Twenty five years into the HIV/AIDS epidemic in 2005, an estimated 39 million people are living with HIV worldwide, and 4.1 million were newly infected according to the UNAIDS Global Report (2006). Despite promising progress such as dramatic increases in global access to treatment, and utilization of counseling and testing services, these numbers are a sobering and urgent reminder of the need for innovative and expeditious advancement in research focusing on prevention of HIV infection.
In addition to ongoing research on HIV vaccines, enthusiasm has grown around novel biomedical approaches that have potential to reshape the landscape of HIV prevention in the 21st century. New interventions in development such as microbicides, cervical barrier methods, pre/post-exposure prophylaxis, suppression of HSV-2, and male circumcision provide unique opportunities to design prevention programs that are appropriate for a variety of populations with diverse needs. Combinations of methods need to be studied as no single method will be 100% effective. The prevention technologies with the potential to generate the greatest benefit for the people most in need of these that can be developed in the least amount of time need to be identified.
All prevention research programs will require commitment from many players, such as the pharmaceutical industry, foundations, public sector sponsors and public-private partnerships, as well as collaborations with research networks, communities. They will also require access to similar populations for testing in clinical trials. The various research programs also face similar challenges, including prevention research community and site development, clinical trial designs and addressing changing standards of care for prevention as well as for treatment of HIV-infected individuals. As stated by the Global HIV Prevention Working Group (http://www.gatesfoundation.org/):
"As new HIV prevention approaches move forward into advanced stages of development, the world faces serious financial, logistical, and ethical challenges in completing ongoing prevention trials, and in mounting the additional large-scale trials that will be needed to fully test new prevention tools and strategies."
However, current research funding structures encourage silo-style research; opportunities for cross-talk, communication and collaboration have been lacking. A mechanism to bring together all prevention research programs is needed in order to bridge the various programs and provide a platform for dialogue, coordination and collaboration.
The Forum for Collaborative HIV Research Biomedical Interventions for Prevention of HIV Infection Working Group consists of international experts in prevention and clinical sciences, including the community, academic, industry and government sectors.
The objectives of the Working Group are:
- Review the current prevention research landscape
- What needs to be done to advance prevention research?
- Have we covered all the bases?
- Discuss the research agenda
- What are the criteria for setting research priorities?
- Promote the movement away from the silo approach to an integrated approach
The first Working Group meeting was held on September 18-19, 2006 in Washington DC. The organizing group for this first discussion includes:
Ward Cates, FHI
Myron Cohen, UNC Chapel Hill
Nick Hellmann, Gates Foundation
Veronica Miller, FCHR