Margaret McGlynn

  In this guest post, Margie McGlynn, president and CEO of the International AIDS Vaccine Initiative (IAVI), Zeda Rosenberg, chief executive officer of the International Partnership for Microbicides (IPM), and Renate Baehr, executive director of DSW (Deutsche Stiftung Weltbevoelkerung) mark International Women’s Day with a call for continued research to develop new women’s health tools. On this day honoring the political, social, and economic contributions women have made worldwide, nearly 2,000 women will die of AIDS and 790 will perish in pregnancy or childbirth. If we wish to truly advance the health and rights of women globally, we must give them the tools they need to protect their own health. Yet, while the benefits of investing in women—and their health in particular—are well-established and far-reaching, less progress has been made over the past decade toward attaining Millennium Development Goals that address women’s health and gender equality than virtually every other goal.   HIV is a case in point. In the regions hardest hit by the AIDS pandemic, such as sub-Saharan Africa, women bear a disproportionate burden of HIV, accounting for six out of every 10 new infections. A unique combination of factors, having as much to do with biology as with gender inequality, contribute to women’s increased vulnerability. Researchers have made remarkable progress toward developing tools for HIV prevention that could empower women to protect themselves from the virus. Photo credit: PATH/Evelyn Hockstein Fortunately, researchers have in recent years made remarkable progress toward developing tools for HIV prevention that could empower women to protect themselves from the virus. A number of such products and strategies are under development today, including microbicides, AIDS vaccines, multi-purpose prevention technologies (MPTs) and the use of antiretroviral drugs (ARVs) as pre-exposure prophylaxis (PrEP). Take, for example, IPM’s monthly vaginal ring that is currently in the late stages of clinical evaluation. The device slowly releases the ARV dapivirine to prevent HIV. Another product that has already been shown to be partially effective, a microbicide gel containing the ARV tenofovir that is used around the time of sex, is now being tested in a confirmatory trial. And though the latest results from the VOICE trial found that PrEP did not work in that study due to low adherence, a number of other studies have demonstrated that if used consistently, ARVs can do much to prevent HIV. Further, long-acting preventive tools like the dapivirine ring could help address the challenge of adherence for women. IPM and others are also developing MPTs that slowly release ARVs along with a contraceptive to prevent HIV and unintended pregnancy—both leading causes of death for women worldwide. Researchers have also made significant strides toward the development of preventive HIV vaccines. A trial conducted in Thailand four years ago establishes hope that HIV can be prevented by vaccination. Vaccine design too is advancing apace. Scientists around the world have isolated scores of broadly neutralizing antibodies to HIV, uncovering clues to the design of broadly effective vaccines against the highly variable virus. Recent modeling by IAVI suggests that even a partially effective HIV vaccine could significantly reduce the number of new infections among women, if it were deployed in the context of expanded prevention and treatment programs. These models suggest that a vaccine with 50 percent efficacy given to 30 percent of the adult population in low- and middle-income countries would prevent 2.8 million infections in women over 10 years. Vaccines, microbicides and other new preventive technologies could empower women to protect their own health because they could be used discreetly, without the need for negotiation with their sexual partners. Taken together, these new tools and measures could—if deployed with existing methods of HIV prevention—eventually end the AIDS pandemic. Until then, preventing HIV and supporting family planning would improve the health and economic well-being of entire families and advance key development goals. When women are healthy, they have more opportunities for education and employment, which in turn strengthens communities. A paper commissioned by DSW recently reported, for example, that the promotion of HIV prevention and sexual and reproductive health research can help countries make gains toward poverty reduction. This International Women’s Day, we call on the global community to recommit to investing in new preventive tools and health technologies for women. The health of women is, after all, essential to the well-being and economic stability of not only the women themselves and their families—but of entire nations.

In this guest post, Margaret McGlynn, president & CEO of the International AIDS Vaccine Initiative (IAVI), writes about a new partnership between IAVI and the Indian government. The post originally appeared on the US Agency for International Development’s (USAID) Impact blog. When you’re dealing with a global public health crisis, having an international presence isn’t just advisable—it is imperative. This applies as much to the development of new tools to prevent disease as it does to treatment. An AIDS vaccine candidate, for example, must be tested in the people who will eventually use it and against the strains of HIV it is devised to protect them from. That’s why (IAVI), in partnership with USAID, has worked diligently over the past several years to establish itself as a truly global nonprofit partner. Using donor funds, IAVI has created an enviable network of research centers in sub-Saharan Africa dedicated to assessing novel AIDS vaccine candidates in clinical trials and conducting supporting epidemiological studies on HIV. These partnerships have made meaningful contributions to the research capacity of many developing countries—a capability that is now helping local researchers tackle other diseases. IAVI and its partners are now applying that same model to support the design of a new generation of AIDS vaccine candidates. Today, IAVI and the Translational Health Sciences and Technology Institute (THSTI), an autonomous institute of the Indian government’s Department of Biotechnology (DBT), launched an HIV Vaccine Design Program near New Delhi. The program is dedicated to the large-scale generation and preclinical evaluation of immunogens, the active ingredients of vaccines. It will focus on devising immunogens capable of eliciting antibodies that can prevent infection by a broad range of the circulating genetic variants of HIV. That challenge, known to researchers as the neutralizing antibody problem, has long stymied progress toward an AIDS vaccine. But recent discoveries of antibodies capable of blocking a number of HIV variants have provided researchers with clues to the design of potentially powerful new vaccine candidates. The HIV Vaccine Design Program will use these insights to develop new methods to generate large numbers of potential HIV immunogens and rapidly assess their potential for use in candidate vaccines. Much of the work will take place in a laboratory housed within THSTI that is being built and staffed with support from IAVI, DBT, and THSTI. The program’s location is no accident. Over the past decade, IAVI has enjoyed a productive partnership for the clinical evaluation of candidate AIDS vaccines with key medical research institutions of the Indian government. Indian scientists have also actively participated in an international consortium of HIV laboratories supported by IAVI to advance HIV vaccine research. The government of India, meanwhile, is in the early phase of its “Decade of Innovation,” a policy that seeks to harness a growing roster of home-grown biotechnology companies, the nation’s deep pool of scientific talent, and global research partnerships to boost innovation in a variety of high-tech fields. The HIV Vaccine Design Program provides an opportunity to engage an emerging economy in the global quest to develop a vaccine against HIV. For India, it creates an opportunity to address a crisis of significant relevance to Indians. As importantly, it seeds the kinds of collaborations that often foster scientific and technical innovation and generate ideas that might be applied to address other diseases that have long hampered development.

The following guest post from International AIDS Vaccine Initiative (IAVI) President and CEO Margaret McGlynn, AVAC Executive Director Mitchell Warren, and UNAIDS Executive Director Michel Sidibe comes on the release of Investing to End the AIDS Epidemic: A New Era for HIV Research & Development, a report from the HIV Vaccine & Microbicides Resource Tracking Working Group. This post originally appeared on Science Speaks. Close to 25,000 scientists, policymakers, and advocates from around the world are gathering here in Washington, DC, this week for the 2012 International AIDS Conference, where much of the discussion will be about how we can end the AIDS pandemic. The fact that these conversations will be based not just on hope but on real scientific progress proves how far we’ve come and how much we’ve learned in the struggle against AIDS over the last decade. Unprecedented public and private commitments to HIV prevention, treatment, and care over the last 10 years have saved the lives of millions of men, women, and children. Now more than ever we can see the path that leads to the end of the AIDS pandemic. Researchers, policymakers, funders, and advocates alike have long understood that new prevention options need be developed and made widely accessible to truly turn the tide on AIDS. Recent years have brought amazing breakthroughs in HIV prevention research. If prevention research were a business, now would be the time to invest. A decade ago our organizations launched the HIV Vaccine & Microbicides Resource Tracking Working Group in response to a call in the 2001 UN Declaration of Commitment on HIV and AIDS to track investments toward new tools and strategies for HIV prevention. Our data show that donors have remained committed to advancing research and development of new prevention tools to support a broader and more effective response to the HIV pandemic. The Working Group’s latest report, Investing to End the AIDS Epidemic: A New Era for HIV Research & Development, documents 2011 research investments in preventive and therapeutic HIV vaccines, cure research, microbicide development, pre-exposure prophylaxis (PrEP), and operations research to support implementation of such evidence-based interventions as the prevention of vertical transmission, voluntary medical male circumcision, and the use of antiretroviral therapies for HIV prevention. The report also looks back over a decade of mostly increasing investments that have made a number of key scientific advances possible and continue to fuel progress toward more effective biomedical approaches and improved implementation of existing prevention tools. Most of the $1.24 billion invested in new HIV prevention tools in 2011 came from dedicated public sector donors, especially the United States government. While funding for HIV prevention research and development saw a slight drop from the previous year, we acknowledge that difficult economic times have shrunk many public sector budgets. We laud funders and advocates for acknowledging the potential value of these tools through continued support and long-term vision. The prevention of HIV contributes to healthier populations and can save precious funds for other vital health and development needs. We are excited about how far HIV prevention research and development will go over the next decade, and we’re grateful for the continued support of committed donors in difficult economic times. Yet, capitalizing on exciting science will require stabilized funding to be supplemented as new breakthroughs move us toward effective new tools. We are concerned that staying the course might not be enough. The field will need sustained support for research across the development pipeline—from the basic scientific research that underpins new approaches to HIV prevention, to the translation of that research into candidate products and new strategies, to the costly large-scale trials that evaluate the safety and efficacy of promising products. Ending the AIDS pandemic requires us to think big and to think strategically. Join us in supporting the exciting science that will help make ending the AIDS pandemic a reality.

Margaret McGlynn is the president and CEO of the International AIDS Vaccine Initiative (IAVI). In this guest post to mark HIV Vaccine Awareness Day, she writes about the potential impact of a safe and effective HIV vaccine around the world. The post originally appeared on the US Agency for International Development’s (USAID) Impact blog. Throughout my career, I have witnessed the tremendous power of vaccines to prevent sickness and save lives—delivering incredible victories for humanity against diseases such as polio, smallpox, and measles. These vaccines would not have been possible without the inspiration, persistence, and courage of researchers, volunteers, and health workers around the world. And so today, on HIV Vaccine Awareness Day, I join countless others around the world in reflecting on what it would mean to see AIDS consigned to a list of former pandemics. To achieve that goal, it is essential that we enlist the participation of researchers around the world in the design and development of HIV vaccines. Young researchers such as Gladys Njeri Macharia in Kenya—who has dedicated her career to exploring immune responses to HIV—will play an especially important role in that effort. And one day, critical scientific questions addressed by this research might help lead to an effective vaccine. Thanks to a USAID-supported program, Gladys Njeri Macharia is studying how rare individuals might be blocking HIV infection. Photo credit: IAVI New modeling data available today from IAVI and the Futures Institute, with support from USAID, illustrates how a safe, preventive HIV vaccine that is accessible and affordable can help us end the AIDS pandemic. This information is available in a series of publications and an interactive web tool. The potential impact of a vaccine is striking. Because HIV is so extraordinarily resistant to the immune response, it is highly unlikely that any single vaccine will be able to prevent infection by all variants of the virus. Still, our modeling shows that if an AIDS vaccine that is only 50 percent effective is introduced in 2020 to 30 percent of the population in low- and middle-income countries, 5.2 million new HIV infections could be averted over the first decade. Higher efficacy and more coverage would have an even greater impact on the pandemic. The world must continue to scale up and improve the response to HIV by using powerful prevention tools that are currently at our disposal. These include condoms, treatment, and voluntary medical male circumcision. Our new models show that a vaccine can build on these existing tools and take us down the last mile to the end of the AIDS pandemic. A 50 percent effective vaccine combined with greater use of current HIV-prevention tools could prevent nearly 20 million new HIV infections by 2030—20 million people that would not need to face the physical, emotional, and social hardships caused by the disease and could avoid lifelong, daily antiretroviral treatment to stave off AIDS-related illness or death. This HIV Vaccine Awareness Day, IAVI and our partners remember those we have lost to AIDS, gain inspiration from those living with and combating the disease today, and look forward to building on the incredible momentum of recent discoveries and study results to deliver on the tremendous potential of an AIDS vaccine. To access IAVI and the Futures Institute’s impact modeling publications and interactive modeling tool, visit www.iavi.org/