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HIV R&D Investment

In a financial climate with increasingly limited resources, tracking investment in HIV R&D provides the field with vital information to chart the course forward. Monitoring funding trends allows identification of promising areas where investment is needed, prioritization of research, analysis of the effects public policies have on funding trends and fact-based advocacy to support future investment in research. As later-stage and follow-on trials move forward, understanding and evaluating research in the context of public, private and philanthropic funding is increasingly important to ensure continued movement down the path towards ending AIDS. For 16 years, AVAC has been a part of a variety of resource tracking efforts—tracking funding for HIV across the research agenda.

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Resource Tracking for HIV Prevention Research and Development Working Group
Since 2004, the Resource Tracking for HIV Prevention Research and Development Working Group (formerly the HIV Vaccines and Microbicides Resource Tracking Working Group) has collected information annually on the amount invested in research and development for HIV prevention options, including vaccines, microbicides, pre-exposure prophylaxis (PrEP), treatment as prevention, male circumcision, female condoms, vertical transmission prevention, and also cure and therapeutic vaccine research.

The Latest Funding Trends
The report indicates an uptick after five consecutive years of declining investment. In 2018, funding for HIV prevention R&D increased by a modest 1.2 percent or US$13 million from the previous year, growing to US$1.14 billion. While the increase is encouraging, it’s the smallest net increase since 2003. This impacted the various prevention categories differently. Investment increased for pre-exposure prophylaxis (PrEP), female condoms and prevention of vertical transmission (PMTCT) but decreased for voluntary medical male circumcision (VMMC), preventive vaccines, microbicides and treatment as prevention (TasP).

Despite the significant variation by technology category, donor trends remained more or less the same. Public sector (79 percent of overall or US$900 million) and philanthropic sector (14.4 percent of overall or US$164 million) investments remained mostly unchanged from 2017, while the private sector saw a 30 percent surge in investment, rising to US$74.7 million in 2018. Actual commercial investment levels are bound to be much higher as not all private companies responded to the Working Group’s request for data.

While US and European investment remained steady in 2018, the recorded levels are still the lowest in over a decade at US$829 million and US$57.5 million, respectively. Outside the US, prominent increases came from the UK, Germany, Canada, Australia and the European Commission, while declines were observed from Brazil, France and Japan. Global philanthropic levels also saw no change in 2018 and the Bill and Melinda Gates Foundation (BMGF) remained the preeminent funder at US$149.7 million or 91 percent of all sector investment.

As it stands, the US public sector and BMGF account for 86 percent of all funding. Citing the promise of the current R&D pipeline, the report cautions against this funding imbalance and the resulting impact on the longevity and sustainability of the field. Much hope can be drawn from the latest scientific strides: the ongoing late-stage efficacy trials for long-acting injectable PrEP and antibody mediated-prevention; the Phase III trial launching in 2019 that is bringing us closer than ever to a licensed HIV vaccine; and the dapivirine vaginal ring that may soon be approved for use in women. All of the above is contingent on sustainable financing and a diverse donor base that cushions against mercurial shifts from large donors.

Download The Report: HIV Prevention Research & Development Investments 2018: Investing to end the epidemic

global HIV prevention R&D investment by Technology Category, 2000-2018

HIV Cure Research Resource Tracking
In 2014, the HIV Vaccines and Microbicides Resource Tracking Working Group and AVAC began a collaboration with the International AIDS Society’s (IAS) Towards an HIV Cure initiative. AVAC, Treatment Action Group (TAG) and the IAS brought together a group to review and allocate grants towards HIV cure research and analyze data on global funding. The working group released a report in September 2020, Global Investment in HIV Cure Research and Development in 2019.

The Working Group estimates that in 2019, US$328.2 million was invested in cure research, representing a 1 percent increase over the US$323.9 million invested in 2018, and an increase of 272 percent over the US$88.1 million invested in 2012.

The majority of investments (US$306.7 million) came from the public sector with US$20.7 million invested by philanthropies such as amfAR, the Bill and Melinda Gates Foundation, and Institut Pasteur. Despite outreach by the Working Group, only one company responded to the survey, whilst several companies are known to have active cure research programmes, resulting in a signficant underestimation for commercial investment in cure research.

Resource Tracking Activities
In July 2016 at the International AIDS Conference in Durban, South Africa AVAC collaborated with Funder’s Concerned About AIDS (FCAA) to bring together a group of organizations and individuals who undertake and specialize in resource tracking for funding of HIV and related health priorities. The group was an effort to better collaborate in the area of resource tracking, to share methodological knowledge and to bring together sources of resource tracking information for the field.

The culmination was a session at AIDS 2016 titled, Using Funding Data to Advocate for Global and Domestic Resources in the Critical Push towards the End of AIDS, featuring resource tracking efforts from the Centre for Economic Governance and AIDS in Africa (CEGAA), the Global Forum on MSM and HIV (MSMGF), Treatment Action Group (TAG), Funders Concerned About AIDS (FCAA) and the Resource Tracking for HIV Prevention research and Development working group.

This session was a follow-up to the initial resource tracking collaboration that took place at AIDS 2012 in Washington, DC entitled, Know Your Resources: How to use funding data to strengthen your messages in the critical push for investing in the end of AIDS.