION27 and MSF to discuss the Treatment for All march and other actions for AIDS 2016; Sunday, July 17 at 6:30pm – 8:30pm; The Royal Hotel, 267 Anton Lembede St, Durban, 4001; RSVP here; [email protected]

• Red Card Actions: A group of organizations are printing red cards to hold up in conference sessions when speakers are using rhetoric that is not matched by action. These will be handed out to activists at the beginning of the week.

• Treatment March: Join TAC and Health Gap March for Quality Treatment for All; Monday, July 18 at 12pm–3pm; Meet: King DinuZulu Park; [email protected].

• No Sterilization March: Join ICW and ICWEA and others for March Against Coerced & Forced Sterilization of Women Living with HIV; Tuesday, July 19 at 12pm; at the AIDS 2016 Conference.

• Responding to UNAIDS’ Session: From Commitments to Action: Implications of the 2016 UN High Level Meeting on Ending AIDS; Join MSMGF in action planning in response to the UN High Level Political Declaration, Wednesday, July 20 at 1pm – 2:30pm; at the MSM Networking Zone, Global Village, Booth 617.

• Code Red: Demand a New Era in the AIDS Response; Global Call to Action by TAC, Health Gap and +SECTION 27; endorse Call to Action here.

• HIV Prevention 2020: A framework for delivery and a call to action; read the Lancet’s latest issue for a worldwide plan to reduce HIV incidence.

• Activism for Hepatitis C Drugs: Join ITPC in calling on drug company Gilead to stop blocking the the registration of sofosbuvir so it can be used in combination with daclatasvir; and to stop threatening generic drug production in Morocco, Tunisia and Egypt. For details, contact [email protected].

• Indian Government Crack-down on Activist Organizations: Activist discussion hosted by Canadian HIV/AIDS Legal Network, Health GAP and Lawyers Collective on Potential against government attacks civil society organizations and detrimental effects on intellectual property in India. For information on actions, contact [email protected].

• Global Fund Replenishment: International Civil Society Support (ICCS) and Global Fund Advocates Network (GFAN) are organizing a number of actions/events focused on targeting key donor countries regarding contributions to the Global Fund. There will be a Call to Action during the press conference on Wednesday, July 20 to launch the Cost of Inaction report. For more information, contact ICCS.

P.S.

Check out the HIV Prevention Roadmap of relevant sessions and activities at the conference, and the Research Literacy Networking Zone in the Global Village—a destination we hope will be on your path through a busy conference week.

And take a look at this slide set that gives background and detail on Durban activism past and present in context—including the organizers, “asks” and timing of upcoming marches.

Welcome to the first in a series of quick updates we’ll be sending over the next 10 days to help activists and advocates prepare to navigate the 21st International AIDS Conference, which will be held in Durban, South Africa, July 18–22.

In this update we highlight the HIV Prevention Roadmap of relevant sessions and activities at the conference, and the Research Literacy Networking Zone in the Global Village—a destination we hope will be on your path through a busy conference week.

HIV Prevention Roadmap

The International AIDS Conference includes hundreds of sessions, side events, marches and meetings—many focused on HIV prevention research and implementation. This Excel sheet allows you to sort by focus; the PDF has everything mapped out day by day. If there are events that are not on the roadmap but should be, please email us. And next week’s updates will hone in on specific topic areas and roadmaps (e.g., women’s prevention, PrEP, VMMC, R&D of new options and more).

Research Literacy Networking Zone

AVAC, in partnership with IRMA, NHVMAS, TAG, WACI Health and WRHI, is excited to host the first-ever Research Literacy Networking Zone (Booth 606 in the Global Village) at AIDS 2016. The RLNZ will be a space where conference delegates and local community members can come together to network and discuss ongoing and planned HIV prevention and cure research, as well as the rollout of new interventions.

In addition to features like a Help Desk and Recharging Area (for mind, body and devices!) there is a robust schedule of events at the Zone. The daily schedule features a range of sessions organized by contributors from around the globe. The full program is available to download here, and a pocket program will be online at our RLNZ page next week and printed postcards will be available in Durban. We hope that you’ll include some of the Zone sessions in your plan for the week and stop by to say hello when you have a minute!

Stay tuned for additional updates next week!

One crucial priority for the United States Agency for International Development (USAID) is bringing a durable end to the HIV/AIDS epidemic. For almost two decades, USAID has provided funding for research and development of an HIV vaccine and other biomedical prevention options. In addition, they have provided complementary support for advocacy and capacity-building efforts, with particular focus in countries that bear the largest burden of the epidemic.

USAID recently announced two five-year awards under its new HIV Vaccine and Biomedical Prevention Research Project. These two awards are complementary and collaborative. The first will focus on conducting preclinical and clinical HIV vaccine research and development and strengthening scientific capacity, especially in Africa. The second supports advocacy, research literacy, policy, communications, community engagement and regulatory activities for biomedical HIV prevention research globally, with a focus on low- and lower middle-income countries.

AVAC is pleased to announce that the first grant was awarded to the International AIDS Vaccine Initiative (IAVI) and the second to AVAC. AVAC is grateful for this USAID support that will enable us to expand our research advocacy work—which has been at our core since AVAC’s founding over two decades ago.

As part of our proposal to USAID, we outlined an exciting coalition, involving a wide range of partners key to our field, to accelerate and support prevention research. We look forward both to implementing this project with partners new and old, and to collaborating with IAVI to ensure synergy between the two awards.

Only by working in collaboration across countries, prevention options, and partners—as exemplified in these awards—will we achieve a durable end to this epidemic.

This update provides information on the AVAC Advocacy Fellows program; an invitation to apply; links to application forms, a short informational video, and details on an upcoming informational call for interested applicants on Thursday, 7 July 2016. Submission deadline for applications is Monday, 15 August 2016.