PEPFAR at 20: Keeping the promise

Our latest episode of Px Pulse is out, PEPFAR: Keeping the promise.  

PEPFAR is one of the greatest US foreign policy and global development achievements of the century. The program has saved upwards of 25 million lives since it launched in 2003. But as PEPFAR marks its 20th anniversary, it’s also fighting for its future.  

The US Congress needs to reauthorize PEPFAR for another five years by September 30 and reaffirm its commitment to this lifesaving program. Until a couple of months ago, most in global health and development expected smooth sailing for a five-year reauthorization of the program, as has happened throughout the past 20 years. PEPFAR has enjoyed deep and broad bipartisan support since its founding. Evangelical Christians, staunch conservatives and progressive liberals, Democrats and Republicans, HIV activists, civil society advocates and public health leaders have all championed PEPFAR, year in and year out. But a handful of Republicans, including past PEPFAR allies, are pulling reauthorization into high-stakes partisan politics. 

In this episode, Px Pulse talks to some of the people who put PEPFAR dollars into action and to global health leaders who explain why PEPFAR’s approach has been so effective, and what’s at stake in this debate. 

Tune in to hear: 

    Ilda Kuleba from Mothers 2 Mothers talks about the impact of PEPFAR on their work across 10 countries, training and employing HIV positive mothers as peer healthcare workers. 

    Dr. James Mukabi of World Vision’s Kenya program talks about how this Christian relief organization has changed the lives of thousands of orphans and other populations who are vulnerable to HIV.  

    Tom Hart, President of the ONE Campaign, which was co-founded by the rock star Bono, to be an early champion of PEPFAR and other poverty fighting efforts talks about PEPFAR’s accomplishments at the global level and what’s next as Congress debates reauthorizing the program.

    PEPFAR’s supporters have a job to do, to make sure everyone understands that the world has a lot to lose if PEPFAR is weakened and so, so much to gain if US policymakers unite in their support. We hope you will listen and pass on the episode, download the resources and, most especially, add your voice in support of PEPFAR.

      Announcing the New AVAC.org and Digital Resources

      We are delighted to share the new and improved AVAC.org! On our new site, you can easily access all the great data, policy analysis, tools and resources that you’ve come to expect from AVAC, including our much-loved infographicspodcastsWeekly NewsDigest and Pandemic Watchwebinarsresearch literacy materials and so much more! 
       
      The updated AVAC.org also reflects the expanded vision and practice of our dynamic programs. AVAC will always work to accelerate ethical development and equitable delivery of effective HIV prevention options. But, we also know that responding to HIV and preparing for future pandemics requires a comprehensive, integrated, and sustained response that is rights-based, people-centered and evidence-informed.
       
      To AVAC, this means connecting the dots between HIV prevention, sexual and reproductive health and rights, pandemic preparedness, strengthened health systems, research engagement and community leadership. It means recognizing that resilience in global health requires us to confront the threats posed by disparities in access, entrenched stigma, discrimination, criminalizing key populations and inadequate responses to other sexually transmitted infections.

      Visit the new AVAC.org for resources, tools and analysis that make these connections as we continue to track and translate the field, including:

      • Information on the entire pipeline of biomedical prevention strategies being investigated today
      • Our projects, which showcase the incredible partnerships and collaboration that underpin everything we do
      • Our podcast, PxPulse, which will deepen your knowledge and help you “check the pulse” of this fast-paced field and the urgent challenges still ahead
      • PxWire our quarterly update on where we are in biomedical prevention research
      • Our HIV clinical trials database, where you can find details on all biomedical prevention trials and our broader resource database containing fact sheets, infographics, blog posts and more on HIV prevention and the broader issues surrounding global health equity
      • Links to our newsletters—Pandemic WatchWeekly NewsDigest, and our Advocates Network

      And be sure to check out three vital AVAC resources that give you all the information you need on PrEP accessSTI vaccine and diagnostics R&D and HIV prevention R&D funding.

      We are immensely proud to share these resources with you. We hope these tools and analyses will help to power your advocacy, accelerate ethical development and equitable delivery of effective HIV prevention options, and advance global health equity.

      How do People Who Use/Inject Drugs Intersect with PrEP Research and Service Delivery?

      On Wednesday, September 6, The Choice Agenda (TCA), the International Network of People Who Use Drugs (INPUD) and our wonderful expert speakers discussed the health and wellness priorities of people who use/inject drugs, and how these communities (“key populations”) intersect across PrEP research, development, and implementation activities. They highlighted critical gaps in the PrEP agenda, underscore opportunities for improvement, and share strategies for better inclusion, representation and meaningful engagement.

      Speakers: John Kimani, Kenya Network of People Who Use Drugs (KeNPUD) Dr. Sunil Solomon, Johns Hopkins University, Dr. Tetiana Kaleeva

      ** With special thanks to WHO, this webinar will offer simultaneous Ukrainian translation.**

      Recording / Slides / Resources

      AVAC 2024 Advocacy Fellows Applications Now Open!

      Application Deadline: 2 October 2023

      AVAC is thrilled to invite applications for the 2024 Advocacy Fellows Program. Fellows accepted into the program, will mark the 13th cohort of this program. Read further to explore the history of the program, learn about new features for 2024, find application details, and register for upcoming informational sessions.

      Download Application Materials HereApplication deadline: 2 October 2023

      About AVAC’s Advocacy Fellows Program

      Achieving successful HIV prevention relies on programs and research shaped by communities and grounded by their needs and priorities. Skilled and informed community advocates drive this process. AVAC’s Advocacy Fellows Program expands and strengthens the capacity of civil society advocates and organizations to monitor, support and help shape HIV prevention research and rapid rollout of new effective interventions in low- and middle-income countries facing substantial HIV burdens.

      The program provides intensive support to emerging and mid-career advocates to execute advocacy projects addressing locally identified gaps and priorities. Fellows receive comprehensive training, financial backing, and technical assistance to strategize and execute a targeted 18-month project hosted by an organization within their country.

      In its 15-year history, 85 Fellows and 75 partner organizations across 15 countries have participated in the program. They have influenced policy, championed community perspectives, strengthened healthcare systems, demystified HIV prevention research, advocated for fairness and transparency on local, regional, and global scales and now lead many national and regional organizations. Discover more about the program’s impact here. As the 2022 Fellows conclude their Fellowships, learn more about their projects and achievements here.

      What’s New in 2024

      While HIV biomedical prevention advocacy remains central, we encourage projects with a strong focus on health equity, structural considerations, and links to TB, STIs, and sexual and reproductive health and rights. Advocacy projects related to pandemic prevention, preparedness and response are also welcomed.

      Eligibility

      • Emerging or mid-career community leaders and advocates who want to advance their advocacy skills and advocate for HIV, SRHR, STI, TB, and pandemic prevention and preparedness.
      • Individuals with experience or education in HIV or public health, or in advocacy for key populations (e.g., sex workers, LGBTQIA+ individuals, pregnant individuals, people who use drugs) or for social and economic justice.
      • Based in low- and middle-income countries with substantial HIV burdens and ongoing HIV prevention research or introduction of new interventions.
      • Please note that for 2024 fellowships, priority focus lies in Eastern and Southern Africa.

      Proficient in written and spoken English.

      Application Process

      Learn More

      Applications are due by 2 October 2023, and 2024 Fellowships will run from April 2024 through September 2025.

      Spread the Word

      Help us reach potential advocates by sharing this information within your networks.

      We look forward to receiving your application and making a positive impact together.

      AVAC Advocacy Fellows Program 2024-2025 Application Social Media Tile

      The AVAC Advocacy Fellows Program is now recruiting its 13th class and is looking for the next cohort of emerging and mid-career advocates to explore what’s needed to address epidemics and progress global public health equity.

      Want to help spread the word? Download our shareable social media tile.

      Avac Event

      How do People Who Use/Inject Drugs Intersect with PrEP Research and Service Delivery?

      On Wednesday, September 6, please make plans to join The Choice Agenda (TCA), the International Network of People Who Use Drugs (INPUD) and our wonderful expert speakers to discuss the health and wellness priorities of people who use/inject drugs, and how these communities (“key populations”) intersect across PrEP research, development, and implementation activities. They will highlight critical gaps in the PrEP agenda, underscore opportunities for improvement, and share strategies for better inclusion, representation and meaningful engagement.

      Speakers: John Kimani, Kenya Network of People Who Use Drugs (KeNPUD) Dr. Sunil Solomon, Johns Hopkins University, Ukrainian Provider

      ** With special thanks to WHO, this webinar will offer simultaneous Ukrainian translation. **

      Our Take: Are the UN Declaration on PPPR and the Pandemic Accord going in the right direction?

      The last few weeks have been filled with high-level negotiations among UN Member States on the way forward for global pandemic prevention, preparedness, and response (PPPR) efforts. Below, please find an analysis of the negotiated language to date in the Pandemic Accord, and the UN Declaration on PPPR, and their implications for equity in PPPR. These analyses were conducted by AVAC and partners working in collaboration to track progress toward equity in these agreements and develop an advocacy agenda for provisions in both that ensure equity in global health advances. The Declaration is an agreement that involves heads of state and potentially a role for all ministries of government. The Pandemic Accord is being negotiated by members of the WHO to strengthen PPPR.

      The Pandemic Accord: A look at negotiations to date

      The first draft of the WHO-led Pandemic Accord was released in May, containing edits to the zero draft from the Member States. As expected, edits from high-income countries introduced challenges to equity provisions in the text— particularly provisions aimed at ensuring that agreements to share access to data on pathogens is paired with commitments to also share the benefits developed from research using those data (termed pathogen access and benefits sharing). Other equity provisions that were challenged include intellectual property, and language on how the world should allocate vaccines, therapeutics, and diagnostics in the event of a global pandemic threat. Throughout the document, certain high-income Member States inserted caveats or wording, such as “encourage” or “as appropriate”, which would make implementation voluntary or compliance more subjective. Other phrases to weaken the agreements, such as replacing “commit to” with “recognize the importance of”, were also inserted.

      Negotiations so far have resulted in weaker, alternative language to several key articles than in the so-called zero draft of the accord. These include articles on technology transfer, the Pathogen Access and Benefit Sharing (PABS) System, health workforce strengthening, and the proposed Supply Chain & Logistics Network. There are, however, some clauses that have been strengthened. Global R&D networks, laboratory networks for genomic surveillance, knowledge translation, and the harmonization of regulation to accelerate WHO pre-approval and authorization all have stronger commitments and more details than before. You can find the first draft here and a closer analysis of the changes made between the zero and first draft here.

      The UN Declaration on PPPR: What’s in the Zero Draft?

      The zero draft of the UN Declaration on PPPR, set to be adopted at the High-Level Meeting on September 20, was released in June.

      Many provisions in the draft Declaration are positive, recognizing and affirming key points related to human rights and inclusive provisions that prioritize vulnerable and marginalized populations. The draft recognizes vaccine inequity as a vital concern, affirms key principles of equity and non-discrimination and the need to ensure adequate support for both health workers and the WHO. However, there are very few, if any, concrete targets set, leaving little to hold countries accountable. Missing from the Declaration, in particular the section on Overarching Health Related Issues, is the need for countries to prioritize and commit to building on the global responses to ongoing epidemics, including HIV/AIDS, TB, malaria, polio, other neglected disease outbreaks such as Ebola, Marburg, and cholera, and antimicrobial resistance (AMR).

      This is a missed opportunity with enormous implications. It signals a troubling and serious global inability to build on existing health and community infrastructures, integrate responses, and avoid erecting isolated pillars in global health architecture. Many of the capacities needed for PPPR already exist in the response to these other health threats. They can and must be expanded and strengthened for broader pandemic preparedness. In addition, the history of the responses to HIV/AIDS, TB, and malaria have made clear that community leadership in the response and civil society engagement are essential to achieve success in PPPR. The current response to existing health threats, which through trial and error have built resilient and effective systems, should serve as the foundation for any future pandemic preparedness and response efforts. The Declaration’s silence on this issue is gravely concerning.

      The Declaration’s clauses relating to agreements on pandemic-related tools and products are strong, and notably stronger than those in the first draft of the Pandemic Accord. But equity provisions, and access to those tools, could be strengthened further, by including compulsory licensing and transfer of know-how when necessary.

      It’s vital for advocates to engage with these processes, and leverage their power to influence the emerging architecture in global health. Decisions being made now will have implications for years to come. And the voices of advocates are having an influence. For example, the US government’s contribution to the current draft of the UN declaration recently added specific recommendations from AVAC and partners on the inclusion of Good Participatory Practice. It’s up to all of us to make sure GPP and other provisions that ensure equity in global health are in place when the drafts become final.

      You can find the Declaration zero draft here and see our analysis and the changes we call for here.

      What’s Next

      These negotiations are setting the direction for pandemic readiness for years to come. As discussions continue in the weeks and months ahead, it’s imperative for advocates and countries to be raising their voices and calling for language and commitments that will ensure equity in PPPR. Building on the lessons the world has learned from ongoing epidemics, and integrating the response must be a priority to ensure the tragic results of inequity in global health are not repeated, again and again.

      AVAC will be sharing these analyses with our partners and governments with whom we work with. For more background, read AVAC’s Advocates Guide for PPPR. And you can take action now by sending these resources to your country’s UN representatives and other influential voices in your networks!

      IAS Science 2023 Conference: What you need to know

      The 12th annual conference of the International AIDS Society (IAS) on HIV science takes place July 23–26 in Brisbane, Australia, and virtually. This year’s conference will offer the latest on vaccine and cure science, research updates on broadly neutralizing antibodies, important discussions on trial design in the era of PrEP, the potential of community-led models of care and the importance of integrating services for HIV and sexual and reproductive health (SRH). AVAC and partners will be there! Read on for an overview.

      Just ahead of the conference, UNAIDS released their annual state of the epidemic report, The Path that Ends AIDS. The report charts a path that can end AIDS, and documents important progress, but challenges remain. Among them, global resources for HIV are marking another year of decline. With anti-LGTBQIA+ legal actions increasing in the US and in several African countries and reduced resources, efforts to end the epidemic will fail. See AVAC’s new graphic on the issue.

      title card with presentation info

      IAS Resources

      • Use AVAC’s Roadmap to find sessions where prevention, pandemic preparedness and the larger issues of global health equity are in the spotlight. You can download it as a sortable spreadsheet or PDF.
      • Follow events in real time, AVAC will offer comments and updates on Twitter, and our friends at NAM/AIDSMAP will be reporting throughout the conference. Join the conversation using the conference hashtag #IAS2023.

      Satellites, Sessions and Panels Featuring AVAC and Partners

      All times listed are local in Brisbane, Australia. Click for a time zone converter.

      Sunday, July 23

      Tuesday, July 25

      Wednesday, July 26

      Poster Presentations

      • No Data No More: A tool to end the exclusion of trans and gender-diverse people in HIV research
      • Raising New Voices in HIV Cure Research: A review of an advocacy-for-cure academy and grant program
      • The Value of Measuring Outcomes of HIV Advocacy: Utilising a novel and participatory approach for advocacy evaluation
      • HIV Prevention Research & Development Investments 2001-2021: Shifting investment priorities fund innovation in a challenging global health landscape
      • Revolution of Transgender Health Programming: The role of transgender activists in Health programming for Malawi

      While many will be gathering in Australia for the IAS conference, the 27th International Society for Sexually Transmitted Diseases Research (ISSTDR) is happening in Chicago at the same time – and AVAC will be there, too. Stay tuned for an update later this week for AVAC’s STI Roadmap and dedicated STI conference page. Advocates, implementers and researchers in both fields have much work to do together.

      STI & HIV World Congress Kicks Off July 24

      Follow The Conversation!

      Next week, the STI & HIV World Congress (also known as ISSTDR) kicks off in Chicago, Illinois, USA and AVAC will be there. This is the first major face-to-face meeting of STI & HIV professionals since 2019 and one of the only spaces the global STI community comes together to promote ongoing STI research efforts and exchange information on current investigations. This is also the first time AVAC is attending ISSTDR in hopes of expanding STI advocacy and community engagement.

      STI & HIV World Congress Resources

      Use AVAC’s Roadmap to find sessions where prevention, pandemic preparedness and the larger issues of global health equity are in the spotlight. You can download it as a sortable spreadsheet or PDF. The full conference program is also available.

      Follow events in real time with the official hashtag, #ISSTDR2023, AVAC will offer comments and updates on Twitter.

      Visit STIWatch.org, our updated and expanded online resource for the sexual and reproductive health and rights (SRHR) community to better understand and advocate for STI vaccine and diagnostics research, development and rollout.

      palm card advertising STI Watch

      STI & HIV World Congress 2023 Highlights

      Check out some AVAC-featured sessions below.

      The STI Prevention Pipeline: Where Are We, and What Will It Take to Move Forward Faster?
      Monday, July 24 11am–2pm in the Mayfair Room
      Join us to explore the current development and implementation stages of STI vaccines and diagnostics and identify ways to accelerate research through advocacy.

      Symposium: New Vaccine Approaches to STI Prevention STI Vaccine Acceptance and Equity
      Tuesday, July 25 2:30pm-4:00pm at Chicago 6
      Join AVAC’s Alison Footman to dive into the topic of STI vaccines and equity as new interventions come into reach.

      Setting Up a Remote/Home Testing STI Programme: A Practical Toolkit
      Tuesday, July 25 2:30pm-4:00pm in Sheraton IV/V
      Join us to explore the power of remote testing to affordably curb STI acquisitions.

      Community Happy Hour
      Monday, July 24, 6:00pm-8:00pm at Lizzie McNeill’s
      Join AVAC and partners for a no frills happy hour for the STI community. All are welcome!

      ISSTDR Advocacy Zone
      Tuesday, July 25 to Thursday, July 27 in the Exhibit Hall
      Visit the Advocacy Zone, a space to ask important questions, connect with fellow STI advocates, and begin to chart next steps in advancing STI R&D.

      Language for HIV Cure

      This document shares up-to-date, community-preferred terminology within cure research.