By 2008, effective, more affordable antiretroviral drugs to treat HIV were offering new hope to millions of people in low-resource countries. Yet the epidemic remained a health crisis. The previous year alone, a staggering 2 million people had died from AIDS-related illnesses (Joint United Nations Programme on HIV/AIDS, 2008 [2.13 MB PDF]).
In addition, even in countries where less-expensive generic drugs were available (and that still wasn’t everywhere), they were not enough to stem the devastation. Sometimes, initial treatments failed due to viral resistance or created unmanageable side effects for patients. When that happened, alternative drugs were prohibitively expensive—increasing the cost of treatment anywhere from two to eleven times as much.
Unless more manufacturers became interested in making affordable antiretroviral drugs, or more public-sector donors became willing to fund research and development for new tools, new options were likely to arrive slowly or not at all—costing lives.
Around the same time, advocates saw a promising window for action. In the United States, the President’s Emergency Plan for AIDS Relief (PEPFAR)—the largest investment, by any nation, to combat a single disease around the world—was up for reauthorization in the US Congress. With it came a new chance to invest in lifesaving research and development (R&D) for desperately needed drugs and technologies.
Recognizing this opportunity, advocates from across sectors came together via the Global Health Technologies Coalition (GHTC)—convened by PATH—and sprang into action.
In early discussions on PEPFAR reauthorization, US legislators focused primarily on increasing funds for existing technologies, rather than supporting new innovation. Yet health advocates, including PATH and other GHTC members, knew that overturning the status quo also required investment in the R&D of affordable new tools and technologies.
GHTC advocates worked to ensure that commitments to fund R&D would be included in PEPFAR.
How advocacy unlocked health innovation
GHTC provided the structure to keep up momentum, coordinate efforts, and achieve consensus. With PATH as convener, the group agreed on commitments they wanted to see included in the PEPFAR reauthorization bill. These focused on the overall need for R&D on vaccines, HIV prevention, and diagnostic tools, as well as on specific approaches that make it less risky for manufacturers and developers to pursue new solutions.
With their requests clearly outlined, members of the coalition and their networks met with a wide variety of policymakers. They enlisted support from the Center for Global Development; Gavi, the Vaccine Alliance; and the World Bank. They met with US Treasury representatives to win their support for innovative financing models. They held briefings with the US Congress, and more.
Thanks to the coalition’s work, the PEPFAR reauthorization included not only the anticipated billions in funding, but also robust new support for R&D.
Until the world has the tools to stop HIV altogether, the fight against HIV/AIDS will continue.
Since 2008, however, years of combined efforts by thousands of organizations, governments, and communities worldwide—including GHTC—have made progress. Between 2005 and 2013, deaths from HIV/AIDS have dropped by more than 35 percent (WHO, 2016). In many communities, treatments that once cost as much as US$10,000 a year are now available for around $150 (United Nations Development Programme, 2015).
At the same time, GHTC has grown into an even more effective force for change, addressing not only HIV/AIDS, but a wide variety of health issues. Today, it’s more than 25 nonprofit members (including think tanks, product development partnerships, and advocacy groups) continue to advocate for sustained investment in R&D across health areas. Together, we are building the groundwork to bring more products to widespread and lifesaving use.
Project partners: Center for Global Development; Gavi, the Vaccine Alliance; and the World Bank