Modeling Studies in AIDS Vaccine R&D - PowerPoint Presentation

1. Modeling Studies in AIDS Vaccine R&D 1Arne NaevekeExecutive Director Advocacy, Policy and CommunicationsIAEN – AIDS 2014 Pre-conference – July 19, 2014, Melbourne, Australia

2. Our objectives for modeling in AIDS vaccine R&DDemonstrate the impact of an AIDS vaccine in accelerating progress in the global HIV responseQuantify the influence of different product characteristics on the impact and cost-effectiveness of an AIDS vaccine2

3. Major Obstacles to ‘Getting to Zero’ PersistThere are still 2.1M new infections every year (2013)Rates are still growing in specific populations and regionsAccess, enrollment and adherence to available prevention and treatment remains challenging for specific populations and regionsAnnual funding in LICs/MICs is currently falling $3-5B short of the $22-24B needed to fully scale up existing tools (2013)3

4. A Vaccine Is Needed to “Get Close to Zero” Potential impact of an AIDS vaccine as part of the UNAIDS Enhanced Investment Framework, IFE Modeling project – UNAIDS, Futures Institute, IAVI, AVAC [funded by USAID]422.5M16.0M7.4MCumulativeinfectionsavoided2011-50New HIV Infections* An illustrative vaccine with an assumed efficacy of 60%, not representative of any specific candidate in development. Coverage reaches 70% in generalized HIV/AIDS epidemics, 60% in concentrated epidemics.

5. 5A Vaccine Used in Combination with Other NPTs Achieves Most Dramatic and Quickest ImpactModeling project – UNAIDS, Futures Institute, IAVI, AVAC [funded by USAID]Vaccine efficacy 60% and vaccination coverage 70%/60% in generalized/concentrated epidemicsNew HIV Infections – NPTs added to full scale up of Investment Framework Enhanced (IFE)

6. The Impact of a Vaccine Will Be Highly Dependent on Its Efficacy6Modeling project – UNAIDS, Futures Institute, IAVI, AVAC [funded by USAID]Vaccination coverage reaches 70%/60% in generalized/concentrated HIV/AIDS epidemicsNew infections at varying vaccine efficacy levels – IFE full scale-up

7. 7Total Cost Per Regimen will be Key to Achieving Cost-effectiveness in LICs and Lower MICsCost($)/QALY12003800Lower MICsLICsModeling project – UNAIDS, Futures Institute, IAVI, AVAC [funded by USAID]Vaccine efficacy 60% and vaccination coverage 70%/60% in generalized/concentrated epidemics.CE definitions and categories from according to the Word Development Indicators (WDI) of the World Bank.

8. 8Lower Cost Per Regimen is Even More Important at Lower Efficacy LevelsCost($)/QALY12003800Lower MICsLICsModeling project – UNAIDS, Futures Institute, IAVI, AVAC [funded by USAID]Vaccination coverage 70%/60% in generalized/concentrated epidemics.CE definitions and categories according to the Word Development Indicators (WDI) of the World Bank.

9. Preliminary Conclusions from Impact ModelingAn AIDS vaccine is needed in combination with other prevention approaches to truly achieve and sustain the end of AIDSA modestly effective vaccine does reduce new infections significantly, but a highly effective vaccine is needed to get “close to zero” and to provide the cost-effectiveness needed to support broad accessCost per regimen is a critical factor to achieve acceptable cost-effectiveness in low and middle income countries, particularly at lower efficacy levels9

10. Next stepsRefine and finalize cost per regimen assumptions“Stress-test” coverage assumptionsComplete calculations of the influence of variables on impact and cost-effectivenessFurther update as the epidemic and the response evolve10

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