Funding for COVID-19 overshadows HIV/TB research expense

LAHORE: Global funding for COVID-19 vaccine development has exceeded 10 times in less than a year the amount allocated for HIV and TB research and development in 11 years.

“A staggering amount of $103.8 billion has been thrust into COVID-19 vaccine development within a period of just 11 months of 2020 as compared to a paltry $9.5 billion ($8.5 billion for HIV and $1billion for TB) for HIV and TB research and vaccine development during 11-year period from 2009 to 2019,” according to the statistical data compiled by Treatment Action Group (TAG-USA).

“According to KENUP Foundation, the governments, to-date, spent at least $111.6 billion on COVID-19 vaccines and therapeutics, 95 per cent of which went into coronavirus vaccine development alone. It betrays a whopping amount of $103.8 billion spent on COVID19 vaccine research and development alone,” says Mike Frick from TAG-USA quoting the latest statistics on R&D funding at a session titled “HIV & TB: An R&D tale of two vaccines” during the ongoing 4th HIVR4P // Virtual hosted by International AIDS Society (IAS).

Of the total funding pooled into COVID19 science, as many as 32 per cent came from public funding from the United States, 24 per cent from the European Union (EU/member states) and 13 per cent contribution came from Japan and South Korea.

“There is a stark difference in funding for COVID vaccine research in one year in comparison with HIV and TB research and vaccine development in over a decade and reasons are complex,” said Prof Sheena McCormack, Professor of Clinical Epidemiology and MRC Clinical Trials Unit at UCL, UK.

“Never has there been a moment in history where everyone focused on one single pathogen,” said Galit Alter, Professor of Medicine at Harvard Medical School, US. The scientists in cancer labs, allergy labs, immunity labs and HIV researchers – all collaborated to fight a single virus, which allowed us to move at a pace that is unheard of, and eventually paid off in the form of development of an efficacious vaccine against COVID-19 in less than a year. The research in the fields of HIV and TB remains on a halt during this period.

“Now the question is how we can leverage the same momentum and community-based science that pushes us to solution to HIV as well,” observes Galit Alter. Until now, she said, HIV vaccine development has been incredibly silo. Therefore, the solution lies in breaking down those silos and maximize on efficiency to develop the next product.

While COVID-19 accounted for infections among 91 million people, with two per cent mortality rate, globally in one year, the HIV epidemic, entering its fifth decade, has affected 75.7 million people with mortality rate of 43 per cent. To-date, HIV has led to 32.7 million mortalities, including one million deaths each year, while Tuberculosis (TB) accounts for killing of more than one million people per year and is responsible for the deaths of one billion people in the past 200 years. For HIV and TB, the need for universally effective vaccines has never been more urgent, as public health systems struggle with the growing cost of these epidemics and threats of new pandemics, such as COVID-19, affecting prevention and treatment. While the HIV vaccine field is still exploring multiple strategies, the TB vaccine field has found a new hope with BCG and M72/ASO1E at a time of former’s (BCG) centennial anniversary this year.

Although the two epidemics affect overlapping populations and their vaccine R&D faces similar struggles, the two fields seldom interact on solving common challenges. Conversely, the cross-disease benefits harnessed from TB and HIV vaccine science are clearly evident for COVID-19 research and development outcomes. “Tools, concepts, capacity, and infrastructure stemming from TB and HIV investments have informed and jumpstarted COVID-19 research and responses,” said Mike Frick and quoted Dr Tony Fauci, Director of the US National Institute of Allergy and Infectious Diseases (NIAID), as saying, “Everything we do with every other pathogen spins off things we've learned with HIV and TB.”

The Resource Tracking for HIV Prevention R&D Working Group, in its report, said that HIV field has delivered important clinical trial results that broaden the range of HIV prevention options will in coming years. New HIV prevention options are moving from labs and clinics toward people’s lives and exciting new products are moving forward in the research pipeline. Decades of sustained funding for HIV prevention R&D has made this possible, although the pace of research has often been slowed by falling or static funding. “The cutting-edge platforms and technologies developed to combat the COVID-19 pandemic offer new tools and promise in the quest for vaccines against HIV and other infectious diseases, but the latest research and resources required consistent supply of funding to build on the important gains made in HIV prevention,” the report says.

“Responding to this new pandemic must not take resources away from the ongoing HIV pandemic or the world will see an even greater public health crisis. Just as COVID research benefited from long-term HIV research investments, lessons learned most recently in COVID vaccine development must now urgently be applied back to HIV prevention R&D,” said Mitchell Warren, Executive Director of AVAC (AIDS Vaccine Advocacy Coalition), which leads the Working Group.