The goal of a safe, effective and globally available HIV vaccine was given a reboot with the launch of a five-year strategy at an HIV research conference this week.

The new Global HIV Vaccine Enterprise five-year strategy was unveiled on October 22 at the opening of the HIV Research for Prevention 2018 Conference in Madrid, the world’s only scientific conference dedicated exclusively to biomedical HIV prevention.

Currently there are about 36.7 million people worldwide living with HIV/AIDS – about 2.1 million of these children. About 10 per cent of the 1.8 million people newly infected each year with the virus that can lead to AIDS are children. Most of these children live in sub-Saharan Africa and were infected by their HIV-positive mothers during pregnancy, childbirth or breastfeeding.

The International Aids Society (IAS), which is backing the vaccine enterprise strategy, says developing a vaccine, like other innovative prevention approaches in development, was not a substitute for other forms of HIV prevention, but would “provide a powerful new tool that can hasten reaching a genuine tipping point in the global epidemic”.

Glenda Grey, president  of the South African Research Council, said the vaccine strategy plan captures “the promise and challenges of a unique and exciting moment in HIV vaccine development and offers a roadmap for action to bring us closer to the end of this epidemic”.

In New Zealand about 197 people were diagnosed with HIV in New Zealand in 2017 – the first drop of HIV transmission since 2011 – and in total about 3,500 people in New Zealand are estimated to be living with HIV. The New Zealand Aids Foundation last year launched its Ending HIV programme with the goal of ending HIV transmissions in New Zealand by 2025 by continuing to promote condoms as the mainstay prevention but adding the daily HIV prevention pill PrEP (Truvada, which contains two antiviral medicines) which from March 1 this year Pharmac will fund for people at high HIV risk on the advice of an HIV specialist.

IAS says in both high-income countries and resource-limited settings, recent evidence demonstrates that the combination of scaled-up HIV treatment with strong investments in science-based primary HIV prevention can lead to sharp, rapid decreases in new infections.

“Pre-exposure antiretroviral prophylaxis (PrEP) has, when combined with scaled-up HIV treatment, made possible the extraordinary reductions in new HIV infections reported in many cities in Europe and North America,” says the IAS 2018 annual letter.

“However, PrEP has achieved minimal coverage in low- and middle-income countries, and no clear plan is presently in place to guide or accelerate PrEP expansion.

“There are also signs that global commitment to research on new prevention technologies is stagnating. Even as scientific developments have renewed optimism on the feasibility of HIV vaccines and other prevention breakthroughs, HIV research funding has effectively remained flat for the past decade,” says the annual letter.

IAS President Anton Pozniak said the new vaccine strategy launched this week presents an opportunity to address some of the most significant challenges in HIV vaccine development.

“While the HIV vaccine landscape offers greater scientific promise than ever before, the field also faces real challenges in terms of aligning scientific priorities, developing the smartest and most effective research studies, maintaining funding and engaging and maximising the contributions of all global stakeholders in the search for a vaccine,” he added.

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