Funding for HIV prevention research and development (R&D) is crucial for continued innovation in the field. Tracking this funding, its volume, direction and source, makes it possible to address opportunities and gaps, hold the global community accountable to its promises, and sustain forward momentum in the fight to end the epidemic.
In 2016 global funding for HIV prevention R&D declined by 3 percent or US$35 million from the previous year, falling to US$1.17 billion. This marks the lowest annual investment in HIV prevention R&D in more than a decade. The US public sector contributed three fourths of overall funding at US$881 million, while the Bill and Melinda Gates Foundation (BMGF) made up 89 percent of all philanthropic investment (US$141 million out of US$157 million). Together, the US public sector and BMGF constituted 88 percent of total funding in 2016.
Funding for preventive AIDS vaccines, PrEP and medical male circumcision (VMMC) increased by four percent, 39 percent and 57 percent, respectively, while investment towards microbicides, prevention of vertical transmission (PMTCT), treatment as prevention (TasP) and female condoms declined by six percent, 7 percent, 86 percent and 52 percent, respectively.
US public sector investment increased by 3.6 percent in 2016, from US$850 million to US$881 million—a surge linked to the four percent increase in US National Institutes of Health (NIH) funding, which gave the field an additional US$31 million from 2015.
European public-sector funding decreased by US$10 million from last year, and at US$59 million, was the lowest European funding recorded in the last decade. Investment from other countries outside the US and Europe decreased by 76 percent, falling to US$12 million from US$50 million in 2015.
Philanthropic funding remained stable at US$157 million or 13.6 percent of the overall funding. The BMGF remained the largest funder and increased its contribution by 12 percent, to US$141 million. Wellcome Trust investment fell for the fourth consecutive year as it committed half the amount that it did in 2015 (down to US$3 million from US$6 million).
Contributions from the commercial sector decreased by 25% from 2015 levels, and amounted to US$56 million.
Other key findings from the 2016 funding analysis include:
- An intensifying funding imbalance exists with a handful of donors accounting for the majority of spending. According to estimates tracked by the Working Group, for every dollar spent on HIV prevention R&D, 88 cents came from just two donors.
- There is diminished funding beyond the US public sector, with 15 countries representing only six percent of the overall funding at US$71 million (down from US$119 million in 2015).
- In keeping with the trend observed since 2010, the number of philanthropies engaged in HIV prevention research dropped from 27 to 12 in 2016.
- The emphasis on implementation science or the ‘science of delivery’ is still strong for biomedical options like circumcision and PrEP.
- Development assistance for health (DAH) funding for HIV prevention R&D declined for the 5th consecutive year. Effective and innovative prevention strategies are key to ending the AIDS epidemic, which is why prevention R&D must regain its prominence in the global agenda.