Will compressed and overlapping steps get a vaccine faster? The innovations advocated for in Vaccines development that are being employed in the COVID-19 response today include: running certain clinical trials in parallel instead of sequentially; gearing up manufacturing capacity before final study results are in and negotiating public/private commitments in advance to facilitate sustainable access to new vaccines.
Excerpted from Five “P”s to Watch.
Will compressed and overlapping steps get a vaccine faster? The innovations advocated for in Vaccines development that are being employed in the COVID-19 response today include: running certain clinical trials in parallel instead of sequentially; gearing up manufacturing capacity before final study results are in and negotiating public/private commitments in advance to facilitate sustainable access to new vaccines.
Excerpted from Five “P”s to Watch.
In many ways, the collaborative research movement grew up around Vaccines. Thanks in large part to HIV advocacy, out-of date research models that were competitive and closed-door are increasingly yielding to more transparent and collaborative research and development efforts—in both the HIV and COVID-19 responses.
Building on big science partnerships, data sharing and collaboration pioneered over the last 15 years of Vaccines research and development, global initiatives are marshalling the talents, experiences and resources of key stakeholders. And just as HIV laid the foundation for more effective partnerships in research, lessons from the COVID-19 experience can also inspire greater collaboration and broader involvement by a range of players in the vaccines research effort.
Excerpted from 5 “P”s to Watch.
This infographic shows a timeline for each of the three major vaccine efficacy trials proposed or underway now.
This graphic shows the many types of Vaccines undergoing research, categorized by the immune response they are designed to elicit—broadly neutralizing antibodies, non-neutralizing antibodies, T-cell responses or a combination of these.
This infographic lays out AVAC’s top-line recommendations from AVAC Report 2019: Now What? The recommendations fall into three categories: deliver — prevention programs whose impact is well-measured and -defined; demonstrate — next-generation engagement for next-generation trials; develop — new targets for the post-2020 world.
The most widely-known UNAIDS Fast-Track goals were the 90-90-90 targets focused on diagnosing people with HIV, linking them to ART and supporting them to achieve virologic suppression. But these were only part of what the UNAIDS modelers said was needed to reduce new HIV diagnoses to 500,000 per year; the model also included significant scaling up of primary prevention including the targets listed below. There are gaps across the board, which helps explain how the world fell short of the hoped-for reduction in new HIV diagnoses.
Excerpted from AVAC Report 2019: Now What?
UNAIDS’ Fast-Track Goals for ending the epidemic focused on testing 90 percent of people living with HIV, linking 90 percent of those people to ART, and supporting 90 percent of those individuals to reach virologic suppression. This busy figure summarizes recent research on how reaching these targets impacts incidence.
Each orange arrow shows the level of virologic suppression among PLHIV in the community at the start and end of the trial, the pairs of arrows represent different trial arms. The figure in the box above is the absolute difference in suppression between the two arms. For PopART, which had three arms, there are two different comparisons. The longer arrows belong to the intervention arms, which had a greater increase in virologic suppression across the trials. The blue bars show the point estimate for, and confidence interval around, the relative incidence in the intervention arm compared to the control arm. The bottom line: arms with community-wide testing saw incidence drop. Rapid expansion of ART leading to virologic suppression is feasible. This is good news for communities and individuals.
Excerpted from AVAC Report 2019: Now What?
What get’s measured matters if and only if that measurement is linked to impact. The most common approaches to evaluating primary prevention don’t measure up. They measure commodities but not use. A count of the condoms or PrEP bottles handed to people does not tell you whether the condoms were used, the pills were taken—or even, often, whether the people receiving the commodities were at high risk of HIV. A simple, universal prevention cascade could help change that. This one, which presumes that HIV testing has happened and is focused on people at risk of HIV, suggests four stages (see A) and then shows how solutions could be tailored to fix the cascade (see B).
Excerpted from AVAC Report 2019: Now What?
This is PEPFAR’s own visualization of how its AGYW programs can effect change. It’s notable for the definition of a care package that touches on the individual and her community, and for the way it defines a range of outcomes. There isn’t anything comparable for PEPFAR’s Key Population Investment Fund, which is infusing resources into a range of countries. Some of that funding is going for ART; for primary prevention, a theory of change linked to incidence is a must. AVAC is working with allies in KPIF countries to make this demand.
Excerpted from AVAC Report 2019: Now What?