An Advocacy Chronicle on Universal Healthcare in Tanzania, with Atuswege Mwangomale of Sikika

In this episode of PxPulse: The Advocacy Chonicles, Atuswege Mwangomale goes deep on the advocacy work behind the passage of Tanzania’s Universal Healthcare Law. Atu serves as Head of Health Programs for Sikika, a Tanzania-based advocacy organization with a long track record of promoting best practices in governmental financing in the health sector, and advocating for improved health outcomes. Sikika, along with AVAC, is also a member of the COMPASS coalition, which uses data and coalitions across Africa to identify strategic campaigns to advance the HIV response. 

Sikika’s advocacy has been crucial to the ultimate passage of Tanzania’s Universal Health Insurance Bill in 2023, but full funding must still be secured for the law to achieve full impact.  

Atu explains the promise of UHC in Tanzania, how Sikika won the trust of government allies, and why working in coalition was essential to success.

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PxPulse: The Votes are In — What’s next for the US’ role in global health and HIV prevention

KFF’s Jen Kates and AVAC’s Suraj Madoori lay out the challenges and the priorities in 2025 and beyond. 

In the days, months and years ahead under a new US Presidential Administration, advocacy for choice, freedom, science, and rights will require intentional strategies to protect hard fought gains in HIV treatment and prevention and in global health generally, and to safeguard policies and programs that advance it. And there will be major implications for the global AIDS response.

Navigating through the work ahead involves assessing the potential impact on PEPFAR and Global Fund support; on USAID, NIH, CDC and the FDA; on the US relationship to WHO and other UN agencies; and on evidence- and rights-based policies and programs generally. Joining us to begin those efforts and better understand the landscape for advocacy are Jen Kates from KFF and our own Suraj Madoori.

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PxPulse: The Advocacy Chronicles with Danielle Campbell from PrEP in Black America

In this episode of the Advocacy Chronicles, we’re putting the spotlight on the US, on the dismal statistics on access to PrEP in Black communities, on the state of HIV prevention among Black Americans overall, and the work of one advocacy group— PrEP in Black America (PIBA). Danielle Campbell is one of the founders of PIBA and a long-time advocate for HIV prevention and health equity. She joins the Advocacy Chronicles to talk about PIBA’s call to action for an HIV research agenda that prioritizes the needs of Black communities. And we also explore the tactics that have led this group to quickly rise as a powerhouse, bringing together communities and government to find solutions that improve the US HIV response.

Danielle is a member of the research faculty at the Charles R. Drew University of Medicine and Science and a member of the community scientific subcommittee for a global HIV research network. She is an experienced clinical research manager who integrates principles of health equity and implementation science into biobehavioral research into HIV treatment, prevention and cure research and she is a past Chair of the HIV/AIDS Section of American Public Health Association (APHA) and has served as Chair of the Science Board and Co-Chair of the Joint Policy Committee.

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Lenacapavir: The case for investing in delivering HIV prevention

The promise of long-acting PrEP has been super-charged this year by studies showing the powerful efficacy of an antiretroviral known as lenacapavir (LEN).

This episode of PxPulse goes deep on LEN for PrEP. Recorded just days before Gilead’s announcement that PURPOSE 2 also found very high efficacy, Dr. Flavia Kiweewa, a principal investigator of PURPOSE 1, the first trial to announce efficacy, lays out the research findings and what they mean. And Chilufya Kasanda Hampongo of Zambia’s Treatment Advocacy and Literacy Campaign and Mitchell Warren of AVAC talk about how to change a long history of squandered opportunities to get rollout right.

The PURPOSE1 trials announced findings in June that a twice-yearly injection of LEN was 100% effective among cisgender women, with zero new cases of HIV. And the PURPOSE 2 trial among cisgender men, and trans and non-binary people, was shown to reduce the risk of HIV by 96%.

LEN now enters a select category, one of five ARV-based options for PrEP that all protect against HIV if you take them. But many of the people applauding the results from PURPOSE 1 and 2 will tell you that breakthrough science like this is, as hard as it is, is still the easy part. To break the back of the HIV epidemic demands overcoming an altogether different challenge—coordinating and accelerating every step in rolling out new products so that everyone who needs HIV prevention can get it.

Listen to this podcast to learn what must be done to finally deliver on the promise of highly effective HIV prevention, from pills to rings to injectable PrEP and beyond.

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PxPulse: An Advocacy Chronicle on U=U in South Africa with Mandisa Dukashe

On this episode of PxPulse: The Advocacy Chronicles, Mandisa Tyadi Dukashe, Treatment Technical Lead at the South African National AIDS Council (SANAC) describes her work in helping to inspire and launch a National U=U Campaign in South Africa in 2024.

What is U=U? Undetectable equals Untransmittable refers to a major breakthrough in the science and understanding of HIV treatment. From data published in 2019, researchers confirmed that people living with HIV who have an undetectable viral load and take medication as prescribed have zero risk of transmitting HIV to their sexual partners.

This evidence galvanized a worldwide campaign, with the hope that spreading the word, Undetectable equals Untransmittable, would reduce stigma around HIV and inspire people to maintain their treatment. 

The WHO released guidance in 2023 on how to monitor viral load, which provided supportive global policy for ministries of health. But WHO action is not enough to set public health policy or fulfill the promise of U=U.

Mandisa has long list of credentials behind her: She’s the co-founder of the U=U Africa Forum, part of the U=U Global Community Advisory Board, an alumnus of the AVAC Cure Research program and the AVAC Advocacy Fellows Program. Among many accolades, she has also been recognized as a 2021 Amazing People Living with HIV by HIV Plus Magazine.

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PxPulse: The Advocacy Chronicles with Ruth Akulu

On this episode of the Advocacy Chronicles: a look at advocacy in Uganda for the Dual Prevention Pill (DPP), a new product combining oral PrEP and oral contraception.

Ruth Akulu is a Youth Representative of the Uganda Country Coordinating Mechanism Board for Global Fund, member of the DPP Civil Society Advisory Group, and a 2022 AVAC Advocacy Fellow. Akulu talks about her work to mobilize regulatory authorities to prepare for the DPP. And while she was at it, the establishment of a groundbreaking new initiative, the Product Regulator’s Engagement Committee, which is supporting ongoing engagement between government regulators and young women representing their communities.  

Listen to learn why the DPP is a priority for young women and HIV prevention, the challenges Ruth confronted and tactics that supported the success of this advocacy.

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PxPulse: The Advocacy Chronicles with SMUG’s Allan Mwasa

On this episode of The Advocacy Chronicles, we’re speaking with Nsubuga Allan Mwasa, a Ugandan activist, clinical psychologist and an advocate for mental health and LGBTQ+ rights. Allan serves as Strategic Initiatives Manager at Sexual Minorities Uganda, or SMUG, which has been at the forefront of the fight for LGBTQ rights, often facing severe challenges including legal battles and violent opposition.

Despite these challenges, SMUG continues to advocate for the fundamental human rights of the LGBTQ community. It does this through legal action, public awareness campaigns, and international advocacy. SMUG is also part of Convening For Equality Uganda, or CFE, a coalition of civil society groups dedicated to challenging Uganda’s Anti-Homosexuality Act. The Anti-Homosexuality Act (AHA), signed into law in May 2023, significantly increased discrimination and violence against the LGBTQ+ community. Despite widespread international condemnation and ongoing legal challenges, the law was upheld by the Constitutional Court in April 2024. Petitioners have since filed an appeal to the Supreme Court seeking to overturn the law, which remains one of the strictest in the world, including life imprisonment and death penalty for certain offenses.  

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Follow the Conversation at Convening For Equality Uganda’s Social Media Accounts

An HIV Vaccine: Looking into the Future with Nina Russell 

On HIV Vaccine Awareness Day in 2024, the field is confronting extraordinary breakthroughs and extraordinary challenges.  

It’s considered one of the most important and most difficult scientific enterprises in the history of modern medicine—the hunt for an HIV vaccine. It has led to vast knowledge of HIV and the immune system, and to breakthrough technology (think COVID vaccines and mRNA platforms). But developing an effective HIV vaccine is still out of reach. Meanwhile, HIV incidence remains intractably high in hard-hit regions around the world, even as the field is hoping to speed up access to longer-acting PrEP. It’s a complex landscape, alongside incredibly complex science in HIV vaccine R&D.

In this episode of PxPulse, Dr. Nina Russell, Director of TB & HIV Research and Development for the Bill and Melinda Gates foundation, talks about where she sees promise in the science, the goals for an HIV vaccine, and why it has an essential role to play, alongside the scale up of PrEP.

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PxPulse: The Advocacy Chronicles with APHA’s Yvette Raphael 

Our debut episode of the Advocacy Chronicles features Yvette Raphael, the Executive Director of Advocacy for Prevention of HIV and AIDS (APHA) in South Africa, and a leader in the development of The Choice Manifesto, supported from start to finish by CASPR.

As co-chair of the African Women Prevention Community Accountability Board (AWPCAB), Yvette and other board members launched the manifesto in Kampala, in September 2023, calling for choice in HIV prevention options for women — such as oral and injectable cabotegravir for PrEP, the dapivirine vaginal ring and the Dual Prevention Pill — and a commitment to expanding access to them. A call heard by UNAIDS Executive Director Winnie Byanyima, who was on hand at the launch to endorse the manifesto.  

Yvette, who is also a 2014 AVAC Advocacy Fellow and celebrated as one of South Africa’s leading human rights activists, lays out why The Choice Manifesto matters and how advocates are leveraging it. 

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Decolonizing Global Health: Dr. Madhukar Pai and COMPASS Africa Tell Us Why and How

Produced and hosted by Jeanne Baron.

Investing in the long-term success of African leadership is essential to breaking cycles that perpetuate inequity and that stall progress in the HIV response. In January, The Coalition to build Momentum, Power, Activism, Strategy and Solidarity (COMPASS Africa) announced a major transition, with Pangaea Zimbabwe assuming the role of secretariat and the launch of a decentralized approach to governance across the coalition. These changes come as other efforts, such as negotiations on the Pandemic Accord, are struggling to advance, uphold or safeguard equity.

In this episode of PxPulse, we talk about why and how the decisions that shape global health must be made by those facing the greatest risks. As the world evaluates the pandemic response and debates on decolonizing global health gain momentum, equity in global health has never been more urgent. 

This conversation features global health leader and critic, Dr. Madhukar Pai. And two members of the transnational coalition COMPASS Africa, Francis Luwole and Barbra Ncube, offer an up-close look at the coalition’s pioneering new model for power-sharing.

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