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.

“If you think the days of advocacy are over, you’re crazy. We need the energy of the ‘80s and ‘90s now more than ever.”

That’s what Tony Fauci said earlier today, during a conversation we had with him to reflect on his legacy and the future of the global AIDS response and public health generally. It was an extraordinary moment of candor and reflection as we talked about what’s been accomplished in the HIV and COVID-19 responses, what’s ahead and what the future looks like for NIAID, Dr. Fauci, and pandemic preparedness.

Among many highlights in that conversation was hearing Dr. Fauci, who has often talked about the importance of community engagement and civil society leadership in shaping the research agenda, call out the urgent need for advocates and activists to raise their voices and engage leaders at every level. It’s a crucial ingredient to ensure all the options for prevention, including new long-acting interventions, reach everyone who needs it.

We couldn’t agree with Dr. Fauci more! AVAC was founded 27 years ago, and we are more committed than ever to this essential work and to advancing global health equity with our many partners, who day in and day out bring their passion, vision and dedication to ending AIDS. It’s these partnerships that will drive success, and your support that makes it possible!

Whether it’s convening conversations between communities and health leaders, tracking and translating the field, or building coalitions to set an agenda for access—at AVAC we understand the importance of bringing people together, of ensuring that vitally important conversations get the time and focus needed to identify priorities and take on the challenges. Coming together, listening, learning and defining next steps is the key to a deeper, more sustained engagement, one that will catalyze solutions that bring prevention to everyone who needs it.

Tomorrow, as part of #GivingTuesday, a global day dedicated to giving back, we ask you to consider supporting AVAC and our work bringing people together, identifying solutions, and putting them into action, with all the energy that Dr. Fauci described:

• Donate: Visit www.avac.org/donate.
• Amazon Smile: Shop at Amazon.com? Visit smile.amazon.com and select AVAC as your charity of choice and a portion of your purchase price is donated to AVAC – at no additional cost to you!
• US Combined Federal Campaign: If you are a US government employee, support our mission through the Combined Federal Campaign, CFC #12308.

We are continually energized, and inspired, by the opportunities to work with so many remarkable individuals and organizations around the world – and we thank you for your support, which allows us to continue this critical work as part of a comprehensive and integrated pathway to global health equity.

Next month Dr. Anthony Fauci will step down from his role leading the US National Institute of Allergy and Infectious Diseases (NIAID) after a half a century of public service. His vision, passion, and commitment to ending the AIDS epidemic and advancing global health equity has been an inspiration to AVAC and to so many. As we contemplate the gap Dr. Fauci leaves and the work ahead to ensure the hard-fought gains in public health under his leadership are not lost, AVAC will sit down with Dr. Fauci for a conversation looking back and looking ahead. Join us!

Much Accomplished, Much to Do: A Conversation Looking Back & Looking Ahead with Tony Fauci

Monday, November 28 at 11:30am EDT; 19h30 EAT

Register here

Earlier this week at the G20 Leaders Summit in Indonesia, the Pandemic Fund was officially launched. This fund is intended to provide resources to and strengthen the capacity of low- and middle-income countries in mitigating the risks of future global health threats.

Ahead of the meeting, AVAC joined the Pandemic Action Network and 50+ civil society groups urging G20 leaders to ramp up action so everyone has the tools to curb COVID-19 and improve resilience to and prevent future pandemics.

In addition, AVAC joined a number of US-organizations in a letter to US Government officials urging them to adhere to four lessons learned in pandemic preparedness and response.

While this new Pandemic Fund represents progress, advocates know from HIV, TB and COVID-19 that meaningful inclusion of civil society and communities in decision-making around the global architecture of pandemic preparedness and response (PPR) is essential. But there’s risk civil society could end up excluded from key points in the process, resulting in catastrophic failure to allocate resources to those that need them most.

AVAC has compiled a few resources to keep you informed and engaged.

Join
This Thursday, November 17, the Interim Civil Society Board members of the Pandemic Fund will host a town hall meeting to share information and updates on the Pandemic Fund, its governing processes, decisions taken and tasks ahead, and invite feedback from civil society and community colleagues. Register for the Zoom meeting!

Read
In a new blog post, AVAC’s Multilateral & PPR Advocacy Specialist, Samantha Rick, shares key takeaways from the World Health Summit earlier this month, which casts a light on what’s happening with PPR and what it all means for HIV.

In a new Viewpoint in the Lancet HIV, Living with COVID-19 and preparing for future pandemics: revisiting lessons from the HIV pandemic, Judy Auerbach and colleagues make the case for more dialogue among polarized perspectives, identifying shared priorities, and drawing on multidisciplinary evidence to better apply lessons learned from COVID-19 to emerging infectious disease outbreaks.

Follow
@PandemicAction: The Pandemic Action Network is a partnership of global health organizations driving action to end the COVID-19 crisis and ensure the world is prepared for the next pandemic threat.

And continue to watch this space.

PrEP Tracker data, preparing for new products, the HIV prevention pipeline and our prevention “playlist.” All that and more in the latest issue of PxWire.

In mid-October, AVAC attended the World Health Summit in Berlin. Historically hosted by the German government, this year marked the first time the Summit was jointly led with the WHO (World Health Organization).

While there was lots to talk about in the three days of the summit, four areas for the coming year are clear priorities.

COVID, COVID, and more COVID

Structures that worked

The global response to COVID-19, particularly the collective failures in preventing spread and severe disease and death, dominated WHS 2022. Bright spots in the global response were noted throughout the meeting—systems known as infection prevention and control (IPC), set up in response to Ebola and HIV/AIDS, were successfully deployed in many places against COVID-19. But glaring gaps stood out. Questions around equity in the distribution of vaccines and treatments, manufacturing capacity, and cooperation across governments were pushed off to next year’s summit. Still, the laser focus on strengthening structures to respond to future pandemics was long overdue. For years, few have prioritized resources for pandemics, even as HIV/AIDS, cholera, hepatitis, and Ebola posed chronic challenges.

Other COVID highlights

In one session devoted to HIV/AIDS (featuring inaugural Virchow Prize winner PEPFAR Ambassador John Nkengasong), some panelists called for increased domestic resource mobilization. This issue is complex and deserves attention. Overall, national government funding makes up 60 percent of global HIV/AIDS resources, and countries are facing compounding challenges in raising funds for public health due to increasing need to divert domestic resources to debt repayment. Just this past week, advocates wrapped up the inaugural Africa Health R&D Week where community leaders discussed the importance of and challenges involved in increasing domestic financing of research and development in African countries. Advocates at the World Health Summit noted that many of the major failures in the COVID-19 response occurred in high-income countries, for example in the US. Some of the most successful responses were mounted in Senegal, Ghana, Vietnam, and many Pacific Island nations, and we saw successful vaccine rollouts in Chile, Uruguay, Nepal, and Cambodia. One shortcoming from the program as a whole was that the summit featured far too few speakers and advocates from countries that had success in stopping the spread in spite of funding constraints.

Community Engagement

WHO Initiatives

Meaningful inclusion of civil society & communities, or the lack thereof, was a major theme of the summit. A town hall with WHO Director General Tedros Adhanom Ghebreyesus highlighted new (and almost new) initiatives to broaden the range of voices included in decision-shaping at the WHO (though all decisions are still finalized by Member States only): a recently launched WHO Youth Council and the Civil Society Commission. The Civil Society Commission will be accepting applications in the coming months.

Beyond WHO

Mechanisms for civil society and community engagement were proposed or interrogated during Q&A portions of nearly every session, showing the real appetite among advocates for more meaningful inclusion in decision-making, particularly in forthcoming decisions on the global architecture of pandemic preparedness and response (PPR).

The formation of the WHO’s Intergovernmental Negotiating Body (INB) to draw up a global PPR agreement and the possibly linked Pandemic Fund (officially launched this week at the G20 Summit), developed by a coalition of donor countries, both present great opportunities for civil society participation. But there’s equal risk civil society could end up excluded from key points in the process, resulting in catastrophic failure to allocate resources to those that need them most.

Where is the money?

All roads lead to primary health care – that was the conclusion reached at every session. The answer to reaching the ‘last mile,’ to expanding access to the most vulnerable groups and key populations, to health system resiliency in the face of concurrent pandemics, to routine immunization challenges, and to quality surveillance of emerging threats is a strong, robustly staffed primary health system in every country. Advocates, institutional leaders, and multilateral champions are all aligned on this, but the funding hasn’t yet followed. As siloed, disease-specific emergency funding continues to drive the world’s efforts (even at WHS with large new commitments to polio from the German government and the Gates Foundation), where is the funding for health systems? Historically, global health security initiatives have not sufficiently considered the role of primary health systems in pandemic prevention and response. High-income countries and donors have typically been much more interested in surveillance, epidemiology, and monitoring than broad health systems strengthening. With no other global funding mechanism devoted to building such a foundation, Pandemic Fund presents a real opportunity to jumpstart global commitment to strong, inclusive, resilient health systems that are ready to weather future challenges. These health systems are prerequisites for hitting targets against global health threats, and finally overcoming decades-long challenges.

What does all of this mean for HIV?

The global attention to PPR structures presents a critical opportunity to drive progress toward the 2030 goals. The systems and structures created by the HIV/AIDS response provide a model for what to do and what not to do. Infrastructure and stakeholder engagement, with civil society recognized as equal partners, have brought innovation and measurable success. But progress has been uneven and unequal, with key populations continuing to be left behind, and far too many decisions controlled by Global North decision-makers. The institutions and groups working on PPR now have much to learn. Integration of global health priorities is essential to meeting 2030 goals. Those ‘in the room where it happens’ must prioritize comprehensive inclusion of community and civil society and growing the pot of resources to address health inequities, and retaining commitment to ending current pandemics and epidemic threats as much as future ones.

The International Conference on Family Planning (ICFP) convenes next week November 14- 17, in Pattaya City, Thailand. ICFP is the world’s largest gathering of family planning (FP) and sexual and reproductive health and rights (SRHR) professionals in the world and is a platform for advocates, researchers, and stakeholders to help achieve access to family planning for all.

At AVAC we know that making options real choices is key to effective prevention. We’ll be at ICFP advocating for multilayered prevention, an approach that can—and should—integrate both SRH and HIV information, services and products, including multipurpose prevention technologies (MPTs), such as condoms or the Dual Prevention Pill; and embed these services and products in “multisectoral strategies”, such as policy reform, community norms-changing and economic empowerment. Learn more about how SRH integration should be at the center of products, policies, and programs in a video called “What Does Successful HIV/SRH Integration Require?”.

Follow AVAC and FP2030 for more on-the-ground updates at ICFP, and be on the lookout for a special Twitter takeover from AVAC’s own Kate Segal who will share a day-of perspective on November 15 live from our Twitter feed!

If you are participating in ICFP, make sure to check out AVAC’s sessions below.

Tuesday, November 15 – Wednesday, November 16

The DPP (Dual Prevention Pill) would be a revolutionary tool to prevent HIV and unintended pregnancy. It is one of the many multipurpose prevention technologies (MPTs) products poised to address multiple health prevention needs. Although a lot of the groundwork of the DPP is in place, including a coalition of organizations committed to the acceleration of the product named The DPP Project, there is still much work to be done to advocate meaningful investment in communities and ensuring universal access when rollout happens.

Tuesday, November 15

3:15

An all-Inclusive Look: Tailored FP Services to Meet the Needs of LGBTI groups, with FP2030, where AVAC will have the opportunity to present our commitment to take specific actions to expand access to voluntary, rights-based contraception.

Wednesday, November 16

10:15 – 11:30

Nothing About Us Without Us: Putting Advocates at the Forefront from Product Development to Delivery, where Advocacy for Prevention of HIV & AIDS (APHA), Pangaea Zimbabwe Aids Trust (PZAT), and AVAC will discuss the critical role advocates have played in advancing HIV prevention products through the pipeline and the need to ensure research, development and delivery of additional multipurpose prevention products (MPTs) and new contraceptives leverage these experiences and networks.

AVAC, IAVI, the Coalition to Accelerate & Support Prevention Research (CASPR) and stakeholders invite you to the inaugural Africa Health R&D Week, November 8 – 11, a week-long virtual event intended to build on international, continental, and regional advocacy efforts towards increasing domestic financing of research and development as a critical component of health in Africa. Register here.

The event will feature a range of speakers, including: Agnes Binagwaho, Vice Chancellor of the University of Global Health Equity, Vuyiseka Dubula, Director of the Africa Centre for HIV/AIDS Management, Stellenbosch University, Ogwell Ouma, Acting Director of Africa CDC, as well as a panel of African researchers and advocates.

Africa Health R&D Week will be an annual forum to catalyze a continental movement that builds bridges between researchers, policymakers, regulators, civil society and community members committed to Africa’s health transformation through health.

We encourage you to register for this event, which will comprise a series of informative, networking, and motivational events for advocates, media, policymakers, program implementors, researchers, and funders. The week will help bring clarity to key issues and trends of domestic resource mobilization for health R&D on the continent.

Learn more:
Agenda / Concept Note / Flyers