Advocacy in Uncertain Times: HIV Vaccine Awareness Day Turns 20

These are hectic times. There is more information coming at all of us than at any time in human history. And much of what we’re seeing and hearing is cause for alarm – about the health, security, and well-being of the worldwide communities we serve as AIDS advocates.

In the midst of it all, today – May 18th – is HIV Vaccine Awareness Day (HVAD). It’s the 20th anniversary of US President Bill Clinton’s landmark speech at Morgan State University calling for the development of an HIV vaccine in the next decade: “We are grateful that new and effective anti-HIV strategies are available and bringing longer and better lives to those who are infected, but we dare not be complacent. HIV is capable of mutating and becoming resistant to therapies and could well become even more dangerous. Only a truly effective, preventive HIV vaccine can limit and eventually eliminate the threat of AIDS.”

Twenty year on this HVAD is unlike any other. It comes in a week that saw the US President expand the Global Gag Rule, which cuts US funding from organizations that will not agree to stop even mentioning abortion as an option for women. This anti-woman and anti-public health policy will now impact many more recipients of US funding. Many public health and human rights organizations have spoken out against this policy, including my organization AVAC, which is committed to the rights and health of girls and women worldwide, and stand strong with our allies in this fight.

Keeping HIV prevention on the agenda amidst such troubling news is difficult, to say the least. How, in the midst of it all, do we advocate for an HIV vaccine, which will not be available until into the 2020s, at the earliest?

We do it by advancing a near-, mid- and long-term agenda with passion and precision. And today advocates can do that with more confidence than ever. History tells us that an effective preventive vaccine is essential to ending epidemics. An epidemic can be controlled with treatment and other prevention—just as HIV is coming under control today. But it takes a vaccine to end an epidemic and to eradicate a disease.

This year our HIV Vaccine Awareness Day message is simple: No end without a vaccine; and no vaccine without funding.

To ensure the funding takes political will, activism, advocacy and scientific advancement.

In today’s context of shrinking budgets for global health and competing priorities, the absolute minimum for donors must be holding fast to current levels. The relatively flat funding for the past 10 years has enabled major progress for HIV vaccine development, and immunology and other key research. Retreating now would wipe out critical gains not only in the science, but in global research capacity that has also served other areas of disease research, like Ebola and Zika vaccine development.

To sustain momentum, we need sustained funding for basic science, vaccine design, clinical trials and product development. The United States and other governments need to stand firm in their commitments to HIV vaccine research, and so do industry and private funders. It’s a stark fact that unless this work is considered a core part of the HIV response and provided ongoing support, vaccine development will fail and the end to HIV will be indefinitely put on hold.

On HIV Vaccine Awareness Day 2017, AVAC and our fellow advocates also call on the vaccine research field itself to show accountability for its resources by:

  • Making data-driven, collaborative, transparent decisions about which candidates advance in human trials.
  • Investing in the hard discussions about how HIV vaccine trials happen in the era of oral PrEP and other new prevention options.
  • Ensuring the swift, ethical conduct of planned and ongoing trials and planning ahead such that the field can act quickly on various trial outcomes.

We also call on our allies working on the global HIV response to recognize that resources for HIV vaccine and other research cannot be left behind. Even – if not especially – in difficult and overwhelming times.

Where will we be along that path on the 21st HIV Vaccine Awareness Day and in subsequent years? Much depends on the political will and recognition of the continued need for an HIV vaccine. A safe, effective, preventive vaccine is both scientifically possible and essential to long-term control of the epidemic. We know that today’s HIV prevention tools can do a lot to bring epidemic levels of new diagnoses under control. We know, too, that a strategy like long-acting injectable ARVs that might reduce HIV risk for months at a time with fewer adherence challenges could be a huge step forward for prevention.

The hard truth is we will pass many more May 18ths before we can celebrate a licensed accessible HIV vaccine. And HIV vaccine research can only succeed with enduring advocacy and fresh voices taking up the charge. That means the next generation of vaccine champions will need to rise to the challenge of keeping the hope for and need for an HIV vaccine in the forefront of HIV advocacy. Public health history tells us that a vaccine is an essential tool for ending an epidemic. And for HIV, now is not the time to falter or turn back.

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