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Placing HIV/AIDS research at the heart of policymaking

HIV/AIDS is one of the most destructive pandemics in the world's recorded history. Around 65 million people have been infected with HIV and over 25 million have died since the first case of AIDS was detected in 1981. According to new statistics in from the UN, AIDS shows no si...

HIV/AIDS is one of the most destructive pandemics in the world's recorded history. Around 65 million people have been infected with HIV and over 25 million have died since the first case of AIDS was detected in 1981. According to new statistics in from the UN, AIDS shows no signs of letting up. Over the last 25 years, researchers and policymakers the world over have been working hard to reduce the spread of the disease and provide adequate treatment to those infected. Yet critics of the global response to HIV/AIDS say that research efforts are often too fragmented to make a real difference, while not enough is being done to coordinate those policy areas which are inextricably linked to the disease. CORDIS News caught up with some of those working at the heart of the matter at the European Commission's Research DG to find out more about how EU resources have been channelled into researching the virus, as well as the steps taken to ensure that these activities are linked with HIV/AIDs-related work elsewhere in the Commission, and worldwide. Funding of research for HIV/AIDs has always been part of the EU's research priorities, Dr Ole Olesen, scientific officer at the 'Poverty-related diseases' unit of DG Research, told CORDIS News. Since appearing in the first research framework programme in 1985, the HIV/AIDs budget has gradually increased, peaking in FP6, when approximately €200 million was allocated to the disease, nearly five times the amount spent under FP5. To date, €125 million has been spent on projects. Broken down, a total of 60% went to research into prevention, mainly vaccines (40%) and microbicides (20%), while the remaining 40% supported treatment activities. 'So far we are quite happy with this distribution,' said Dr Olesen. 'One of the big achievements of FP6 is that we have created a portfolio of projects that matches the HIV pipeline.' At one end of the pipeline is the European and Developing Countries Clinical Trials Partnership (EDCTP), a joint partnership launched in 2003 involving 16 European countries and several African nations. The aim is to accelerate the development of new clinical interventions to fight HIV/AIDS, malaria and tuberculosis. 'The EDCTP has acted as a guiding mechanism to the research funding we have delivered to more traditional types of projects in FP6,' explained Dr Olesen. While a laudable initiative, the partnership has been criticised for its slowness in getting off the ground. One reason for this has been the difficulty in attracting the €600 million initially sought for its budget. Set up under Article 169 of the European Community Treaty, the partnership relies of co-funding by participants. Having received €200 million from the Commission, the figure must now be matched by €200 million from the participating countries and another €200 million from the private sector. 'The starting phase has been quite slow,' said Manuel Romarís, scientific officer at the 'Poverty-related diseases' unit of DG Research. 'But now in the last year, there has been a big improvement in funding commitment by participating countries.' Among those that recently stepped up their support are the Swedish Agency for International Development Cooperation (SIDA) research board and the German Government, which both approved approximately €1 million per year over the next three years. Elsewhere, the UK Medical Research Council is negotiating an additional €7.5 million for EDCTP activities for the period 2007-2010, while the Institute of Tropical Medicine in Belgium has committed €500,000 per year over the same period. Since its launch in 2003, the EDCTP has published several calls, including one in 2004 for a clinical trial of a treatment for HIV infected children, funded using EDCTP resources only. A second in 2005 focused for capacity-building projects for microbicides, which received €7 million from the EDCTP and matching funds from participating countries. In July 2006, the EDCTP published another call, this time for research into the prevention of mother-to-child transmission of HIV. The €6.1 million call is co-funded by France, Ireland, the Netherlands, Spain and the UK. 'These are long term investments,' explained Dr Romarís. 'Clinical trials can take several years, so results won't be available for some time.' Probably the most exciting development for the EDCTP is the imminent arrival of the first private partner: the Bill and Melinda Gates Foundation. 'A new joint call by the foundation and EDCTP partners is foreseen to support capacity development to conduct phase II clinical trials of HIV preventive vaccines in Africa,' said Dr Romaris. He explained that the Gates Foundation had made a contribution towards the €20 million call of USD8.5 million (€6.4 million). Participating countries will now be expected to match the foundation's contribution. He added that the foundation had expressed interest in expanding this partnership beyond HIV vaccines, to other diseases. Dr Romarís said that he is very keen to see this joint call published as soon as possible, since he believes it will attract other private sector funders to the partnership. Asked what prompted the increase in the budget for HIV/AIDS in FP6, both Dr Romarís and Dr Olesen pointed to the Commission's 'Programme for Action' (pfA) to reduce poverty related diseases, which they described as a 'milestone' in Commission policy-making. 'This is one of very few umbrella policies which exists in the Commission that spans across DGs to form a common objective,' explained Dr Olesen. The programme comprises three pillars: trade, development and research, which feed one another. 'The research should pave the way for new drugs and new vaccines for HIV/AIDS, malaria and tuberculosis. The trade policy will make them affordable while the development policy will bring healthcare and medicines to sick people in [developing] countries,' said Dr Olesen. One concrete action to come out of the programme so far has been a joint call by EuropAid and FP6. 'This has been extremely useful because we are linking the money coming from development with money for research for the same objective,' said Dr Romarís. Several FP6 research projects, following an evaluation of their social impact, have already benefited from additional funds from this call to the tune of €15 million. 'So we can imagine that in addition to conducting research in a hospital, the extra money could, let's say, pay for awareness programmes for HIV/AIDS,' Dr Romarís explained. Dr Romarís noted that examples of this mixed policy approach are also springing up at national level. For example, the UK's international development department recently started directly funding clinical trials on microbicides. 'This is a step forward because they have understood that funding research on microbicides could help with the development of the population,' said Dr Romarís. 'This is very much a model that could be applied elsewhere in Europe.' In addition to integrating HIV/AIDS research into a much wider EU response to the pandemic, Dr Romarís noted that the Commission was also working to ensure that its research activities fit in with those undertaken elsewhere in the world. 'We are trying to synergise our research activities to avoid any duplication and maximise the complementarity of all our programmes,' explained Dr Romarís. To this end, the Commission is one of 16 organisations, both private and public, to participate in the Global HIV Vaccine Enterprise. The aim of the alliance is to accelerate the development an HIV vaccine. 'We are putting together the resources to ensure that the best work here [Europe] and elsewhere is going to help those that need it,' explained Dr Romarís. Under FP7, in addition to providing significant financial contributions to vaccines, microbicides and treatment research, the Commission will also be looking to provide further leadership in this field globally. 'The Commission is an international organisation, which is very well placed to promote new ideas, and new types of partnerships. We can therefore represent [European] stakeholders at a much larger scale,' explained Mr Olesen, adding: 'FP7 will allow us to create partnerships between European scientists, between scientists in different sectors, both public and private, and scientists from the North and the South.'