More Robust Investment Needed to Fully Fund Prevention Research to Help End the Epidemic
Mexico City — Investment in HIV prevention research and development ticked up modestly in 2018, following five years of steady declines in funding according to a new report released today at the 10th IAS Conference on HIV Science. The modest increase in funding, while encouraging, is not enough to fully fund the needed research to develop new prevention options to help meet ambitious goals of curbing and eventually ending the HIV epidemic.
The Resource Tracking for HIV Prevention R&D Working Group’s (RTWG) 15th annual report, HIV Prevention Research & Development Investments, 2018: Investing to End the Epidemic, documents an overall increase of 1.2 percent or US$13 million from the previous year, bringing the total funding for the year to US$1.14 billion.
This increase in funding comes at a time of great promise in the field, with the largest slate of preventive HIV vaccine trials in history underway or planned and key antiretroviral-based prevention options in efficacy trials (long-acting injectable PrEP) and under regulatory review (monthly dapivirine vaginal ring). In addition, many other promising HIV prevention options are in early-stage human trials or in pre-clinical development. Adequate funding to keep the pipeline of potential new prevention options moving swiftly is critical.
As in previous years, the US continued to be the major funder of HIV prevention research, with 87 cents of every dollar spent on HIV prevention R&D coming from just two donors: the US public sector contributed almost three-fourths of all global funding (US$829 million out of US$1.14 billion), while the Bill and Melinda Gates Foundation remained the principal philanthropic donor, accounting for 91 percent (US$149.7 million out of US$164 million) of all sector investment.
Overall European public sector funding was the lowest seen in more than a decade, with an 0.7 percent dip from 2017 levels to a total of US$57.5 million. There were, however, key increases from non-US public sector donors, including a 54 percent increase by the UK, a 73 percent increase from Germany and nine percent from Canada. In addition, funding from the European Commission increased by 25 percent.
The RTWG was encouraged by the overall increase in funding and noted the important increases from these key public sector donors, but renewed a call for increased funding from a greater range of donors to help guarantee the stability of R&D financing and cushion potential impact if any of the major funders were to reduce their investments.
Just nine philanthropic donors contributed to HIV prevention R&D in 2018, down from a high of 27 in 2015. While philanthropic donors account for a small percentage of overall funding, this low number of donors is concerning.
“We know what we need to do to end the epidemic. We need universal testing and treatment; we need to scale up existing prevention options; and we need to invest in research and development for new prevention choices that will meet the various needs of people at risk of HV infection. No one approach on its own will ever be enough,” said Mitchell Warren, executive director of AVAC. “There has never been a more important time to invest in HIV prevention R&D. Current donors must sustain and increase their commitments and we need new donors to invest in promising research that is necessary to bring this epidemic to an end.”
The RTWG has tracked more than US$19 billion in investment towards biomedical HIV prevention since 2000 and warned that the greatest impact of this investment could be lost without continued and sustained support to move promising prevention options from laboratories and clinics into the lives of those who most need them.
“Bringing HIV prevention programs to scale requires strengthened research, sustained investments and the political will and program leadership to ensure the rapid translation of research into programs,” said Dr. Shannon Hader, deputy executive director of UNAIDS. “The global agenda to end AIDS by 2030 will not be possible without the convergence of service delivery and research. The investments in the AIDS response will have far-reaching consequences.”
Since 2000, the Resource Tracking for HIV Prevention R&D Working Group (formerly the HIV Vaccines & Microbicides Resource Tracking Working Group) has employed a comprehensive methodology to track trends in research and development (R&D) investments and expenditures for biomedical HIV prevention options. AVAC leads the secretariat of the Working Group, that also includes the International AIDS Vaccine Initiative (IAVI) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). This year’s report is additionally made possible by the support of several donors, including the Bill & Melinda Gates Foundation and the American people through the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the US Agency for International Development (USAID). The contents are the responsibility of AVAC and the Working Group and do not necessarily reflect the views of PEPFAR, USAID or the United States Government. AVAC does not accept funding from the pharmaceutical industry.