Prevention Must be at the Forefront to Meet Global HIV Goals

In advance of the AIDS 2016 conference, AVAC Executive Director Mitchell Warren and Director of the London School of Hygience & Tropical Medicine Peter Piot co-authored a call inSTAT for an expanded focus on a comprehensive approach to HIV prevention. Alongside a fully-funded effort to provide treatment for people living with HIV, a range of prevention options are essential to defeat HIV and must be developed and delivered. This theme echoed again and again at Durban.

Read Prevention Must be at the Forefront to Meet Global HIV Goals for a succinct case for prevention.

Magical Thinking and Surge Pricing: AIDS 2016 update—Day 1 

Hello from the other side—also known as “Conference Land”. The streets in and around the International Conference Center in Durban are thronged with badge-wearing delegates, the Uber taxi prices are surging, and there are already piles of publications scattered across the floor of some of the session rooms where the pre-conferences have taken place. And all this means that there are already things to report, even though the official meeting only starts tomorrow. We can’t be exhaustive, only selective. In this update we offer a quick take on some of the day’s events, focused on the theme of “magical thinking”.

(And read on for more on what you can expect in each of our daily updates from Durban.)

Magical thinking that hurts

UNAIDS in its Prevention Gap report and the Kaiser Family Foundation in its report on the financing of the response have both identified the first drop in HIV funding in five years. There is US$7.2 billion funding gap in the price tag set for achieving the 90-90-90 goal. At a civil society dialogue session with UNAIDS head Michel Sidibe, Amanda Banda of Médecins Sans Frontières challenged Dr. Sidibe not to indulge in “magical thinking” that characterizes global leaders who claim that ending AIDS is possible in the context of this dire funding trend. Tomorrow, beginning at noon, thousands more will voice the same challenge at the March for Health: Quality treatment for all. AVAC will be there—join us!

Magical thinking that excites

At the UNAIDS workshop on the 90-90-90 targets, Nittaya Phanupak of the Thai Red Cross presented on a PrEP and “test and treat” initiative designed by and with key populations, particularly MSM. This multi-pronged effort includes use of MSM social networking sites to promote PrEP and allow visitors to the site to book appointments for testing, PrEP and/or ART. Seventy-six percent of the people who booked appointments online showed up in person. The program also allows for supervised self-testing via video conference—think a Skype chat with a trained counselor—that is reaching more first-time testers and finding more new HIV-positive individuals than traditional clinic-based testing. Okay, so this isn’t magic. But it’s major in terms of meeting people where they are.

Blogging from AIDS 2016

Check out the myriad voices covering the conference, in real-time, across a range of issues at the conference. Read WhatsUpHIV.

Daily updates

Each day you can expect quick updates and links to blogs on prevention activism, links to the great science coverage from NAM and sounds of the conference from the “Truth Booth” to give a flavor of what’s going on from the plenaries to hallway chats. We will also provide a preview of the next day’s events in the Research Literacy Networking Zone (RLZN) as well as some of the sessions we’ve starred on our calendars for the following day.

Monday 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 great programming in the RLNZ (Global Village, Booth 606). See Monday’s schedule below:

10:00 – 11:00 – Communicating Complex Science Clearly (WRHI)
11:15 – 12:15 – One Woman, Many Voices (AVAC, ICW EA, WRHI)
12:30 – 13:30 – Stories in Sisterhood: Using Digital Storytelling to Enhance Knowledge and Intent to Use PrEP (Texas Woman’s University)
14:00 – 15:30 – Understanding Cure Research (IAS)
16:00 – 17:30 – Regulatory Pathway for HIV Prevention Products: The Dapivirine Ring (IPM)

[The full program and session details are available to download here.]

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

Invitation to Endorse the Final Community Consensus Statement on Access to HIV Treatment and its Use for Prevention: The Next Cornerstone for Patients’ Rights

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.

New! AVAC Report 2016 Big Data, Real People: The annual state of prevention advocacy

If you’re packing for Durban, we hope you’ll pause right now and add to your bag AVAC’s annual state of the field, Big Data Real People. The full PDF, Executive Summary and graphics are available here.

As always, AVAC Report is our annual advocacy analysis, with an agenda that spans the next 12 months—and beyond. We’ve designed it be a clear, succinct, actionable statement of the strengths and weakness of HIV prevention data today—and we hope you’ll join us in amplifying these messages at next week’s gathering.

Even if you’re not heading to Durban, we hope that this year’s Report will top your packing list for the journey through the next 12 months of advocacy and action.

In the Report, we argue that the state of HIV prevention data collection in 2016 is poor. One part of the solution lies in the adoption of “HIV Prevention Data Dashboards”. This tracking tool could bring the same specificity and accountability to non-ART prevention services that the “treatment cascade” of diagnosis, initiation, retention and virologic suppression does for antiretrovirals for people living with HIV.

The world cannot even pretend that ending AIDS is possible without action on non-ART prevention. We need to roll out what we have, continue R&D on what we still need, as well as scale up ART for all people living with HIV. That’s what the new UNAIDS Prevention Gap report says. That’s what AVAC has said for years. That’s what we hope you’ll say in Durban and over the coming year.

Here’s the Report, a roadmap for the coming year. Please read it, join us on the journey, let us know what you think!

Join AVAC at these AIDS 2016 Prevention Sessions

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

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)

Be Heard: A preview of prevention activism in Durban

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?

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.

Preparing for Durban: Part I

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!

USAID Reaffirms Commitment to HIV Vaccine and Biomedical Prevention Research and Advocacy

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.

Call for 2017 AVAC Fellows

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.

“We Neglect Primary HIV Prevention at Our Peril”

Inspired by a steady decline in new HIV infections and AIDS-related deaths, the sustainable development goals call for ending the AIDS epidemic as a public health threat by 2030. However, the world is not on track to end the epidemic. – “We neglect primary HIV prevention at our peril”, Lancet HIV

The July issue of The Lancet HIV, launched online earlier this week, focuses on the need to scale up prevention to reduce new infections—reiterating that achieving the UNAIDS’ 90-90-90 treatment targets is not possible otherwise.

As the editors note in the introduction to the issue, “We can do much with existing interventions, but as the papers in this issue show evolution of programmes and technology will be needed to have the greatest effect.”

The issue is made up of a series of papers that attempt to show what needs to happen in prevention to reduce incidence and reach global and national targets. The papers cover a range of topics, including:

  • How we might create, use and understand a “prevention cascade” to assess programming;
  • What modeling shows we might be able to achieve if available interventions are appropriately scaled;
  • A framework for how to achieve UNAIDS’ ambitious targets and the actions need to get there; and more.

For those attending AIDS 2016, please save the date for a special session that will focus on this issue and its call to action: What Will it Take to Reach the Fast Track Prevention Targets: What, Who and How, on Monday, July 18, 14:45–16:45, Session Room 5.

In addition, as many in the field prepare to head to Durban next month, we are pleased to see that the Second Durban Declaration, released today by the International AIDS Society for endorsement through the end of the AIDS 2016 conference, devoted significant ink to prevention, both the implementation of what’s currently available, the need for research into new options and the fundamental structural barriers that must be addressed.