1. FOR HIV PREVENTION
RESEARCH & DEVELOPMENT
RESOURCE TRACKING
HIV Prevention Research & Development Preliminary Funding Trends 2000–2015
Investment priorities to fund innovation
in an evolving global health and
development landscape
Emily Donaldson, AVAC
Presenting on behalf of the Resource Tracking for HIV Prevention R&D Working Group

2. Grants Collected (Preliminary Data Collection)
Methodology
Comprehensive and consistent investment data collection and disaggregation methodology since 2004 (collection since 2000)
Data collection period January – June 2015
Grants Collected (Preliminary Data Collection)
R&D Categories
Grants Collected
Data Sources
Preventive HIV vaccines
361 grants
Public funders
546
Microbicides
91 grants
Philanthropic funders
221
PrEP
73 grants
Industry funders 20
Treatment as prevention
89 grants
Male circumcision
22 grants
Female condoms
10 grants
Prevention of vertical transmission
33 grants
HSV-2 vaccines
20 grants
HIV cure
655 grants
Therapeutic HIV vaccines
6 grants
The Working Group began tracking global investment in HIV vaccines and microbicides research and development in 2000, and have collected 15 years of data using a consistent methodology of data collection and disaggregation since Within 15 years, tracking of investment has evolved to follow the full pipeline of biomedical HIV prevention options—including: PrEP, treatment as prevention, voluntary medical male circumcision, female condoms and prevention of vertical transmission and HSV-2 vaccine R&D investment. The group also tracks HIV cure and therapeutic vaccine investment as part of a collaboration with the International AIDS Society’s Towards a Cure Initiative.
The group tracks all areas of research for biomedical HIV prevention from basic research to clinical trials to implementation science.
Investment data is self-reported from public, private and philanthropic funders on grants.
The Working Group tries to maintain a data set that is comparable year-to-year, while allowing for the limitations inherent to global resource tracking. The primary limitation is that data collection largely depends on the response rate of public, private and philanthropic funders, and year- to-year variability is to a degree a reflection of this response rate.
Additionally, funds were allocated to the year in which they were disbursed by the donor, irrespective of whether the funds were expended by the recipient in that year or in future years.
Lastly, all figures are reported in current US dollars and have not been adjusted for inflation.

3. Global HIV Prevention R&D Investment, 2000-2015
(US$ millions)
431.5M
659M
663M
773M
947M
1.18B
1.23B
1.19B
1.22B
1.27B
1.24B
1.31B
1.26B
1.25B
1.18B+
In 2015, the reported funding for HIV prevention R&D was 1.18 billion, declining by $70 million, or 9 percent, compared to 2014’s total of $1.25 billion.
+Preliminary data *Tracking funding for female condom and treatment as prevention research began in 2010 **Tracking funding for prevention of vertical transmission began in 2008 *** Tracking funding for PrEP began in 2002 **** Tracking funding for adult male circumcision began in 2001

4. Global HIV Prevention R&D Investment Recent Trends
(US$ millions)
1.31B
1.26B
1.25B
1.18B+
For a closer look at the global investment trend of the past few years, investment in biomedical HIV prevention R&D has been declining from the 2012 all-time high of 1.31 billion. Overall funding declines are largely due to decreases in investment from public-sector sources the US and Europe.
+Preliminary data *Tracking funding for female condom and treatment as prevention research began in 2010 **Tracking funding for prevention of vertical transmission began in 2008 *** Tracking funding for PrEP began in 2002 **** Tracking funding for adult male circumcision began in 2001

5. TOTAL HIV PREVENTION R&D
Global HIV Prevention R&D Investment by Sector
(US$ millions)
TOTAL HIV PREVENTION R&D
2013
2014
2015 *preliminary
% change
US Public Sector
887
868
836
-4%
European Public Sector 77 69 67
-3%
Other Governments 65 52 47
-10%
Multilaterals
0.6 0%
Total Public
1,029.60
989.6
951
Total Philanthropic
193
200
156.5
-22%
Total Industry
37.3
62.9 75
19%
Total Global Investment
1,260
1,242
1,183
-5%
2015 saw near across the board decreases from funders, with only industry funders increasing their aggregate contribution from 2014.

6. Global HIV Prevention R&D Investment 2015 by Funder Type
(US$ millions)
Taking a closer look at 2015 funding sources, the majority of funding came from public-sector sources in the US, including the NIH, CDC and USAID. For the past 6 years the US public-sector has provided approximately 70% of funding for HIV prevention R&D, The NIH alone provided nearly 60% of all funding in 2015.
Philanthropic funders are the second highest source of funding, with the majority of investment coming from the Bill & Melinda Gates Foundation and the Wellcome Trust. However, both funders decreased their contribution in 2015.
Both Industry and public-sector sources in Europe provided 6 percent of funding, followed by governments in other countries and multilaterals.

7. Treatment as Prevention Prevention of vertical transmission
Global HIV Prevention R&D Investment by Prevention Option (US$ millions)
In 2015, as in past years, HIV vaccine research investment made up the majority of investment in HIV prevention R&D, followed by investment in microbicides, treatment as prevention, prevention of vertical transmission, PrEP, male circumcision, and female condom research data shows a major drop in investment in microbicides and an increase in vaccines, somewhat reflective of the cyclical nature of funding for large scale trials. For example, you’ll note that PrEP investment declined in 2015 which may be surprising to those of you who are following the PrEP landscape. This decline is is representative of several studies finishing and nearly 14 studies starting or scheduled to begin in the timeframe.
Increases in vaccine investment are primarily due to an NIH increase of $5 million from 2014, and two new European Commission initiatives--EAVI 2020 and the Euro HIV Vaccine Alliance. Other funders also increased their investment, including a substantial increase from industry.
Microbicide R&D investment declines mainly came from the NIH, European Commission and the Netherlands.  Medical male circumcision saw declines from the Gates foundation, NIH and the Wellcome Trust and treatment as prevention from Gates, the CDC and NIH.
Female condoms saw an increase in funding with new invesmtent from India, and prevention of vertical transmission saw decreases from USAID and EC funding, although more funders entered the space this year.
PrEP
Treatment as Prevention
VMMC
Prevention of vertical transmission
Female condoms

8. Top 5 Countries Investing in HIV Prevention R&D (US$ millions)
836 UK
France
18.4
Netherlands
8.2
26.8
Japan
4.5
Looking at the top 5 countries investing in biomedical HIV prevention, we can see that different countries have different funding priorities. For example, in the UK, treatment as prevention and vaccines make up the largest pieces of the funding pie, while in the Netherlands PrEP, vaccines and microbicides are all large funding priorities.

9. 738,188 HIV Prevention Clinical Trial Participation, 2015 33,663
HIV Prevention R&D Trial Participants by Region in 2015
Total: 869,015
6,849
33,663
North America
The last bit of data the Working Group collects is information on clinical trial, demonstration project and other implementation study participation. As we know, contribution to R&D goes beyond financial investment, and moving HIV prevention options forward would not be possible without the participation of volunteers in research.
In 2015, the majority of volunteers were from sub-Saharan Africa—with the majority of those volunteers living in Uganda, Kenya and South Africa. Treatment as prevention studies had the largest number of volunteers, followed by PrEP trials and demonstration projects, microbicide trials, vaccine trials and medical male circumcision studies.
Only one in 6 trial participants in 2015 belonged to a population most affected by HIV, including MSM and transgender women, injection drug users, and women.
85,458
Latin America & the Caribbean
738,188
1,853
Western & Central Europe
Sub-Saharan Africa
South-East Asia, East Asia and Oceania

10. Advocacy, Policy, and Funding Trends
The US public sector remains the single largest source of funding for HIV prevention R&D.
Philanthropic funding is an important but declining part of HIV prevention research, falling 23% from
Commercial funding continues a multi-year increase in several areas of R&D.
Funding continues to be concentrated amongst a small number of large investors.
There is increasing attention from diverse funders to the science of implementation.
To sum up the trends identified by the Working Group:
The US public sector funds the majority of HIV prevention R&D., highlighting the need for a more diverse funding base.
With declining public-sector funds, philanthropic organizations increasingly fund vital parts of HIV prevention research. However, many smaller philanthropies are decreasing their funds or shifting away from HIV prevention R&D altogether.
Industry funding increased, playing a pivotal role in some of the clinical trials in 2015.
And lastly, there is increasing investment and interest in implementation science around several biomedical HIV prevention options.

11. Acknowledgements
Significant contributions from the Working Group organizations, AVAC, the International AIDS Vaccine Initiative (IAVI), and the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Working Group members Kevin Fisher (AVAC), Deepak Mattur (UNAIDS), Thomas Harmon (IAVI), Polly Harrison (AVAC) and Mitchell Warren (AVAC)
I’d like to acknowledge the significant contributions of the Working Group, and especially Laura Lazar who as I mentioned is the primary researcher and author on the report this year.
FOR HIV PREVENTION
RESEARCH & DEVELOPMENT
RESOURCE TRACKING

12. The full report will be available in October
The full report will be available in October. For the one-page summary, including graphics and archived reports, please visit:
Lastly, for more information, the full report and past reports you can visit the Working Group’s revamped website, which also has some great data visualization tools. Thank you.
Closing statement: In a financial climate with increasingly limited resources, tracking investment in HIV R&D provides the field with vital information to chart the course forward. Monitoring funding trends allows identification of gaps, prioritization of research, analysis of the effect public policies have on funding trends and fact-based advocacy to support future R&D investments. Understanding and evaluating research in the context of public, private and philanthropic funding is increasingly important in a time on constrained funding.
FOR HIV PREVENTION
RESEARCH & DEVELOPMENT
RESOURCE TRACKING