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.
Download the report — HIV Prevention Research & Development Investments 2018: Investing to end the epidemic
The Latest Funding Trends
The report indicates an uptick after five consecutive years of declining investment. In 2018, funding for HIV prevention R&D increased by a modest 1.2 percent or US$13 million from the previous year, growing to US$1.14 billion. While the increase is encouraging, it’s the smallest net increase since 2003. This impacted the various prevention categories differently. Investment increased for pre-exposure prophylaxis (PrEP), female condoms and prevention of vertical transmission (PMTCT) but decreased for voluntary medical male circumcision (VMMC), preventive vaccines, microbicides and treatment as prevention (TasP).
Despite the significant variation by technology category, donor trends remained more or less the same. Public sector (79 percent of overall or US$900 million) and philanthropic sector (14.4 percent of overall or US$164 million) investments remained mostly unchanged from 2017, while the private sector saw a 30 percent surge in investment, rising to US$74.7 million in 2018. Actual commercial investment levels are bound to be much higher as not all private companies responded to the Working Group’s request for data.
While US and European investment remained steady in 2018, the recorded levels are still the lowest in over a decade at US$829 million and US$57.5 million, respectively. Outside the US, prominent increases came from the UK, Germany, Canada, Australia and the European Commission, while declines were observed from Brazil, France and Japan. Global philanthropic levels also saw no change in 2018 and the Bill and Melinda Gates Foundation (BMGF) remained the preeminent funder at US$149.7 million or 91 percent of all sector investment.
As it stands, the US public sector and BMGF account for 86 percent of all funding. Citing the promise of the current R&D pipeline, the report cautions against this funding imbalance and the resulting impact on the longevity and sustainability of the field. Much hope can be drawn from the latest scientific strides: the ongoing late-stage efficacy trials for long-acting injectable PrEP and antibody mediated-prevention; the Phase III trial launching in 2019 that is bringing us closer than ever to a licensed HIV vaccine; and the dapivirine vaginal ring that may soon be approved for use in women. All of the above is contingent on sustainable financing and a diverse donor base that cushions against mercurial shifts from large donors.