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AVAC Report 2014/2015 talks a lot about how to set and meet strategic targets. This is fairly simple for proven strategies like ART for HIV-positive individuals and VMMC. It is more complex, but doable for emerging strategies like oral PrEP. It is hardest for strategies in development, including AIDS vaccine and multi-purpose prevention technologies that would provide contraception and HIV prevention in a single product. Science doesn’t run on a schedule, and a breakthrough can come at any time, or not at all.
In this context, setting milestones can set false expectations. But while success doesn’t (often) run on a schedule, it is possible to establish mechanisms for accountability and targets related to long-term goals. That’s why our recommendation for 2014/15 is: Demand short-term results on the path to long-term goals.
Here are some key steps to take in the next year.
Define accessible messages and milestones for broadly-neutralizing antibody research.
There is increasing activity in bNAb research happening in HIV-positive and HIV-negative individuals? Partners working on passive immunization trials report that its tremendously complex to explain the science, purpose and possible outcomes of these trials. The field needs to ensure that this trial conduct and communications work is well-resourced and that best practices and messages are shared and adapted inreal time, and in adults and infants. Answers to key questions compiled into a single document that helps stakeholders sort out this sophisticated field.
Plan and program around roll-out of other ARV-based prevention options. Ensure stakeholder engagement in cure research and passive immunization trial design.
It’s not possible to set a deadline for having an antibody-inducing vaccine, but it is possible to have milestones for research literacy tools, documented stakeholder engagement, transparent exploration of the concerns and support for these trials, and a way forward that reflects both good science and good participatory practice.
Define the standard of prevention for next-generation efficacy trials including of AIDS vaccines and multi- purpose prevention technologies.
This is an age-old recommendation that is made, each year, in a brand-new world. As oral PrEP comes on line, ART guidelines change, and the world prepares for a potential microbicide ring or gel, it is essential to re-visit the principles for incorporating emerging strategies.