The total amount spent on HIV prevention research in 2013 dropped by 4 percent (US$50 million) to US$1.26 billion. Key reasons for this decline include a reduction in investments by the United States and European government donors and changes in the international development landscape. This is presented in a report from the HIV Vaccines and Microbicides Resource Tracking Working Group.
Investment declines are evident across research and development related to voluntary medical adult male circumcision (VMMC) and female condoms, despite both proving effective preventative measures that should be scaled-up as part of broader HIV prevention programs. Investment has increased for research and development in other areas including treatment as prevention (TasP) and pre-exposure prophylaxis (PrEP), which have more recently proven effective and now require additional research to support wide scale implementation. Cuts in public sector funding and withdrawn support from philanthropic funders, played a role in the pronounced decline for microbicides funding.
Research and development has produced a wide range of valuable medicines, diagnostics and devices to prevent and treat HIV, ultimately increasing access to vital HIV services. However in a time when HIV services need to be expanded, better treatments and additional HIV prevention options are vital, a decline in funding can be devastating. It is not the time to pull back from science, but rather to push forwards towards ending the AIDS epidemic. No sustained impact on the cycle of new infections can be made without the development and aggressive rollout of new prevention options – Voluntary Medical Male Circumcision (VMMC), treatments as prevention (TasP) and pre-exposure prophylaxis (PrEP), microbicides and eventually vaccines. Sustained and flexible funding is needed to ensure the development of efficient new options, and further implement what has proven to be effective in terms of prevention and treatment.
This decline in prevention funding comes within a changing and very challenging human rights environment, criminalising those most at risk of HIV and making it increasingly difficult to answer critical questions supported by HIV prevention research and development. This will influence research and development on how trials are funded and where they can be conducted.
A combination of long-term vision, scientific innovation and generous funding has eradicated smallpox, is close to eradicating polio, and has brought us to an era in which a positive HIV test is no longer an automatic death sentence. Therefore consistent and sustainable funding for HIV prevention research and development must continue to end the HIV and aids epidemic.