Sexual and Reproductive Health Integration Advocacy Roadmap
This roadmap addresses the critical need for integrated sexual and reproductive health (SRH) and HIV services. This integration is essential for enhancing public health outcomes, socio-economic benefits, and individual health and rights. The Roadmap aims to revitalize and sustain advocacy efforts for SRH and HIV integration, empower communities to hold stakeholders accountable for implementation, increase political and program support to enable the shift from policy to practice, and foster dynamic partnerships across research, advocacy, implementation, and policy sectors.
It was developed by Copper Rose Zambia (CRZ) as part of the Coalition to Accelerate and Support Prevention Research (CASPR). It draws on extensive input, including desk reviews, interviews, focus group discussions, and a specialized workshop held at the 2023 International Conference on AIDS and STIs in Africa (ICASA).
Avac Event
The Road Ahead – SRH Integration Advocacy
Join Copper Rose Zambia, as a part of CASPR, for a webinar, The Road Ahead – SRH Integration Advocacy. The webinar will launch the SRH Integration Advocacy Roadmap, and feature healthcare providers, advocates, and more to discuss the future of sexual and reproductive health integration.
Anna Miti Joins The Choice Agenda (TCA) as Co-Moderator
AVAC and The Choice Agenda (TCA) are delighted to welcome Anna Miti as the TCA’s new co-moderator. Based in Harare, Zimbabwe, Anna is a seasoned journalist, advocate for gender equality, an AVAC Cure Fellow, former AVAC Advocacy Fellow and co-convener of the Zimbabwe Media Science Cafe, who brings her passion for amplifying community voices to this role.
Launched by AVAC with Jim Pickett in April 2022, TCA is a global forum for advocacy on the latest in HIV prevention. With monthly webinars hosting informed discussions and a moderated listserv of nearly 3,000 subscribers from 40+ countries, TCA offers the HIV prevention community a platform to come together, learn from one another and chart the way forward. Anna will work alongside Jim and the AVAC team to foster inclusive advocacy around efforts to expand equitable access to HIV prevention tools around the world.
“As a long-time member of the TCA, I have valued it as a place for robust discussions and a vital platform to access new, timely and relevant information. I am excited to now contribute to this platform as co-moderator. Together with other advocates, I aim to strengthen the TCA’s impact and contribute even more to HIV and science advocacy.” – Anna Miti, TCA co-moderator
“On behalf of the TCA community, I am thrilled to welcome Anna into the brand-new role of co-moderator. Her dedication to HIV prevention research advocacy, her deep well of experience, and her exceptional communication skills will help us improve and expand our work to support HIV prevention research literacy and advocacy. The sun never sets on TCA, and I couldn’t be happier to have such a savvy, partner to help us take TCA to the next level.” – Jim Pickett, AVAC senior consultant and TCA moderator.
PxPulse’s new episode, Lenacapavir: The case for investing in delivering HIV prevention, goes deep on LEN. Recorded just days before Gilead’s announcement that PURPOSE 2, its second major trial of LEN as injectable PrEP, 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 PURPOSE 1 trial 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, as hard as it is, is still the easy part. Breaking 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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On the Frontlines of AMR: A Systems Approach
This is a UNGA side event at Yale Club of New York City, 50 Vanderbilt Ave, New York, NY 10017
At this year’s UN General Assembly, policymakers, advocates, diplomats, and practitioners will convene a High Level Meeting (HLM) on antimicrobial resistance (AMR). As new global commitments are made by state actors, Management Sciences for Health (MSH) will convene a group of experts to illustrate the importance of supply chains and strong health systems in combating AMR.
Through a panel discussion featuring practitioners, health workers, and advocates, MSH and partners will explore the role of supply chains, laboratory capacity, health facilities and other foundational aspects of health systems in meeting the increasingly complex challenge of AMR.
Topics discussed may include (but are not limited to): the importance of supply chains and regulatory systems in addressing AMR and supplying critical medicines, the critical role of laboratories, microbiology services and diagnostic tools, the importance of adequate water and sanitation in health facilities, and the role of healthcare workers in remaining combating and monitoring AMR.
MSH hopes that this discussion will “make real” the challenges and opportunities presented by this year’s HLM and provide real-world examples of how to address the growing threat of AMR.
Speakers:
Opening remarks: Marian Wentworth, President and CEO, Management Sciences for Health
Keynote introduction: Côte d’Ivoire Minister of Health Pierre Dimba
Scene Setting Remarks: Dr. Mirfin Mpundu, Senior Antimicrobial Resistance (AMR) and Biodefense Advisor, Emerging Threats Division of the Office of Infectious Diseases, Bureau for Global Health, USAID
Panelist: Francis Aboagye-Nyame, Project Director, MTaPS project, Management Sciences for Health
Panelist: Patrick Mubangizi, Africa Director, Fleming Fund, Mott MacDonald
Panelist: Dr. Caline S. Mattar, MD, Associate Professor of Medicine and Director of Global Health
Scholars Pathway in Internal Medicine, Washington University School of Medicine
Panelist: Josette Vignon, Madagascar Country Director, WaterAid
Closing Remarks: Dr. Jide Idris, MBBS, MD, MPH, Director General of the Nigeria Centre for Disease Control and Prevention
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Breaking New Ground: Expanding Access to Lenacapavir—Lessons from Dolutegravir and the Future of HIV Prevention
This UAN Call, titled Breaking New Ground: Expanding Access to Lenacapavir—Lessons from Dolutegravir and the Future of HIV Prevention, brought together global health experts, community advocates, and civil society organizations to discuss the challenges and opportunities in ensuring equitable access to Lenacapavir.
This webinar was hosted by Unitaid.
Avac Event
Do Vaginas Demand Perfection? Implications for Event-Driven PrEP
Dr. Jenell Stewart (University of Minnesota, Hennepin Healthcare) joined The Choice Agenda to discuss and analyze recent research on HIV PrEP and implications for event driven PrEP across sex and gender.
Major advances in long-acting HIV treatment and prevention, including the latest PURPOSE 1 results of lenacapavir for PrEP, hold great promise for achieving global targets. However, planning to coordinate among stakeholders, including pharmaceutical companies, governments, and multilateral organizations to deploy and ensure equitable access to these products, particularly in low- and middle-income countries, requires immediate action.
“Civil society organisations and HIV activists have been instrumental in holding pharmaceutical companies, financial donors, governments, and international organisations accountable for commitments to the international HIV treatment response for decades,” the authors write. “These organisations and activists are needed to promote transparency in pricing, challenge restrictive patent practices, advocate for affordable and widespread availability of drug innovations, prevent companies from restricting broad access to medications, and require funding to allow this work to be done independently.”
Key Messages
Long-acting antiretrovirals are perhaps the greatest advance in HIV care in over a decade and provide great promise towards achieving global HIV prevention and control programme targets.
Current long-acting agents are firmly under the control of originator pharmaceutical companies and remain unavailable or cost-prohibitive across much of the globe.
If action from the broader HIV community is stagnant, the populations who are most in need of these long-acting agents are unlikely to receive any benefit until well into the 2030s, resulting in a large number of preventable HIV infections.
Coordination by international agencies, with assistance from relevant financial donors and stakeholders, will be needed in the complex research and access programmes required to provide widescale use of these indispensable products to people living with HIV or affected by HIV.
Resources on Long-Acting HIV Prevention
The Lens on LEN: this primer for advocates shares the basics on injectable lenacapavir as PrEP.
Long-Acting PrEP Status Update: this webpage shares graphics and information synthesizing the current status of long-acting PrEP products. It’s updated quarterly.
PrEP Products Overview: this page on PrEPWatch shares the status of PrEP products in development and approved. Injectable Cabotegravir Evidence Gap Tracker: this webpage summarizes the latest insights from the Biomedical Prevention Implementation Collaborative (BioPIC) on injectable CAB for PrEP, links to learn more, and information on where evidence is still needed, mapped against priority evidence gaps.
The Long Wait for Long-Acting HIV Prevention and Treatment Formulations
This commentary in The Lancet HIV calls on WHO, financial donors, manufacturers, and governments to take coordinated action to make long-acting HIV prevention and treatment available at scale in lower- and middle-income countries.
Harnessing Private Sector Strategies for Family Planning to deliver the Dual Prevention Pill
The latest edition of the Journal of the International AIDS Societyfeatures newly published research by AVAC and partners on the benefits of delivering family planning and PrEP using pharmacies, e-pharmacies and telemedicine, in addition to private sector clinics. The research demonstrates why these delivery methods should be prioritized for rolling out the Dual Prevention Pill (DPP), a daily pill that combines oral PrEP with an oral contraceptive to prevent both unintended pregnancy and HIV.
Meta-analysis of Pregnancy Events in Biomedical HIV Prevention Trials in Sub-Saharan Africa: Implications for Gender Transformative Trials
CASPR partners authored new research published in AIDS and Behaviorhighlighting the need for clinical trial teams to balance the goals of generating scientific evidence with participants’ fertility choices. The authors argue that to better support participants, trials should adopt strategies that accommodate changing fertility preferences, plan for pregnancies, and consider the ethical implications of allowing pregnant participants to continue in studies. This approach would contribute to a more gender-transformative approach to pregnancy in HIV prevention trials.
Mark Your Calendars: Upcoming Webinar
TOMORROW, August 27: Opportunities to Expand Equitable Access to HIV Prevention Services through Community Pharmacies Join The Choice Agenda and RxEACH, a national coalition effort working to expand and sustain access to HIV prevention and linkage to care services in community pharmacies for a webinar discussing the opportunity to expand equitable access to HIV prevention services, including PrEP, and what is needed to grow and sustain community-based HIV prevention service programs in pharmacies.
August 29: PrEP Your Booty Join The Choice Agenda and HPTN 106 (REV UP), an innovative clinical trial from the HIV Prevention Trials Network that will investigate the safety and acceptability of a tenofovir-based rectal douche for HIV prevention, for a discussion with researchers leading the study.
September 11: Innovations in GPP Join AVAC and champions of Good Participatory Practices (GPP) as they illustrate the evolution of GPPS from CABs and town hall meetings to more innovative and partnership-based approaches.
The DPP is the Multipurpose Prevention Technology (MPT) closest to market and the first-ever with PrEP. Following the recent successful conclusion of a bioequivalence study, where researchers demonstrated the active ingredients functioned in the body the same as when PrEP and oral contraception are taken separately, the DPP could be approved by regulators by late 2025. The DPP could be a desirable choice for women seeking an option that will meet multiple needs in their sexual and reproductive health (SRH).
The research found that a significant proportion of family planning (FP) services in Kenya (22%), South Africa (11.4%) and Zimbabwe (17.3%) are delivered using the private sector (such as private provider networks, pharmacies, e-pharmacies and telemedicine). But these channels remain underutilized and represent a largely untapped — yet growing — delivery channel with great potential to expand access to PrEP.
“Addressing the underlying reasons why this is the case will be a prerequisite to DPP rollout, not just in these three countries, but in all countries with high HIV incidence where the private sector is a popular source for FP, such as Eswatini, Lesotho, Malawi, Namibia, Uganda and Zambia”.
The authors write.
Based on these findings, regulators should update national guidelines to allow for more diverse PrEP delivery. Training on PrEP delivery could be expanded among nurses and other providers, as well as doctors. Clinics, pharmacies, telemedecine and e-pharmacies could offer PrEP. Implementers and researchers should also undertake research to better understand willingness and ability to pay, how these factors align with the cost of DPP delivery, and what additional subsidy may be needed to ensure successful rollout of the DPP.
This research supports a Market Preparation and Introduction Strategy that is guiding plans for how, where and to whom the DPP is introduced. Providing users a range of options to access the DPP in non-traditional channels will minimize stigma, improve convenience, and offer discretion — all of which are features that will increase overall uptake and continuation. See our resources on the DPP below.
