AVAC Playbook 2012-2013: Progress toward global goals

AVAC first published its Playbook of global goals for ending AIDS in late 2011. This infographic from the AVAC Report 2012 builds on the objectives from 2011 and identifies five priorities for action in 2013.

Press Release

AVAC statement on PEPFAR Blueprint

New York, NY – PEPFAR’s blueprint has enormous potential to accelerate global HIV prevention efforts. It rightly emphasizes that we need to ‘follow the science’ if we intend to deliver life-saving HIV prevention and treatment breakthroughs to millions of people worldwide. The blueprint underscores that success depends on scaling up combinations of effective strategies. It also places much-needed emphasis on voluntary medical male circumcision, which could prevent millions of HIV infections and do so more affordably than almost any other method today.

It’s particularly encouraging that the blueprint focuses on translating scientific breakthroughs into lives saved. Powerful new HIV prevention options could together lead to dramatic reductions in HIV infections, but we don’t have all the information we need to scale them up in the right combinations for various communities. Urgent questions about the real-world use of new prevention tools in combination have been clear for months or even years, yet the work to answer them is barely under way. That’s as unconscionable as it is unnecessary.

The blueprint also recognizes that ending AIDS will not be easy or quick. While current options can have a tremendous impact, continued science and innovation are essential to ultimately halt new HIV infections and deaths from AIDS.

The US has shown great leadership, and now it’s time for the rest of the global community to step up. Frankly, we are not on pace to end AIDS – but we could be. Global agencies, governments, donors and advocates need to work with PEPFAR now to agree on the most urgent priorities, set specific goals and demonstrate real progress within the next year.

A PDF version of this is available for download.

Contact:

Mitchell Warren, mitchell@avac.org, +1-914-661-1536

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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 AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.

Press Release

AVAC Report Defines Agenda for Ending the Global AIDS Epidemic

New York, NY — AVAC today issued a three-part, science-based agenda for ending the AIDS epidemic within our lifetimes. The new report, titled The End?, is a unique strategic vision encompassing key steps to accelerate impact with existing HIV prevention tools, emerging strategies and longer term research. It identifies critical priorities in each of these areas and advances specific recommendations for both 2012 and for the next decade.

“The past year has seen building excitement about the possibility of ending AIDS in our lifetime. It is an ambitious goal, but a realistic one, provided we have a clear path forward and the will to do what’s needed,” said Mitchell Warren, AVAC executive director. “The science-based agenda in this year’s AVAC Report fills a gap at a critical moment: it describes the full spectrum of actions needed to realize the potential of existing, emerging and long-term biomedical HIV prevention options and change the AIDS response forever.”

The report comes at a pivotal moment for the AIDS response. Just weeks ago, US Secretary of State Hillary Clinton committed the US government to realizing an “AIDS-free generation.” A recent report from UNAIDS mapped a new framework for AIDS investments which are focused on high-impact, evidence-based strategies. Yet at the same time, the Global Fund to Fight AIDS, Tuberculosis and Malaria announced that it has insufficient funds for its next round of grants, effectively delaying any new funding commitments until 2014. Ensuring that the Fund is replenished and continues to support countries worldwide is a top priority for ending AIDS.

“Secretary Clinton and other leaders have put a spotlight on what’s possible. Now, it’s time to agree on a coherent, long-term plan to make it happen,” said Warren. “While our success at ending AIDS is far from assured, the scientific data are speaking loud and clear and expectations are running high. It is essential that funding, implementation and research commitments align. The future of the epidemic hangs in the balance.”

Game-changing research advances fuel optimism
Recent studies have demonstrated that antiretroviral (ARV) medications and other tools can prevent HIV transmission, creating new opportunities to accelerate the global decline in new HIV infections:

  • In 2006, trials showed that voluntary medical male circumcision can reduce a man’s risk of infection from a female partner by about 60 percent.
  • In 2011, a large US-funded trial released data showing that starting effective HIV treatment earlier reduced individuals’ risk of transmitting HIV by 96 percent.
  • In 2009 and 2010, trials of oral and topical pre-exposure prophylaxis (PrEP) using ARV medications in specific populations of HIV-negative people provided proof of concept that PrEP is an effective prevention tool.
  • In 2011, scientists identified vaccine-induced immune correlates of risk that help explain the positive finding from the RV144 AIDS vaccine trial—the first to demonstrate that a vaccine can have an impact on HIV transmission—and point the way to discovery of an effective AIDS vaccine.

AVAC Report 2011 outlines priorities for success
The agenda for action in the AVAC Report covers three major priority areas. Each area demands action today, while the dividends in terms of impact on the epidemic will be seen in the short, medium and long term:

  1. Deliver today’s proven strategies at scale, for immediate impact on the epidemic.Scale up innovative HIV testing programs to identify people who can benefit from prevention and treatment; expand access to treatment to preserve health and prevent transmission; and realize the full potential of voluntary medical male circumcision, a so-far underutilized tool.

    For 2012, specific global goals include achieving universal access to ARVs at CD4 counts of 350 or below; and ensuring that relevant countries have long-term plans in place to roll out voluntary medical male circumcision with the goal of achieving 80 percent voluntary circumcision rates.

  2. Demonstrate and roll out emerging tools, including PrEP and microbicides, for even greater impact in five to 10 years.Quickly establish clear plans to understand how and for whom these promising tools might work; launch pilot projects to determine their best uses in different populations; and then prioritize their use in the populations, and in combinations, where their potential impact is greatest.

    For 2012, global goals include swift implementation of pilot projects, establishing a clear pathway for confirmatory research on the tenofovir-based microbicide gel, and building and maintaining a pipeline of longer-acting options.

  3. Develop long-term solutions, including an effective vaccine and a cure.Sustain funding to capitalize on recent scientific advances that have energized the research field.

    A key 2012 goal is to close funding gaps for trials that are needed to pursue leads from the RV144 vaccine trial. Such trials are increasingly threatened by potential research budget cuts in the U.S. and other nations. In addition, it is increasingly important to define how a vaccine could impact combination prevention.

Success hinges on sustained financing, used wisely
The report urges that resources for HIV prevention be allocated for greatest possible impact. Where necessary, funding that supports low-impact activities should be reprogramed, based on evidence, to further reduce infections and save more lives. Moreover, AVAC argues that to end the AIDS epidemic, the field needs to define, evaluate and implement combination prevention in every community affected by HIV.

“If we’re serious about ending the epidemic, then we all need to make certain that precious resources are put where they’re needed most,” said Warren. “And we need to ensure that adequate resources are available. We cannot meet these ambitious goals if the Global Fund, PEPFAR and other essential programs are not adequately funded.”

In launching the report, AVAC called on the United States, global health donors and developing countries to increase funding for scale-up of interventions including HIV testing, treatment and voluntary medical male circumcision. At the same time, renewed promise in the vaccine research field can only be pursued through sustained support from the US and other research sponsors.

“Today’s exciting science comes at one of the most challenging and frustrating economic times,” said Warren. “But the case for investing in the AIDS fight is the strongest it has ever been. If we spend more today—and spend it more wisely—we can save money over the long term and rid the world of one of the most devastating and prolonged epidemics in history.”

The full AVAC Report 2011: The End?, along with AVAC’s Playbook 2012, podcasts, graphics and other materials about ending the epidemic, are available at www.avac.org/report2011.

A PDF version of this press release is available here.

Contact:
Mitchell Warren, mitchell@avac.org, +1-914-661-1536
Kay Marshall, kay@avac.org, +1-347-249-6375

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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 AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.

Press Release

AVAC Applauds Secretary of State Hillary Clinton for Ambitious, Science-Based Vision to End the AIDS Epidemic

New York, NY — AVAC welcomes today’s remarks by U.S. Secretary of State Hillary Rodham Clinton as the first step in an ambitious vision for ending the global AIDS epidemic.

“Secretary Clinton rightly recognized that this is an era of unprecedented opportunity for changing the course of the AIDS epidemic and making an AIDS-free generation a reality. The announcement of an additional US$ 60 million for combination prevention impact evaluation in four countries is a useful first step in terms of realizing the vision. In the coming months, it will be critical for the Obama Administration to build on the plan that she outlined with specific commitments and objectives for the near-, mid- and long-term,” said Mitchell Warren, AVAC executive director.

Secretary Clinton emphasized three core prevention strategies that, if fully implemented, would lead to an AIDS-free generation: prevention of mother-to-child transmission, voluntary medical male circumcision and effective antiretroviral treatment for people who are HIV positive.

“HIV testing and counseling programs are the foundation for each of the interventions Secretary Clinton described, and it will be critical for the Obama Administration to focus on massive scale-up of innovative, ethical testing programs as part of its articulated plan for an AIDS-free generation,” Warren said.

“It is also critical to sustain investments in research and development of additional powerful prevention tools, including pre-exposure prophylaxis (PrEP) using ARVs in HIV-negative people, microbicides, and an AIDS vaccine,” Warren added. “If voluntary medical male circumcision, treatment as prevention and prevention of mother to child transmission are taken to scale, the number of new infections will plummet. Deploying additional tools over the long term,could help realize the greatest achievement of ending the AIDS epidemic in our lifetime.”

“This is truly a new era in the AIDS response, with unprecedented opportunities. Research has brought us a host of new ways to prevent HIV, but we have a long way to go before realizing their full potential. Having identified these key areas, the United States needs to continue to show leadership by articulating a clear plan with milestones for progress. Other developed and developing country governments, communities and donors need to show leadership, ownership and initiative as no single nation can end the epidemic on its own.”

AVAC will release its annual report on the state of global HIV prevention at the end of November, laying out a science-based prescription for the coming decade to realize the end of the AIDS epidemic.

Contact:
Mitchell Warren, mitchell@avac.org, +1-914-661-1536
Kay Marshall, kay@avac.org, +1-347-249-6375

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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 AIDS vaccines, male circumcision, microbicides, PrEP and other emerging HIV prevention options as part of a comprehensive response to the pandemic.

Press Release

Report on HIV Prevention Research Funding Says New Investment Critical to Capitalize on HIV Prevention Research Breakthroughs

Rome – In the last year, promising trial results and critical scientific breakthroughs have changed the HIV prevention landscape, providing new opportunities for both a broader response to the epidemic with new prevention options and broader clinical and laboratory agendas with new research targets. At the same time, investment in biomedical HIV prevention research remained stable despite the effects of the recent global economic downturn, according to a new report released today in Rome at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention. 

Capitalizing on Scientific Progress: Investment in HIV Prevention R&D in 2010 is the seventh annual report from the HIV Vaccines and Microbicides Resource Tracking Working Group documenting investments in biomedical HIV prevention research from public, philanthropic and commercial sectors. This year’s report argues that capitalizing on recent promising scientific breakthroughs will require substantial additional and sustained investment from a broader set of donors.

The major, and surprising finding of the report, given the global funding environment, is that overall investment in HIV prevention R&D had actually increased, with the modest exception of a one percent decline in vaccine R&D. The report documented a total US$1.19 billion investment in research and development (R&D) for four key HIV prevention options: preventive vaccines, microbicides, pre-exposure prophylaxis (PrEP) using antiretroviral drugs, and operations research related to medical male circumcision. Even in the aftermath of a global recession, this investment approached the previous historical high of US$1.23 billion reached in 2007 for these four prevention technologies.

Yet to capitalize on the recent exciting prevention breakthroughs being discussed at the IAS conference, more investment will be needed across prevention technologies and from bench research to operational and implementation research.

“Certainly in this era of economic restraint it is good news that donors continue to see the value of investing in prevention research,” said Paul DeLay, Deputy Executive Director, Programme, UNAIDS, the Joint United Nations Programme on HIV/AIDS. “But as we capitalize on the recent breakthroughs and move quickly to make new forms of prevention available to those who need them most, we need donors to also move quickly to ensure that funding shortfalls do not become roadblocks.”

There is an urgent need to direct resources to accelerate promise into progress. Yet the report recognized that funders continue to confront budgetary constraints, with some having reduced or eliminated their HIV prevention research programs altogether. Funding for HIV prevention research also remains highly concentrated among relatively few funders, and the Working Group warns that this narrow base of funding will threaten the sustainable research effort required at this critical time and highlights the need for broadening that base, importantly including emerging economies.

“The recent promising results of PrEP and treatment as prevention trials tell us that thirty years into the epidemic we may finally be on the path to ending AIDS,” said Mitchell Warren, AVAC executive director. “New prevention options—medical male circumcision, PrEP, microbicides and eventually vaccines—will play a critical role in reducing the cycle of new infections. As we look toward the next 30 years of AIDS, investment in prevention research has never been more important. Going forward we need funding structures that are flexible, agile, and generous enough to adapt rapidly to new opportunities.”

“We have seen tremendous progress in HIV prevention research over the last two years,” said Margaret McGlynn, President and CEO of the International AIDS Vaccine Initiative (IAVI). “Sustaining the momentum built through these advances depends on access to stable funding that can be flexibly applied to the most promising areas of research. This will allow us to build upon the field’s successes and to move promising concepts from the pipeline into clinical trials as swiftly as possible.”

“The recent exciting results in the PrEP and microbicide fields are proof that investment in HIV prevention research is bringing women and men around the world much closer to having a broad range of effective HIV prevention options,” said Zeda Rosenberg, CEO of the International Partnership for Microbicides (IPM). “Wise investments now in laboratory and clinical research, and in efforts to roll out new interventions will pay off as HIV infections decline significantly in the coming decades.”

The report is available online at: www.hivresourcetracking.org

Kay Marshall (AVAC), kay@avac.org, +1-347-249-6375
Sophie Barton-Knott (UNAIDS), bartonknotts@unaids.org, +41 79 514 6896/
+41 22 791 1697
Lauren Wesolowski (IAVI), lwesolowski@iavi.org, +1-212-328-7420

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The Working Group is composed of AVAC, the International AIDS Vaccine Initiative (IAVI), the International Partnership for Microbicides (IPM), and the Joint United Nations Programme on HIV/AIDS (UNAIDS).

2010 AVAC Report: Turning the Page (Thai translation)

The AVAC 2010 Report, Turning the Page, highlights that the biomedical prevention field is entering the next chapter of its development. The past year brought the first evidence, from the Thai Prime-Boost trial, that an AIDS vaccine could prevent HIV in humans, as well as significant preclinical findings around potent, HIV-specific neutralizing antibodies.

At the same time, two microbicide trials testing the candidate PRO 2000 yielded seemingly different, but ultimately disappointing results, and the field now prepares for the release of results from CAPRISA 004, the first ARV-based microbicide effectiveness trial.

2003 AVAC Report: 4 Years and Counting: How do you Fight a Disease of Mass Destruction?

When America became frightened by the bio-terror threat, Congress and the Administration moved swiftly to put funding and incentives in place. That same kind of decisive action is needed to accelerate research and ensure an AIDS vaccine is available to all who need it. This Report looks at the bioterror model, and provides the results of our new industry survey.

2002 AVAC Report: 5 Years and Counting: Science, Urgency and Courage

Five years away from the date former President Bill Clinton set as a goal for finding an AIDS vaccine, there are more candidate vaccine products in development than ever before. No one knows if any of the current experimental vaccines will work. No one even knows what immune response a vaccine needs to elicit to prevent HIV disease. The only way to obtain answers is to ask tens of thousands of altruistic and courageous participants to participate in dozens of trials. The only way to obtain answers is to invest hundreds of millions of dollars to fund these trials.

2001 AVAC Report: 6 Years and Counting: Can a Shifting Landscape Accelerate an AIDS Vaccine?

In 1996, AVAC was the first organization to demand that development of an AIDS vaccine become a national goal. President Clinton set that goal in May 1997, calling for a successful vaccine by 2007. We are now six years away from the goal and counting. None of the challenges are insurmountable. The optimism that characterizes HIV vaccine research today should drive policy makers and researchers to grapple effectively with the issues that remain. An HIV vaccine is possible. The question is how soon we find it, and who gets it when we do.

2000 AVAC Report: 7 Years and Counting: How Can We Overcome Obstacles to an AIDS Vaccine?

The last year was one of great activity across US agencies and throughout the world. This Report documents the steadily increasing activity in the quest for a vaccine against HIV. We have also identified several actions necessary to accelerate development of HIV vaccines, and we outline all of this in the AVAC Report for 2000.