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Harmonizing, Integrating and Vitalizing European Research on hiv/Aids

Final Report Summary - HIVERA (Harmonizing, Integrating and Vitalizing European Research on hiv/Aids)

Executive Summary:
HIVERA was designed as an instrument for creating sustainable cooperation and coordination between national funding bodies and their programmatic activities in HIV/AIDS research. For years, a wide range of financial support for an overall high amount has been successfully dedicated to this research area through national and/or EU-funded health research programmes. However, in 2010, there was still little cooperation between national funding programmes for HIV/AIDS research, while this field is highly international, operationally as well as competitively. The absence of programme coordination in a context of economic crisis is an important hurdle to confront the emergence of major new questions, the more as early clinical and epidemiological trends are signalled initially in small, specific patient populations. HIVERA has therefore created a platform where governmental policy makers across Europe, together with leading scientific experts and other relevant stakeholders such as independent charities, patient’s community representatives, international organisations involved in the fight against AIDS, industry and public health bodies, could meet and discuss relevant problems and innovative approaches, draw up common visions for the future, and implement joint measures to ensure Europe's leading position in the field. Duplicating existing European activities was avoided by actively linking up HIVERA with ongoing networks, and by implementing joint transnational calls on emerging issues in HIV/AIDS.

As an initial nucleus, HIVERA envisaged the coordination and cooperation of national programmes or programme areas in 8 countries (BE, DE, EE, FR, IT, PT, RO, TR), but it enlarged the areas with Hungary joining HIVERA in 2013 and Latvia participating to the third joint transnational call in 2014 (while Turkey withdrew after one year for economic reasons). An inventory was made of relevant programmes, individual projects and major public and private actors in the national RTD landscapes of countries participating in HIVERA as well as Ireland and Czech Republic. This inventory was initiated in the developing phase of this ERA-Net to provide a clear picture at time 0 of HIVERA. It was then dynamically continued throughout the project through email exchanges, also in view of monitoring coordination efforts and to avoiding redundancy. Thorough analyses of synergies and complementarities at both programme and project level was performed together with national and international organisations and other stakeholders. The results obtained helped defining starting points for sustainable transnational cooperation, either by re-or co-programming ongoing activities, or stepwise coordination and synchronization of national programmes. The latter started with transnational calls, respecting the national specializations and interests, and resulted in three joint calls over the duration of this ERA-Net. An additionnal year was decided so that a third joint transnational call could be launched in 2014. Longer-term perspectives in RTD strategies, namely a European research agenda on HIV/AIDS, was elaborated as a position paper on the basis of a strong common knowledge basis. For that purpose, studies on major programme initiatives outside Europe showing the international perspectives of the field, foresight studies using e.g. bibliometrical approaches and other activities were conducted. A precise documentation and analysis of the national programmes´ implementation approaches (including IPR and exploitation management) facilitated the validation of RTD programmes and the respective financial support level in the field. Strategies to overcome barriers that hinder transnational cooperation were designed.

HIVERA supported the EU public health and enterprise policies and governed the research field itself by stimulating the dialogue with the broader public and tackling major science and society issues. Finally, it provided Europe with a strong research network, which allowed coordinated responses towards potential threats to the public health concerning infectious diseases. This ERA-Net will continue through Horizon 2020 through a ERA-Net Co-fund tool merging with another Era-Net called Infect-ERA so that HIV research and network can continue to be strenghtened.

Project Context and Objectives:
HIVERA is a European coordination action devoted to AIDS/HIV research throughout Europe. It is funded by the European Commission and coordinated by the National agency for research on Aids and viral hepatitis in France, the ANRS, and involves ministries, research organisations, governmental bodies, funding agencies from Member and Associated States like Belgium, Estonia, France, Germany, Hungary, Italy, Portugal, and Romania. HIVERA aims at harmonizing and vitalizing AIDS/HIV research policies across Europe through common actions such as wide joint funding programmes on AIDS/HIV research.

Context:
In Europe, approximately 2.1 million people are living with HIV. The number of newly infected people continues to increase with in parallel a progressively ageing patients' population, leading to secondary HIV and therapy related diseases. In such situations, the control of AIDS/HIV epidemics is faced with challenges like universal access to prevention, treatment, care and support.
In order to meet these emerging issues and to raise innovative approaches in HIV/AIDS research, sustainable cooperation between national funding bodies is needed at the European and international level. Reaching common and multilateral policies is highly relevant for public health and will help to ensure Europe's leading position in the field.

Aim and objectives:
HIVERA ERA-Net aims at structuring extensive research and innovation activities of high international standard through common actions such as joint transnational calls and training of scientific project managers with high standards in programme management and in scientific evaluation. A more efficient use of the resources shall be achieved by the strategic bundling and focussing of scattered funding, by stimulating mutual and synergetic specialisation of national research landscapes, and by identifying and avoiding duplications.The main objective of HIVERA is the establishment of a European-wide joint funding programme on HIV/AIDS research.
Other objectives are:
- to compile information about existing funding schemes in Europe for HIV research and to identify the most promising areas for joint initiatives
- to develop HIV-related national schemes among the participating ministries and funding bodies for common joint calls
- to coordinate a pan-European platform for scientific and patient communities, policy-makers, other relevant stakeholders involved in HIV/AIDS research
- to foresight on future challenges in HIV research through developing a proposal for a European strategic agenda.

Project Results:
Exchange of information and cooperation with existing national/regional funding programmes and activities
During the first period of HIVERA, exchange of information on existing national/regional funding schemes and activities was done through surveys among HIVERA and non-HIVERA institutions. This inventory served for the implemention of HIVERA activities. It helped strenghtening the network and promoting mutual learning process to increase the potential for harmonisation and integration among the partners.
Moreover, a platform for programme managers and researchers was created on the website of HIVERA as an interface between science and funding policy to feed into future national and European funding programmes to discuss the ethical, legal and social basis for research funding and the implementation of its results according to the existing laws and regulations.

Proactive strategy towards new partners
If Turkey withdraw soon after the beginning of the ERA-Net, Hungary joined the consortium on 2013 and Latvia joined for the third and last joint transnational call.

HIVERA had to face the fact that major changes in the national funding schemes were made during the time of its implementation. Indeed, many countries do not have any longer specific and dedicated HIV/AIDS national programs.
Thus, most of the countries in Europe have no dedicated programme to HIV research and that was the main reason for failing in gathering data from Spain and The Netherlands in particular.
In terms of contacts, we stated in the 1st periodic report that Spain, Ireland, The Netherlands and Switzerland were all contacted for joining HIVERA without success. An ERA-Net in the field of HIV was not a priority in their strategic European agenda as explained in the WP1-WP2 Survey (Del 1.2 2.1).

Spain (ISCIII) was contacted for the second time in period 2. It was suggested that Spain join at least HIVERA call 2013 even with a minimal amount which could be completed by ANRS in case of success of a proposal with Spanish researchers. Negative reply from ISCIII was received.

The global context has certainly impacted such kind of cooperation in which funding commitments are looked for. Moreover, it was noted that the strategic priorities were divergent across Europe.

The consortium focused then on involving more partners from Central and Eastern Europe to help strengthening cooperation with Central/Eastern community. This was very important since almost all transnational research is operating among western European organisations. This was a success as Hungary and later Latvia both joined the project. HIVERA permitted a strong participation of Central and Eastern European countries.

Finally, in view of a future for HIVERA, several contacts were carried out and Spain (ISCIII) expressed its consent to join a future ERA-Net Co-fund. UK and the Netherlands were also contacted but negative replies were received.

Surveys and foresight studies
Long term strategies and foresights on future challenges in HIV/Aids research in the years and decades ahead started in the framework of WP4 and WP1 through a survey and a structured literature review. A task force was appointed with the participation of senior scientists and expert programme
managers specialised in the field.
The survey and studies helped in getting mutual knowledge on national research policies in Europe and delineating priorities in the field.
2 papers were published in peer reviews:
- HIVERA foresight study on « Epigenetics of HIV infection: promising research areas and implications for therapy » 2013
Authors: Eva Ay, Ferenc Banati, Maria Mezei, Agnes Bakos, Hans Helmut Niller, Krisztina Buzás, and Janos Minarovits
- HIV research productivity and structural factors associated with HIV research output in European Union countries: a bibliometric analysis. 2015
Authors: Uusküla A, Toompere K, Laisaar KT, Rosenthal M, Pürjer ML, Knellwolf A, Läärä E, Des Jarlais
Foresight survey
- « Future trends and challenges for HIV/AIDS research and programme management » 2012
Conducted among researchers, clinicians and programme managers in the field, the survey helped in getting mutual knowledge of the respective funding schemes fo the partners and hence, in establishing financial, administrative and legal framework for HIVERA joint calls.

Strategic Research Agenda
The aim of the elaboration of a SRA was to identify key priorities and concrete tools to help structuring and coordinating HIV/AIDS research in Europe.
A think tank meeting was organised in January 14th 2013 in Paris followed by a workshop for policy-makers, stakeholders and experts held on November 13th 2013 in Brussels.
The following research themes to be prioritized were identified:
1. Paving the way towards the epidemics
2. Anticipating the consequences of aging on the care and management of people with HIV infection
3. Cure/eradication of HIV disease in the individual patient
4. Behavioural and social science: IDU, MSM, Migration flows
5. Other research priorities: HIV vaccine research, HIV/HCV co-infection, HIV and tuberculosis co-infection, resistance of HIV to antiretroviral drugs

Joint calls for transnational research
Preparation and implementation of tools for the joint funding activity including legal and
contractual frameworks and guidelines to applicants and evaluators.

Partnering events
The partnering events provided the scientific community with the opportunity to receive further information about HIVERA and the origin and content of the respective joint calls, and to form multilateral research consortia. Two partnering events were organised respectively for the 2nd and the third joint transnational calls.
- January 25th 2013 Paris: it gathered 36 researchers and 4 coordinators communicated on their project ideas
Among the 62 applicant teams in the 13 proposals, 17 attended
- September 26th 2014 Budapest: it gathered 30 researchers
Among the 39 applicant teams in the 8 proposals, 12 attended

Training for applicants
The organisation of trainings aimed at enhancing good practice in writing proposals and facilitate trans-border cooperation.
Two training sessions were organised:
- March 19-20th 2012 Bucharest
- September 26th 2014 Budapest

Potential Impact:
Potential impact
The lauching and implemention of joint calls for proposals helped strengthen already existing research collaborations and initiated the formation of new multidisciplinary research consortia. Supporting the combination of research groups helped increase the impact of HIV/AIDS European research and contributed to a common vision for a European Research Area. Various fields of research were involved as interdisciplinary vision has always been an added value to face emerging issues in this field moving fast. EU funding had an important impact for the long-term perspective of an intersectoral and transnational approach for shaping a European research policy on HIV/AIDS.
With a successful coordination and dissemination of our results and interactions with policy makers, EU officers, European research collaborations and consortia, patients, communities and other stakeholders, HIVERA had an impact on research policy development within partners and also at the EU level.
HIVERA has had an integrative character for countries with different status within and towards the EU, and the ERA-Net fully involved them and reinforced their research capabilities. Particularly, funding transnational research through HIVERA calls helped reinforcing Central European cooperation in HIV research, usually performed among Western researchers. Thus, Hungary, Latvia and Romania have been active partners and researchers from those countries set up projects with Western European teams. A Romanian researcher is the coordinator of one selected projectt from the third joint transnational call.
Latvia joined specifically for the 3rd joint transnational call, proving that HIVERA succeeded in involving funding bodies from outside HIVERA partners.
Moreover, among the 9 funded projects through the calls, we can point out that some of the projects coordinators are young investigators. Therefore, not only HIVERA succeeded in gathering various countries with different research capabilities but it also permitted to create consortia gathering young investigators and experienced researchers. The development of mutual understanding and trust among the partner organisations contributed to durable international cooperation, long-term impact and increasing membership.
Joint multilateral calls for proposals have been major instruments to ensure the durability of the HIVERA network beyond the funding period. Thus, although the ERA-Net HIVERA has came to completion on 30th April 2015, the funded projects are still going on.

The actors involved in HIVERA activities were numerous: stakeholders, patients’ groups, health providers and community representatives and the scientific community. HIV-patient associations have been strongly involved via the Advisory Board and the Scientific Evaluation Committees' experts that brought their expertise for the design of the calls and for the selection of the projects keeping in mind patients' best interest. International organisations such as EDCTP was also approached to discuss the possible links that could be created between HIVERA and EDCTP2 and an EDCTP representative participated to the Kick-Out Meeting of HIVERA on April 21st 2015.

Dissemination activities
Public awareness of the network achievements and AIDS/HIV related-issues have been achieved through the HIVERA website created at the beginning of the project.
In the public part all results targeted at the general public or special interest groups have been presented. External dissemination of knowledge was done via the organisation of workshops, papers published in scientific journals, and other media such as regular newsletters (8 in total). Indeed, progress within the project is absolutely dependent on the free availability of information concerning results and data within the consortium. Therefore, all publications are available on the website of HIVERA.
Administrative and technological information are available to the partners of the consortium, through communications via emails and during meetings and workshops. The Intranet part of the website designed for communication restricted to the consortium partners has been a very useful additionnl tool. Eventually, relevant results and activities have been communicated to the scientific community and key stakeholders via the traditional routes of publications in peer reviewed journals and, where applicable, meetings and workshops. The HIVERA website has been the major tool for information sharing and dissemination of the ERA-Net results.
The indicators used to assess the impact could be the ones extracted from the HIVERA Website but unfortunately due to a technical problem, only partial data are currently available and do not permit to draw conclusions. No other indicators were used to assess the impact.

The elaboration of a Strategic Research Agenda focused on future challenges and foresights for a joint European research on HIV Aids will help design the future scope of intervention. Indeed, a continuation through Horizon 2020 is in preparation via an ERA-Net Co-fund tool. HIVERA will merge with another ERA-Net, Infect-ERA. The SRA will therefore be the basis for continuing HIV research across Euroep and defining the priorities so that Europe remains a key player on this competitive international arena.

List of Websites:
HIVERA website: www.hivera.eu

HIVERA Coordination:
ANRS 101 rue de Tolbiac 75013 Paris
Tel: +33 1 53 94 60 23

Project Managers
Roxane Brachet (2010-2014)
Esther Vix (2015) esther.vix@anrs.fr

HIVERA Secretariat
Sandy Lecarpentier sandy.lecarpentier@anrs.fr