Overall Funding in 2020
Total investment in HIV biomedical prevention R&D in 2020 decreased from the previous year by US$54 million. This is the second consecutive year that HIV prevention R&D observed a decline in funding, and it continues the post-2012 trend of either declining or flat funding. Investment levels varied by prevention technology. Funding decreased for preventive HIV vaccines, pre-exposure prophylaxis (PrEP) and voluntary medical male circumcision (VMMC), while funding increased for microbicides investment and treatment as prevention (TasP). For a detailed breakdown of investments by technology category, please see this section.
Furthering past trends, the majority of global funding originated from the public sector, at 86 percent or US$935 million, with the US contributing 92 percent of the total public funds, a marginal decrease from the previous year’s 95 percent. European public investments increased by 57 percent in 2020, coming in at US$64 million, which represented seven percent of all public funding. Investments from all other regions totaled US$14 million, or one percent of all public funding.
Philanthropic investment decreased by 20 percent, to US$127 million or 12 percent of total global funding, and commercial investments fell by 55 percent, to US$31 million or three percent of the total. Findings from the commercial sector should be taken with caution due to its historically low rates of reporting.
What are the historic and current trends for investment in HIV prevention R&D?
US public sector investment decreased by one percent in 2020, from US$869 million in 2019 to US$857 million in 2020. A three percent decrease was observed for the National Institute Health of Health (NIH), from US$758 million to US$734 million. Funding by the Military HIV Research Program (MHRP) rose six percent, to US$38 million, and the Centers for Disease Control and Prevention (CDC) recorded a 44 percent decrease, down to US$1 million in 2020. The United States Agency for International Development (USAID) invested five percent more, rising from US$73 million in 2019 to US$77 million in 2020. A full list of all the biomedical prevention technologies tracked by this analysis can be found here.
European public sector funding increased by 56 percent from 2019, totaling US$64 million, but this is still far from its peak of US$124 million in 2009. Europe’s public sector decreased its funds for female condoms (no funds in 2020), microbicides (down 42 percent), prevention of vertical transmission (down 63 percent) and preventive vaccines (down 31 percent), while it increased its funds for studies related to PrEP (up 48 percent) and treatment as prevention (up 18 percent).
Global philanthropic funding levels dipped further in 2020, falling from US$145 million to US$127 million. While still the largest donor, accounting for 95 percent of all sector funding, the Bill & Melinda Gates Foundation (BMGF) lowered its contributions to US$121 million. The majority of BMGF investment was directed toward vaccines (76 percent) and PrEP (14 percent), with smaller disbursements for VMMC (five percent) and microbicides (one percent). While the overwhelming majority of philanthropic funding originated from the US, European philanthropies like Institut Pasteur, Aidsfonds and the Wellcome Trust continue to reliably fund HIV prevention R&D.
Commercial funding identified for HIV prevention R&D decreased from US$71 million to US$32 million. The Working Group evaluated funding from less than a dozen companies in 2020, but commercial R&D investments likely far exceed those that the Working Group was able to review. The cohort of commercial funders who participated in the 2020 Resource Tracking survey varied widely compared to those who participated in 2019, which may explain the wide gap in funds reflected in 2020 responses.
Notably, the Working Group identified a rise in PrEP funding from the commercial sector, up 21 percent from 2019. In 2020, the commercial sector invested mostly in clinical and preclinical research, with one company backing basic microbicides research.