Recent medical innovations in the fight against HIV bring new hope of ending the epidemic within our lifetimes. Products like oral pre-exposure prophylaxis (oral PrEP) and the dapivirine ring offer excellent protection against HIV and are particularly revolutionary for women and girls, who represent 70–80 percent of new HIV infections in sub-Saharan Africa but have never had prevention methods they can control. The development of these products, however, is just the beginning—while new products typically scale within 2 years of launch in developed countries, they often take decades to scale in low- and middle-income countries where HIV prevention could have the greatest impact.
In 2015, FSG joined the OPTIONS Consortium, a 5-year project funded by the U.S. Agency for International Development (USAID), in partnership with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). OPTIONS applies systems thinking to accelerate market introduction of these new HIV prevention options, especially for women and girls. The consortium represents an international, multidisciplinary partnership that brings together a unique combination of global, regional, and country experts across the antiretroviral (ARV) research-to-rollout continuum.
FHI 360 leads the consortium, which comprises two additional global HIV prevention research and advocacy core partners, Wits Reproductive Health and HIV Institute (Wits RHI) and AVAC. Additional primary partners, including FSG, bring specialized technical knowledge and strong in-country capacity: Avenir Health, FSG, London School of Hygiene and Tropical Medicine (LSHTM), LVCT Health, McCann Global Health, and Pangaea Zimbabwe AIDS Trust (PZAT).
Over the last 2 years, the OPTIONS Consortium has focused on:
- Helping Kenya and South Africa efficiently and effectively introduce oral PrEP
- Advocating for access to oral PrEP for women and adolescent girls
- Developing tools and resources based on lessons learned from the oral PrEP rollouts in Kenya and South Africa to inform the introduction of oral PrEP in new markets
- Supporting the launch of new PrEP products in the pipeline, such as the dapivirine ring
FSG was contracted by FHI 360 to serve as a strategic primary partner to the Consortium, developing research and analyses to facilitate decision-making by global donors and country-level decision-makers, including:
- A framework for oral PrEP introduction
- Situation analyses for Kenya, South Africa, and Zimbabwe to capture the current state of progress toward the introduction of oral PrEP and to identify key strengths, gaps, and areas for consideration in planning and investment moving forward
- Impact and cost assessments based on existing data and projections of HIV infection rates to determine where PrEP products could be most cost-effective in Kenya and Zimbabwe
- An assessment of the potential for private sector delivery channels to reach women at high risk for HIV transmission
- An overview of evidence and an agenda for action to move the dapivirine ring from clinical trials to market introduction
In June 2017, Kenya’s Ministry of Health, supported by the OPTIONS Consortium, celebrated the national launch of oral PrEP, using many of the tools developed by FSG to guide their implementation framework. Moving forward, the OPTIONS Consortium is supporting the rollout of oral PrEP in additional markets in sub-Saharan Africa and developing new resources focused on the adoption and implementation of other HIV prevention products, such as the dapivirine ring.
About FHI 360
FHI 360 is an international nonprofit working to improve the health and well-being of people in the United States and around the world. They team with governments and civil society to create jobs, educate children, provide lifesaving health care, and bring about positive social change by using research and evidence to design and deliver programs that change behaviors, increase access to services, and improve lives.
Learn more about the OPTIONS Consortium: