New Investment Critical to Capitalize on HIV Prevention Research Breakthroughs

According to the latest  report ‘Capitalizing on Scientific Progress: Investment in HIV Prevention R&D in 2010’, released by the HIV Vaccines and Microbicides Resource Tracking Working Group (comprising AVAC, the International AIDS Vaccine Initiative IAVI, the International Partnership for Microbicides IPM, and the Joint United Nations Programme on HIV/AIDS UNAIDS. , in Rome, at the 6th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention, flexible, agile and generous funding structures are needed to ensure development and delivery of new lifesaving options for HIV prevention.
In the 30 years, since the first reported cases of AIDS, researchers have made extraordinary advances in understanding, treating, and preventing HIV infection. There are now more than 20 approved antiretroviral drugs, and in 2010 the number of people receiving ART grew by 25% from 2009, (from 5.3 million to 6.6 million). At the same time, there has been recent global success in promoting HIV prevention through safer sexual practices. During the last decade, HIV incidence has declined in 33 countries, and HIV prevalence among young people has fallen in 15 countries.

 Also, in the last two years, a number of promising trial results and critical scientific breakthroughs have changed the HIV prevention landscape, providing new opportunities for both a broader response to the epidemic with new prevention options and broader clinical and laboratory agendas with new research targets. The first good news came in October 2009, when The US- and Thailand-funded Phase III HIV vaccine clinical trial RV 144, with 16,000 Thai participants, reported that a vaccine combination had reduced risk of infection by 31%—the first clinical evidence that a preventive AIDS vaccine would be possible. Then, in July 2010, the US- and South Africa funded CAPRISA 004 trials showed that use of 1% tenofovir (TDF) vaginal gel reduced women’s risk of acquiring HIV from their male sexual partners by an estimated 39% and also showed a 51% reduction in acquisition of HSV-2—providing the first proof that a microbicide would be possible. In November 2010 the US- and BMGF-funded iPrEx trial results showed that daily oral tenofovir/ emtricitabine (TDF/FTC) reduced the risk of HIV infection by an estimated 44% in men who have sex with men and in transgender women, thus proving for the first time that HIV prevention using PrEP would be possible. Finally, in May 2011, the US-funded HIV Prevention Trials Network (HPTN) 052 trial established that immediate versus delayed initiation of Anti Retroviral Treatment by HIV-positive individuals reduced transmission to their partners by 96%, proving for the first time that treatment could also act as prevention.

At the same time, investment in biomedical HIV prevention research remained stable despite the effects of the recent global economic downturn. A surprising finding of the report is that during 2010 the overall investment in HIV prevention research and development (R&D) had actually increased, approaching the previous historical high of US$1.23 billion reached in 2007. The report documented a total of US$1.19 billion investment in R&D for four key HIV prevention options: preventive vaccines, microbicides , pre-exposure prophylaxis (PrEP) using antiretroviral drugs, and operations research related to medical male circumcision.

However, care must be taken that the funding stability seen over this period does not lead to a false sense of security about future funding trends. The scientific successes of the past two years demonstrate the need to direct resources so as to convert promise into progress as fast as possible.

"We have seen tremendous progress in HIV prevention research over the last two years," said Margaret McGlynn, President and CEO of the International AIDS Vaccine Initiative (IAVI). "Sustaining the momentum built through these advances depends on access to stable funding that can be flexibly applied to the most promising areas of research. This will allow us to build upon the field's successes and to move promising concepts from the pipeline into clinical trials as swiftly as possible."

Flexible, agile and generous funding structures are needed to ensure development and delivery of lifesaving new options for HIV prevention, both in earlier translational research and late stage clinical research. With positive clinical evidence and new scientific knowledge now available in several important areas, the lack of long-term funding particularly threatens to impede progress, most critically when the next essential step is a late-stage confirmatory trial. While scientific questions still predominate as the primary challenges for HIV vaccine R&D, for other fields, notably microbicides and PrEP, scarcity of funding for clinical and implementation research is a crucial issue. To capitalize on these recent exciting prevention breakthroughs, more investment will be needed across prevention technologies and from bench research to operational and implementation research.

“The recent exciting results in the PrEP and microbicide fields are proof that investment in HIV prevention research is bringing women and men around the world much closer to having a broad range of effective HIV prevention options,” said Zeda Rosenberg, CEO of the International Partnership for Microbicides (IPM). “Wise investments now in laboratory and clinical research and in efforts to roll out new interventions will pay off as HIV infections decline significantly in the coming decades.”

Some of the new interventions remain experimental (RV 144); others require confirmatory trials (CAPRISA 004); and others have as yet unarticulated pathways to implementation (iPrEx and HPTN 052).
This year’s report argues that capitalizing on these promising scientific breakthroughs will require substantial additional and sustained investment from a broader set of donors. The challenge is to build on the current momentum when many HIV prevention R&D funders, especially in government agencies, find themselves under increasing pressure to reduce spending. The HIV prevention field will need to focus its existing resources strategically for maximum impact. The global commitment to HIV prevention research was most recently evidenced by the Declaration of Commitment on HIV/ AIDS and the Political Declaration on HIV/AIDS draft resolution submitted to the General Assembly after the High-Level meeting on HIV-AIDS held in June of 2011. The Declaration asserts the goal of “investing in accelerated basic research on the development of sustainable and affordable microbicides and other new prevention technologies, including female-controlled prevention methods, ….[and] research and development for a safe, affordable, effective and accessible vaccine.”

Citizen News Service

Published in:
Citizen News Service(CNS), India/Thailand
Elites TV News, California, USA 
Wikio News, Africa
Health, Thailand, India