On December 9th, AVAC and partners will hold a congressional briefing aimed at preserving funding for the US Military HIV Research Program (MHRP). The Department of the Army is considering cutting over 70 percent of the MHRP Army research budget in 2012. The upcoming briefing will inform Congressional staff about the potential impact of the cuts prior to the upcoming vote on the US Department of Defense appropriations bill. The potential reduction in the MHRP budget cut comes at a time when international vaccine research is building on the results of the landmark RV144 study, which was conducted by the MHRP with Thai collaborators and showed the first evidence that an AIDS vaccine could protect against infection. Subsequent follow-up studies which also included MHRP scientists have identified immune correlates linked to risk of infection among vaccine recipients. AVAC has been working with partners since this summer to urge the US Congress and the Obama Administration to restore MHRP funding through visits, sign-on letters and blog postings.
US Military HIV Research Program Faces Drastic Budget Cuts
Zambia National Good Participatory Practices Workshop
On October 20th, AVAC and the Center for Infectious Disease Research in Zambia (CIDRZ) conducted a national workshop on the Good Participatory Practice (GPP) guidelines. About 70 individuals participated, representing research teams throughout the country, community advisory boards, advocacy and civil society groups, and media. The workshop was designed as a key step forward in building stronger relationships between the media and Zambian research stakeholders. In 2009, media reports disseminated inaccurate rumors regarding a large-scale microbicide trial, MDP 301. As a result, the Zambian Ministry of Health temporarily halted all HIV prevention research in the country. Today, prevention trials are being approved and initiated once again and work is ongoing to strengthen media reporting capacity. The past year—in part due to AVAC Fellow Oliver Kanene’s work—has marked a thawing of the relationship between researchers and the media. Introducing the guidelines to this audience helped put a needed and appreciated framework around how to navigate relationships between researchers and other stakeholders. Media and other key groups, namely regulatory and ethics authorities, are extremely excited to develop a “national GPP consensus” that will mitigate possible controversy in the future and ensure that research can move forward in this country.
Modeling the End of the Epidemic
“We need to use modeling to communicate what the possibilities are and what’s been gained from investments to date.” This was the consensus of a small group of advocates, activists, public health leaders and modelers gathered on September 9 by AVAC and amfAR to take a closer look at the state of epidemiological modeling as it relates to the goal of ending the AIDS epidemic. There is scientific evidence for a range of potent prevention strategies including treatment as prevention, male circumcision in the immediate term and, in the future, microbicides, PrEP and vaccines. But decision makers face real challenges about determining priorities and budgets. Models can’t provide the answers, but they can give a sense of the benefits and trade-offs for different scenarios. On October 3, Tim Hallett, a modeler and epidemiologist from Imperial College London, met in Nairobi with AVAC and a small group of East African advocates including several of our Fellows, to discuss how advocates can be what Hallett calls “informed consumers” of HIV models. In the coming weeks and months, AVAC and its allies will be working to help frame the questions and modeling the needs critical to ending AIDS. Watch this space.
Ensuring Gender Sensitivity in the Rollout of Medical Male Circumcision in South Africa
Leader Kanyiki, an AVAC Fellow, has been working with allies in South Africa since the beginning of this year to ensure civil society input into the National Implementation Guidelines for Medical Male Circumcision. This document, to be released on December 1, will guide South African policy and strategy for this powerful prevention tool. Kanyiki held meetings with policy makers, the Department of Health (DOH), the South African National AIDS Council (SANAC) and civil society as part of contributing to the drafting process, with a particular focus on gender sensitivity. Through the work of Kanyiki and allies, the final document states, “The involvement of women, both as sexual partners and mothers, will be promoted to the greatest extent possible. Men who wish to be circumcised will be encouraged to discuss the decision with their sexual partner.” While the inclusion of gender sensitivity language in significant, monitoring its implementation as South Africa’s medical male circumcision rollout moves forward is critical.
Advocating for Increased HIV Prevention Funding in Uganda
AVAC Fellow, Sylvia Nakasi, recently published a letter, “Uganda must move fast on HIV”, in The New Vision, a leading newspaper in Uganda. Her letter reflected on the recent announcement that Rwanda would consider implementing immediate antiretroviral treatment for all serodiscordant couples on the basis of effective data on treatment as prevention from the HPTN 052 trial. Nakasi called on Uganda to take similar steps, citing modeling data that suggests putting more resources into prevention now decreases how much will be needed to spend for treatment in the future. “As a country we need to move faster and also learn from our neighbors next door and speed up the process from research results to policy.” Given that Uganda sees 350 new HIV infections every day, prevention is a clear priority.
AVAC Welcomes New Members to PxROAR Program
In August, five additional members joined AVAC’s US domestic advocacy leadership program, PxROAR (Prevention Research, Outreach, Advocacy and Representation)—Ilanito Cerna-Turoff, Fulbright Program; Steve Houldsworth, Saint Louis Effort for AIDS; Julie Patterson, AIDS Taskforce for Greater Cleveland; Carlos Pavão, Consultant; and Charles Stephens, AID Atlanta. The PxROAR program offers training for US advocates in biomedical HIV prevention research education and advocacy through mentorship, peer support, networking opportunities, and technical and financial support. The inaugural PxROAR class focused on individual projects ranging from a literature review of best practices for informed consent, to building a cadre of HIV-positive women prevention research advocates. This group of seven will work with the new members on a common campaign about which we’ll provide updates in future issues.
WHiPT Report Contributes to Greater Civil Society Involvement in MMC Implementation
Carol Odada, coordinator of Kenya’s Women’s HIV Prevention Tracking Project (WHiPT) team, presented the WHiPT report, Making Medical Male Circumcision Work for Women, at the recent meeting of Kenya’s National Male Circumcision Task Force. As a result of her presentation, which highlighted a range of concerns including the fear that medical male circumcision (MMC) will be conflated with female genital mutilation, Carol was invited to join the committee coordinating MMC roll out in Kuria, a Kenyan district where female genital mutilation is still practiced. “We will be able to document practices both good and bad,” Odada says, noting that after the presentation other MMC implementers also asked for guidance from the WHiPT team on addressing women’s concerns during rollout.
WHiPT Report Contributes to Greater Civil Society Involvement in MMC Implementation
Carol Odada, coordinator of Kenya’s Women’s HIV Prevention Tracking Project (WHiPT) team, presented the WHiPT report, Making Medical Male Circumcision Work for Women, at the recent meeting of Kenya’s National Male Circumcision Task Force. As a result of her presentation, which highlighted a range of concerns including the fear that medical male circumcision (MMC) will be conflated with female genital mutilation, Carol was invited to join the committee coordinating MMC roll out in Kuria, a Kenyan district where female genital mutilation is still practiced. “We will be able to document practices both good and bad,” Odada says, noting that after the presentation other MMC implementers also asked for guidance from the WHiPT team on addressing women’s concerns during rollout.
A New Tool for Laypeople Serving on Institutional Review Boards
The New HIV Vaccine and Microbicide Advocacy Society (NHVMAS), a partner in AVAC’s work on Good participatory practice for biomedical prevention research, recently published two new training manuals: one for training laypersons serving on ethics committees on how to read and give feedback on protocols, and one on the basics of research ethics. The training manuals and a PowerPoint presentation for training laypersons serving on ethics committees are available for download here. If you have trouble downloading the files or require printed copies, contact us at [email protected].
Epicentro, IRMA and AVAC work to expand the HIV prevention research advocacy community in Latin America
International Rectal Microbicide Advocates (IRMA) and AVAC have partnered with Epicentro gay men’s community center in Lima, Peru to bolster HIV prevention education and advocacy in Latin America. Epicentro is adapting advocacy materials on PrEP and rectal microbicides, conducting community surveys on awareness of recent developments in HIV prevention research and gay men’s concerns and priorities. They held their first advocacy call with their new network, La Red, on August 25. You can follow their work on the IRMA-ALC blog and an active Facebook page. For AVAC materials translated into Spanish, visit www.avac.org/espanol.