Px Pulse Px Pulse

Our debut episode of the Advocacy Chronicles features Yvette Raphael, the Executive Director of Advocacy for Prevention of HIV and AIDS (APHA) in South Africa, and a leader in the development of The Choice Manifesto, supported from start to finish by CASPR.

As co-chair of the African Women Prevention Community Accountability Board (AWPCAB), Yvette and other board members launched the manifesto in Kampala, in September 2023, calling for choice in HIV prevention options for women — such as oral and injectable cabotegravir for PrEP, the dapivirine vaginal ring and the Dual Prevention Pill — and a commitment to expanding access to them. A call heard by UNAIDS Executive Director Winnie Byanyima, who was on hand at the launch to endorse the manifesto.  

Yvette, who is also a 2014 AVAC Advocacy Fellow and celebrated as one of South Africa’s leading human rights activists, lays out why The Choice Manifesto matters and how advocates are leveraging it. 

In this episode of PxPulse, we talk about why and how the decisions that shape global health must be made by those facing the greatest risks. As the world evaluates the pandemic response and debates on decolonizing global health gain momentum, equity in global health has never been more urgent. 

This conversation features global health leader and critic, Dr. Madhukar Pai. And two members of the transnational coalition COMPASS Africa, Francis Luwole and Barbra Ncube, offer an up-close look at the coalition’s pioneering new model for power-sharing.
Get more details and resources at https://avac.org/resource/decolonizing-global-health/

People who are pregnant or lactating (PLP) have historically been excluded from research because of concerns for the developing fetus. But this has led to a dearth of data on new interventions against health threats for this population. In the case of HIV, pregnancy raises the risk of acquiring HIV by up to three times, but providers often do not have the data to know whether a new intervention is safe or how it will work for pregnant patients. As a result, PLP and their physicians are left to make difficult decisions around the use of proven HIV prevention products as they await more data specific to pregnancy and lactation. 

But change is in the air. Champions for the inclusion of PLP in research are paving the way for a paradigm shift— one that will redefine this population from needing protection from research to being better protected through research. In this episode of Px Pulse, AVAC’s Manju Chatani-Gada takes us through conversations with a trial participant who became pregnant, researchers, policy-makers, and donors to understand why this population gets excluded, the impact it has, and what to do about it.

2023 is a big year for PEPFAR. PEPFAR’s considered one of the greatest US foreign policy and global development achievements of the century; the program has saved upwards of 25 million lives since it launched in 2003. But PEPFAR is marking its 20th anniversary while fighting for its future. Its authorization expires Sept. 30th. Until a couple of months ago, most expected smooth sailing for a five-year reauthorization of the program, which has enjoyed deep and broad bipartisan support since its founding. Evangelical Christians, staunch conservatives, DC Democrats, progressive HIV activists, and public health leaders have championed PEPFAR year in and year out. But a handful of Republicans, including past PEPFAR allies, are pulling reauthorization into American abortion politics— despite US laws on the books that prohibit PEPFAR dollars from funding abortions. Supporters across the political spectrum, including many Christian conservatives, are now rallying to ensure this uniquely effective program continues. 

In this episode, Px Pulse talks to some of the people who put PEPFAR dollars into action, bringing life-saving medicines, prevention and healthcare to people living with HIV, orphans and other vulnerable communities. And we talk to health leaders who explain why PEPFAR’s approach represents a gold standard in advancing global health, and what’s at stake in this debate.

With several large HIV vaccine trials in the last few years finding no efficacy, the field is in transition. There are diverse ideas in vaccine research, but there's no clear concept that's ready to test in a late-phase trial or move toward product development currently. Researchers are back to testing new ideas in early-phase research.

In this episode of our Px Pulse podcast, Dr. Katy Stephenson explores the implications of recent trial results, the big questions driving next-generation vaccine development, and new strategies underway in early-phase research. Katy is a doctor, a researcher, a professor of medicine at Harvard Medical School, affiliated with Beth Israel Deaconess Medical Center, and part of the Center for Virology and Vaccine Research.

In March 2023, the Ugandan Parliament moved forward broad-reaching legislation to further criminalize LGBTQIA+ people. 

The bill would make it a crime to even identify as lesbian, gay, bisexual, transgender or queer, with sentences up to life imprisonment. It gives authorities wide powers to crackdown on anyone who does not report on same-sex couples or who promote gay rights, including prohibitions on media coverage. And the law could impose death sentences in some cases, including for the transmission of HIV. Uganda’s President Museveni has the power to stop the bill. But so far he is issuing statements for other African countries to follow Uganda down this path.

Anti-gay hate laws and actions by authorities are sweeping across the region with recent crackdowns in Ghana, Kenya, Rwanda, Tanzania and Zambia.

After the news broke from Uganda, AVAC and partners came together for a call with advocates in Uganda. They are fierce and imperiled voices who are readying to fight for LGBTQIA+ people in Uganda, but at AVAC, we know they are fighting for all of us.

On the call, advocates dug into the specifics of how these attacks have gained momentum and their ties to US-based religious extremists. And advocates discuss what needs to happen next.