Key Population Trans National Collaboration (KP-TNC)
A cross country collaboration strengthening advocacy for key populations
Civil Society for key populations (KPs) must overcome significant challenges in their advocacy. Stigma, discrimination, disinformation, repression, criminalization, violence, and economic inequities burden and marginalize LGBTQIA+ people, sex workers, people who use drugs and other key populations who are vulnerable to HIV exposure. The KP-TNC fosters a community of practice and builds coalitions to develop strategies and advance advocacy for global health equity at large, and for HIV prevention and treatment among key populations.
About This Project
The KP-TNC is made up of consortiums of KP-led organizations in eight countries: Ghana, Kenya, Malawi, Nigeria, South Sudan, Tanzania, Zambia and Zanzibar. It plays a crucial role in strengthening relationships between KP organizations and development partners, regional organizations, the African Union, PEPFAR, The Global Fund and country governments. The latter holds special importance for TNC members who operate in countries where discrimination and criminalization of key populations has posed a serious barrier to advocacy. These constraints have undermined the development of effective policy and programs, depriving policy makers of essential impute from key populations on the design and implementation of programs aimed at delivering health services to them. The work of the KP-TNC is shoring up these critical failings with deeply informed, well resourced KP-led organizations who bring innovation and solutions that work.
The KP-TNC provides members with strategic training & education, and offers a platform for developing best practices. Advocacy is focused on PEPFAR’s Country Operational Plans (COPs), the Key Population Investment Fund (KPIF), other global, regional or country process for health programming, and expanding KP leadership in the design, implementation and evaluation of programs that deliver healthcare services to key populations.
Advocacy for Pandemic Prevention, Preparedness and Response (PPPR)
Making the connections between HIV, Global Health, Pandemic Readiness and Equity
Efforts to prepare for the next pandemic are changing the trajectory of global health. Governments around the world are coordinating on a range of agreements to meet the challenge of future global health threats. For Pandemic Prevention, Preparedness and Response (PPPR) to succeed, it is imperative that lessons from the HIV response are integrated into the architecture being built for PPPR. This means principles of equity must be embedded at every level of these agreements, and governments and civil society must be empowered to hold each other accountable to their commitments. The HIV response is inextricably linked to the progress or failure of PPPR. If done correctly, engaged and supported civil society and an integrated, fully funded response to HIV and the globes other current pandemics become the foundation for PPPR to effectively respond to emerging threats.
About this Project
HIV advocates bring essential expertise to advocacy for PPPR. AVAC works in partnership to track the process and content of these agreements. Through collaboration, we identify gaps, develop an advocacy agenda and put forward concrete proposals. We champion key priorities aimed at ensuring principles of equity guide the structure and operation of the global architecture for PPPR that is being built in the aftermath of the COVID-19 pandemic.
In a reimagined vision for pandemic readiness and global health, each country contributes their fair share, based on resources available, to be distributed globally, with priority for serving those most in need and achieving global health equity. As we saw during the COVID-19 Pandemic, richer countries have long abandoned global public health concerns once they consider the situation to be under control in their own countries (as with HIV, TB, malaria, and other infectious diseases). This isolationist approach must end: until access to essential health services and biomedical interventions is equal for all, we are all vulnerable to new health threats.
There is a significant opportunity to harness new initiatives and reform existing infrastructure to better address health issues, recommitting the world to the primary health care (PHC) measures outlined in the Astana Declaration and prioritizing health systems strengthening. There is growing recognition of the interrelated nature of global health and the need to integrate health responses between disease areas and with trade, education, labor, and finance. Resources for PPPR have historically been too little and too focused on infrastructure (laboratory capacity, gene sequencing functionality, and surveillance) while donor countries typically see PHC and health systems strengthening as an in-country responsibility. Multilateral-driven policy initiatives and platforms such as the WHO Pandemic Accord, new Pandemic Fund, and UN PPPR High-Level Meeting (HLM) present a great opportunity to, for the first time, collectively fund and strengthen health systems and primary health care—if the decisions incorporate lower- and middle-income country (LMIC) and civil society priorities.
Partnerships to Promote Effective HIV Prevention Policy
Working with global partners to advance policy priorities
Overview
Ending the HIV epidemic depends on political will, committed resources and a policy environment that supports and adequately finances equitable access to HIV prevention research, services, interventions, and products with communities at the center. Nearly four decades of HIV advocacy has shown us the power and potential of a strong ecosystem of partners in creating and sustaining effective local, national and international policies.
About the Project
AVAC and partners founded the Global AIDS Policy Partnership (GAPP) and the Federal AIDS Policy Partnership (FAPP) to create diverse coalitions of organizations who are committed to maintaining and expanding well-resourced, evidence-based HIV treatment and prevention programming and funding at the US and international levels. Through these coalitions, AVAC brings diverse perspectives and expertise to identify policy priorities and support the creation of campaigns to advance them.
The Global AIDS Policy Partnership As a co-chair of the Global AIDS Policy Partnership (GAPP), AVAC helps the 70-member coalition expand and improve US global HIV/AIDS programming through PEPFAR and the Global Fund. The GAPP is comprised of more than 70 US organizations—including advocates, civil society and faith-based organizations, philanthropy, implementers, professional membership organizations, and NGOs.
Federal AIDS Policy Partnership AVAC is also a member and a co-convener of the Research Working Group of the Federal AIDS Policy Partnership (FAPP), a national coalition of more than 120+ local, regional, and national organizations advocating for federal funding, legislation and policy to end the HIV epidemic in the United States. Much of FAPP’s policy and advocacy work is accomplished through seven FAPP-affiliated working groups. The Research Working Group works to advance the HIV research agenda through relationship building with the National Institutes of Health (NIH), Centers for Disease Control and Prevention (CDC) and other HIV research funders, identifying gaps in HIV research, educating policy makers on the value of HIV research (for the field, but also for the broader research enterprise), and increasing federal funding through advocacy and coalition building.
Global Health Technologies Coalition AVAC co-founded and participates in the Global Health Technologies Coalition (GHTC), a coalition of more than 40 organizations and institutions advocating for US and multilateral policymakers to enact policies and investments to accelerate development of health technologies that are affordable and accessible to the communities who need them.
AVAC Advocacy Fellows Program
Supporting emerging advocates and a generation of advocacy
Applications
AVAC is no longer accepting applications for 2024 Advocacy Fellows.
Well-supported advocates keep the global response to HIV on track. Effective HIV prevention depends on programs and research that are fundamentally grounded in the needs and priorities of people who need prevention most. Passionate, skilled community advocates are the lynchpin to this process. They explain the science, define priorities, hold stakeholders accountable and influence the field.
About AVAC Advocacy Fellows
More than 10 years ago, AVAC launched its first Advocacy Fellows program to identify emerging HIV prevention champions, support their efforts, help hone their skills, strengthen the capacity of civil society to shape the agenda for HIV prevention research and influence how fast new interventions move into policy and programs. Today, the Advocacy Fellows program continues, offering 12 – 18 months of intensive support to emerging and mid-career advocates to complete an advocacy project focused on HIV prevention and global health equity- from research to programs to structural interventions that address human rights.
AVAC provides technical and financial support to Fellows—both salary and project budget—for the duration of the Fellow’s year. The Fellows program is implemented through a close collaboration among the Advocacy Fellow, the Host Organisation and AVAC.
Advocacy Fellows are housed by “Host Organisations” who are the fiscal and administrative grant partners. Hosts provide daily supervision to Fellows, ensure their projects are aligned with the organization’s goals and ensure that their activities and strategies are contextualized in the country/community.
Impact
Since launching in 2009, nearly 100 alumni fellows from 70+ partner organizations across 15+ countries have participated in the program. They have gone on to change policy, champion community perspectives, help strengthen healthcare systems, demystify HIV prevention research, and insist on fairness and transparency locally, regionally and globally.
I had no knowledge about good planning, accountability and execution of a good project. But with the assistance of the fellowship team at AVAC, as I write now, I feel I am one of the most supersonic HIV cure advocates the world has ever seen!
Moses Supercharger
2017 AVAC Advocacy Fellow
The AVAC Fellowship turned a naive nurse to a robust advocate. Now I can advocate for anything that I believe is right, even if I may be the only man standing and be unpopular… South African’s U=U scale up would not be where it is now if it was not for what I started then [when I was an AVAC Fellow].
Mandisa Dukashe
2020 AVAC Advocacy Fellow
The Choice Agenda
The Choice Agenda is a global forum for advocacy on the latest in HIV prevention research
Overview
Discussion, debate, and information sharing has been core to HIV advocacy and activism for over four decades resulting in many hard fought global gains in HIV treatment and prevention.
Today, as we work to make complex science accessible, identify where advocacy and action are needed, and pursue bold national, regional, and international agendas that improve global responses to HIV and prepare to prevention future pandemics, we need a space to come together.
About the Project
The Choice Agenda provides such a space—it is a new global forum for advocacy on the latest in HIV prevention. With monthly webinars hosting highly-informed discussions with advocates and experts across the field and a moderated listserv of nearly 2000 subscribers from 40 countries, the Choice Agenda platform is serving as an essential space for the HIV prevention community to come together to discuss, debate and chart the way forward.
The Choice Agenda program, and all of its participants take on a wide range of topics. Together, the TCA community drills into critical choices, including the need for short acting, non-systemic, user-controlled options, and a wide range of tailored implementation strategies that must define advocacy, the HIV response, and global health equity at large. Participants are also provided with links to a curation of exceptional resources to support further education and advocacy.
Join the Listserv
Join in on agenda-setting conversations. Members are encouraged to share their opinions and concerns and contribute to discussions and debates in the space. They can also reach out with suggestions about webinar content and speakers. Reach out to Jim at jimberlypickett@gmail.com to be added to the list.
The Webinars
The Choice Agenda hosts monthly webinars and moderates passionate, highly-informed discussions with advocates and experts across the field. Upcoming events are above on this page. Recordings are available here. Materials from previous events will be posted soon.
Stay in Touch
Follow along on Twitter via #TheChoiceAgenda and email Jim to join the listserv.
So many interesting threads and important to have a platform where people can voice difficult issues in a frank and challenging way. I am learning so much.
Dr Rachel Baggaley
WHO
Thank you so much Jim for moderating this forum. I want to nominate Jim to be the next PM for Thailand.
Udom Likhitwonnawut
AVAC consultant
Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC)
Launched in 2021, MOSAIC, short for Maximizing Options to Advance Informed Choice for HIV Prevention, is an $85 million five-year global project. It is funded through the generous support of the American people through the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the US Agency for International Development (USAID). The project focuses on HIV prevention for adolescent girls, young women, and other women by accelerating introduction and scale-up of new and emerging biomedical prevention products.
Choice Matters
Adolescent girls and young women (AGYW) and other women continue to account for more than half of the number of people living with HIV worldwide. As new PrEP options become available, women in all their diversity should be presented with their choice of methods to prevent HIV.
What MOSAIC Means for Women
MOSAIC works in Botswana, Eswatini, Kenya, Lesotho, Namibia, Nigeria, South Africa, Uganda, Zambia and Zimbabwe to support health systems to better provide adolescent girls and young women (AGYW) with access to multiple effective PrEP products that meet their changing needs and desires. MOSAIC initiatives advance and promote informed choice and its integration in policies and programs.
Project Objectives
Focus on the needs and preferences of women
Gather research and evidence on connecting people to products that work for them
Work closely with regulators and policymakers to expedite the rollout of products
Advocate for the rapid integration of products into national programs
Strengthen local partnerships to promote product introduction
The MOSAIC consortium is led by FHI 360 along with core partners Wits Reproductive Health and HIV Institute (Wits RHI), Pangaea Zimbabwe AIDS Trust (PZAT), LVCT Health, Jhpiego and AVAC. The work is also supported by technical partners from Afton Bloom, Avenir Health, Columbia University, Mann Global Health, RTI International, the University of Pittsburgh and the University of Washington.
PxROAR and CureROAR
Supporting Advocate Education and Campaigns
AVAC’s PxROAR (Prevention Research, Outreach, Advocacy and Representation) and CureROAR trains US, European and African partners in advocacy to advance research and ultimately rollout of interventions related to HIV cure and prevention. The program provides mentorship, peer support, networking opportunities, technical support and financial assistance.
Supporting Advocacy Where it’s Needed
The ROAR programs bring together advocates around regional or topic-based issues to support specialized advocacy. Each ROAR cadre develops expertise and an advocacy agenda to advance key priorities. Providing this support means critical issues, such as the inclusion of transgender people in research or investment in cure research or scrutinizing the role of FDA approval in global access to new prevention options will be doggedly advanced by informed and effective advocates.
About the Project
The ROAR programs educate its members on the science of HIV prevention and cure research. Additionally, they demystify and empower members to understand the process of then delivering proven interventions to the communities that need these options most.
The ROAR programs also provide a platform for specific advocacy campaigns. The five cadres of ROAR advocates are PxROAR US, PxROAR Europe, PxROAR Africa, PxROAR TG and CureROAR. Members are based in Africa, the US and Europe, and represent the range of HIV-affected communities.
PxROAR United States & PxROAR Europe: These programs expand members’ capacity to contribute to advocacy for research, development and implementation of new HIV prevention options. Members track FDA and EMA licensing processes and advocate for sustained funding to key research entities including the US National Institutes of Health and European-based research institutes funded through the EU’s Financial Framework 2014-2020 and Horizon 2020.
PxROAR Africa: Through dialogues, shared learning and strategic action, this ROAR team advances the human right to health, including comprehensive HIV prevention treatment and care. With extensive experience in advocacy and activism aimed at securing self-determination, free expression, and culturally competent health services, PxROAR AFRICA’s work focuses on agendas that will eventually end HIV epidemics in their communities. Members represent LGBTQI individuals, sex workers and other criminalized and marginalized populations.
PxROAR TG: PxROAR TG articulates an HIV prevention advocacy agenda specifically for trans people within the framework of key populations’ needs and programs. Members are based in Southern and Eastern Africa.
CureROAR: The HIV cure field is undergoing a period of robust scientific investigation. The CureROAR program supports members to understand the relevant science and prepare an advocacy agenda that will ensure cure research reflects the needs, priorities and experiences of all populations affected by HIV. CureROAR is made up of members from countries where cure research is taking place and CureROAR members represent communities affected by HIV.
Contact
For more information on the PxROAR program, please email avac@avac.org.
Advocacy and Action for Sexually Transmitted Infection Prevention
Accelerating the development and delivery of STI prevention
AVAC’s work to advance advocacy for STI prevention and integrate it with HIV prevention and global health equity involves supporting a network of advocates, expanding research literacy, and identifying priorities for the field.
Action That’s Long Overdue
Sexually transmitted infections (STIs) are widespread, remain difficult to prevent, and can have severe health consequences, including increased risk for HIV acquisition. While most STIs are curable, they often go undiagnosed and untreated because they tend to cause few or no initial symptoms. Available diagnostics are often too costly to use for routine screening in many low to middle income countries (LMICs), and to date few vaccines exist to address the most common STIs.
Despite the scope and urgency of the problem, STIs receive little public policy or community attention. These infections are often stigmatizing and their effects are most devastating among groups with little political power, such as adolescent girls and young women, sex workers, gay men, and other men who has sex with men.
STIs intersect with HIV and other key priorities for global health equity- developing an advocacy agenda to expedite research, development and rollout of strategies to test for and prevent STIs that is integrated into a broader response is fundamental to global health. Current knowledge and technology suggest breakthroughs are possible and could deliver better, affordable diagnostics and new prevention options.
Supporting a Network of Advocates
STIs intersect with the concerns of many vibrant advocacy communities including those working in HIV, sexual and reproductive health, cancer, infertility, and maternal and newborn health. AVAC draws from these communities to raise awareness of STI advocacy, and interest and expertise in scientific research on STI vaccines or diagnostics.
Expanding and advancing the pipeline of research and development for diagnostics and vaccines, along with driving policies and funding to bolster use of the diagnostics that already exist, are essential for prevention across global health.
Expanding Research Literacy for STI prevention
AVAC and partners provide a host of resources to track and translate research related to STI prevention.
STI Watch.org tracks vaccine research for seven of the most common STIs, and features a roadmap for development of new vaccines from WHO, NIH and other partners.
The STI Advocates Network reaches a growing list of seasoned advocates developing expertise in STI research with news and information for their advocacy. Sign up here.
STI R&D Investment, AVAC’s resource tracking report provides an annual analysis of global funding trends for STI prevention research.
Media Science Cafes provides additional resources on STI research for journalists.
STI subawards provides grantees an opportunity to explore how to better advocate for and communicate about STI vaccines, diagnostics, and other prevention tools. Learn more in the blogpost, Paving the Road for STI Prevention Advocacy.
Identifying Priorities for the Field
A growing network of STI advocates are accelerating the development of a pipeline of new diagnostics and vaccines. This work depends on champions to make the connection between a robust pipeline of STI prevention products, reduced STI prevalence, reduced HIV risk, and dramatic strides in the improved health of women and other key populations.
With ready access to STI-focused data and information provided by the resources above, advocates are identifying baseline data, gaps and resource needs; and consolidating messages and advocacy priorities. This in turn informs collaborations with health and political leaders to set goals for research, investment, policy, planning, and integrated programs for STI and HIV prevention.
A coordinated approach to scaling up access to HIV prevention products
BioPIC is pioneering an integrated and adaptable approach to introducing new HIV prevention products to people who need them, with a focus on injectable cabotegravir (CAB) for PrEP.
Overview: Why Now?
The HIV response needs coordination and innovation in product delivery now.
The HIV prevention products that exist today hold the potential to curb incidence. But knowledgeable observers, drawing lessons from the slow roll out and low uptake of oral PrEP in the early years of its availability, know that coordination must be intensified. Without it, highly efficacious products never reach the populations that need it.
About the Project
The BioPIC collaboration involves civil society, donors, researchers, policy makers, implementers and normative agencies such as WHO and UNAIDS, is made possible through the generous support of the Bill & Melinda Gates Foundation, and was established in partnership with AVAC, CHAI and ViiV Healthcare.
The BioPIC Framework
BioPIC developed the Adaptable Product Introduction Framework for all stakeholders involved in product introduction, from clinical research to rollout in low- and middle-income countries. The framework prioritizes activities that must begin in parallel to phase III clinical trials. Stakeholders with a role in early phase product development may also benefit from these considerations with better coordination around anticipated needs.
BioPIC Priorities
Plan to provide global and national bodies with needed evidence on safety and efficacy:
Plan in advance to obtain safety data for pregnant and breastfeeding women
Plan in advance and bolster systems to monitor resistance
Conduct research for additional populations not included in clinical trials
Streamline regulatory review and development of normative guidance
Understand resource needs and the impact of CAB-LA:
Model impact in different country contexts
Build consensus and methodology for monitoring, target-setting and evaluation
Conduct cost and payer analyses to inform budgeting
Coordinate and align product procurement
Enable programs to quickly move from small projects to scale:
Analyze delivery channel to identify opportunities and challenges prior to early implementation projects
Support the development guidance and tools at the earliest stage of implementation.
Consolidate implementation questions in fewer, larger-scale projects
Identify methods to support high uptake and continued use:
Engage and build community mechanisms to refine program design and implementation
Conduct human-centered design research to understand factors that encourage or inhibit uptake and continued use, tailored for providers, communities, and priority populations
BioPIC Think Tanks
An ongoing series of think tanks, conducted by BioPIC, are generating key insights for people-centered product delivery. Coordinating Implementation Science for CAB for PrEP
Find details on each topic including reports, findings and additional resources on PrEPwatch.org’s dedicated BioPIC page, featuring an archive of past think tanks. Visit PrEPWatch.orgevents for upcoming think tanks.
For additional assistance, reach out to Cat Verde Hashim at catherine@avac.org.
Coalition to Accelerate Access to Long-Acting PrEP
Overcoming access challenges to new PrEP options
Structure of the Coalition to Accelerate Access to Long-Acting PrEP
The Coalition to Accelerate Access to Long-Acting PrEP brings together leading donors, agencies, and advocates aimed at a practical goal: jointly develop strategies and take coordinated action to identify and overcome access challenges to just-approved and future PrEP options. AVAC serves as the Secretariat.
Overview: A critical moment for ending the epidemic
In 2012, Oral PrEP was approved for use as a safe and effective option for HIV prevention. But the field moved too slowly, missing 2020 prevention targets by millions. In 2022, the number of initiated oral PrEP users finally hit three million, but still only a fraction of the estimated number of people who need it and could benefit from it.
In 2021 and 2022 new, longer-acting PrEP options are readying to reach the market, even as new UNAIDS data shows the AIDS response is truly “in danger”. The world cannot afford to squander another decade navigating these challenges. This coalition is setting an agenda for bold action, leveraging global urgency, and coordinating partnerships.
About the Project
Product developers, policy makers, normative agencies, donors, program implementers, researchers, generic manufacturers, civil society, advocates and communities each have critical roles to play. The Coalition is applying lessons learned from oral PrEP, creating plans to overcome the unique challenges for new prevention options, and ensuring that new, longer-acting PrEP options including injectable CAB and the dapivirine vaginal ring will be available and equitably accessible to all who need them, more quickly than ever before.
Discrete working groups are taking on: Demand assessment; Evaluation of cost and regulatory procedures; Finance and procurement; Demand creation and supportive policies. Each of these working groups involve robust representation from ministries of health and civil society. To extend the reach and impact of this work, the Coalition engages with efforts underway to:
