In Brief

HIV/AIDS Community Mourns Loss of its own Aboard MH17

If we can see a future without HIV—if we get to the end of AIDS—it will be more than a vaccine that gets us there, says Gregg Gonsalves, HIV-infected activist, former ACT UP (AIDS Coalition to Unleash Power) member, and co-director of the Global Health Justice Partnership at Yale University Law School.

It will be the people.

Among the many lives tragically lost the day Malaysia Airlines flight 17 came down over eastern Ukraine, the HIV/AIDS community is still hurting from the loss of Lucie van Mens, a former program director with the Dutch STOP AIDS NOW! Group; Bridging the Gaps’ Martine de Schutter; lobbyist Pim de Kuijer, and Glenn Thomas, who helped the World Health Organization’s outreach in global health, tuberculosis, and HIV/AIDS as a communications officer. Also killed in the crash were Joep Lange, leading HIV researcher and former president of the International AIDS Society, and his longtime partner Jacqueline van Tongeren, who was also communications director of the Amsterdam Institute of Global Health and Development (see Joep Lange's Long Reach).

Alvaro Bermejo, director of AIDS Alliance, knew both Martine de Schutter and Pim de Kuijer and says it is people like them who make a difference. “They were people who dedicated themselves to making the world a better place,” Bermejo says. “They were passionate and committed to working for a common good, and that makes it particularly difficult to have lost them.”

Working in HIV often means connecting with disenfranchised and marginalized parts of both wealthy and poor societies. Van Mens found her calling there. A former program director with the Dutch STOP AIDS NOW! group, van Mens set up outreach and health care initiatives for sex workers and people in red light districts across Europe before joining the Female Health Company to make female condoms more widely available, especially in African countries.

Like many initiatives in Europe, STOP AIDS NOW! is a partnership. Started by project funder Aids Fonds, STOP AIDS NOW! marshals the collaborative efforts of several groups in fighting AIDS with an eye to development and anti-poverty initiatives.

STOP AIDS NOW! director Louise van Deth brought de Kuijer aboard because of something he said. “I was an activist diplomat. Now I want to be a diplomatic activist,” van Deth recalls. “He was just that—he was our lobbyist but good in reaching out to people and building a network, building relationships.” De Kuijer was active in Dutch politics and was sent out to be an election monitor in teetering or fledgling democracies—including the Ukraine. He was persuasive and effective, van Deth says, playing a role in defeating a government proposal to reform sex work in Holland—prostitution is legal there—which would have driven people underground again, where they would have little access to public health services.

Van Deth says de Schutter worked with STOP AIDS NOW! for a dozen years before going to Bridging the Gaps. “She was right for the role because she was good at connecting people. It’s a complicated program,” van Deth says. “It has five partners in the Netherlands, all different, and they work with 100 partner organizations in 13 countries, all supporting sex worker organizations, marginalized groups, men who have sex with men, and drug users.”

Both Gonsalves and Bermejo describe the hurt to what is still an HIV community. “The AIDS response loses many of its leaders: to stigma, violence, planes, to AIDS itself,” he says. “We often take our colleagues for granted, and when you lose them and reflect on the work that they do, you really appreciate the difference they make.”

With the advent of highly active antiretroviral therapy in 1996, prospects massively improved for millions of HIV-infected people, perhaps leaching some of the urgency that brought together researchers and activists in the early days of AIDS. “Maybe some of that camaraderie and community is gone,” Gonsalves says. “But it’s still vital to keep it alive if we are ever to conquer this epidemic.” —Michael Dumiak

HIV Vaccine Funding Declines, While Cure Funds Rise

The latest report on funding for HIV prevention research, released by the HIV Vaccines and Microbicides Resource Tracking Working Group two days before the start of AIDS 2014 in July, notes that investment in HIV prevention research dropped to US$1.26 billion in 2013, a 4% decline, with funding for HIV vaccine research and development declining by 3% from $847 million in 2012 to $818 million last year. This is the largest real decrease in AIDS vaccine investment since 2008, and it follows five years in which funding had either declined or remained stable, from a high of $961 million in 2007 (see figure, below).

A major factor driving down HIV prevention funding was the across-the-board spending cuts known as sequestration that were mandated by Congress last year to reduce the US federal budget deficit. The legislative action drained $153.7 million in AIDS research spending from the US National Institutes of Health (NIH), resulting in a 7% drop in NIH funds for AIDS vaccine research and a 14% drop in funding for microbicides.

Decline in Prophylactic Vaccine Funding in 2013  

Click image to view. Figure courtesy of AVAC and the HIV Vaccines & Microbicides Resource Tracking Working Group. See the full report at http://hivresourcetracking.org/sites/default/files/RTWG2014.pdf.


The report notes that European countries also invested 10% less in HIV prevention research and development in 2013 compared to 2012, while philanthropic support fell 5%, a drop that would have been even greater if not for contributions by the Bill & Melinda Gates Foundation, which maintained its significant support for HIV prevention research ($160 million) in 2013, and the UK-based Wellcome Trust that upped its contribution from $10 million to $16 million.

Still, with US public sector investments—primarily from the NIH—financing 70% of HIV prevention research across the globe, the significant decline in US funding had a significant impact on grants and programs.  As a result of sequestration, 280 research grants went unfunded, including 31 dedicated to AIDS vaccine research, according to the working group.

Emily de Lacy Donaldson, program coordinator at AVAC, a global HIV prevention group based in New York and a member of the working group that prepared the report, said no one quite anticipated how much cuts by the US government would impact funding levels. The drop in the number of grant proposals being funded and the support for early career investigators was particularly troublesome, she said. “We’re hopeful things will turn around in the coming year.”

Despite the dip in funding for vaccine research, other prevention strategies, including treatment as prevention and pre-exposure prophylaxis (the use of antiretrovirals to prevent infection), received more funding last year as researchers conducted dozens of demonstration projects on how best to implement the strategies.

There was also an uptick in spending on HIV cure and therapeutic vaccine research, areas in which funding rose from $88.1 million in 2012 to $102.7 million in 2013. US investment in this area is expected to increase even more with US President Barack Obama’s announcement that $100 million in NIH funds will be reprioritized to launch a new HIV Cure Initiative. Cure funding could also be higher than captured in the resource tracking report as companies invested in cure research do not directly report their expenditures to the working group.

For more detail, the full report is available at www.hivresourcetracking.org. —Mary Rushton