Treatment as Prevention
Investment in Research & Development Related to Treatment as Prevention
Investment in research into the early initiation of AIDS treatment drugs as a prevention strategy has continued to increase since the Working Group began tracking funding towards the HIV prevention modality in 2010. Countries continue to include treatment as prevention in national strategies as models show that it could dramatically alter the course of the epidemic. Ongoing research seeks to answer questions about how best to implement treatment as prevention programmatically,and to address implementation in specific populations and settings. Total global investment in treatment as prevention R&D in 2013 was US$117 million in 2013, an increase of US$19 million from 2012.
Public-sector agencies from the US provided a significant portion of funding, with more than US$64.8 million from the NIH, US$3.1 million from the CDC and US$11.25 million for combination prevention studies from PEPFAR. US NIH funding is supporting ongoing trials in Botswana, South Africa, Tanzania, Thailand, Zambia and Zimbabwe, as well as combination prevention trials in South Africa and Uganda.
In 2013, the Government of British Columbia invested nearly US$20 million in its Stop HIV/AIDS campaign, an increase of US$8 million from 2012. European public- sector funding came from France, Belgium, Germany, Switzerland and the UK. France’s National Agency for Research on AIDS and Viral Hepatitis (ANRS) is funding the Start ART trials, focusing on the acceptability and feasibility of treatment and prevention at the individual and community levels. China is also funding large-scale implementation efforts in treatment as prevention.
The majority of philanthropic funding came from the BMGF, the Dream Fund of the Dutch Postcode Lottery, Médecins Sans Frontières (MSF) and the Wellcome Trust. The Dream Fund of the Dutch Postcode Lottery is funding the MaxART trial taking place in Swaziland and sponsored by STOP AIDS NOW! and the Clinton Health Access Initiative (CHAI).
While there is no direct commercial investment in R&D for treatment as prevention, substantial quantities of ARV drugs have been donated for clinical trials. In the HIV Prevention Trials Network’s HPTN 052 trial, for example, study drugs are being donated by Abbott Laboratories, Boehringer Ingelheim, Bristol- Myers Squibb, Gilead Sciences, GSK and Merck & Co. For the MaxART trial, Mylan is donating first-line and second-line ARVs, and will be providing additional support to the trial in 2014.