Investing in the End of the Pandemic: A New Era for HIV Prevention Research & Development

The world of HIV and AIDS research and development (R&D) is changing dramatically, and sessions this week at the XIX International AIDS Conference have examine how R&D advocates need to adapt and adjust their strategies in this new environment. The global financial crisis is at the forefront of many people’s minds, along with issues like increasing demands on already strapped country-level budgets and the possible shift from the Millennium Development Goals to the Sustainable Development Goals. At a session on Tuesday to discuss persuading policymakers to invest in tuberculosis (TB) R&D, Richard Horton from the Lancet said that TB advocates have recently recognized the need for a different approach that involves going directly to policymakers, as well as bringing TB scientists and researchers together with national decision-makers in order to create a collective will to address the leading killer of HIV-positive people worldwide. Two members of parliament from the United Kingdom—Cathy Jamieson and Pamela Nash—stressed that in addition to making their evidence and arguments simple and understandable, advocates need to connect their issues to a politician’s constituents, as constituents are always a policymaker’s top priority. “My job as a politician is to listen to the evidence and expertise that you bring, and then make sure funding is available to address those priorities,” Jamieson said. (from left to right): GHTC Director Kaitlin Christenson, IAVI's Prince Bahati, Henriette Laursen of AIDS-Fondet, Christine Lubinski from the Infectious Diseases Society of America, and Chamunorwa Jefrey Mashoko from AVAC. Photo credit: PATH Later that afternoon, the GHTC and several coalition members—Aeras, AVAC, the International AIDS Vaccine Initiative (IAVI), and the International Partnership for Microbicides—hosted a session to discuss how advocates can adapt their advocacy to meet today’s challenges. Four main themes emerged—the first focused on taking a community approach to R&D advocacy that includes a range of diseases and products. “Policymakers are tired of vertical advocacy,” Prince Bahati of IAVI said, adding, “We as advocates have the opportunity to create a platform of integrated advocacy, comprised of advocates, and scientists. We need to adapt to the transition that is happening and create one voice.” Chamunorwa Jefrey Mashoko, an AVAC advocacy fellow, added that a key part of this effort will involve scientific collaboration between African and American researchers. Panelists also discussed the need to engage new voices in their advocacy, including researchers working on new HIV and TB tools, as well as the people and communities who will ultimately benefit from these new products. Christine Lubinski from the Infectious Diseases Society of America said that some of the most successful project she’s worked on involved taking members of Congress to African countries in order to see first-hand TB and HIV research projects and clinical trials, and to meet African scientists. She added that it’s vital to show policymakers that there is a domestic constituency who believes in global health R&D, comprised of academic institutions, scientists, and researchers. “We have game-changing tools in the pipeline,” Lubinski said, adding, “We have a real opportunity with some of these new products, and I believe that’s our biggest weapon as advocates.” Additionally, the panelists talked about how there is a great need to recognize investments that have been made in global health R&D from donors, as well as how to engage new donors from countries such as Brazil, Russia, India, and China. Finally, the panelists stressed the importance of advocating for new tools as well as increased access to existing and proven tools. “There really isn’t a division between advocating for R&D and advocating for existing tools,” Henriette Laursen of AIDS-Fondet said. She added, “We can look at the historical successes of R&D and recognize that they are both part of the package.” Kim Lufkin is the GHTC’s communications officer.

On the second day of the XIX International AIDS Conference, the need for a host of new tools to prevent and treat HIV and AIDS has already made it to the forefront of the agenda. Of particular note has been the resounding call for a vaccine to prevent HIV, with leading policymakers, scientists, and advocates saying that the world will never reach the end of AIDS without this powerful tool. In a session that focused on improving the effectiveness and efficacy in the HIV and AIDS response, Senator Lindsey Graham (R-SC) said that a vaccine is desperately needed to help make a sizable dent in the pandemic. Graham’s call for a vaccine was echoed by Bill Gates from the Bill & Melinda Gates Foundation. The “ultimate tool” in the fight against HIV and AIDS “will be a vaccine,” Gates said, adding that the US government has been the largest supporter of efforts to develop and vaccine “by far.” He also said that microbicide gels and rings will be powerful prevention products. Without a number of these new tools, the world cannot “talk seriously about moving toward the end” of the pandemic. “We will get these tools, but only if we stay the course.” Later in the afternoon, National Institutes of Health (NIH) Director Francis Collins and Jon Cohen from Science magazine chaired a panel that looked at what lies ahead in HIV and AIDS science. Gary Nabel, director of the NIH’s Vaccine Research Center, said “we’ve never been in a more exciting position” in the search for an HIV and AIDS vaccine. He added that recent discoveries related to broadly neutralizing antibodies over the past two years have made HIV vaccine research “like a phoenix rising from the ashes.” When sharing their hopes for the status of HIV and AIDS research, several panelists also stressed the urgent need to develop new HIV prevention and treatment options. Nabel said that by 2020, he expects researchers will be “in the midst of efficacy trials for an HIV vaccine candidate.” Robert Siliciano of the Johns Hopkins University School of Medicine stressed that by 2020, scientists will be leading clinical trials for new drugs that attack HIV reservoirs. And Dawn Averitt-Bridge of the Well Project said that by 2020, she hopes the world has effective microbicides to prevent HIV, a functional cure for the disease, and that “research makes it into the lives of the people and families we all care so much about.” Cohen ended the session with a call for young people to become the “next generation of scientists” leading HIV and AIDS research. “I’m looking to the young people, because that’s where the revolution is going to happen.” Kim Lufkin is the GHTC’s communications officer.