Feature story

Global HIV prevention targets at risk

29 October 2018

As the world grapples with how to speed up reductions in new HIV infections, great optimism is coming from the world of HIV prevention research with a slate of efficacy trials across the prevention pipeline. Major HIV vaccine and antibody efficacy trials are under way, as is critical follow-on research for proven antiretroviral-based prevention options.

However, a new report by the Resource Tracking for HIV Prevention R&D Working Group shows that rather than bolstering the new research by increasing investments into these exciting new advances, resources for HIV prevention research and development are actually slowing down.

In fact, in 2017, HIV research funding declined for the fifth consecutive year, falling to its lowest level in more than a decade. In 2017, funding for HIV prevention research and development decreased by 3.5% (US$ 40 million) from the previous year, falling to US$ 1.1 billion.

“Make no mistake, we are in a prevention crisis and we cannot afford a further funding crisis,” said Mitchell Warren, AVAC Executive Director. “It is unacceptable that donor funding for HIV prevention research continues to fall year after year even as research is moving new options closer to reality. We need continued and sustained investment to keep HIV prevention research on track to provide the new tools that will move the world closer to ending AIDS as a public health threat.”

The report warns that meeting the UNAIDS HIV prevention Fast-Track target of less than 500 000 new infections by 2020 (new HIV infections were at 1.8 million in 2017) will not only require the expansion of existing options such as voluntary medical male circumcision and pre-exposure prophylaxis, but also the development of innovative new products, including long-acting antiretroviral-based prevention options and a vaccine.

Indeed, sustained funding will be critical to keep the full gamut of HIV prevention research moving forward in a timely manner, as even small declines in funding could delay or sideline promising new HIV prevention options that are needed to end the AIDS epidemic.

“With 5000 people becoming infected with HIV every day, it is critical that we both scale up the effective HIV prevention programmes we currently have and invest in new technologies and solutions so that they can become a reality for the populations most affected by HIV,” said Tim Martineau, UNAIDS Deputy Executive Director, a.i. “Doing both will avert new infections, save lives and reduce the rising costs of life-long antiretroviral treatment.”

The Government of the United States of America continues to be the major funder of HIV prevention research, contributing almost three quarters of overall funding in 2017. However, this was also a decrease of almost 6%, bringing funding from the United States to a five year low of US$ 830 million. The report highlights that the uncertainty around continued political will to fund the AIDS response is a serious concern. 

This week, researchers, implementers, advocates and funders are gathering at the HIV Research for Prevention (HIVR4P 2018) conference in Madrid, Spain, to review progress in HIV prevention research. There is much to be optimistic about in HIV science and in the accumulated knowledge of how to end the epidemic; however, the sobering changes in the funding and policy environments are raising some serious concerns about the future of the response to HIV and the world’s ability to respond to the continued challenges that HIV presents.

The report and infographics on prevention research investment are online at www.hivresourcetracking.org and on social media with #HIVPxinvestment.

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 investments and expenditures for biomedical HIV prevention options. AVAC leads the secretariat of the working group, which also includes the International AIDS Vaccine Initiative and UNAIDS.

Report and infographics on prevention research investment