West & Central Africa Oral PrEP Initiations, 2023

As of Q3 2023, the top five West and Central African countries for PrEP initiation have surpassed 10,000 initiations; Cameroon, Cote d’Ivoire, Democratic Republic of the Congo (DRC), Ghana and Nigeria. Nigeria has marked almost 550,000 cumulative initiations as of this quarter, ranking it second, behind South Africa, worldwide. These milestones can be credited to targeted PEPFAR investments. But despite these successes, West and Central Africa make up only 14 percent of PrEP initiations recorded in Africa, compared to 85 percent reported by East and Southern Africa. These same countries are home to two thirds of all people living with HIV in West Africa. There is vital work to be done to close the gap.

West and Central Africa can and must continue to leverage this recent growth in oral PrEP by making additional HIV prevention options available. In September, Nigeria’s regulators approved injectable cabotegravir (CAB for PrEP)—approving the first new biomedical HIV prevention option in a West and Central African country since oral PrEP. But at this time, only one other CAB for PrEP application has been submitted in the region, in Côte d’Ivoire, and none for the dapivirine vaginal ring (DVR). Only one CAB for PrEP implementation study is planned for the region.

Excerpted from PxWire Volume 13, Issue 4.

PEPFAR Support for PrEP in 2023

PEPFAR’s role has been instrumental to accelerating global uptake of PrEP to date. In 2023, four countries started providing PrEP for the first time, and seven countries exceeded 70,000 new PrEP initiations, most of which are attributable to PEPFAR. This lifesaving, uniquely effective, program must see continued full funding and a 5-year reauthorization to carry on this work and help to put the world on track to control the epidemic.

Excerpted from PxWire Volume 13, Issue 4.

Vaccine Research and Development: Key Lessons and Ways Forward

From Lab to Jab

This issue brief on the vaccine research and development (R&D) process is one of a series of four briefs, which provide a roadmap for advocacy to advance the development of essential vaccines for HIV, COVID-19, tuberculosis, and other global public health threats, and approaches to ensure equitable access to these life-saving vaccines. Additional topics cover the role of mRNA technology, the need for local vaccine production, and issues around global access.

Vaccine Access: What’s Working and What’s Next

From Lab to Jab

This issue brief covers the web of issues that influence access to vaccines. It is one of a series of four issue briefs, which provide a roadmap for advocacy to advance the development of essential vaccines for HIV, COVID-19, tuberculosis, and other global public health threats, and approaches to ensure equitable access to these life-saving vaccines. Additional topics cover the research and development (R&D) process, the role of mRNA technology; and the need for local vaccine production.

Vaccine Development History

A graphic showing the duration between discovery of the microbiologic cause of selected infectious diseases and the development of a vaccine.

Excerpted From the Lab to Jab.

mRNA Technology: What It Might Mean for Future Vaccines

From Lab to the Jab

This issue brief on mRNA technology covers what it is, how it works, current knowledge gaps and ideas for advocacy to harness its potential. It is one of a series of four issue briefs, which provide a roadmap for advocacy to advance the development of essential vaccines for HIV, COVID-19, tuberculosis, and other global public health threats, and approaches to ensure equitable access to these life-saving vaccines. Additional topics cover the research and development (R&D) process, the need for local vaccine production, and issues around global access.

Local Vaccine Production: Harnessing Its Potential for Equity

From the Lab to the Jab

This issue brief on local vaccine production covers the current state of local production, what is needed to facilitate it, and ideas for advocacy to harness its potential. It is one of four briefs in a series providing a roadmap for advocacy to advance the development of essential vaccines for HIV, COVID-19, TB and
other global public health threats, including approaches to ensure equitable access to these life-saving vaccines once developed. Additional topics cover the research and development (R & D) process, issues around global access; and the advent of the mRNA platform for vaccines.

From the Lab to the Jab

A series of advocate guides to the latest in vaccine R&D

From the Lab to Jab are a series of briefs to learn the latest in vaccine R&D for HIV, COVID-19, TB and other global public health threats. Access them all here and stay tuned for a related webinar in early 2024. Watch this space or sign up for our email newsletter.

GPP Body of Evidence

A clearinghouse of case studies and analyses demonstrating the power of GPP

Since its first draft, the GPP guidelines have been adopted and used in HIV research and far beyond. AVAC has collected this body of evidence for GPP to demonstrate the power of GPP, to show how GPP can be measured and replicated, and to offer GPP training, tools and connection to everyone involved in the research enterprise. Visit here.

Inclusion of Pregnant and Lactating People in HIV Research

What you need to know 

Produced and hosted by Jeanne Baron

People who are pregnant or lactating (PLP) have historically been excluded from research because of concerns for the developing fetus. But this has led to a dearth of data on new interventions against health threats for this population. In the case of HIV, pregnancy raises the risk of acquiring HIV by up to three times, but providers often do not have the data to know whether a new intervention is safe or how it will work for pregnant patients. As a result, PLP and their physicians are left to make difficult decisions around the use of proven HIV prevention products as they await more data specific to pregnancy and lactation. 

But change is in the air. Champions for the inclusion of PLP in research are paving the way for a paradigm shift—one that will redefine this population from needing protection from research to being better protected through research. In this episode of Px Pulse, AVAC’s Manju Chatani-Gada takes us through conversations with a trial participant who became pregnant, researchers, policymakers and donors to understand why this population gets excluded, the impact it has and what to do about it.   

Tune it to hear:

  • Dr. Anne Drapkin Lyerly, Principal Investigator of the PHASES Project to advance equitable inclusion of pregnant women in HIV research and its follow-on project, PREPARE, focused on ethical HIV research in adolescents who are pregnant. 
  • Elisia Madende, trial participant in the HPTN 084 trial in Zimbabwe 
  • Dr. Ashley Lima, Health Science Specialist and Lead Technical Advisor for Socio-behavioral Research — USAID Office of HIV/AIDS Research Division 
  • Dr. Takunda Sola, HIV Prevention and Key Populations Medical Officer — Zimbabwe MoH AIDS/TB Unit 

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