Choice, Access and Equity at AIDS 2024

Choice, access, and equity were central themes during the sessions and discussions at #AIDS2024 on Wednesday and Thursday. Highlights included new data on long-acting cabotegravir, a plenary calling out the need to move with speed, scale and equity in the rollout of new PrEP options, updated guidelines to improve access to post-exposure prophylaxis (PEP), a renewed commitment to the African Women’s Choice Manifesto, new data highlighting the omission of key populations from sustainability planning, and much more.

AIDS 2024 Preconference Highlights

AIDS2024, this year’s annual conference of the International AIDS Society opened with a spotlight on troubling trends. A series of preconferences took on critical topics including supporting key populations in a time of increasing discrimination; new and novel research and implementation of STI prevention and treatment, witnessing a soaring rise in incidence; and the importance of implementing new PrEP options to create more choice for people who need HIV prevention most.

First Full Day of AIDS 2024

Lenacapavir for PrEP has taken center stage at the 25th International AIDS Conference, #AIDS2024, which opened Monday with many highlighting its potential for long-acting PrEP for HIV prevention. “It is gobsmackingly exciting to see zero in a clinical trial” AVAC’s Mitchell Warren told Forbes. The potential to bend the curve of the epidemic depends on speeding access to prevention options like LEN, that show high efficacy.

LEN in the Spotlight at AIDS 2024

Midpoint at #AIDS2024 in Munich, one of the most significant advances in HIV prevention in the history of the response, the efficacy of lenacapavir as PrEP, was presented at the Co-Chair’s Choice session. The findings, zero infections and 100% efficacy among the trial participants in the PURPOSE 1 trial, brought a standing ovation.

Global HIV Prevention Advocates Call for Accelerated Timeline for Widespread Access to Injectable Lenacapavir for PrEP

A global cadre of HIV prevention advocates is calling for an accelerated timeline for access to the HIV prevention drug lenacapavir. Gilead, the developer of the drug, announced topline results from a large study among cisgender African women on 20 June, followed shortly thereafter with a statement about access. 

PrEP in Black America (PIBA) and Black Public Health Academy Share Statement on Lenacapavir Results

PrEP in Black America (PIBA) and Black Public Health Academy share statement on results of twice-a-year infectable lenacapavir for PrEP proving efficacious among African cisgender women and what this means for Black communities in the US.

From The Lab To The Jab: Lessons learned and what’s next in HIV vaccine research

On 3 June 2024, AVAC hosted a webinar highlighting its Lab to Jab issue briefs on research and development, production and equitable global access to vaccines.

Platforms, Not Pathogens

“[Our approach to access and equity] has to be intentional, not incidental, and it has to be empowered, not vulnerable.” — Dr. Jerome Kim, International Vaccine Institute

Panelists stressed an intentional, rather than incidental approach to ensuring global vaccine access and equity, going from pathogens to platforms, and having LMICs move from consumers to actors. They described ways to transform vaccine R & D from a financial imperative of pharmaceutical corporations into a system that addresses health needs through medical innovation. They underscored the importance of new, equity-based models to move low- and middle-income countries from being recipients of vaccine technology to co-creators from the very beginning of the R & D process. These models can work through in-country partnerships for vaccine development and production, shared technology and know-how, use of TRIPS flexibilities, intellectual property waivers and access conditions, and establishing a local production ecosystems.

The webinar featured Dr Jerome Kim, Director General of the International Vaccine Institute, Othoman Mellouk, Access to Diagnostics and Medicines Lead at the International Treatment Preparedness Coalition, and Dr Els Torreele, Founding Director of æqua, a recently created think tank on equity and economic justice for health. The panelists discussed international initiatives for vaccine development, the current state of vaccine research and access, and how they can be improved. 

From Consumers to Actors

“Driving innovation at the regional R&D hubs means creating access to the technology platforms that can be adapted to new pathogens or the local health needs.” — Dr. Els Torreele, æqua

As of December 2023, only 56% of the world’s population received a complete series of COVID-19 vaccines, and only 28% had at least one booster dose. Many low- and middle-income countries (LMIC) were last in line to purchase overpriced vaccines. Lack of access to Mpox vaccines in Africa, where it is endemic, continues. These inequities are driven by the current profit-driven model and intellectual property barriers—but there could be a different way.  

One major initiative discussed is being spearheaded by the International Vaccine Initiative (IVI), a UN-chartered organization dedicated to accelerating vaccine R&D for global health. Through its robust partnerships, and funding from the Gates Foundation, it has developed two approved vaccines (for cholera and thyphoid)–for less than $30 million each. The IVI also hosts the Advancing Vaccine End-to-End Capabilities in Africa (AVEC) Initiative, which aims to accelerate the development of the African ecosystem for vaccine R&D. Its aim is to support a powerhouse of continental manufacturing through a sustainable pan-African alliance that executes on the ground. 

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On Access and Equity

“The problem is, until now, our countries are thinking mostly as consumers, not as actors. We only heard a little bit about some initiatives during COVID, because everybody woke up.” — Othoman Mellouk, International Treatment Preparedness Coalition

Landmark Trial in South Africa and Uganda Finds Twice Yearly HIV Prevention Injection Safe and Highly Effective

AVAC Calls for Accelerated Regulatory Review and Ambitious Introduction Plans

Adding additional HIV prevention options means more people may find an option that is right for them. Beyond expanded choice, a twice-yearly injection has the potential to transform the way we deliver HIV prevention to people who need and want it most.

Announcing the Next Class of Advocacy Navigators

We are thrilled to announce AVAC’s 3rd class of Advocacy Navigators! This group of 12 emerging advocates from nine countries was selected from 100s of interested applicants. They will be paired with six mentors, seasoned advocates who are alumni of AVAC’s Advocacy Fellows program. These mentors provide support and guidance as the Navigators strengthen and expand their skills in HIV prevention advocacy.

Tracking PrEP Rollout & Learning Lessons

Over the last two years, BioPIC—a project led by AVAC with support from the Gates Foundation—has been gathering and sharing evidence on these critical lessons to ensure the next generation of HIV prevention products reaches everyone who needs and wants them with much greater speed and equity.