Vaccines

Without addressing HIV among marginalized populations and human rights, it will not be possible to end the AIDS epidemic as a public health threat by 2030, according to experts at a World Health Assembly side event.

A high-level panel, which included UNAIDS Executive Director Michel Sidibé, called on health ministers to pledge to remove structural barriers to accessing HIV services and health care for all. The speakers also stressed the need for political commitment to leave no one behind. Ensuring that marginalized populations are not excluded from the universal health coverage target of the next sustainable development goals will be vital, they noted.

According to the participants, there is a risk that countries could seek to advance progress towards universal health coverage by focusing on easier to reach populations. In order to ensure that no one is left behind, measures will be needed to reduce the discrimination facing all marginalized groups and to ensure their meaningful participation in the development and implementation of health strategies.

The event set the stage for further dialogue among ministers of health to promote sharing of experiences on securing access to HIV services and health care for all.

Organized by the International HIV/AIDS Alliance, co-hosted by Luxembourg, Morocco and Ecuador and supported by UNAIDS, the event took place on 19 May at the International Red Cross and Red Crescent Museum in Geneva, Switzerland.

GENEVA, 18 May 2015—On HIV Vaccine Awareness Day, UNAIDS is calling for a renewed global commitment to finding an effective HIV vaccine.

“A vaccine would be a major step towards ending the AIDS epidemic,” said UNAIDS Executive Director Michel Sidibé. “There have been encouraging recent scientific advances that give us hope for the future development of an HIV vaccine.”  

UNAIDS is committed to leaving nobody behind in the HIV response. A major advantage of vaccines is that they promote equity and can be used effectively in all communities and settings, including those where many other health services can be harder to deliver.

Studies show that an HIV vaccine is possible. The RV144 vaccine trial in 2009 lowered the rate of HIV infection by 31%. There is much hope that ongoing research will build on this trial and deliver results. Newer vaccine candidates, as well as neutralizing antibodies, are also being studied.

Vaccines have eradicated smallpox, and polio is close to eradication. Vaccines have also effectively controlled diphtheria, pertussis, tetanus, mumps, measles and rubella, among other infectious diseases.

However, in 2013, HIV vaccine research and development saw the largest decline in investment since 2008. In order to transform promising concepts into an effective and accessible vaccine increased and sustained funding will be critical.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

NEW YORK, 25 September 2014—Roche today announced a major Global Access Program to sharply lower the price of HIV viral load tests in low- and middle-income countries. This new initiative creates a ceiling price of US$ 9.40 per test, and will reduce Roche’s average price by more than 40% in low- and middle-income countries.  When fully implemented, the Global Access Program is projected to save more than US$ 150 million in costs over the next five years.

By increasing access to viral load testing, this new deal will dramatically improve the quality of HIV treatment services and strengthen capacity to achieve the global goal of ensuring that 90% of all people receiving antiretroviral therapy achieve viral suppression. The high price of viral load testing – is an important reason why less than one in four people on antiretroviral therapy currently have access to viral load testing. 

Increasing the affordability and availability of viral load testing is pivotal to hopes to end the AIDS epidemic. With the aim of laying the foundation to end the AIDS epidemic by 2030, the world has embraced a new treatment target for 2020: 90% of all people living with HIV know their HIV status; 90% of all people with diagnosed HIV infection receive antiretroviral therapy; and 90% of all people receiving HIV treatment are virally suppressed. More than 13 million people currently receive HIV treatment.

“We welcome this significant price breakthrough—the urgent call of people living with HIV is being answered. Now, with viral load testing, we can help ensure HIV treatment improves quality of life,” said UNAIDS Executive Director Michel Sidibé. “I congratulate all partners for this timely agreement. It is an excellent example of public-private partnership in action and the kind of innovation needed to accelerate ending the AIDS epidemic.”

With viral load testing, doctors and nurses in developing countries can help ensure that their patients are on the right drug regimens and keep the amount of the HIV virus in their patients at ‘undetectable’ levels. This helps ensure that patients stay healthy while also preventing HIV transmission. 
The UNAIDS sponsored Diagnostics Access Initiative, launched at the International AIDS Conference in Australia in July 2014, issued a call to the global community to achieve more affordable pricing for viral load testing. Through the leadership of South Africa and in partnership with CHAI, UNAIDS, The Global Fund and the US President’s Emergency Plan for AIDS Relief (PEPFAR), suppliers were challenged to lower viral load prices, and Roche is the first company to step forward and offer the HIV community an access policy that will accomplish these goals. Other partners in the DAI include the World Health Organization, US Centers for Disease Control and Prevention, African Society for Laboratory Medicine, UNITAID, the Global Fund, PEPFAR, Clinton Health Access Initiative and UNICEF.

“We applaud all the global partners who came together to ensure that over 31 million people living with HIV/AIDS in low and middle-income countries will be able to access viral load testing at this reduced price,” said President Bill Clinton, Chairman of the Clinton Health Access Initiative. “The Clinton Health Access Initiative has partnered with South Africa in its fight against HIV for more than a decade. We are honored to work with a government that is committed to HIV treatment not only in its own borders, but around the world.”

South Africa is the largest purchaser of viral load tests in the world, and the National Health Laboratory Service (NHLS) has the largest viral load program on the continent. The NHLS worked closely with Roche and other partners to create a framework that would benefit not only the 2.5 million people on treatment in South Africa, but millions more receiving antiretroviral therapy across sub-Saharan Africa and beyond.

“To end the AIDS epidemic in South Africa, we will need to build on this record of success to deliver the very highest quality of HIV treatment services, as measured by the proportion of people living with HIV who have viral suppression,” said President Jacob Zuma of South Africa. “Thanks to our ongoing partnership with the Clinton Health Access Initiative and UNAIDS, South Africa has been able to significantly reduce the per-patient price of this essential diagnostic test.”

The Global Access Program continues the longstanding leadership of Roche, which has played an important role in the AIDS response.

“As the leader in HIV viral load testing, Roche supports the UNAIDS 90-90-90 goal and the Diagnostics Access Initiative by expanding access to quality HIV testing through affordable pricing to those countries hardest hit by the disease,” stated Roland Diggelmann, Chief Operating Officer of Roche Diagnostics. “With 70% of all people living with HIV residing in Sub-Saharan Africa, we believe our commitment can truly make a difference to UNAIDS’ goal for achieving control of the HIV/AIDS epidemic.”

Leading AIDS donors welcomed the Program and pledged to effectively leverage it to scale-up viral load testing. “PEPFAR is committed to moving forward to increase use of viral load to monitor patient outcomes for PEPFAR-supported clients with the ultimate goal that all patients remain undetectable for their own health and for increasing control of the HIV pandemic,” said Ambassador Deborah L. Birx, M.D., the US Global AIDS Coordinator. “We are working on roll-out plans in partnership with countries to ensure that over the next four years all PEPFAR-supported patients and clinicians have access to accurate quality viral load data.” PEPFAR currently supports antiretroviral therapy for more than four million patients, excluding South Africa. 

“The Global Fund welcomes this new initiative,” said Global Fund Executive Director Mark Dybul. “Due in large part to the high price of available technologies, many treatment programs have yet to prioritize scale-up of viral load testing. The Roche Access Program offers an important incentive to rapidly expand access to viral load testing.”

The Clinton Health Access Initiative was founded in 2002 (then the Clinton HIV/AIDS Initiative) to support government partners and address the HIV/AIDS crisis in developing countries. CHAI began work in South Africa in 2003, where they supported the government in their first national HIV treatment scale-up plan. Since then, CHAI has helped South Africa save $900M on ARV costs over 4 years; supported a testing initiative that reached 15 million people over 15 months; and assisted in the scale-up of HIV treatment to more than 4,000 health facilities around the country.

The Clinton Health Access Initiative’s role in helping to structure the new viral load agreement was made possible by the UK Department for International Development (DFID), one of CHAI’s closest and most long-standing partners. DFID funds pioneering market shaping work for essential health commodities such as medicines, vaccines, diagnostics and contraceptives. This helps organizations and governments to allocate and spend their funding more efficiently and enhances access for those most in need. They also work closely with the government of South Africa and support their efforts to aggressively scale-up HIV treatment and achieve greater efficiency in HIV spending.

About the Clinton Global Initiative

Established in 2005 by President Bill Clinton, the Clinton Global Initiative (CGI), an initiative of the Clinton Foundation, convenes global leaders to create and implement innovative solutions to the world's most pressing challenges. CGI Annual Meetings have brought together more than 180 heads of state, 20 Nobel Prize laureates, and hundreds of leading CEOs, heads of foundations and NGOs, major philanthropists, and members of the media. To date, members of the CGI community have made more than 3,100 Commitments to Action, which have improved the lives of over 430 million people in more than 180 countries.

CGI also convenes CGI America, a meeting focused on collaborative solutions to economic recovery in the United States, and CGI University (CGI U), which brings together undergraduate and graduate students to address pressing challenges in their community or around the world. For more information, visit clintonglobalinitiative.org and follow us on Twitter @ClintonGlobal and Facebook at facebook.com/clintonglobalinitiative.

UNAIDS

The Joint United Nations Programme on HIV/AIDS (UNAIDS) leads and inspires the world to achieve its shared vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths. UNAIDS unites the efforts of 11 UN organizations—UNHCR, UNICEF, WFP, UNDP, UNFPA, UNODC, UN Women, ILO, UNESCO, WHO and the World Bank—and works closely with global and national partners towards ending the AIDS epidemic by 2030 as part of the Sustainable Development Goals. Learn more at unaids.org and connect with us on Facebook, Twitter, Instagram and YouTube.

Report shows prevention R&D funding falls 4% due to public sector research budget reductions in US, Europe

Melbourne, Australia, 18 July 2014 – Investment in HIV prevention research fell US$50 million, or 4 percent, to US$1.26 billion in 2013, due to declining investments by the United States and European government donors, changes in the international development landscape and changes in the pipeline of HIV prevention products in various stages of development and implementation, according to a new report from the HIV Vaccines and Microbicides Resource Tracking Working Group.

HIV Prevention Research & Development Investment in 2013: In a changing global development, economic, and human rights landscape is the tenth annual report by the Working Group, a collaboration between AVAC, UNAIDS, and the International AIDS Vaccine Initiative (IAVI). The report summarizes investment in HIV prevention research across seven prevention options. The report was released today ahead of the 20th International AIDS Conference (AIDS 2014) in Melbourne, Australia. Breakdowns by prevention modality are available in the full report at www.hivresourcetracking.org.

Despite overall US budget cuts in 2013 and a decline in support for HIV prevention research, the US government remains the single largest funder of prevention research, accounting for more than 70 percent of total investment over the past five years. The US contribution decreased US$44 million to US$881 million in 2013, largely due to automatic, across the board cuts to all federally funded programs as a result of sequestration. Funding from European government donors, including 12 countries and the European Commission, was also reduced as priorities for international development in some countries have continued to shift.

“Research and development has produced a valuable range of medicines, diagnostics and devices to prevent and treat HIV which have to be made more widely available. However, funding is declining at a time when services need to be expanded and better treatments and additional HIV prevention options are needed,” said Luiz Loures, Deputy Executive Director, UNAIDS. “Now is not the time to pull back from science, but rather to push forward towards ending the AIDS epidemic.”

Investment declined in research & development related to voluntary medical adult male circumcision (VMMC) and female condoms, both options that have long been proven effective and are now being scaled-up as part of broader HIV prevention programs. Investment increased for R&D related to treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP), which have more recently proven effective and now require additional research to support wide scale implementation.

Vaccine R&D in 2013 also saw the largest real decrease in investment since such research began, with the effects of U.S. sequestration, reduced bilateral funding from European governments, and the lack of large efficacy trials in the latter part of the year accounting for much of the decline. Substantial public sector funding cuts and dropped support from past philanthropic funders also played a role in the more pronounced decline for microbicides funding, which still drew heavily on the US government for support even as its contributions declined.

“There is a growing consensus that we can end the AIDS epidemic if we develop and deploy the right tools and reach those most at risk,” said Mitchell Warren, AVAC Executive Director. “But we won’t be able to make a sustained impact on the cycle of new infections without development and aggressive rollout of new prevention options – voluntary medical male circumcision, PrEP, treatment as prevention, microbicides and eventually vaccines. We need sustained and flexible funding to ensure that we efficiently develop new options, demonstrate how proven options can be rolled out and deliver what we know works.”

The decline in prevention funding comes within a changing and very challenging human rights environment. Harsh new anti-homosexuality laws and other legislation criminalize those most at risk from HIV/AIDS and make it increasingly difficult to answer critical questions supported by HIV prevention R&D, such as how to meet the needs of men who have sex with men, transgender people, sex workers, people who inject drugs and other populations most affected by HIV. This will continue to have an impact on how those trials are funded and where they can be conducted.

"A combination of long-term vision, scientific innovation and generous funding has eradicated smallpox, is close to eradicating polio, and has brought us to an era in which a positive HIV test is no longer an automatic death sentence," said Margie McGlynn, IAVI President & CEO. "A vaccine will be essential to the global, comprehensive response that can end AIDS once and for all, and sustained and broadened support will be crucial to its development."

The report is online at www.hivresourcetracking.org.

The HIV Vaccines and Microbicides Resource Tracking Working Group is composed of AVAC, the International AIDS Vaccine Initiative (IAVI) and the Joint United Nations Programme on HIV/AIDS (UNAIDS). The Working Group has been tracking investment in HIV prevention research since 2004.