HIV Prevention and Equity in 2022 & Beyond

Dear Advocates, Partners and Supporters,
 
This year was an incredible one of reflection, engagement, opportunity, and action. More than 40 years into the HIV epidemic – and in the midst of multiple other pandemics and persistent inequities – AVAC and its partners continue to reshape, reimagine and fight for effective HIV prevention.
 
We began 2022 with a new strategy reflecting an evolving field and critical opportunities for HIV prevention and for global health:

• Research is accelerating, with more options available than ever before. But progress toward crucial targets has been far too slow, and these biomedical options are not yet real choices for the people who need them.
• COVID accelerated science, but significant gaps in access underscored the necessity for smart, equitable, and people-centered pandemic preparedness, prevention AND response.
• And a global movement for social justice continues to demand that we all reexamine critical questions of equity, including health equity.

As we close out the year, we’ve been asking ourselves, how have we done? And the answer, we hope, lays the foundation for bold action in 2023 and beyond.
 
Thanks to an incredible partnership network and committed donors and collaborators, I am proud to say that we’ve made significant progress. But, as Tony Fauci reminded us all last month when he and I had a chance to chat about history AND the future, “much accomplished; much more to do.”
 
In all that we do at AVAC, we keep three aims in mind. Track and translate the science so the research enterprise and the communities who need prevention most are working hand in hand. Advocate for evidence-based, high-impact, community-centered programs, products and policies. And catalyze the relationships, partnerships, coalitions, advocacy agendas, joint commitments and action plans that get it all done.
 
Here’s a look at just some of the work we’ve done to advance all three in 2022. 
 

We served as a bridge between the scientific field and communities where research happens.

• Published new evidence on a wide range of critical topics:  
  • Correlations Between Oral Pre-Exposure Prophylaxis (PrEP) Initiations and Policies that Enable the Use of PrEP to Address HIV Globally in PLOS
  • JIAS Viewpoint on HIV vaccines in 2022: where to from here?
  • Catalyzing action on HIV/SRH integration: lessons from Kenya, Malawi, and Zimbabwe to spur investment in Global Health Action 
  • "It's Almost as if Stakeholder Engagement is the Annoying 'Have-to-do'…": Can Ethics Review Help Address the "3 Ts" of Tokenism, Toxicity, and Tailoring in Stakeholder Engagement? in the Journal of Empirical Research on Human Research Ethics
  • Safety data needed for concurrent use of ARV-based PrEP in Lancet HIV
• Convened critical conversations to reframe and re-energize the search for an HIV vaccine; created a snapshot of Phase 1 mRNA HIV Vaccine Trials that are underway and a backgrounder on experimental medicine vaccine trials (EMVTs) that are driving the field forward.
• Spoke with advocates and global leaders on our PxPulse podcasts about all forms of HIV prevention and what needs to happen next to ensure equitable access.
• Redesigned PrEPWatch.org, a one-stop clearinghouse for the latest PrEP data on implementation and uptake, resources, and information on PrEP policies, programs and products, approved and in development.
• Created STIWatch.org, the first and only resource on all things STI vaccine development.
• Tracked and translated new developments: created and shared more than 17 accessible, up-to-date resources on the full spectrum of biomedical HIV prevention products from research to rollout and real-time analysis of emerging developments.

 

We deepened our investment in supporting the next generation of skilled and informed advocates with the belief that advocacy and action must be founded on principles of power-sharing.

• Developed and continuously track our Plan for Accelerating Access and Introduction of Injectable CAB for PrEP to ensure time is not wasted and opportunity is not squandered, and importantly, that civil society plays a meaningful role. 
• Supported the African Women’s HIV Prevention Accountability Board and our CASPR and COMPASS partners in meeting with global leaders, including Winnie Byanyima of UNAIDS, Amb. John Nkengasong of PEPFAR and Atul Gawande and Han Kang of USAID, to make the urgent case for faster and more equitable access to both the dapivirine vaginal ring (DVR) and injectable cabotegravir – and to listening to and engaging with civil society before making decisions.
• Welcomed the 12th class of the flagship Fellows Program with 8 new Advocacy Fellows working on access to the DVR, U=U campaigns, and integrating SRH with HIV services.  
• Established CureROAR to support a cadre of advocates to gain knowledge in the science and process of cure research, and to develop an advocacy agenda to ethically advance cure research.
• Introduced The Choice Agenda (TCA), a global forum for advocacy on HIV prevention, with agenda-setting conversations, deep-dive webinars on key issues in the field and moderated passionate, highly-informed discussions with 1,000 advocates and experts across the field.
• Launched an advocacy campaign with PrEP4All and other partners to ensure the US National PrEP Program reaches those who need prevention most – with a huge year-end victory this week when the US Congress included as part of its fiscal year 2023 budget a call for the Centers for Disease Control and Prevention (CDC) to expand equitable national PrEP access in order to end the HIV epidemic!

 

We expanded our work to cultivate and sustain dynamic partnerships that set a bold and innovative agenda for HIV prevention. 

• Launched The Coalition to Accelerate Access to Long-Acting PrEP, a new initiative to ensure an accelerated, equitable, sustainable and collaborative approach to making longer-acting PrEP options accessible as quickly and as equitably as possible.
• Co-hosted the first Africa Health R&D Week and launched the Domestic Resource Mobilization (DRM) Learning Collaborative.
• Joined a wide range of partners in urging a comprehensive approach to Pandemic Preparedness, Prevention and Response, outlining a funding agenda for the Pandemic Fund and articulating key needs for future global health governance.
• Hosted 20+ virtual and in-person think tanks and consultations to update and gather feedback on the latest developments related to the Dual Prevention Pill (DPP) market introduction, injectable CAB for PrEP, and the MATRIX pipeline of new HIV prevention and multipurpose prevention options.
• Hosted with Wits RHI and CASPR a GPP Symposium exploring innovation in Good Participatory Practice (GPP) and strategizing for expansion of GPP in 2023.
• Convened 3,000+ participants on 28 webinars to explore issues key to the future of the AIDS response, HIV prevention and global health equity.

 

Yes, together we’ve been able to do so much this year. But there remains a long, unfinished agenda for all of us in 2023 and beyond, that no one organization can address alone. The challenges ahead can only be defeated by building global solidarity, sharing responsibility and accountability, and mobilizing a response that leaves no one behind.
 
Thank you to all of our partners, AVAC staff, board, donors, and the remarkable individuals and organizations around the world who allow us to continue this critical work as part of a comprehensive and integrated pathway to global health equity.

In solidarity and with enormous gratitude,
Mitchell Warren and all of us at AVAC
 
P.S. We are grateful for all forms of support and partnership. If you can, please do consider a financial contribution to AVAC to help keep this work moving, together.