A decade of unprecedented investment in HIV prevention research has led to major scientific breakthroughs in vaccines, microbicides, voluntary medical male circumcision, treatment as prevention and pre-exposure prophylaxis, or PrEP, but sustained financing will be needed to capitalize on these breakthroughs to deliver new options that can help end the AIDS pandemic, according to a report released at the XIX International AIDS Conference in Washington, DC.
The report, Investing to End the AIDS Epidemic: A New Era for HIV Prevention Research & Development, tracks investment in prevention research in 2011 and looks back at a decade of tremendous growth in funding, despite sometimes uncertain prospects for some HIV prevention options. Yet, the authors note that capitalizing on recent breakthroughs in the field and ensuring a pipeline of new next generation products will require sustained and flexible investments from a range of donors in the coming years.
The eighth annual report from the HIV Vaccines and Microbicides Resource Tracking Working Group shows that funders invested a total of US$1.24 billion in research and development (R&D) for six key prevention options: preventive HIV vaccines, microbicides, PrEP using antiretroviral drugs, treatment as prevention, prevention of vertical transmission and operations research related to medical male circumcision. This investment is down slightly from the US$1.27 billion invested in 2010 for these six research areas. Investments in vaccine and microbicide R&D decreased in 2011, though decreases for microbicide R&D were attributed to funding disbursement cycles and did not represent declines as compared with past investments.
“This is a critical time. We now have 8 million people on antiretroviral treatment and we are seeing reductions in new HIV infections, even in the most affected communities. But it is not enough to think that HIV is a disease that can be managed with pills. HIV has to be brought to an end and funding shortfalls must not become the roadblocks that prevent us from achieving our goals,” said Michel Sidibe, Executive Director of the Joint United Nations Programme on HIV/AIDS, (UNAIDS).
“Recent advances toward the development of a preventive HIV vaccine have fueled optimism within the AIDS vaccine field. Researchers around the world are now working to build on this progress to develop next-generation vaccine candidates and advance the most promising of these candidates toward large-scale efficacy trials,” said Margaret McGlynn, IAVI President & CEO. “I am more optimistic now than ever before that the development of a preventive AIDS vaccine is within reach. However, in order to build on this recent progress it is critical that we sustain financial commitment and support for HIV vaccine R&D.”
In the past two years, beginning with results from the landmark CAPRISA 004 microbicide trial announced at the last International AIDS Conference, we have seen tremendous breakthroughs in antiretroviral-based prevention, including TDF/FTC (Truvada) as daily oral PrEP, which was approved by the US Food and Drug Administration as a new prevention option last week, and the HPTN 052 treatment as prevention study which provided evidence that early treatment of HIV-positive people may also protect their HIV-negative partners.
Analyses completed in the past year have unveiled crucial clues as to how the candidate in the RV144 HIV vaccine trial provided protection against HIV. In addition, recent advances in identifying and characterizing broadly neutralizing antibodies to HIV are informing potentially powerful new vaccine candidates.
For microbicides, Phase III clinical trials are underway that could provide the results needed to license and deliver marketable products, including 1 % tenofovir gel and vaginal rings that could offer women protection for a month, two months or longer–and might eventually combine an antiretroviral drug with a contraceptive hormone to provide dual protection. Additional PrEP trials are looking at different drugs and less-than-daily dosing that might be easier for people to adhere to.
Recent positive results underscore the importance of preparing for success and capitalizing on areas of progress and promise. The prevention field continues to need funding structures that can adapt quickly and are sufficiently generous to allow for rapid expansion in the event of positive outcomes.
Indeed, the HIV prevention research field is facing a new and exciting era with many new HIV prevention options becoming available, including female condoms, voluntary medical male circumcision, antiretroviral treatment as prevention and PrEP. The report notes that additional funding will be needed to effectively roll out all available options, which represents an investment opportunity for countries heavily impacted by HIV, particularly emerging economies.
As the rallying cry to end AIDS is heard this week from policymakers, researchers, funders and advocates gathered in Washington, DC, and as we work together to craft a response to AIDS, the Working Group notes that research to develop and roll out new prevention options is a vital component for success and must be appropriately funded.
“For the first time, the end of the AIDS epidemic is within reach,” said Mitchell Warren, Executive Director of AVAC. “New prevention options – voluntary medical male circumcision, PrEP, treatment as prevention, microbicides and eventually vaccines – will play a critical role in reducing the cycle of new infections. The past decade has been a period of increasing investment in HIV prevention R&D and has yielded unprecedented success. With sustained and flexible funding, the future of HIV prevention research will be even more promising.”
The report is available online at: www.hivresourcetracking.org .
SOURCE: PR Newswire