House of Commons - International Development Committee

The 2010 Millennium Development Goals Review Summit - International Development Committee Contents

Written evidence submitted by the International AIDS Vaccine Initiative (IAVI)

IAVI would like to thank the International Development Select Committee for the opportunity to submit written evidence and hopes this document acts as an informative contribution to their inquiry.

KEY OUTCOMES FROM THE SUMMIT

1. Two keys outcomes were adopted at the 2010 UN Summit on the Millennium Development Goals (MDG), namely the "outcome document"[15]—which includes an action agenda for achieving the Goals by 2015—and the UN Secretary General's Global Strategy for Women's and Children's Health[16] which aims to save the lives of more than 16 million women and children by intensifying efforts toward attaining MDGs 4 and 5 (to reduce child mortality and improve maternal health).

2. IAVI is encouraged by the commitments made and welcomes the renewed focus expressed in both documents on the health of women and children as a central element to the achievement of all the development goals. Progress in maternal and child health is closely interconnected with the goal of combating HIV and AIDS (MDG 6). Globally AIDS is the leading cause of death among women of reproductive age with more than 800,000 maternal deaths linked to HIV. In several African countries AIDS is the leading cause of death among infants and young children—each year nearly 400,000 children in Africa are born with HIV[17],.[18]

3. The links between women's health and HIV and their disproportionate vulnerability to infection are impossible to overlook. Interestingly, research findings recently published in the AIDS journal, suggest that malaria, and other common African infections, may make women more susceptible to HIV and AIDS than they are in the developed world. The study found immune cells in the genital tract are more activated in African women. Researchers believe these findings may shed new light on why HIV infection rates are so high in Africa.[19]

4. At a high-level side event held during the Summit and hosted by UNAIDS, world leaders agreed that sustainable progress towards global goals to end poverty and ensuring healthy societies will not be achieved without synergy between AIDS and other health and development initiatives. A new publication from the United Nations Development Programme which was launched at this event, advocates this "AIDS plus MDGs" approach. The publication highlights the need to rethink the relationship between HIV and the MDGs, and outlines three important elements: understanding how HIV and the other MDGs impact one another; exchanging programmatic lessons across HIV and the other MDGs; and, creating synergy and increasing cost-effectiveness through strategies that simultaneously address HIV and other MDGs.[20] These developments have important implications for maternal and child health, and highlight the need to take a comprehensive approach in tackling the challenges ahead.

5. A recent publication from the World Health Organisation (WHO), UNAIDS, and UNICEF entitled Towards Universal Access highlights implications for public policy in relation to sustaining commitments to the fight against HIV and AIDS and the necessity of these in securing future progress toward the MDGs. The report states that "while the response to other global health priorities must be further strengthened, this must happen in addition to, not instead of, a continued and increasing commitment to HIV." It goes on to say "that despite encouraging progress made in expanding access to HIV testing, prevention, treatment and care in low—and middle-income countries—global targets for HIV prevention, treatment, care and support are unlikely to be achieved in 2010. This has important implications for a range of MDGs beyond those specifically related to HIV, such as MDGs 4 and 5, with targets related to child and maternal health".[21]

6. IAVI would like to take this opportunity to emphasise how the increasing impact of HIV on women and children reflects the real need to support the development of an AIDS vaccine in order to save the lives of mothers and newborns. This is echoed in the Summit's outcome document which commits to accelerating progress in MDG 6 through "significantly intensifying prevention efforts" and "the empowerment of women and adolescent girls so as to increase their capacity to protect themselves from the risk of HIV infection".

7. The document also highlights the need for new prevention technologies in several instances: it stipulates that HIV prevention programmes "should promote policies that ensure effective prevention and accelerate research and development into new tools for prevention, including microbicides and vaccines" and also states a commitment to accelerating progress in promoting global public health for all through "enhancing public-private partnerships for health-care service delivery, encouraging the development of new and affordable technologies and their innovative application and developing new and affordable vaccines and medicines needed, in particular, in developing countries".

8. IAVI is pleased to see well deserved attention being given to new prevention technologies such as the development of an AIDS vaccine in not only the outcome document but the Strategy as well. IAVI agrees and fully advocates the messages captured in the Strategy document that technological innovations can also play a critical role in relation to achieving the MDGs. The Global Strategy quite rightly places emphasis on the value and importance of coordinated research and innovation, and the role of public-private partnerships in accelerating the development of new vaccines, drugs and technologies.

9. Research and development for new, innovative health tools are essential to achieve the MDGs and enable more equitable and sustainable improvements across health services and health outcomes. Previous investments in research to develop new vaccines, drugs, diagnostics, and other tools have led to some of the greatest advances in global health to date, saving countless lives and resulting in billions of dollars in cost savings.

10. While the ultimate goal of AIDS Vaccine Research & Development is the widespread distribution of effective, preventive vaccines, it still produces several secondary benefits especially in developing countries. The development of new health prevention technologies will accelerate progress towards the MDGs, notably to combat diseases such as AIDS, reduce poverty and child mortality, and improve maternal health. Most importantly, it contributes to building capacity for science, technology and innovation (ST&I) in developing countries which can also help accelerate economic growth and development.

11. It's worth noting that a lot of the key points highlighted above are conveyed in the text of the Summit's outcome document. Despite this, it's important to stress that when it comes to putting the words into action and implementing the strategy it is imperative that Member States uphold their commitments and recognise the impact HIV has on maternal and child health. IAVI strongly advocates the gains that can be made across the health-related MDGs from scaling-up and strengthening a range of HIV prevention approaches that must be available to meet women's and girls' varied needs and preferences.

DFID'S ROLE IN DELIVERING AGREED STRATEGIES

12. The UK announced at the Summit that it is committed to doubling the number of maternal, newborn and children's lives saved and the Department for International Development (DFID) will set out how it aims to increase efforts up to 2015 in a new Business Plan for Reproductive Maternal and Newborn Health. The UK pledged to provide an annual average of £740 million (US$1.1 billion) for maternal, newborn and child health from 2010 to 2015—an additional spending of £2.1 billion over this period. IAVI commends the UK Government for its commitment and leadership to improving the health of women and children.

13. As expressed in the Summit's outcome document, the fulfillment of ODA pledges are crucial. Therefore, IAVI is delighted that the UK government aims to honour their commitments and urges DFID to ensure their efforts to address maternal and child health in their new Business Plan takes a comprehensive and integrated approach—one that prioritises strengthening the response to HIV and AIDS and acknowledges that stopping the spread of HIV is a prerequisite to reaching most of the other MDGs. IAVI recommends that this approach encompasses vaccine development, and the scaling-up and strengthening of a range of HIV prevention approaches including prevention of mother-to-child transmission (PMTCT) services.

14. We are witnessing much success in tackling HIV infections rates[22]—which have reportedly dropped by 25% in some of the worst-hit countries in the region—and tremendous progress is being made in HIV Vaccine Research with a so-called "renaissance in HIV Vaccine Development"[23],.[24] However, it would be regrettable if, for these reasons, AIDS funding was to be seen to be dropped from the agenda. Unless political and financial commitments are sustained, the recent gains made will be reversed.[25] The report "Towards Universal Access" from the WHO, UNICEF and UNAIDS states that "reduced funding for HIV services not only risks undoing the gains of the past years, but also greatly jeopardizes the achievement of other Millennium Development Goals, especially those related to maternal and child health".[26]

15. There is a need for long-term sustainable funding in HIV Vaccine Research and Development (R&D), and the UK government has a key role to play in supporting this agenda. It's important that DFID integrates research into their strategic business plans and acknowledges the importance of fostering more innovation, especially at the early stages of AIDS vaccine R&D, in forging a comprehensive approach to global health challenges and specifically in achieving their goal to improve maternal and newborn health.

16. IAVI would be pleased to receive an assurance of long-term political commitment from the UK Government in supporting the search for new and better prevention options, and ultimately developing a preventive AIDS Vaccine which is effective, safe and accessible to women and girls. This will positively contribute towards the MDGs responsible for improving women's and children's health.