Scientific research and development has thankfully increased the number of prevention options we have today to stop the spread of several infections including HIV and TB. But are they actual choices for the people-at-risk of getting infected?

The deadly gap and unacceptable delay in converting scientific breakthroughs into public health gains must be eliminated if we are to end AIDS and TB.

“We have to fill the product introduction gap – accelerate time to regulatory approvals of product introduction to impact; demand creation and programme platforms for prevention; and differentiated and integrated service delivery for people. We must also fill the product development gap – long acting and event driven; user-friendly and developed with users; dual purpose and multi-purpose methods must be our top priority,” said Mitchell Warren, Executive Director of AVAC. Mitchell was speaking at AIDS 2024 Affiliated Independent Event on TB and HIV organised recently in lead up to 25th International AIDS Conference (AIDS 2024).

“We have to work simultaneously to fill the gaps in both areas. If we neglect one of them, we are not going to create the sustainable and durable end to either TB or AIDS. That is what combination treatment and prevention has to look like. Also, it takes a global community of advocates, researchers, policymakers, funders to move forward,” emphasised Mitchell.

Mitchell wears many hats (and with great aplomb). He is also a member of the Scientific Advisory Board of the President’s Emergency Plan for AIDS Relief (PEPFAR), the International AIDS Society (IAS) Governing Council, IAS Towards an HIV Cure Initiative, President of the TB Alliance Stakeholder Association, and Past President of the Global HIV Vaccine Enterprise.

Thankfully the targets such as ending TB, AIDS and malaria by 2030 are ambitious but sadly these are not met. “They hopefully drive policies, programmes and investments, but they rarely actually achieve the success that we seek. Targets that were established in 2014 – 10 years ago – for where the world needed to be by 2020 to have fewer than 500,000 new HIV infections per year, have been missed. The gap between the targets set up to end the AIDS epidemic by 2030 and what was actually achieved, is huge. The gap got larger over the last 5 years, particularly because of the COVID-19,” said Mitchell.

“And yet UNAIDS rightly put out more ambitious targets in 2020 for where we needed to be in 2025. The good news is that these new targets recognise a much greater centrality around policies and behaviour change and put the individual at the centre of the epidemic (that was not the case in 2020). But we still have a long way to go before we come even close to what we call the 95-95-95 targets. But more important is the recognition that the people we are leaving behind are our biggest worry. We sought to develop a method mix in HIV prevention- like........

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