AT THE FOREFRONT OF IDENTIFYING AND ADVANCING
EMERGING ISSUES IN THE PREVENTION, CARE, AND
TREATMENT OF PEOPLE AFFECTED BY HIV/AIDS

FOR 33 MILLION PEOPLE AROUND THE WORLD - INCLUDING MORE THAN 1 MILLION AMERICANS - HIV/AIDS IS A DAILY REALITY.

Their challenges drive the work of the Forum for Collaborative HIV Research. Since its founding in 1997, the Forum has been at the forefront of identifying and addressing emerging issues in the prevention, care, and treatment of people affected by HIV/AIDS.

The Forum is a public-private partnership that provides neutral ground in fighting one of the most formidable diseases in human history. Through the Forum, researchers and advocates, national and international regulatory agencies, pharmaceutical and diagnostic companies, health care providers and private foundations have an independent and unbiased venue in which to compare data, debate consequences, and advance life-saving research.

At the time of the Forum's founding, more than 20 million people worldwide were living with HIV/AIDS, yet the era of Highly Active Anti-Retroviral Therapy (HAART) had just begun. Along with the optimism born from treatment options came a host of questions about the best uses, side-effects, and long-term effectiveness of the new drugs. The Forum was initiated under the Clinton administration to accelerate the science that would answer those questions.

The Forum's Executive Committee, itself representative of diverse constituencies, identifies the major research gaps in need of urgent attention. Forum staff organizes roundtables to address these issues, incorporating perspectives from across the spectrum of Forum membership. Reports issued by the roundtables are publicly disseminated, feeding into far-reaching research agendas and policy formation. The entire process generates knowledge and drives change.

A DECADE OF ACCOMPLISHMENTS

Beginning with a focus on treatment strategies, the Forum gradually broadened to address a range of global HIV/AIDS issues, including treatment-related toxicities, immune-based therapies, health services research, co-infections, prevention, and the transference of research results into care. Forum recommendations have changed the ways that clinical trials are conducted, accelerated the delivery of new classes of drugs, heightened awareness of TB/HIV co-infection, and helped to spur national momentum toward universal testing for HIV. Among the Forum's accomplishments:

• DEVELOPING NEW CLINICAL TRIAL DESIGNS WITH A HIGH STANDARD OF FAIRNESS TO PATIENTS WHILE ALSO ACCELERATING DRUG DEVELOPMENT. The new trials replaced placebo "control" groups, with control groups of patients receiving personally optimized regimens of licensed drugs, and encouraged collaboration by pharmaceutical companies.

• UNDERSTANDING AND OVERCOMING EARLY DRUG SIDE EFFECTS, including lipodystrophy, a condition caused by select antiretroviral regimens that redistributes body fat. Its disfiguring effects prompted some patients to end treatment. Forum insights engendered understanding of how different HIV drugs contribute to the syndrome.

• SPURRING WORLDWIDE MONITORING OF TOXICITY. In 2003, the Forum took up the issue of monitoring for long-term toxicity, or pharmacovigilance, for HIV/AIDS treatment in the developing world. This work, facilitated by the Forum, has led to the development of global standards by which adverse events are evaluated and measured in the developing world by the World Health Organization.

• SPEEDING DEVELOPMENT OF A NEW CLASS OF ANTI-HIV DRUGS. In 2005, Forum roundtables spurred collaborative research into CCR5 inhibitors, accelerating the delivery of this new class of drugs.

• FACILITATING RESEARCH TO ADVANCE UNIVERSAL HIV TESTING. Recognizing that universal testing is a key step in AIDS prevention and in patient care, in 2008, the Forum sponsored the National Summit for HIV Prevention, Diagnosis and Access to Care. It became a launching pad for accelerating research and advocacy regarding universal testing, as recommended by the US Centers for Disease Control and Prevention.

THE FUTURE

Forum roundtables have contributed to enormous progress in the fight against HIV/AIDS. In the process, they have become a unique model for disease research, streamlining intelligent pathways toward treatment and prevention. These successes already have prompted a new Forum collaboration around hepatitis C, and the Forum model could advance research against cancer, tuberculosis, malaria, and other diseases.

Going forward, the Forum will continue its ground breaking work in a number of areas, including universal testing for HIV/AIDS, global pharmacovigilance, and work on PrEP, the pre-exposure prophylactic use of antiretrovirals to prevent HIV infection. A PrEP Trials Working Group, initiated by the Forum in 2008, will expand its critical collaboration on this innovative biomedical approach to prevention.

The Forum's unique approach to propelling breakthroughs in HIV/AIDS prevention, treatment, and access to care is poised to deliver additional vital results in the battle to make HIV history.

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