Jomo Kenyatta University of Agriculture & Technology

KIGALI, RWANDA — The opening night message was clear. “UNAIDS warns that if urgent steps are not taken, we may find ourselves back in the dismal era of 2000. We must all agree here today that we cannot go back,” Linda-Gail Bekker, a leading HIV researcher and director of the Desmond Tutu HIV Centre in South Africa, said in an impassioned rallying cry on Monday evening. Bekker concluded the first night of the International AIDS Society conference on HIV Science in Rwanda with a somber tone informed by a decades-long rollercoaster fighting the epidemic. Her speech at the confab’s opening session took place just minutes after protestors took to the stage to express frustration with the global response. Recent slashes to global HIV funding threaten to set the fight against the epidemic back by a quarter-century, to a time when life expectancy had plummeted by more than 10 years in some communities, Bekker said. A few years after the turn of the millennium, the US government formed the President’s Emergency Plan for AIDS Relief. PEPFAR has saved 26 million lives, the government has estimated. For the past six months, though, PEPFAR has been under threat from the Trump administration. A day after Bekker’s sobering speech, the US Senate voted on party lines to advance a bill that would restore a $400 million cut to PEPFAR that had been part of President Trump’s wider funding cuts. Three Republicans voted against the overall bill containing the restored PEPFAR funds, but with VP JD Vance as the tiebreaker, the bill advanced and is likely to pass the full Senate. In a pre-conference session on Sunday, a PEPFAR leader reassured attendees that its work would carry on. “I think it’s worthwhile saying to this audience that Secretary [of State Marco] Rubio supports PEPFAR, that this administration supports PEPFAR and the work that we do and we will continue to do,” Ingrid Katz, director for behavioral sciences for PEPFAR, said during a panel on Sunday. When reached for an interview, Katz replied in an email that she’s “not able to speak with journalists.” But even if that $400 million remains at PEPFAR’s disposal, it doesn’t provide an immediate band-aid to the 24/7 chaos that has impacted HIV clinicians, researchers and other leaders in the field this year. Cuts to USAID , NIH funding and other programs will continue to be felt. These ructions occur as control of the HIV epidemic has flatlined. The number of people who contracted HIV was about the same in 2024 as the year prior. UNAIDS estimated last week that six million more people will get HIV and four million more will die of AIDS-related causes between 2025 and 2029 “if US-supported HIV treatment and prevention services collapse entirely.” UNAIDS executive director Winnie Byanyima called it a “ ticking time bomb .” The timing of the PEPFAR update couldn’t be more ripe. The confab in Kigali, Rwanda, is one of the only moments this year that thousands of leaders in the HIV field have been able to convene in person to discuss the fallout and consider ways to address the pullback in critical resources. Intended as a biennial gathering on scientific advancements, this year’s conference largely became a spotlight on all the ways the funding cuts have harmed the field. “This exciting science is almost being overshadowed by the funding cuts,” Kenneth Ngure, dean of the School of Public Health at Jomo Kenyatta University of Agriculture and Technology in Kenya, told reporters at IAS. “This is a time for breakthroughs. However, the money is not breaking through,” Yvette Raphael, executive director of Advocates for the Prevention of HIV and AIDS, said at the meeting. At the conference on Monday, the World Health Organization added Gilead’s twice-yearly PrEP injectable to its HIV prevention guidelines, and Merck said its once-monthly PrEP pill would enter Phase 3 in August. Gilead and Merck, plus GSK’s ViiV Healthcare, are among the few pharma companies remaining in the HIV space. “It’s kind of become a bit of a hackneyed phrase, that we have these incredible opportunities and yet the world, the international community [and] government are not willing to take the steps necessary to realize their potential,” Tom Ellman, a southern Africa medical unit leader at Doctors Without Borders, said in an interview with Endpoints News on the sidelines of IAS. One of his first roles in the HIV field was here in Rwanda, shortly after the genocide in the 1990s, he said. “That has never been more true than it is today,” Ellman said. “When I say today, I mean in this six-month period where we’ve seen these appalling, vicious cuts, not just from the US but other governments, European governments, across the board in humanitarian support.” The resource pullbacks have rippled across the conduct of clinical trials, scientific research and delivery of treatment and prevention tools in the world’s most affected regions. Rollout of healthcare services ancillary to HIV, continuation of awareness campaigns that help build trust in communities and even the ability for some researchers to travel to conferences like this one have been damaged, leaders in the field said at various sessions at IAS. “The effect of these cuts jeopardizes the national HIV control and reflects the fragility of our global health,” Francisco Mbofana, executive secretary of Mozambique’s National AIDS Council, said during a Tuesday panel at IAS. The cuts have been so deep, Bekker told reporters at IAS on Tuesday, that she and her colleagues “have all struggled to get our heads around the number.” UNAIDS said some countries have been able to intervene and increase their budgets for HIV programs. Other leaders at IAS said the funding cuts will force the field to find places for efficiency. Technical leaders in government health departments will also need to communicate more with treasury or finance departments. Click on the image to see the full-sized version “Technical people in health are very good at putting more and more things on the agenda to be funded. We never, ever think of what we will stop doing,” Yogan Pillay, director of HIV & TB delivery at the Gates Foundation and a former South Africa health department leader, said during an IAS panel. “Unfortunately, at this point in time, we’ve got to have a hard look at what we stop doing.” While the funding pullback is likely to be felt for years to come, multiple HIV leaders emphasized the need to continue backing ambitious goals while also investing directly in local communities. “We should be funding big, new ideas. We should also remove these artificial barriers of getting money to people on the ground,” Solange Baptiste, executive director of the International Treatment Preparedness Coalition, said on a panel. Local communities are the experts at delivering HIV care and prevention tools, she noted. Editor’s note: This article was updated to note that the US Senate has voted to restore a planned $400 million cut to PEPFAR.

MYDAWA, the first online pharmacy in Kenya, has received $1.2 million in grant funding from the Bill and Melinda Gates Foundation to develop and evaluate innovative Post-Exposure Prophylaxis, or PrEP, delivery. The company says its new telehealth application enables end-to-end virtual healthcare for customers seeking to access Pre-Exposure Prophylaxis, a medication that is taken after possible exposure to HIV, and PrEP, which is taken daily by those who have an ongoing risk of acquiring HIV. "MYDAWA is here to be your partner throughout your PrEP journey. MYDAWA will facilitate everything from your first consultation to delivering PrEP to a place convenient for you! To get started simply book a consultation," according to the e-pharmacy's website. "Or if you have already taken a Mylan or Sure Check HIVST – upload an image of your HIVST result here to get started!" Approximately 38 million people around the world are living with HIV, with upwards of 21 million in Eastern and Southern Africa, according to a recent report in Kenya's TECH Magazine . But the stigma associated with HIV has prevented many from seeking care. "This is particularly apparent among populations who are vulnerable to stigma such as men who have sex with men and female sex workers," according to the report. "This challenging environment in tackling HIV facilitated the search for a different approach to PrEP initiation through online channels that are more discrete." The new telehealth approach was developed in partnership with several organizations including the University of Washington, Jomo Kenyatta University of Agriculture and Technology, Fred Hutch Cancer Research Centre, Jhpiego and Audere. The website offers facts about PrEP, HIV self-test kits and guidance on how to get approved to purchase the medications through telehealth consultations on MYDAWA's platform. With funding support, telehealth services increased in Africa during the COVID-19 pandemic. Andrea Fox is senior editor of Healthcare IT News. Email: afox@himss.org Healthcare IT News is a HIMSS publication.

Wuhan Institute of Virology/Courtesy Hector Retamal/AFP via Getty Images Researchers at the Wuhan Institute of Virology (WIV), which is possibly linked to the origins of COVID-19, reported the discovery of a novel DNA virus in animals in the journal Virologica Sinica. The scientists analyzed tissue specimens from 232 animals, including 226 rodents, five shrews and one hedgehog, collected from five counties in Kenya and tested for DNA viruses. The viruses belong to seven viral families, and the researchers utilized PCR to run the tests. They noted that although surveillance programs focus more on RNA viruses - such as SARS-COV-2, the virus that causes COVID-19 - less is known about DNA viruses. The researchers identified a range of DNA sequences associated with adenoviruses, adeno-associated viruses, herpesviruses and polyomaviruses. Conducting phylogenetic analyses, they found most were distinct from previously described viruses. They also noted this was the first report of a full-length genomic characterization of a polyomavirus in Lemniscomys species. The virus was dubbed LsPyV KY187 and “has less than 60% amino acid sequence identity to the most related Glis glis polyomavirus 1 and Scirus carolinensis polyomavirus 1 in both large and small T-antigen proteins, and thus can be putatively allocated to a novel species within Betapolyomavirus,” the authors wrote. Viruses Not Known to be Transmissible to Humans “The results of this study are important for our understanding of viruses and their evolution in non-human animals,” Sean Beckmann, Ph.D., assistant professor of biology at Stetson University in Florida, who was not involved in the study, told BioSpace. “However, these findings should be taken in context. None of the viruses identified, or the novel viruses, are known to be transmissible to humans, and the authors don’t make any claims about their pathogenicity.” The authors emphasized that the research supports the need to continue studying rodent-borne viruses in East Africa. In addition, because the new virus does not appear to be closely related to any known pathogens, its effect on humans is “unclear and needs to be further assessed,” the researchers stated. Beckmann was equally cautious. “These findings are still valuable and important, but they shouldn’t be a cause for alarm that a bunch of new human pathogens have been found. Among the viruses that were identified, we don’t have any evidence of rodent to human transmission within those groups," he said. WIV and its Link to COVID-19 Transmission Theories The WIV is a leading research institute that focuses on viruses, but its possible association with the origins of COVID-19 has increased scrutiny of its operations. There are two primary theories about the origin of COVID-19: the “lab-leak” theory and the “wet market” theory. The lab-leak theory argues the virus likely originated in bats, which were studied at the WIV, and then was accidentally released from the laboratory, possibly by an infected staffer. The wet market theory proposes that the virus originated in bats, moved to an intermediary animal at the Huanan Seafood Wholesale Market in Wuhan, and then to humans. The market is only a few miles from the WIV. In addition to researchers at WIV, the Kenya study was conducted by investigators from the Chinese Academy of Sciences in Wuhan, China, the Mammalogy Section of the National Museums of Kenya, the Veterinary Services Department of the Kenya Wildlife Service and the Institute of Biotechnology Research, Jomo Kenyatta University of Science and Technology in Nairobi, Kenya. The authors noted, “Emergence and re-emergence of infectious diseases of wildlife origin have led pre-emptive pathogen surveillances in animals to be a public health priority.” Beckmann concurred, telling BioSpace, “Since the emergence of COVID-19 (SARS-CoV-2), there has been increased attention and focus on the potential for other virus/bacteria/etc. to spill over from non-human animals to humans. This is long overdue, and these results do demonstrate the type of information we can gain."