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In 2019, funding for preventive HIV vaccine R&D increased by a marginal 0.7 percent or US$6 million from the previous year, and totaled US$848 million. The public sector accounted for 81 percent of overall investment, at US$686 million, with the philanthropic and commercial sectors contributing 13 percent and six percent, respectively. At US$662 million or 78 percent of all public sector funding, the US remained the largest donor of preventive vaccine research globally. US public sector funding increased by six percent from 2018 levels, an uptick bolstered by the six percent increase in funding from the National Institutes of Health (NIH) that brought its contribution to US$597 million.
European investment in preventive vaccine R&D decreased by 22 percent and amounted to US$18 million, the lowest levels observed since 2000. Philanthropic contributions decreased by 15 percent and totaled US$111 million. This trend is mostly attributed to the US$19 million decrease in funding from the Bill and Melinda Gates Foundation (BMGF), which funded preventive vaccine research at US$99 million in 2019.
The commercial sector contributed US$50.7 million although this number is likely a result of under-reporting from the sector.
The Netherlands, Denmark and Canada increased their commitments in 2019, which helped cushion against decreases from France, UK, Italy, Switzerland and Germany. Funding from the European Commission also decreased from US$9.5 million to US$9.3 million in 2019.
Funding for HIV vaccine R&D was allocated to the following areas in 2019: basic research (17.3 percent), preclinical (46.5 percent), clinical (34.4 percent), cohort and site development (1.3 percent) and advocacy and policy (0.5 percent). As observed since 2016, preclinical research out-funded clinical trials. Further information about the categories used to define R&D can be found in the Methodology section of the Appendix.a
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Investment in microbicide R&D totaled US$154 million in 2019, a six percent (US$9 million) decrease from 2018 funding levels. Not only is this the seventh consecutive year of declining microbicide funding, but it also represents the lowest level recorded since 2005. The public sector remained the largest donor at 98 percent of funding, with the remaining two percent originating from philanthropy. Public funding decreased by six percent and fell to US$151 million, while philanthropic funding increased by 95 percent from the previous year to US$3.5 million. Even though philanthropic funding increased nearly 100 percent due to increased commitments from BMGF, it was not enough to make up for the US$10 million decrease in public sector funding.
The US remained the largest funder of microbicide research at US$134 million, with USAID contributing US$45 million and the NIH US$87.8 million. European funding shrunk by 33 percent to US$16.9 million. Zero allocations for microbicide R&D from the German Federal Ministry of Education and Research (BMBF) and the Netherlands Ministry of Foreign Affairs explain the drop in European funding. In 2018, these funders collectively contributed US$9 million. The two philanthropies backing microbicide R&D saw an increase in funding from 2018 levels, with BMGF rising to US$3.2 million and Institut Pasteur to US$0.3 million.
Allocations for microbicide R&D in 2019 were as follows: basic mechanisms of mucosal transmission (six percent), preclinical research (13 percent), formulations and modes of delivery (12 percent), clinical trials (40 percent), behavioral and social science research (11 percent), research infrastructure (12 percent) and advocacy and policy (six percent).
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In 2019, global investment in PrEP R&D totaled US$99 million; a 16 percent increase from levels observed in 2018. Investment from the philanthropic sector increased by 56 percent, rising to US$33.8 million. This trend is linked to the rise in BMGF funding, from US$21 million to US$33 million. US public sector donors also recorded increased funding, with NIH funding up 15 percent to US$42 million and CDC funding up to US$1.4 million. Commercial sector investment in PrEP remained mostly unchanged at US$19 million.
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Investment in TasP R&D continued to decline in 2019, decreasing 19 percent to US$1.7 million. A marginal increase in philanthropic funding was neutralized by a 24 percent decrease in the public sector. However, recent decreases in TasP funding are linked to the completion of the CDC-funded Botswana Combination Prevention project, which had been ongoing since 2013. Multiple large-scale trials such as HPTN 052, PARTNER, Opposites Attract, PARTNER 220 and HPTN 071 have demonstrated the effectiveness of treatment to reduce onward transmission. This established and robust evidence base likely explains the sharp decline in R&D investment for TasP since 2015.
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The Female Health Company remained the only funder for female condom research and contributed US$0.06 million. This was a 49 percent increase from 2018.
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Investment in VMMC research decreased by three percent and totaled US$9 million. BMGF was the largest donor at US$7.6 million, followed by the NIH at US$1.3 million. Sufficient empirical studies have already affirmed the efficacy of VMMC as a prevention option, which is likely why over 50 percent of the research is allocated to implementation science and the large-scale rollout of services. Other areas of focus include behavioral and social science research (25 percent) and advocacy and policy development (25 percent).
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Funding for PMTCT decreased by four percent, with levels shrinking from US$36 million to US$34.6 million. The number of donors financing PMTCT research decreased from twelve to eight, with BMGF being the only philanthropic donor. Most PMTCT research (almost 96 percent) was funded by the public sector, with the US NIH remaining the largest donor at US$29 million. European funding decreased by 12 percent, falling to US$2.9 million. Philanthropic funding levels also rose to US$1.5 million, bolstered by increased support from BMGF.p
Interested in learning about prevention of vertical transmission? See this resource from the Avert.
This analysis is made possible by the generous support of several donors, including the Bill and Melinda Gates Foundation, and the American people through the US President’s Emergency Plan for AIDS Relief (PEPFAR) and the US Agency for International Development (USAID) as part of the Coalition to Accelerate and Support Prevention Research (CASPR) project. The contents are the responsibility of AVAC and do not necessarily reflect the views of PEPFAR, USAID or the United States Government. AVAC does not accept funding from the pharmaceutical industry.
The Resource Tracking for HIV Prevention R&D Working Group (RTWG) is led by AVAC in partnership with the International AIDS Vaccine Initiative and UNAIDS
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