This graphic from AVAC Report 2012 shows several planned vaccine trials building on the results of the RV144 AIDS vaccine trial.
Follow-on trials based on RV144: Strategy includes development and research tracks
Neutralizing Antibodies: Research pathways in 2013 and beyond
There are multiple lines of inquiry stemming from the discovery of potent, broadly neutralizing antibodies that have been isolated from HIV-infected individuals. This graphic from AVAC Report 2012 presents two pathways exploring the use of BNAbs as an HIV prevention tool.
Reaching the Tipping Point: The time to act is now
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.
The Change We Need to End AIDS in Uganda
2012 AVAC Fellow Alice Kayongo played a leading role in developing a civil society report, “The Change We Need to End AIDS in Uganda”, which details concerns and recommendations for shaping the national AIDS response in Uganda. This report was presented at the Joint Annual Review (JAR) of the country’s five-year National Strategic Plan (NSP) for responding to HIV/AIDS, which was first launched about a year ago. The mid-October JAR meeting was an opportunity to review progress and gaps. In the weeks leading up to the JAR, civil society participated in reviews of draft assessments of progress on the various elements of the NSP, including prevention, treatment and care, and health systems strengthening.
Kayongo was joined in this coalition effort by Sylvia Nakasi and Bharam Namanya of UNASO (2011 Fellow and Host Supervisor, respectively), and Leonard Okello, Alice’s Fellowship supervisor and Lillian Mworeko of ICW-EA (2012 Host)—as well as a broad range of other advocates.
The report, presented at the JAR, included a 10-point plan to halt new infections, save lives and ensure leadership, and provided a detailed critique of the national AIDS response to date.
This advocacy comes on the heels of a dynamic and successful campaign to increase funding for and recruitment of more than 6,000 health care workers throughout Uganda.
For a copy of the report, reach out to fellows@avac.org.
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 finds that world is already falling behind pace to end AIDS epidemic; five essential actions needed in 2013 to avoid historic missed opportunity
New York, NY – AVAC today issued a “top five” list of global actions needed in 2013 to accelerate HIV prevention efforts and preserve the opportunity to end the AIDS epidemic. The recommendations address urgent, unresolved challenges that threaten the delivery of powerful new HIV prevention methods that could help dramatically reduce the 2.5 million new HIV infections that occur worldwide every year. They include critical actions to speed access to HIV treatment, voluntary medical male circumcision (VMMC) and pre-exposure prophylaxis (PrEP), and to safeguard vital new research on vaccines, microbicides, other HIV prevention options and a cure.
“Recent scientific breakthroughs give us reason to be optimistic like never before, but our chances of success are already imperiled,” said Mitchell Warren, AVAC executive director. “Right now, the world isn’t moving as fast as it should be to begin ending the epidemic. There is still time to get back on a winning pace but only with focused, aggressive action now. This can be the year that HIV prevention begins to achieve its potential – in fact, it has to be.”
The priorities are featured in a new report, Achieving the End: One Year and Counting, which offers AVAC’s critical assessment of progress achieved since global leaders began to discuss the opportunity to “begin to end AIDS” in late 2011. The report reflects input from HIV prevention leaders across a broad spectrum.
“We have a narrow window to translate the past year’s excitement into life-saving changes on the ground,” said Dr. Helen Rees, Executive Director of the Wits Reproductive Health and HIV Institute (WRHI) in South Africa and a member of AVAC’s board of directors. “The possibility of ending AIDS is very much alive but depends on much bolder leadership, increased coordination and agreement on a clear set of short-term priorities.”
“The world needs immediate answers to the question, ‘What now?’, and then it needs to act on them,” said Warren. “We’ve identified what we believe are the five HIV prevention priorities that can make the greatest possible difference in the coming year. Whether we’re on pace to end AIDS in a year’s time will depend in large part on our success in these areas.”
AVAC’s priority recommendations for 2013 are as follows:
- End confusion about “combination prevention” – In 2012, there was long-overdue recognition that different countries will need to implement different combinations of HIV prevention interventions for different populations at risk. But the hard work of defining those combinations and establishing priorities has not been done. In 2013, donors, policy makers and civil society need to be held accountable for choosing, implementing and evaluating the right packages of interventions for specific circumstances.
- Close the gaps in the HIV “treatment cascade” – Antiretroviral treatment not only improves and prolongs the lives of those infected, it is among the most powerful HIV prevention strategies available, reducing the risk that an infected person will pass on HIV by up to 96 percent. But only a small proportion of people diagnosed with HIV are linked to antiretroviral treatment and an even smaller share stay on treatment and have their HIV infection suppressed to levels low enough to prevent transmission to others. A range of studies is looking at ways to narrow this gap, but these efforts are uncoordinated and incomplete. In 2013, researchers and funders need to convene and establish a clear research and implementation agenda to close the gaps in the treatment cascade.
- Prepare for new non-surgical male circumcision devices – In 2013, the World Health Organization (WHO) is expected to approve new male circumcision devices that could eliminate the need for surgery, speed recovery and lower costs in many of the 14 priority African countries where VMMC could reduce HIV infections by 20 percent. While the new devices may not be right for every country or setting, there could be months or years of lost opportunities unless national health leaders immediately take action to evaluate their benefits, costs and optimal uses.
- Define and roll out needed PrEP demonstration projects – Global health agencies including WHO and UNAIDS have said they are awaiting the results of real-world demonstration projects before they can provide guidance on the use of PrEP – yet there is no clarity on what range of studies is needed, and few are under way. By the end of 2013, a core set of studies must be defined and moving ahead.
- Safeguard HIV prevention research funding – New momentum on research into HIV vaccines, microbicides and other new tools is threatened due to the possibility of federal budget sequestration in the US and similar pressures in other countries. The potential cuts could slow or halt progress on some of the most promising HIV prevention research in many years. Policy makers must have the courage to preserve this vital research in 2013.
“The most urgent questions about new prevention tools have been clear for months or even years, and yet the work to answer them is barely under way,” said Warren. “That’s as unconscionable as it is unnecessary. Millions of lives depend on our ability to pick up the pace.”
The new recommendations build on AVAC’s long-term agenda for global HIV prevention efforts, issued in late 2011. That report, titled simply The End?, established near-, medium- and long-term goals for delivering available prevention interventions, demonstrating potential impact of emerging tools such as PrEP and microbicides, and developing essential new tools, including AIDS vaccines. In addition to the five key priorities for 2013, AVAC’s new report includes key updates to the long-term agenda for global HIV prevention.
A PDF version of this press release is available.
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.
The Role of Vaccines in Ending the Pandemic
AVAC and a broad array of AIDS vaccine partners convened an interactive session made up of a panel and Q&A session with researchers, funders and local advocates to discuss the latest in AIDS vaccine research and explore how AIDS vaccine research remains a critical and integral part of ending the epidemic. Chaired by Margaret McCluskey of USAID and moderated by Mitchell Warren of AVAC, panelists included Rainer Engelhardt, Public Health Agency of Canada; Glenda Gray, Perinatal HIV Research Unit; Kevin Moody, GNP+; Chidi Nweneka, African AIDS Vaccine Partnership; Punnee Pitisuttithum, Mahidol University; Nina Russell, Bill and Melinda Gates Foundation; and Bill Snow, Global HIV Vaccine Enterprise.
The lively question and answer session touched on many issues including the impact that new strategies like PrEP or a microbicide could have on trial design. As additional prevention strategies are introduced, trial population incidence should fall. This could mean larger trial sizes. Panelists agreed that this will be an issue that needs close attention in the years to come. Bill Snow noted that if trials must be larger because the prevention is more effective and incidence is declining, that is something to be celebrated. One audience member who described his ongoing work with treatment literacy and community education said the question he is asked most often is, “When will we have an AIDS vaccine?” Nina Russell gave a best-case scenario answer based on the timeline for trials designed to follow up on the Thai RV144 result. A coalition dubbed the Pox-Protein Public Private Partnership, or P5, has a South African trial planned of ALVAC plus a protein boost, similar to the regimen tested in RV144. The P5 is comprised of the Gates Foundation, the US Military HIV Research Program, the HIV Vaccine Trials Network, Sanofi and Novartis. Russell said that if this research confirms the Thai RV144 trial, the candidate could potentially move toward licensure by 2022.
Mitchell Warren reminded the audience that history has shown that AIDS vaccine advocacy cannot predict with any certainty when we will finally have a vaccine available for use. Rather researchers, advocates and funders must all work to ensure none of the steps in the timeline take any longer than absolutely necessary.
Press Release
amfAR and AVAC launch Global Action Agenda for Ending AIDS; report lays out policy priorities and milestones through 2015 to hasten a “tipping point” in drive to end AIDS
Washington, DC — Two of the world’s leading AIDS advocacy organizations today released a global action agenda aimed at accelerating progress towards the end of the AIDS epidemic. Announced ahead of the XIX International AIDS Conference in Washington, D.C., the agenda identifies five major short-term priorities for global AIDS programs together with realistic, annual targets that must be achieved through 2015. The recommended actions, if taken together, could accelerate achievement of a “tipping point” in the global AIDS epidemic, at which — for the first time ever — the number of people gaining access to HIV therapy will outpace the number of people becoming newly infected.
The report, An Action Agenda to End AIDS, was developed by AVAC and amfAR, The Foundation for AIDS Research, and was informed by an analysis of modeling research and consultations with top HIV prevention experts. The Action Agenda, available online at www.EndingAIDS.org, will be the focus of a satellite session at the International AIDS Conference on Monday, July 23 at 6:30pm ET, as well as a press conference on Tuesday, July 24 at 2:00pm ET.
“It’s time for talk about ending AIDS to make way for action,” said Mitchell Warren, executive director of AVAC. “When we look back a decade from now, we’ll judge ourselves on whether we made the kinds of hard choices outlined in this plan. If we do, we’ll soon begin to bring the epidemic under control, creating a world defined by declining HIV infections and a growing capacity to treat people in need. If we don’t, we will instead witness millions more preventable HIV infections and needless deaths.”
Recent breakthroughs have expanded the range of effective HIV prevention methods and led to new optimism in the AIDS field. After clinical trials demonstrated that antiretroviral treatment (ART) in HIV-positive people can reduce the risk of HIV transmission, and that voluntary medical male circumcision (VMMC) and other new tools can significantly reduce the risk of HIV infection in HIV-negative people, leaders including U.S. President Barack Obama and Secretary of State Hillary Clinton publicly embraced the possibility of creating an “AIDS-free generation.” Despite these encouraging statements, however, global AIDS efforts continue to lack coherent priorities and are threatened by cuts in funding.
“At this moment of great opportunity, we need to be clear about the critical choices ahead,” said Chris Collins, Vice President and Director of Public Policy at amfAR. “The world can begin to turn the epidemic around within the next three years — but only if we agree on the major priorities, commit to realistic milestones and hold ourselves accountable. This new agenda outlines the critical decisions we need to make in the coming years to put us on a path to beginning to end the AIDS epidemic.”
Year-by-year action steps for all stakeholders
The agenda lays out essential steps that must be taken — year by year through 2015 — by national governments; international organizations, donors and stakeholders; civil society; researchers; and technical agencies. These action steps fall within five overarching priorities:
- Make hard choices by emphasizing, above all other efforts, the rapid scale-up of core interventions that can have the greatest impact. These include HIV testing and treatment, VMMC, prevention of mother-to-child (vertical) transmission, and evidence-based, human rights-based interventions for gay men, sex workers, injection drug users and others at greatest risk.
- Mobilize sufficient, sustainable resources to ensure the rapid scale-up of these core interventions.
- Agree on clear roles and responsibilities and hold one another accountable for results, through agreed timelines, target outcomes, transparent reporting, and real-time assessment of results.
- Build the evidence base to end AIDS, by prioritizing research on the most effective ways to implement new prevention strategies, as well as the continued search for a preventive vaccine and a cure.
- Use every dollar of funding as effectively as possible by lowering the unit costs of core interventions, improving program management, and strategically targeting services.
Tracking critical milestones through 2015
In addition, the report lists a series of key results that must be achieved each year from 2012 through 2015 to fully capitalize on recent research advances. These include cutting the numbers of new HIV infections and deaths, as well as more specific epidemiological and policy-based milestones tied to the global scale-up of critical interventions.
By steadily reducing annual new HIV infections and simultaneously continuing to expand access to HIV treatment, the report authors project that a global “tipping point” can be achieved within two to three years. At that time, roughly 1.75 million people would gain access to HIV therapy yearly, exceeding — for the first time ever — the number of annual HIV infections, which would fall close to 1.5 million. This shift would mark a critical step in controlling the global epidemic.
The targets reflect best-case scenario calculations based on published modeling and epidemiological data, as well as analysis provided by experts in the field. A bibliography and explanation of methodology can be found at www.EndingAids.org.
The feasibility of the report’s targets was also reinforced by encouraging new data released by UNAIDS on July 18. The agency reported that more than 8 million people in low- and middle-income countries were receiving HIV therapy in 2011, a 20 percent increase from the year before. Annual HIV infections declined to 2.5 million in 2011, from 2.7 million the year before.
“The past decade has taught us that when global AIDS efforts have clear priorities and realistic targets, they can have a huge impact,” said Nelson Otwoma, National Coordinator of the National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK). “We’ve already accomplished so much, and now the opportunities are greater than ever. If we can agree on a plan and act decisively to make it happen, then countries around the world will have much to celebrate in the years ahead.”
AVAC and amfAR will continue to track global progress against the recommendations and targets in the Action Agenda over the coming years. Status updates, analysis and other information will be released periodically and made available on www.EndingAIDs.org.
Top AIDS leaders to discuss Action Agenda at IAC satellite, July 23
On Monday, July 23 at 6:30pm, a panel of top experts will discuss the new Action Agenda and provide their assessments of what advocates, policymakers, and scientific and government leaders must do to ensure that the rhetoric of the International AIDS Conference becomes the foundation for an urgent, systematic plan to end AIDS.
The event will be moderated by celebrated journalist Charlayne Hunter-Gault, and will feature Dr. Antony Fauci (National Institute of Allergy and Infectious Diseases), Dr. Agnes Binagwaho (Minister of Health, Rwanda), Dr. Deborah Birx (CDC Center for Global Health), Dr. Helen Rees (Wits Reproductive Health and HIV Institute, South Africa) and other prominent global AIDS leaders.
Details of the event are available online.
This press release is also available as a PDF.
Contact:
Kay Marshall, kay@avac.org, +1-347-249-6375
Cub Barrett, cub.barrett@amfar.org, +1-212-806-1602
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About amfAR: amfAR, The Foundation for AIDS Research, is one of the world’s leading nonprofit organizations dedicated to the support of AIDS research, HIV prevention, treatment education, and the advocacy of sound AIDS-related public policy. Since 1985, amfAR has invested more than $340 million in its programs and has awarded grants to more than 2,000 research teams worldwide.
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.
Yes We Can End the Epidemic: AVAC Fellows Orientation 2012
AVAC’s HIV Prevention Research Advocacy Fellows gathered for an orientation and wrap-up session in Kampala at the end of January. Fellows from 2010, 2011 and eight new fellows from 2012 together with their host organization supervisors gathered in Kampala, Uganda, to take stock of recent accomplishments, plans for the future and take steps to forge an African movement to end the AIDS epidemic. The three-day meeting included debates and discussions about how to prioritize prevention strategies that are available today, such as treatment as prevention and voluntary medical male circumcision (VMMC), and explorations of the agenda for emerging strategies such as PrEP and microbicides and hoped-for interventions like an effective AIDS vaccine. One highlight was an intensive afternoon session on the potential for influencing the Country Operating Plans that guide the President’s Emergency Plan for AIDS Relief (PEPFAR). These “COPs” can be used to leverage additional resources for the pillars of combination prevention—ARV treatment, VMMC and prevention of pediatric infection. In the coming months, advocates will be participating in intensive country-level campaigns.