Why the world needs preventive HIV vaccines

An impact modeling perspective

Hester Kuipers

International AIDS Vaccine Initiative

London, May 18 2012

AIDS vaccines hold tremendous promise

Current efforts in HIV prevention are not having the

desired impact

Expected new HIV infections per year in LMICs under the new investment approach compared with a

baseline scenario (2011-2020)

Doing better with what we have today:

the UNAIDS Investment Framework

Schwartlander et al. “Towards an improved investment approach for an effective response to HIV/AIDS.” The Lancet. 2011.

A vaccine’s potential to drive new HIV

infections towards zero: a perspective on impact modeling

Would a vaccine still be needed if current prevention programs and

antiretroviral therapy (ART) are significantly expanded under the

UNAIDS Investment Framework while the vaccine is still being developed?

Would a vaccine be useful if it was

partially effective?

Would a vaccine result in cost-savings?

0

0.5

1

1.5

2

2.5

3

Mil

lio

ns

26.8 million infections, 2020-2030

Modeling the impact of an HIV vaccine

New infections under current trends of HIV/AIDS programming

IAVI/Futures Institute 2012 (published May 18 )

Without continued

progress in HIV prevention,

population growth

overtakes recent trend of

lowered incidence

0

0.5

1

1.5

2

2.5

3

Mil

lio

ns

No vaccine

26.8 million infections, 2020-2030

Low Vaccine Scenario

50% effective, 30% coverage

5.2 million (19.4%) infections averted

Medium Vaccine Scenario

70% effective, 40% coverage

8.9 million (33.2%) infections averted

High Vaccine Scenario

90% effective, 40% coverage

10.7 million (39.9%) infections averted

Modeling the impact of an HIV vaccine

New infections under current trends of HIV/AIDS programming

Vaccine Introduction 2020

IAVI/Futures Institute 2012 (published May 18 )

0

0.5

1

1.5

2

2.5

3

Milli

on

s Base

Investment

Framework

scaled up

Modeling the impact of an HIV vaccine

New infections under the UNAIDS Investment Framework

IAVI/Futures Institute 2012 (unpublished)

8.8 million infections, 2020-2030

0

0.5

1

1.5

2

2.5

3

Milli

on

s

Vaccine

Introduction 2020

Investment

Framework

scaled up

Modeling the impact of an HIV vaccine

New infections under the UNAIDS Investment Framework

IAVI/Futures Institute 2012 (unpublished)

No vaccine

8.8 million infections, 2020-2030

Low Vaccine Scenario

50% effective, 30% coverage

1.6 million (18.2%) infections averted

Medium Vaccine Scenario

70% effective, 40% coverage

2.7 million (30.7%) infections averted

High Vaccine Scenario

90% effective, 40% coverage

3.3 million (37.5%)infections averted

Preventive vaccines are needed in the response

to HIV/AIDS

A preventive AIDS vaccine can make a substantial

impact in reducing the number of new HIV infections,

and would get us towards zero new HIV infections

faster and with substantial cost savings

Vaccines are proven interventions and offer a

tremendous promise in the response to HIV/AIDS

A long-term strategy to end the AIDS pandemic must

include both the strategic scale-up of existing HIV

prevention, treatment, and care programmes, and

sustained investment in the development of additional

prevention tools, including a preventive AIDS vaccine.

Interactive Website: www.iavi.org/impact

World AIDS Vaccine Day is observed annually on May 18. HIV vaccine advocates mark the day

by promoting the continued urgent need for a vaccine to prevent HIV infection and AIDS. We

acknowledge and thank the thousands of volunteers, community members, health professionals,

supporters and scientists who are working together to find a safe and effective AIDS vaccine. We

also urge the international community to recognize the importance of investing in new

technologies as a critical element of a comprehensive response to the HIV/AIDS epidemic.

www.iavi.org

BACKUP SLIDES

Epidemic type (by country)

Hyper-endemic Generalized Concentrated Low prevalence

General Population

Mass media 80% 80% 20% 20%

Community mobilization 70% 70% 0% 0%

Counseling and testing 3% 3% 1% 1%

Condoms: discordant couples 60% 60% 60% 60%

Vulnerable populations

Youth in school 100% 100% 30% 30%

Youth out of school 0% 0% 0% 0%

CSW and clients 60% 60% 60% 60%

MSM 60% 60% 60% 60%

IDU outreach 60% 60% 60% 60%

IDU needle exchange 60% 60% 60% 60%

IDU drug substitution 0% 0% 40% 40%

Workplace 50% 50% 0% 0%

Condoms: high risk populations 50% 50% 50% 50%

Condoms: medium risk populations 60% 60% 20% 20%

Medical services

PMTCT 90% 90% 90% 90%

Male circumcision 60% 60% 0% 0%

ART 90% 90% 90% 90%

Investment framework coverage targets for 2015

Why the world needs preventive HIV vaccines