Challenging a Season of Hate in 2023

A look back at the last few weeks brings a heavy heart, and, for us at AVAC, a renewed determination to fight back against a sea of reactionary policies that jeopardize healthcare and dismantle civil liberties around the world.

As our Executive Director Mitchell Warren recently told the TheBodyPro, “This is, frankly, a global pandemic. Right-wing politics, moralizing legislatures, and moralizing judicial systems are putting people’s lives at risk.”

Extremist courts and legislatures in the US and in many other countries are pursuing laws that will, at the very least, turn back time in our progress against HIV and at worst destroy the lives of whole segments of society.

In the last two weeks alone, AVAC has had to issue three statements condemning unjust, dangerous and deeply flawed legal maneuvers.

On March 24, we condemned Uganda’s Anti-Homosexuality Bill of 2023, a more poisonous version of a 2014 attempt to further criminalize the LGBTQIA+ community. It’s also just one of condemned Uganda’s Anti-Homosexuality Bill of 2023 several draconian anti-gay bills sweeping across Africa and the US. As Brian Kanyemba of Advocacy for Prevention of HIV and AIDS (APHA) told TheBodyPro, it’s a “Homophobic Spring”. (Watch this space for a podcast in the coming days with stunning reports from Uganda-based advocates on the fight against Uganda’s proposed anti-homosexuality law.)

Two US court rulings have since come down, each attacking access to fundamental healthcare. On March 30th, a US federal judge in Fort Worth, Texas, struck down a section of the Affordable Care Act that requires insurance coverage for many preventive services, including HIV testing and the provision of PrEP. This ruling reinforced an earlier decision that ruled PrEP provision may violate individual religious freedom. AVAC’s statement condemned this ruling that endangers access to PrEP, as well as other life-saving prevention services.

And today, we are again condemning a court ruling from a different US federal judge, this time based in Amarillo Texas, who has issued an unprecedented preliminary injunction suspending the US Food and Drug Administration’s (FDA) approval of mifepristone, a safe and effective abortion medication approved more than 20 years ago. If this decision is allowed to stand, it will restrict access to the most widely used method of abortion and undermine the FDA’s authority on drug regulation generally.

“This decision throws open the door to reversals of other drug approvals based on one individuals’ personal or political beliefs rather than science and evidence. It’s yet another blow in a campaign to roll back bodily autonomy and human rights and cannot be allowed to stand,” said Warren. “In solidarity, we stand with the millions of individuals and families who will be affected by this highly political decision, and we stand with science and medical evidence, which is increasingly under attack in the US.”

In what has become a season of hate, we turn our eyes to the work ahead. We call on the Biden administration to take immediate action to safeguard access to every aspect of sexual, reproductive and preventive healthcare, including PrEP, mifepristone and other abortion services. We call on political leaders and health leaders in every corner of the globe to take action in solidarity with LGBTQIA+ people to protect and expand their civil rights. When fear and reaction gather momentum, we must recommit to an advocacy agenda that champions evidence-based and science-informed policy. We must join together, with clarity and solidarity, to face down the hate and build a world for all of us that is safe, healthy and just.

AVAC Condemns Court Decision that Tramples Human Rights, Endangers Evidence-Based Medical Care and Sets a Dangerous Precedent

As a global organization dedicated to health as a human right, to social justice, and to individual autonomy and choice, AVAC strongly condemns the decision by a federal judge in Texas who issued an unprecedented preliminary injunction that suspends the US Food and Drug Administration’s (FDA) approval of mifepristone, a safe and effective abortion medication approved more than 20 years ago. If this decision is allowed to stand, it will restrict access to the most widely used method of abortion and undermine the FDA’s authority on drug regulation generally.

A counter ruling issued shortly after the Texas decision by a judge in Washington state called for the FDA to maintain access to mifepristone. It is unclear how these competing rulings will play out, but it is assumed this will force the issue to the Supreme Court where it is uncertain how a conservative majority may rule.

“The Texas decision throws open the door to reversals of other drug approvals based on one individuals’ personal or political beliefs rather than science and evidence. It’s yet another blow in a campaign to roll back bodily autonomy and human rights and cannot be allowed to stand,” said Mitchell Warren, AVAC’s executive director. “In solidarity, we stand with the millions of individuals and families who will be affected by this highly political decision, and we stand with science and medical evidence, which is increasingly under attack in the US.”

More than 20 years ago, the FDA reviewed the scientific evidence and approved mifepristone for medication abortion as a safe and effective product. In the intervening time, a tremendous amount of additional evidence has been added to the safety and efficacy profile of the drug, and its effective use outside of a clinic setting.

“The FDA’s job is to evaluate reams of scientific evidence and conduct unbiased, stringent review of new drugs and devices.” said Suraj Madoori, AVAC’s director of policy advocacy. “Friday’s ruling would take decision-making out of the hands of experts and put it into the hands of misguided activist judges, endangering access to other FDA-approved medications. AVAC is especially concerned about implications for access to contraception, treatments used by transgender individuals and HIV prevention drugs.”

“The FDA is recognized as the global leader in stringent, objective review of drugs and devices. Today’s ruling not only endangers public health and access to safe, effective medication, it jeopardizes our national standing and well-earned respect for our regulatory body,” said Madoori.

AVAC calls on the Biden Administration to take immediate action to safeguard access to mifepristone and to the sanctity and credibility of the nation’s drug approval process. AVAC also calls for appellate courts and the Supreme Court to uphold the FDA’s jurisdiction over drug regulation.

“This decision cannot be allowed to stand. AVAC commits to working with our partners and allies to ensure that the right to access evidence-based medical care is not infringed and that the right to abortion, and reproductive rights overall, are protected for all,” Warren added.

Webinar Recording on Global PPPR Equity

Global PPPR Equity: Why do we need agreements on IP and tech transfers?

Over the past two decades, HIV advocates have engaged in hard battles for equitable access to HIV/AIDS drugs and prevention options and have had some big wins. The process of these negotiations has led to strong relationships that have enshrined certain equity provisions as standard in clinical trials and manufacturing of HIV drugs. Through these battles, we’ve learned clear lessons on the necessity for such agreements and what’s required to secure them.

Throughout global PPPR agreements in 2023, governments and advocates in the Global South are asking for provisions on equity in the form of temporary IP waivers, mandatory tech transfer, and mandatory licensing for pandemic tools.

This panel discussed lessons from the HIV epidemic and explore why governments of the Global South and advocates think we still need to address ‘the IP question’.

Featured Speakers included Fifa Rahman, Brook Baker, Fitsum Lakew, and Esteban Burrone

Watch the recording here.

A Look Ahead of Webinars in 2023

Mark your calendars! We have a number of webinars and events coming up, including three this week, that you won’t want to miss. And scroll down for links from our archived webinars.

title card with presentation info

This week!

Braidwood v. Becerra and PrEP Access: Emergency town hall
Tuesday, April 4, 2023, 6:00 PM ET
Register here
Especially if you live in the US, join PrEP4All, AVAC, HIV Medicine Association, Center for HIV Law & Policy, Lambda Legal, and other leading advocacy organizations , for an emergency virtual town hall to help the community better understand the implications of a recent US ruling that would block insurers from covering a range of critical preventive services such as PrEP, HIV testing, STI screening, and more. Read AVAC’s statement on the issue.

DRM Learning Collaborative
Thursday, April 6, 2023, 8:00 AM ET / 3:00 PM EAT
Register here
The Learning Collaborative is a virtual space that brings together global health advocates, civil society organizations and other key stakeholders from Africa to engage in peer-to-peer learning. This webinar will discuss the landscape including challenges and opportunities, and identify priority advocacy towards expanding local manufacture of vaccines, diagnostics, and therapeutics.

Global PPPR Equity: Why do we need agreements on IP and tech transfers?
Thursday, April 6, 2023, 9:00 AM ET / 2:00 PM GMT / 4:00 PM EAT
Register here
Throughout global PPPR agreements in 2023, governments and advocates in the Global South are asking for provisions on equity in the form of temporary IP waivers, mandatory tech transfer, and mandatory licensing for pandemic tools. This webinar will discuss lessons from the HIV epidemic and explore why governments of the Global South and advocates think we still need to address ‘the IP question’. Featured speakers include Fifa Rahman, Brook Baker, Fitsum Lakew, and Esteban Burrone.

Later in April and beyond from The Choice Agenda
:

How to Communicate about Sexual Health and STIs: Sex positivity vs. risk-based language
Thursday, April 20 at 9:30 AM ET
Register here
Our language matters especially when discussing our sexual health. Join The Choice webinar for a conversation focused on sex positivity and risk-based language when discussing sexual health and STIs. Featured speakers include Keosha T. Bond, Joseph Cherabie, and Alison Footman.

HIV Prevention Plus Plus: Developing options that meet the full range of our sexual and reproductive health needs
Tuesday, April 25, 2023 at 9:00 AM ET
Register here
With a growing number of PrEP options already, what will it take to bring a new MPTs (Multipurpose Prevention Technology) to market? This webinar from The Choice Agenda will explore what we’ve learned so far on R&D, marketing, counseling and delivery for MPTs – and discuss what we can do now to prepare prevention markets to include new MPT options. Featured speakers include Ruth Akulu, Gregorio Millet, and Thesla Palanee-Phillips.

PrEP (In)equity: Documenting, measuring, and flipping the script towards justice
Tuesday, May 9, 2023, 9:00 AM ET
Register here
Disparities in PrEP awareness, access, and uptake are stark in the United States, and play out along lines of race, gender, age, and geography. This webinar from The Choice Agenda will break down some of the existing inequities and key calls to action on how we can better strive for PrEP justice in the US. Featured speakers include Leisha-McKinley Beach, Michael Chancley, and Patrick Sullivan.

PrEP That Booty: The latest on rectal microbicide research for the back door
Thursday, June 29, 2023 at 9:00 AM ET
Register here
Researchers and advocates for years have been working on HIV prevention products specifically for the back door (rectum) to provide protection during anal intercourse. This webinar from The Choice Agenda will investigate some of this newfound research with experts working closely in the field. Featured speakers include Jonathan Baker, Craig Hendrix, Juan Michael Porter II and Sharon Riddler.

Past Webinars
Be sure to check out recent webinars including Mpox – Sexual Networks, HIV and Activism, a comprehensive recap of this year’s CROI meeting, Been There, Did That – Research Reflections from CROI 2023, and Making PrEP accessible: Updates on long-acting injectable options from International AIDS Society (IAS).

Save the Date! An upcoming webinar on global PPPR equity

Earlier this week the Medicines Patent Pool (MPP) announced the granting of three sublicenses to manufacture generic versions of injectable CAB for PrEP. All three manufacturers are based in India, and one of them (Cipla) is also planning to manufacture CAB for PrEP in South Africa. Join us Thursday, April 6 at 9:00 EDT for a webinar, Global PPPR Equity: Why do we need agreements on IP and Tech Transfers?, that will focus on the role of intellectual property, licensing agreements and tech transfer in the development and delivery of health interventions including vaccines, diagnostics or therapeutics. And we’ll explore how these issues fit into the ongoing negotiations of the Pandemic Accord that will be part of a new global architecture for Pandemic Prevention, Preparedness and Response (PPPR).

title card with presentation info

These new generic agreements for CAB for PrEP are an important step in accelerating affordable and equitable access to long-acting PrEP in low- and middle-income countries, but as history has shown, licenses are just one step.

HIV advocates know their history-making role of effectively fighting for more equitable access to prevention and treatment of HIV. It’s a legacy that has instilled equity as a guiding principle across global health. It’s a legacy that must be continually defended, and now it must be extended to agreements that will establish a global architecture for Pandemic Prevention, Preparedness and Response (PPPR), including the Pandemic Accord. Negotiations related to Intellectual property rights (IP), commitments on technology transfer and knowledge sharing are central to these agreements.

How quickly generic manufacturers can develop their capacity, how much investment it will take to do it, and at what price they might sell their finished products are all huge questions and the next steps in our advocacy.

And perhaps the biggest question for all stakeholders and new products is what will it take to build a sustainable market and deliver public health impact?

For background on the issues check out the Advocates’ Guide for Pandemic Preparedness and Response (PPPR) in 2023 and our podcast PPPR Advocacy 101: Find out what it means to you.

AVAC Condemns Court Decision that Endangers Access to PrEP and Other Critical, Life-Saving Prevention Services

A new ruling by a US federal judge in Texas strikes down a provision of the Affordable Care Act that required insurance coverage of many preventive services, including HIV testing and the prevention drugs use for Pre-exposure prophylaxis (PrEP), and doubles down on the judge’s previous ruling in a separate case that PrEP provision violates some individuals’ religious freedom. The current ruling will not only affect HIV prevention services, but endangers access to contraception, vaccinations, routine health screenings and a wide range of prevention services.

“This ruling expands on last year’s shocking decision on PrEP and religious freedom and further undermines the right to health for an even larger group of Americans. It is the latest blow in a campaign to roll back bodily autonomy and human rights for a wide swathe of the population and will degrade the quality of life for all Americans by denying life-saving preventive care,” said Mitchell Warren, AVAC’s executive director.

“At a time when science has given us the tools to advance towards the end of the HIV epidemic and rational evidence-based public health policies and programs can implement those tools to save millions of lives around the world, one judge’s continued biased and discriminatory decisions endanger programs and lives far beyond northern Texas,” Warren added. “As advocates, activists and citizens, we at AVAC stand in solidarity with all those whom this decision affects. We firmly believe that the ruling must be called out as a dangerous infringement of the rights of individuals to determine their own healthcare needs with their healthcare providers and that every effort must be made to ensure that it does not stand.”

NEW Px Pulse Episode – PPPR Advocacy 101: Find out what it means to you

To help navigate it all, we’re delighted to launch our newest PxPulse podcast episode and a new Advocates’ Guide for Pandemic Preparedness and Response (PPPR) in 2023.

Over the coming months, global leaders will make key decisions about several initiatives to prepare for the next pandemic. What they commit to and how much they will spend, and how well these plans incorporate equity as a principle across all of these initiatives, is in question.

Deadlines for civil society to influence these decisions are coming up. Among these initiatives are the Pandemic Fund, the Pandemic Accord, several UN High-Level Meetings, and there’s also the Medical Countermeasures, or MCM, platform. The MCM platform would coordinate drugs, vaccines, diagnostics and other equipment for health emergencies.

In our last podcast, we spoke with Chris Collins, President of Friends of the Global Fight Against AIDS, TB and Malaria about all these efforts. He talked about how ultimately these decisions will build a new architecture for Pandemic Prevention, Preparedness, and Response, or PPPR.

Chris and the HIV community have been calling for stronger health systems and expanded domestic funding for health and have been pushing for a rights-based approach to pandemic prevention, preparedness and response—one that builds on the decades of advocacy that has shaped the response to HIV.

But it’s not clear whether planning for the next pandemic is heeding these lessons. Karrar Karrar, who heads up Health Policy at Save the Children, and Samantha Rick, who leads AVAC’s PPPR policy advocacy, have been tracking these efforts closely. They explain exactly what commitments for equity are needed and who needs to hear this advocacy and when.

title card with presentation info

Be sure to check out our Advocates’ Guide for PPPR in 2023, for a breakdown on all the moving parts, the organizations and initiatives to track, and key timelines for the year ahead.

Other helpful resources include:

The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action, Px Pulse podcast with Chris Collins
Prevent, Prepare, and Respond: An analysis of global health architecture for pandemic preparedness, AVAC
We Have Cutting-Edge Science to Make Vaccines, But Will Everyone Benefit?, New York Times commentary from Barney Graham
The World Health Summit: Hitting the target, or missing the mark?, AVAC
Leveraging the HIV response to strengthen pandemic preparedness, PLOS Global Public Health

For the full podcast episode and the archive of previous episodes, visit avac.org/px-pulse. And subscribe on Apple Podcasts, Spotify or wherever you get your podcasts!

AVAC Condemnation of Uganda’s Anti-Homosexuality Bill 2023

This week, Ugandan Parliamant took steps toward implementing an anti-gay policy change that would further criminalize and endanger the lives of LGBTQIA+ people. AVAC condemns the proposed legislation and stands in solidarity with the LGBTQIA+ community in Uganda who face threats to their lives, draconian prison terms, and even the prospect of death sentences if this legislation goes forward.

“This new legislation is a direct violation of the health, rights and humanity of the LGBTQIA+ community, and we urge President Yoweri Museveni not to sign it into law,” said Angelo Kaagwa-Katumba, Senior Program Manager at AVAC. “As LGBTQIA+ people and allies, we’ve been tireless in our work to change attitudes and policy – in Uganda and around the world – because we’ve seen the direct link between criminalization and stigma and the devastating impact both have on HIV incidence. This new legislation duplicates and expands on a previous attempt to legislate hate and oppression of the LGBTQIA+ community in Uganda nearly a decade ago. That legislation was overturned by the Constitutional Court, and we hope to see justice upheld again.”

This “Anti-Homosexuality Bill 2023”, passed earlier this week by the Uganda Parliament, makes it a crime to even identify as lesbian, gay, bisexual, transgender and queer, and gives authorities sweeping power to crackdown on any form of LGBTQIA+ advocacy. This new bill, criminalizing same-sex relations between consenting adults, is a harsher revision to Uganda’s 2014 Homosexuality Act, which outlawed the “promotion of homosexuality,” but was struck down. Ugandan President Yoweri Museveni now has a 30-day window to either approve the bill, return it to Parliament for reevaluation, or veto it – or, by not acting, the bill will be considered approved.

“We are seeing a tsunami of discrimination and oppression of basic human rights around the world right now,” said Mitchell Warren, AVAC executive director. “The proposed anti-gay bill in Uganda is the latest in a wave of anti-LGBTQIA+ actions in several countries, from arrests in Zambia to a backlash in Kenya, to anti-trans laws in several US states and elsewhere, all of which threaten lives and livelihoods, and our ability to connect key populations with the resources they need and deserve to prevent and treat HIV and to live their fullest lives. If we don’t deal with the fundamental reality of stigma, discrimination and criminalization, we will never end the epidemic.”

In Zambia, police arrested leaders of an approved demonstration condemning violence against women in observance of International Women’s Day. Authorities claimed the protest was promoting LGBTQIA+ rights. Same-sex sexual acts have been prohibited under Zambia law since the British colonial period. In Kenya, a February decision by its Supreme Court to bar discrimination on the basis of sexual orientation when it comes to registering LGBTQIA+ organizations has been followed by intense homophobic backlash. The uproar comes as a high court decision that criminalized same sex relationships is being appealed. The US is similarly swept up in a period of terrorizing legislation dismantling the rights of gender diverse populations and threatening their well being. Overall, 2023 has seen a record number of bills in states across the US that target LGBTQIA+ people.

“We stand ready to support the LGBTQIA+ community and their allies in every way that will not only help them survive this moment, but overcome these challenges to turn the tide from hate and fear to global health equity for all,” Warren added.

###

About AVAC: Founded in 1995, AVAC is a non-profit organization that uses education, policy analysis, advocacy and a network of global collaborations to accelerate the ethical development and global delivery of HIV prevention options as part of a comprehensive response to the pandemic. Follow AVAC on Twitter @HIVpxresearch and find more at www.avac.org and www.prepwatch.org.

Upcoming Webinars and a Roundup of New Resources

Whether you are tracking PrEP initiations or cure research, pandemic preparedness or mpox news, emerging advocacy for the inclusion of pregnant people in research, or looking for an overview of prevention research and more from CROI, we’ve got you covered. Below is a roundup of important resources and upcoming webinars you won’t want to miss!

Pandemic Prevention, Preparedness, and Response: AVAC’s position on PPPR

Read AVAC’s, Prevent, Prepare, and Respond: An Analysis of Global Health Architecture for Pandemic Preparedness, a policy position on the future architecture of global health.

And be sure to listen to the latest Px Pulse podcast episode, The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action, featuring Chris Collins, the CEO and President of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria.

title card with presentation info

Sign up for Pandemic Watch! AVAC’s expanded weekly round up of pandemic news

AVAC is broadening the coverage of our COVID News Brief and folding it into the new Pandemic Watch, a weekly round-up of news on COVID, pandemic preparedness, mpox and more. Check out our first issue and subscribe here.

title card with presentation info

An Action Plan for HIV Prevention Research Among Pregnant and Lactating People

The Coalition to Accelerate and Support Prevention Research (CASPR) jointly released with PHASES a new action plan, Advancing HIV Prevention Research in Pregnant and Lactating People (PLP), which identifies priority goals to advance the responsible study of HIV prevention in PLP, a population that must be better served by the research enterprise.

A Look Back at CROI

The 30th Conference on Retroviruses and Opportunistic Infections (CROI) showed an energized field—with scientific advances galvanizing research across a host of disease areas. The highlights in this round up and on our webpage, offer a look at standout research and advocacy from CROI.

title card with presentation info

Upcoming Webinars

The Choice Agenda, Been There, Did That – Research Reflections from CROI 2023
Thursday, March 23, 10:00–11:30am ET
Featuring Monica Gandhi and CROI 2023 Community Educator Scholars. Co-moderated by Devan Nambiar, Gay Men’s Sexual Health Alliance and CROI 2023 Community Educator Scholar.
Register

The Choice Agenda, Mpox – Sexual Networks, HIV and Activism
Wednesday, March 29, 9:30–11:00am ET
Featuring Keletso Makofane, Harvard University & Chloe Orkin, Queen Mary University of London.
Register

When Cure Means Control: An Introduction to Viral Control Off Therapy
Tuesday, March 28, 9:00-10:00 am ET
Featuring Jon LI, Harvard University; Marina Caskey, Rockefeller University; Ann Charoudi, Emory School of Medicine.
Register

Introducing Pandemic Watch, our Curated News Digest and a New AVAC Position Paper on PPPR

We are delighted to launch two new publications: Pandemic Watch, our updated and rebranded curated news digest on pandemic prevention, preparedness, and response (PPPR) and a new AVAC position paper on PPPR and the evolving global health architecture.

graphic for the PPPR document

For nearly three years, AVAC and partners have been tracking the pipeline of COVID-19 research and development, documenting COVID-19’s profound effects on the AIDS response, calling out the need for stronger health systems and expanded domestic funding for health, and pushing for a human rights-based approach to pandemic prevention, preparedness and response—one that builds on the decades of activism and engagement that has shaped the response to HIV.

Early on in the COVID-19 pandemic, AVAC created the COVID News Brief as a way to share vaccine developments and urgent questions surrounding equity, misinformation, social justice and the research enterprise with our community.

Three years on, the world has witnessed remarkable achievements in research and development only to see the benefits of those advances hoarded by rich countries as COVID-19 rages on. Global health leaders and advocates are studying how the HIV and TB responses struggled and adapted in the midst of COVID-19, and lessons that can be applied to PPPR.

Today, as we continue our work in HIV, in COVID and among multiple pandemics in a changing global health architecture, we are delighted to expand our news brief to Pandemic Watch, a new, weekly round-up of pandemic-related news. Pandemic Watch folds COVID-19 news into a curated digest that expands beyond COVID to reflect the evolving field of PPPR. If you already received the COVID News Brief, you’ll automatically begin to receive Pandemic Watch. If you’d like to sign up to receive Pandemic Watch, click here.

Major decisions are coming about the architecture of global health, as priorities for new structures and principles, such as the Pandemic Fund, the Pandemic Accord, and the UN Declarations on Universal Health Coverage and PPPR, among others, are set.

The future depends on a global understanding that pandemics are borderless. As Chris Collins and colleagues wrote in PLOS Global Public Health, “Leveraging the HIV Response to Strengthen Pandemic Preparedness, and shared on our Px Pulse podcast, “The Shape of Pandemic Preparedness is Being Decided. Now is the Time for Collective Action”, the HIV response has given the world a platform to integrate, expand and adapt to new pandemics. This requires investing in resilient healthcare systems; incorporating a central role for community engagement and community leadership; and drawing on lessons learned from decades of negotiations on access to medicines. All of these elements are essential to achieve equity and impact when the world responds to pandemics. Ongoing planning must also prioritize recognition of the unique role of the WHO and its trusted evidence-based guidance, which position it to be the best candidate to coordinate pandemic responses.

We hope you’ll continue to read Pandemic Watch, and check out more background and resources on PPPR.

Resources