Of the estimated 36.7 million people living with HIV/AIDS globally in 2015, 25.6 million live in sub-Saharan Africa. Also, 1.37 million (65%) of 2.1 million new infections that occurred worldwide in 2015 occurred in sub-Saharan Africa. Sub-Sahara continues to bear the greatest burden of HIV infection. If we want to reverse this trend, there is a critical need to invest and scale up prevention and treatment of HIV.

A preventive HIV vaccine is an essential component of a long-term end to the HIV epidemic. Such a vaccine would teach the immune system to create responses that prevent the virus from establishing infection in the body. No licensed preventive HIV vaccine exists at present. However, there are ongoing efforts at developing a HIV vaccine. More than 30 years has been invested in HIV research efforts. Vaccine research is a long and enduring effort. The HIV vaccine and research development is not different.

An HIV vaccine is both possible and essential. In 2009, a clinical trial known as RV144 achieved proof-of-concept that a preventive HIV vaccine is possible, and, since then, researchers have continued to build on the results of that trial. There are three ongoing researches testing concepts for HIV vaccine development. These researches are taking place in countries in Africa and North America. However, if and when a HIV vaccine is developed, the product will and should be effective for all persons.

This is the goal of all stakeholders working in the field of HIV vaccine development. While we wait for a HIV vaccine, global coverage of HIV treatment, care and existing prevention options needs to continue to increase and expand; and we should witness less of new HIV infections and deaths from AIDS. The tools we have can make significant difference if we ensure they get into the hands of those who need it. These tools are making significant differences in country’s HIV epidemic profile when barriers to their access are addressed.

We need to support access of all persons to any HIV prevention tool appropriate for their use – preexposure prophylaxis, post exposure prophylaxis, STI diagnosis and treatment, male and female condoms, HIV treatment as soon after diagnosis. HIV vaccine development and eventual rollout of a successful vaccine requires sustained financial support. Developing a successful vaccine is not cheap, but an HIV vaccine will pay huge dividends in lives saved. Modeling research estimates that in some parts of the world, an effective HIV vaccine could reduce new annual HIV infections by nearly half in its first 10 years, averting tens of millions of infections. We can’t afford to slow down promising and urgently needed research.

AfNHi 1, recognizes the importance and place of HIV vaccine in the efforts towards ending HIV by 2030. The end of HIV is only feasible with a HIV vaccine. It will take concerted efforts from all partners to make the successful development, testing and rollout of a safe, effective, licensed HIV vaccine accessible. Civil Society has a role to play in leading the charge in this campaign. Funding product development and clinical trials alone is not enough. AfNHi encourages the investment of all stakeholders in the HIV vaccine research and development process NOW.

1 AfNHi is an African-led HIV Prevention Research Advocacy Network, whose vision is Africa Free of New HIV Infections.

The global health landscape is changing. In less than two decades, the world has registered some of the most momentous advances against infectious diseases. Global partnerships against epidemics such as HIV, tuberculosis and malaria have galvanized remarkable amount of goodwill and resources that have significantly reduced the burden of these diseases. Those efforts have saved millions of lives globally. A new report by the Brookings shows that the Millennium Development Goals (MDGs) spurred major accelerations in the fight against child mortality, HIV and AIDS, tuberculosis and malaria. The Study found that through expansion and acceleration of pre-MDG rates of progress, between 21 and 29 million lives were saved.

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Kenyan researchers are working on about eight potential HIV vaccines.None has shown efficacy, but scientists believe they are still potent if delivered efficiently into the body.And so they are not giving up.They have resolved to intensify their work and use other methods that will finally give the desired results.“Most of them were found to be safe, but failed to stimulate the body’s immune system,”

Borna Nyaoke, a clinical trial physician at the Kenya AIDS Vaccine Initiative, said yesterday.“Now we are trying different methods that can deliver it directly into the cell.”She said some of the new delivery methods include administering through nasal drops and electroporation, where the vaccine is given through a quick, high-voltage pulse to overcome the barrier of the cell membrane.

“We are working on a HIV vaccine. We will get it, but it will take time,” Nyaoke said during a world HIV Vaccine Awareness Day conference convened in Nairobi by WACI Health, a regional advocacy group. She said all the Kenyan vaccine candidates passed safety levels but stalled at Phase Two.Nyaoke said candidates would take at least another 10 years of testing even if scientists find a better delivery method. It is hard to make an HIV vaccine because the virus mutates quickly and a vaccine against one type may not protect against another.

Vaccines work by mimicking natural infections, during which the body produces antibodies that kill the virus.But HIV doesn’t stimulate this kind of response. The body’s immune systems are generally blind to the virus and unable to launch an effective antibody attack.There is also the lack of good animal models to study. KAVI, an affiliate of the University of Nairobi, has been conducting vaccine research since 2001. Globally, the efforts are more than 30 years old.

WACI health executive director Rosemary Mburu praised HIV research efforts in Kenya and called for more government funding.“Finding a vaccine is costly and involves a lot of research. But it is essential and possible. That is why we need to invest in it,” she said.

UNAIDS says a vaccine would be the most effective way to control the virus.“The biggest impacts in the eradication or control of infectious diseases in the history of public health have been achieved through vaccination,” Michel Sidibé, Unaids executive director, said. “This is why a vaccine is worth continuing to invest in.”

President Donald Trump has reinstated the Mexico City Policy – an abortion-related requirement prohibiting foreign non-governmental organizations that receive U.S. funding from using their resources on abortion or abortion advocacy. But other countries, led by The Netherlands, have moved swiftly to try minimize the impact of the Trump’s order.

The policy – also known as the global gag rule was established by President Ronald Reagan in 1984. It provides that to receive U.S. funds, organizations must desist from using money from any source (including non-U.S. funds) for abortion or abortion advocacy.  President Trump’s provisions go beyond previous ones by Republican Presidents, which barred organizations from receiving U.S. government global-family-planning funding. His gag rules are extended to cover all other U.S. global-health funding. The memorandum signed by President Trump also extends the requirements beyond non-governmental organizations to include “global health assistance furnished by all departments or agencies.” In the last few weeks since this new order was signed, global health advocates have worried that the gag rule will harm global health, reversing gains made against many diseases, including HIV, tuberculosis and malaria. More importantly, the new order would affect the provision of reproductive health services for millions of women around the world.

It is why WACI Health is excited to hear plans by the Netherlands to establish an international fund to mitigate the effects of President Trump’s gag rule on women’s reproductive health services.  Launching the She Decides initiative, Lilianne Ploumen, the Dutch minister for foreign trade and development cooperation, said new funding will be used “to make sure that women and girls all over the world have access to family planning services.” It is reported that seven other countries, including Sweden, Denmark, Belgium, Luxemburg, Finland, Canada and Cape Verde have offered their support.

In her message in support of women’s reproductive health rights, Marie-Claude Bibeau, Canada’s Minister of International Development and La Francophonie, said that Canada will make a significant contribution in sexual and reproductive health rights and advocacy for women’s rights, contribute to sex education for boys and girls, to the provision of contraceptives,  to family planning, to legal safe abortions and to maternal and newborn health.

We commend the Netherlands for coming up with this great initiative. We commend the other countries that are standing up for women in these very uncertain times.  The world has made remarkable progress in the fight against infectious diseases and in promoting and protecting reproductive health rights of women in the last two decades. We cannot stop now.

A growing wave of nationalism is sweeping across the West and demanding a sharper focus on domestic issues and lesser engagement abroad. For global health investments in Africa, which have been heavily supported by international funding, these happenings call for increased domestic investments in health and other areas of development.

The rise of nationalism sentiments have been wide ranging – from Austria, to France and the Netherlands. However, two recent developments – the victory by the Brexiters in the UK in June 2016 and the election of President Trump in the U.S. less than five months later – are certainly the most momentous. The two events are the best exemplifications of the global politics of the times. More and more countries seem to be looking inward, not outward. In his inaugural speech as the President of the United States, Donald Trump vowed: “From this day forward, it’s going to be only America first, America first. Every decision on trade, on taxes, on immigration, on foreign affairs will be made to benefit American workers and American families.”

While it is still early to know what effect the Trump administration’s policies will have on global development, The New York Times has reported that the administration is “preparing executive orders that would clear the way to drastically reduce the United States’ role in the United Nations and other international organizations.” The orders would kick off the process of reviewing and potentially repealing certain forms of multilateral treaties, the Times reported.

For years now, advocates across Africa have been calling on African governments to step up their investments in global health.  Africa bears a disproportionate burden of diseases. It is estimated that sub-Saharan Africa has 11 percent of the world’s population but 24 percent of disease burden. Despite the tremendous progress made against the big three infectious diseases – HIV, TB and malaria – numerous African’s continue to die of these diseases every year. To end these diseases and others that continue to kill many on the continent, advocates have called on African governments to find ways to invest more of their own money towards this cause.

Progress against major infectious diseases in the last two decades has been unequivocal. For instance, an estimated 790 000 people died in the African Region from HIV-related causes in 2014, according to WHO. That was a 48 percent drop in number of deaths from the disease compared to 1.5 million people in 2004. That progress was achieved through strong investments by international development funders and African governments. To end HIV, TB and other diseases as epidemics, advocates have called on international funders and African governments to do more.

With the growing wave of nationalism, and the possibility that contributions by international funders can decline, African countries have a bigger duty to ensure that this progress does not stall.  If funding levels from the U.S. – the single biggest investor in international funding for global health – falls, the dream of ending HIV, tuberculosis and malaria as epidemics by 2030 may not be realized. We hope that the U.S. and other big donor governments will safeguard and advance this work, completing the wonderful job they started. This is especially crucial, as we get closer than ever to ending major diseases as epidemics.

We call on African countries to step up their investments in global health to fill any gaps that may be left by a possible decline in international funding.

If it turns out that the growing anti-globalization sentiments will not result to reduced investments in global health, then that sustained funding and stronger investments by African governments can help us to press forward faster with the goals of ending HIV, TB and malaria as epidemics by 2030 as well as build stronger health systems to tackle other diseases. This would be a landmark victory for all in the world, which would save millions and millions of lives, revitalize communities, create stronger economies and spawn greater benefits for all people in all corners of the world.

In February, Africa elected Chad’s Moussa Faki Mahamat as the new chairperson of the African Union Commission (AU) replacing South Africa’s Nkosazana Dlamini-Zuma.

One of the most remarkable advances in global health under the leadership of Dlamini-Zuma, was the formation of the Africa Centers for Disease Control and Prevention, a public health agency to lead the transformation of Africa’s health.

The birth of Africa CDC is timely and crucial because it will address the uneven burden of disease as evident in sub-Saharan Africa that carries 11 percent of the world’s population but 24 percent of disease burden as per the AU Commission Strategic Plan 2014-2017.

As the secretariat to the Civil Society platform for Health in Africa (CISPHA), we are elated to witness the formation of this historic initiative – which Africa’s civil society advocated for vigorously.

It is a significant opportunity for Africa to improve the health of its people – a key element in shaping the continent’s sustainable development. We urge Mahamat to strengthen this new outfit and anchor it as a centerpiece of his leadership.

The weakness of many institutions in Africa lack of clear leadership and sufficient resources. We hope that the chairperson will give the agency the support it needs – both in leadership and in resources – to allow it to achieve its mandate of achieving better health for the people of the continent.