Conversation Starters—How to Turn the Corner on the HIV/AIDS Pandemic

By Carl W. Dieffenbach, Ph.D., director, Division of AIDS, National Institute of Allergy and Infectious Diseases, National Institutes of Health

March 20, 2017

Refining the HIV/AIDS research enterprise requires that we plan for the future. Our thinking today about the focus and priorities of the NIH HIV clinical trial networks will shape the direction of NIH clinical research through the year 2027. Planning for the next decade offers an exciting opportunity to “think big” about new opportunities for innovation and discovery. On a more granular level, this period is also an opportunity to reevaluate some of the ways in which we do business, and to ensure that processes and policies best support safety, science, and the stewardship of public funds.

The following questions are offered to stimulate your thoughts on these topics, spark conversations with your peers and the community, and engage with NIH. We want to hear your ideas about any or all the topics below. Please submit your comments and questions online. There is no limit to the number of times you can communicate with us.

Over the next few months, consider:

HIV/AIDS Research Strategy

  • NIH articulated its priorities for HIV/AIDS research in 2015. In your view, what can the HIV research enterprise do now to achieve these goals?
  • What are some of the considerations to take into account as NIH develops the next iteration of HIV research priorities?
  • How can we capitalize on the opportunities for synergy among these research areas?

Vaccines

  • What will the state of the HIV vaccine field be in 2020, the end of the current project period? Will we have a correlate of vaccine protection?
  • What are the critical scientific questions that must be addressed to achieve the goal of a safe, effective and durable HIV vaccine?
  • What steps are needed to develop a vaccine for adolescents, youth, and infants?
  • How can NIH better facilitate collaborations to evaluate tuberculosis vaccines as well as pediatric vaccines for other diseases?

Non-Vaccine HIV Prevention

  • How can we foster the desire for the use of non-vaccine prevention tools, encourage their uptake, and optimize adherence to their use? What has not been understood about the needs of those at risk of HIV infection in this regard?
  • Within the current areas of emphasis in HIV prevention, what advances will the field have achieved by the end of the current grant cycle in 2020? What important questions will have been answered?
  • The research enterprise is working toward proof-of-concept and licensure for safe, easy-to-use non-vaccine prevention strategies that are highly effective and accepted by women, men, and adolescents. How will this trajectory change over the next 10 years, assuming some concepts succeed and move on to licensure?
  • What social and behavioral science research questions need to be addressed to underpin future concept and product discovery?
  • The research community has made incredible strides in preventing perinatal transmission of HIV. What are the most pressing research questions that remain in this area?

Therapeutics

Current research investigations include novel therapeutics and a cure; residual inflammation in ART-treated people; TB and other co-infections, including hepatitis; and non-infectious comorbidities.

  • What are the critical questions in each of these areas of emphasis across the life span and for special, targeted populations?
  • What social and behavioral science research questions need to be integrated so that adherence is optimized to assure complete, durable viral suppression?
  • What progress will be made to address these scientific questions between now and 2020?
  • How will these areas of emphasis evolve in the future?
  • What will be the critical research goals and research questions for 2020 and beyond?
  • What are the laboratory requirements to meet the evolving research agenda?

Network Structure and Administration

  • How should research advances lead to changes in strategy and affect the structure of the HIV networks?
  • What are the unique research team, statistical, or laboratory requirements needed for specific areas of research?
  • Do you see gaps or other needs in the field of HIV/AIDS that could help our work?
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