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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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, [email protected], +1-914-661-1536
Kay Marshall, [email protected], +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, [email protected], +1-347-249-6375
Cub Barrett, [email protected], +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.

Click here for more information.

HIV Prevention Research: Defining moments since 2010

Published in AVAC Report 2011, this timeline shows the HIV prevention scientific breakthroughs from July 2010 to Nov 2011, including the CAPRISA 004, iPrEx and Partners PrEP trials.

Many Opportunities for HIV Prevention

To end AIDS, we need HIV prevention options that are highly effective before, during and after exposure or infection. This graphic from AVAC Report 2011 lists some of these tools.

Priority Tools and Actions

This graphic from AVAC Report 2011 outlines the need to define, evaluate and implement combination prevention in every community affected by HIV. The boxes identifies some of the key strategies and actions needed to make this a reality.

AVAC Playbook 2012

AVAC Playbook 2012 includes AVAC’s analysis of what the top strategic goals should be on a global level, and particularly in hard-hit countries, over the year 2012. It also includes AVAC’s organizational priorities for contributing to these goals.

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, [email protected], +1-914-661-1536
Kay Marshall, [email protected], +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, [email protected], +1-914-661-1536
Kay Marshall, [email protected], +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.