A look at the number of participants in vaccines trials in 2019 according to trial phase.
Vaccines Trial Participation in 2019
Regulatory Status of TDF/FTC for PrEP
The TDF/FTC combination pill (brand-name Truvada) that has shown efficacy for PrEP is already used for Treatment U=U in HIV-positive people, and so is approved and licensed in many countries. One key step for this PrEP strategy is to ensure that the drug is licensed (and therefore available) and that it is approved for use for both prevention and Treatment U=U in each country. National guidelines for PrEP use are another key step.
One Timeline, Two Stories, One Message: Putting trials and targets together
One problem with HIV prevention agendas is that they either live in an eternal present or in a far-off future. It’s “work with what we’ve got, which is condoms and VMMC and a little bit of PrEP”, or it’s “nothing can change without an AIDS vaccine”. The future depends on using what’s available, better and more widely, without ever losing sight of what’s in the pipeline.
As the figures below show, in the very same timeframe that the world will miss its critical target for incidence reduction and scale-up of primary prevention, several trials will release results that could change the future. 2020 will be a time of hope and reckoning. But only if the two stories start to be told as one.
HIV Prevention Research and Demonstration Sites in South Africa
This map demonstrates the breadth of HIV prevention research and demonstration projects in South Africa by site and type (e.g. daily oral PrEP demo projects, ARV-based rings, long-acting injectable PrEP, preventative Vaccines, antibodies, hormonal contraceptives). This map was developed by Wits RHI with support from AVAC as part of the Coalition to Accelerate and Support Prevention Research. This graphic first appeared in AVAC Report 2017: Mixed messages and how to untangle them.
Global HIV Prevention R&D Investment by Technology Category, 2000-2017
In 2017, reported funding for HIV prevention R&D decreased by 3.5 percent (US$40 million) from the previous year, falling to US$1.13 billion. The full report, HIV Prevention Research & Development Investments 2017: Investing to end the epidemic, is available for download. And all the graphics are available as well.
HIV Prevention R&D Trial Participants by Region in 2017
Participation of volunteers and the engagement of communities in which trials take place is essential to conducting HIV prevention research. In 2017, there were nearly 600,000 participants in HIV prevention research trials globally, mostly originating from sub-Saharan Africa, Europe, North America and Asia. A majority of participants were enrolled in research investigating TasP and PrEP, and while there are trials aimed specifically at men who have sex with men (MSM), transgender individuals and people who inject drugs, most of the studies do not specify the need to include members of key populations.
The full report, HIV Prevention Research & Development Investments 2017: Investing to end the epidemic, is available for download.
Investment in HIV Prevention R&D by Top Philanthropic Funders in 2017
Global philanthropic funding increased by 4.1 percent from 2016 levels and amounted to US$164 million, or 14.6 percent of overall funding. The Bill and Melinda Gates Foundation (BMGF) remained the largest funder and increased its contribution by 6.6 percent, to US$150.2 million. Wellcome Trust investment fell for the fifth consecutive year to an annual US$2 million.
The full report, HIV Prevention Research & Development Investments 2017: Investing to end the epidemic, is available for download.
Investment in Women-Focused PrEP R&D, 2017
Out of the US$63 million invested in PrEP overall, US$16 million (or 25 percent) was for research explicitly focused on women. Most of this research was preclinical, with an emphasis on discreet products with long-acting formulations, e.g., PrEP implant studies and long-acting injectables. Almost 30 percent of the implementation studies focused on the uptake of and adherence to oral PrEP in high-risk women, and 15 percent focused on PrEP for pregnant and breastfeeding women.
The full report, HIV Prevention Research & Development Investments 2017: Investing to end the epidemic, is available for download. And all the graphics are available as well.
Contraception and HIV Prevention: A clear picture of women’s needs
Women face many choices about HIV prevention and contraception. Funders and governments need to move to integrated programs that provide a variety of services in one place.
Anatomy of a Target
It’s been four years since AVAC advanced these criteria for effective targets in our 2014/15 Report, Prevention on the Line. Then, we identified targets that have advanced the field and ones that have fallen short. Today’s prevention crisis exists in part because the primary prevention targets set by UNAIDS didn’t meet these criteria. Targets for primary prevention are still essential, but they won’t get met without demand creation work, such as we describe in this section. It’s not too late to recalibrate resources and commitment.