amfAR Innovations November 2022

INNOVATIONS HOW MANY HAVE BEEN CURED? A SUMMARY OF HIV CURE, OR TREATMENT-FREE CONTROL, CASES TO DATE Also Inside: New amfAR Grants Total More Than $3 Million Ruling Against PrEP Sets Dangerous Precedent Dismantling HIV Silencing Factors NOVEMBER 2022

NOVEMBER 2022 COVER STORY The biannual newsletter of amfAR, 8-9 The Foundation for AIDS Research How Many Have Been Cured? 120 Wall Street, 13th Floor New York, NY 10005-3908 A summary of HIV cure, or T: (212) 806-1600 treatment-free control, cases to date F: (212) 806-1601 POLICY 1100 Vermont Ave. NW 4 amfAR Dedicates Andelson Office of Public Policy Suite 600 5 amfAR Helps Fire Up the U.S. MPX Response Washington, DC 20005 6 Ruling Against PrEP Access Sets Dangerous Precedent T: (202) 331-8600 6 Blinded by Our Own Data: A Report on PEPFAR’S HIV F: (202) 331-8606 Recency Testing TREAT Asia Exchange Tower 7 CLM: A Powerful Tool for Improving HIV Services 388 Sukhumvit Road Suite 2104 RESEARCH Klongtoey, Bangkok 10110 10 New amfAR HIV Cure Grants Total More Than $3 Million Thailand 12 Anthony S. Fauci, M.D.: A Prodigious Legacy T: (+66) 2 663-7561 12 New Chair Appointed to amfAR’s Scientific F: (+66) 2 663-7562 Advisory Committee www.amfar.org 13 Identifying New Targets in Host Cells to Attack HIV Innovations Staff: 13 Dismantling HIV Silencing Factors Andrew McInnes, Editor Chael Needle, Senior Staff Writer GLOBAL Raoul Norman-Tenazas, 14 ARV Stockouts in India Created a Health Crisis for People Creative Director Yolande Hunter-Johnson, Living with HIV Creative Coordinator 15 Analyzing Service Gaps in India and Indonesia amfAR meets the BBB Wise 16 TREAT Asia Fellows Pay Visit to amfAR’s Offices Giving Alliance’s Standards 16 On Dangerous Ground: New UNAIDS Report for Charity Accountability DONORS 17 Fifty Years of Sharing Continues EVENTS 18 Benefit Event Highlights (amfAR Gala Cannes; amfAR Hamptons; amfAR Gala Venezia) INNOVATIONS, NOVEMBER 2022

FROM THE CEO A New Era of amfAR CEO Kevin Robert Frost, Trustee Amy Andelson, and HIV Research? Board Co-Chair T. Ryan Greenawalt at the dedication of the Andelson Office of Public Policy (see page 4). (Photo by Sam Garvin/amfAR) With the case of Timothy Ray With the COVID-19 pandemic finally appearing standard-bearer for biomedical research and Brown, announced in 2008, the to recede, it is our hope that we are entering an scientific evidence—as he retires at the end of this idea of a cure for HIV transitioned exciting new era of HIV research. For example, year (see page 12). almost overnight from the the remarkable success of COVID vaccines—made theoretical to the possible. Subsequent cures have possible in large part through mRNA technology As always, we tip our hats to you, our generous removed any shadow of doubt. The challenge honed in the course of HIV research—has renewed donors, who have enabled us to come this far. We for us now is to move to the next stage in this hope for an effective HIV vaccine. amfAR grantee hope you’ll stay with us as we move on to further continuum—from the possible to the practical. Dr. Sharon Lewin, president of the International progress, new breakthroughs, and a cure for HIV. AIDS Society, now aims to apply this same As our cover story concludes, amfAR is pursuing powerful technology to a shock-and-kill approach Gratefully, “every possible avenue until we have a cure, or to curing HIV (see page 11). cures, that can be made available to all 38 million people living with HIV.” To that end, we’re rapidly If this is indeed the beginning of a hopeful new era, regaining any momentum we might have lost it is perhaps only fitting that another one comes as a result of COVID-19. In the last four months to an end. That is the era of Dr. Anthony Fauci, alone, we’ve awarded new grants to support a who has led the nation’s fight against infectious range of creative and innovative HIV cure research diseases—and HIV above all—for nearly 40 strategies totaling more than $3 million (see years. We tip our hat to Dr. Fauci, an unflinching pages 10-11). www.amfar.org 3

POLICY amfAR Dedicates Andelson Office of Public Policy At a dedication ceremony in Washington, D.C., on October 3, amfAR, The Foundation for AIDS Research, inaugurated its Andelson Office of Public Policy. The Office is the home base for amfAR’s influential advocacy program, launched in 1990 with a generous gift from Arlen Andelson and his wife Michele in memory of Arlen’s brother, Sheldon. Sheldon W. Andelson was a founding director of amfAR Arlen Andelson Sheldon W. Andelson who died of AIDS-related causes in 1987. A Los Angeles attorney, real estate developer, and investor, he was variously described as a “Democratic Party heavyweight” and “the nation’s most influential gay political figure.” Upon his death, his younger brother Arlen, also a successful attorney and real estate developer, threw himself into the fight against AIDS and joined the amfAR board in 1993. “We were devastated at amfAR when Arlen died in 2019 because Arlen and Michele had become such good friends and mentors to many of us,” amfAR’s Chief Executive Officer Kevin Robert Frost said. “If there was a silver lining, it was that his daughter Amy has taken up the torch and joined our Board of Trustees.” Guests at the dedication included Senator Edward Markey, who knew and worked with Sheldon Andelson; Jirair Ratevosian, Acting Chief of Staff at the President’s Emergency Plan for AIDS Relief and former Deputy Director of Public Policy at amfAR; and Jane Silver, amfAR’s former Director of Public Policy. They were joined by amfAR staff including Vice President and Director of Public Policy Greg Millett and Dr. Susan Blumenthal, Senior Policy and Medical Advisor. “Sheldon was a one-man, multi-national public interest movement. It wasn’t just one issue, it was every issue that he cared about,” Sen. Markey said. “It’s my great honor to be here with all of you … and having Arlen and Sheldon’s family be forever identified with this incredible amfAR family that every day works as hard as it is humanly possible to work on an issue.” “I want to thank all of you here who have worked [at amfAR] Top: amfAR CEO Kevin Robert Frost with Trustee Amy Andelson and members of the Andelson past and present,” Michele Andelson said. “And I look family. Bottom: Senator Ed Markey (D-Mass), amfAR Senior Policy and Medical Advisor Dr. forward to watching the future and eradicating AIDS.” Susan Blumenthal, amfAR VP and Director of Public Policy Greg Millett, Michele Andelson, Kevin Robert Frost (Dedication photos by Sam Garvin/amfAR) 4 INNOVATIONS, NOVEMBER 2022

IN APRIL 2022, A NEW VARIANT OF MONKEYPOX VIRUS INFECTION TIME IS OF THE ESSENCE was identified in the United Kingdom that has exploded into a BIG IDEAS IN BR global outbreak. The first case was diagnosed in the United States Policy action is needed to: POLICY in May and as of July 15 1,814 cases have been reported, with 12,556 cases worldwide. In June 2022, the Centers for Disease Control BOLSTER THE OUTBREAK RESPONSE amfAR Helps Fire Up the U.S. MPX Responseand Prevention (CDC) also announced that they were working with Florida public health authorities on a large and growing outbreak of meningococcal disease. Both conditions are currently concentrated among gay and bisexual men and other men who have sex with men Increase testing and surveillance for monkeypox Expand vaccine access to achieve herd (MSM). These crises are sentinels of a growing threat of infectious immunity as early as possible: diseases, and if they are not effectively contained, they could spread • Focus on containment in MSM Ra(hmceaqscooubnigkerienenyingzpihntohegxel)ptvhaininargutdtsgsimaoumuiednoiesdntogthhfettehhUoae.lsSaeer.smwrseehasnopbcooecnuo, stamemthptfeorAisrtWudbMRieosneiskPetfebehoXonaarelodfrsceaeiundsvrg.eebMrrAfaaaeoynmnadplronddeofhpnyAapDgaogrRhudlrilyo’riwalcsaewwviytincGetieihtomntorrhnhgeedarasigfeskotl,dehelfMnsicrvraPieemsteiuwelgaalribedtiolnnamtlvoidtogrc,efontcrMsPmnonoehokm.evmHoelPinewcyeI.mVirHypnna.t,utog.lh,anxMoteVlhisctcPiacoyocrXtoiecacsutcpdioPsrarv-srolaeaeoekanussconedtisadhdfwntleoetHiikoanfrsIetettVt,,ihldoydecnereoscaiunirslfldiyevcheinta,iovaerteheunqrssuooiuutygrcahenosdu, twththeeetqtcraehifougalwmesmaihoronmptmdrntonloiideustrositae.newrtrdiisbyt,hioetueesovfattsieovwtobhncinloyeykaroodJtkifmuYittsmthopNtsreew.aNibdcraEiutirsceOdtkadinSlvogrcavfeocagfsmcucoritecnumuaiernructeeeenrstitoies majority of cases so far: gay, bi, and other meaHnnawdrrhihsoeAlpdfmutlwianocistetirodanittsioo. rnWiaaelsnadinpaplerleaaudgdirnatgthepefuerlaefpro-irrdetvrheieesiwpr ocenodsmsecmoieiftnmtthiefeincBt itdoeon-uCr RAFT OUT•RJCEYAoNnCsNHidEWeOrSIaTvHoancCceAi-ndReoEts:oeRaereccghoiigemvneeiznignorgefattheer have sex with men (MSM), particularly Black acnodmmunitjioesu.rNnaolns,eTthheeleBsMs,JtaimndeAismoefrtichaeneJsosuernncael otof effectively cutrhbe similaritiesimofmthueniMtyPaXnodurtebdreuackeaenxdpothneenHtIiVal Latino MSM as well as individuals living with HaInVd. limit cPuurrbelinctHaenadltfhu.ture threats. As our analysis shows, projecetpeiddemic—bogthroinwvtohlvine wmeaergkliynatrliaznesdmpisospiounlast.ions monkeypox cases may grow exponentially, and the toitmheertohigachtlyi-swnhoows.e memb• edCriossneasareisdeceovrnaencxcepicantnaedtdiionvnigagmsueeixdnaeinnligdnoescsooctcoiacalalll This includes short-term solutions to serve MSM and Until the recent outbreak, first documented inimpacted Hcoigmhmliguhntitsieosf bthyeprreocvoidminmgeenmdaetrigoennsciyncrleusdoeu:rces to comnbeattworks—weMnSeMed, ntottaoinlolyr othuotrseeaicnhothr atrtaisveling to EtbwhueeeresoGntpelareonnbaAeannlfdrNdicNeoamor.trThitchhbteAhenrmheeaaewvtreiovcsauadrtiisinafifdneAterpeimornifltp,clyaMectnPhttiXarnanghl paapsnraednrshmectvtheeoqesiaoexvmauorsueuliktfetmarshealttbuwhhinnlerergieatittIvmaylNeetatl-hasfasbcCftrroaccaigsRnisrlnhenigtEenda,sed,Ai.ilcnlvbnLiSonacyceoErclgaeugnrcpAeddggaianinisCenoncairfhvCzgito-teaiatEyoraervtcSnnirteoismonSmuantg:on,saseWtwddenba(xdCetihcenairBsainelemltreOaesdienseneis,gmctdd)aaoinptmnctvmoodaoatermharmbtdtidoeneoiimtdateslmcystrrhureteseeooenhstnarfirseittpttsyfsestuste-tteobinexiwnrgaudfmegfmisaietxnehlacpvalgdynti,ataidrfevntuorendasrsintsnpueosgrudmcesveobieuntailthnilglctneseaeirdtgriaavefbefmeitlceoittnyeMtEC•daiXSAnFisFngMdPulkPcorAneAoltrusdoyiNuCodd.pdDaIaiAaTnse.dssgYCffaiutBOvBocslealMeenarcscoMsskittkttirUayguiannNmcnocdtIdfrTaueLo.rYLaaaCratslgRitoebnaiEnmoatnSxhrimMPr,zeibaeOiuSrtarnNMissloliorSttnoyocaEsoina,mdl ones—individuals experiencing MPX have infections (STIs). care,cwomemshuonuitlyd, elenactohuerraagnedmotehmebr egrrsouopf s thesestrecaronvsminggmengudnaeyitriaepnsedtoobptilaseekaxenuadadlovmtahenentra, gafefected fewer lesions and one of the pathways of EXPONENTIAL GROWTH: PROJECTED U.S. of McPoXmvamcucniniteiess, ,traesawtmelel nats, naentdwootrhkesrof transmission is sexual. MONKEYPOX DIAGNOSES AS EARLIEST GROUP healtuphseesoepdrlvreuicglievssi,naagns dwwipethewoHopIrlVek, twpoehdoopiselmengawnahgtloee in OF GAY MEN BECOMES FULLY VACCINATED systesmexicwfaoirlukrteos porfohveidaelthedinufrcaasttirounc,thuerelp. An infectious disease caused by the monkeypox virus, MPX is rarely 12,000 11,311 with contact tracing, interface with fatal, though it may cause severe 10,000 COLcrLeoEsmCeaTmrBcuhnEeiTtryTsEmaRnedDmgAboTevAres:,rnIammndpernsoutvpoepfdfoicritatlsheand illness. Vaccines exist, but the federal survedielllaivnecrey, oefxpvaacncdineadtitoenstainngd, oatnhder services timewly,itbhectotemr mcouonridtyin-baatesedd, acnlidnimcaol rperoviders. government and state and city health 8,000 departments have been challenged 6,000 By July 15th, comIDpErNehTeIFnYsivAeNdDatAaLaLreOnCeAeTdEeEdM, ERGENCY in stocking enough doses and 4,000 diagnoses espR•eEUcSsiaOellUytrRianCnosEfrSedrerautothaossrietsysthoomwoMbiPliXzeis distributing them in a timely and affecrteinsgouBrlcaecsk taondfuLnadtinHoIVcoamndmSuTnIitpierso,grams increased to 1,814 cases equitable manner. TPOXX (tecovirimat), 2,000 19 790 whostoe mpreomvibdeerssearrveicoefstefnorgtlohessuendinosvuerred, an antiviral medication, is approved to 0 173 in dasctuaopnthpdaoutrchttaersedsnueocaatrtbcioehnefnoacndudissaeogdugtorreneaghcaehta,eladtnh.d treat monkeypox. ResetarrecnhdasbeoxupteMriePnXc,epdarbtyicupleaorlpyltehwe ith neweHpsaItVrvtaaonrfidaanHst,IuVws-tiaallfifnaelescdotechdoemclpommuistmmaudendnirtteietsoss as On May 18, the first case of monkeypox 6/1/22 6/23/22 7/8/22 8/4/22 othegr rinefaetcetriofuunsddiinsgeafsoer tsherxeuaatsl hweealatrheclinic in the U.S. was documented in currecnatplyafcaitcyintgo, afrdodmreHssIVatovaprioeltioy.of sexually Massachusetts and the numbers of Flat trend in Start of U.S. Cumulative 6 weeks after diagnoses rose to 173 by June 23. In July, monkeypox community diagnoses by launch of NYC transmitted infections (STIs). amfAR and the O’Neill Institute at diagnoses vaccinations analysis date vaccinations amAofAfllRaorgfeltcohebinsatlslyhreoasuwpldaorndbseeeddpofluannnedtiihnnagtthteeonctvwoisnoiotenxst in NYC campaign surmveuyc-bhagsreedatsetur dreiesso:uRrcEeSPsNhaDri-nMgI w(Riatphiodther (projected) SOURCE: amfAR analysis using data downloaded from Our World in Data, July 10th, 2022 based on current guidelines indicating that it takes six weeks from first dose of vaccine to achieve full protection. Analysis: Log-linear regression: log(cumm_cases) = B_0 + B_1*t, t is days since June 1st (t>=0). Resulting output used to estimate projected cases by August Georgetown Law published a call 4, 2022. Projected number of diagnoses will be affected by: 1. Proportion of population ENpeinstdwhaeotomirortkinao,sgla,oenegsdv.iceDnSetiumndloiyggohratf pPorhfeidcvsoalmoefnecseti,c resource to action to address the monkeypox vaccinated by August 4th; 2. Whether diagnoses begin to reflect the actual number of cases; 3. Behaviors that facilitate transmission. outbreak as a public health emergency. Monkeypox Infection), led by principal Prepared by Jeffrey S Cinrovwelsetyig(Oa’tNoerisll fInrostmitutHe)aarvndarGdreagnMdilPlertEtP(a4mAfALLR,). BLACK AND LATINO MSM HEAVILYTfohrisNbartiieofniaslaapnrdoGdulocbt aoalfnHthdeeaalHthcIVrLoaPwsresva-esnnedtciiostinsouPnpoaplilocsryteePrdroobjpeycraet ogvfraatlnhetenfOcroe’NmeGillilIenasdtitute That policy brief included a modeling Sciences, analysis that predicted monkeypox IItnwc.aGs idleeavdelSocspiteeudndcienyspahatardItCnneAorsPihniapputwtCiitnohtloaumtmhfeAbdRiae, vtUheelnoFpivomeuernnsdtiatoytri,octnohnfeoternAtIDofS diagnoses in the U.S. would increase to REPRESENTED IN MPX DIAGNOSESthis brief. (DATA FROM <40% OF CASES, MAY 17-JULY 22R,e2se0a2rc2h). The views exgprloesbseadl hareeaslothleliyntihtioasteivoef tfhoeuanudtheodrsb. y Wafaa 11,311 by August 4. Eight days after the USA (OVERALL) http://bit.ly/USHIVpolEicl-ySparodjre,cMt .D., M.P.H., former amfAR original projection, the cases had risen to trustee and the Dr. Mathilde Krim–amfAR Data from <40% of diagnoses 11,177, underscoring the two institutions’ 41% Chair of Global Health at Columbia. prescient sense of urgency. Currently, Both studies will assess the impact of the U.S. has the highest number of MPX 26% 28% monkeypox on MSM in New York City, cases in the world. the epicenter of the U.S. outbreak, in order to provide knowledge about MPX amfAR and the O’Neill Institute followed BLACK LATINO PLWHIV and develop targeted interventions. up with two supplemental briefs, Tackling MPX in Black and Latino Source: Epidemiologic and Clinical Characteristics of Monkeypox Cases— Communities and MPX Research Gaps: United States, May 17-July 22, 2022, 71 Morbidity and Mortality Weekly What Remains Unknown. report—Ctrs. for disease Control and prevention (Aug. 5, 2022). www.amfar.org 5

POLICY Ruling Against PrEP Access Sets Dangerous Precedent amfAR strongly condemns a ruling by a federal HIV Epidemic initiative, launched in judge in Texas that restricts access to PrEP, 2019 by President Trump with the prophylactic drugs that prevent HIV acquisition. goal of ending HIV transmissions in the U.S. by 2030. In 2020 there The Affordable Care Act mandates that preventive were more than 30,000 new HIV care like PrEP must be fully covered by private diagnoses in the U.S. and Texas health insurance. However, in Braidwood has the seventh highest rate of HIV Management Inc. v. Xavier Becerra, U.S. District infection in the nation. Judge Reed O’Connor ruled in favor of plaintiffs who claimed they wanted the option to buy health “The advent of PrEP revolutionized HIV prevention potential to seriously undermine efforts to combat insurance that excludes or limits PrEP coverage. for individuals of all genders and it remains one HIV in the U.S. Imagine a healthcare provider having According to the plaintiffs, the HIV prophylaxis of the most important and effective tools we have a religious objection to providing you with heart or violates their religious beliefs because it promotes in preventing HIV acquisition,” said Greg Millett, diabetes medication? It’s unthinkable. Prohibiting “homosexual behavior.” amfAR Vice President and Director of Public access to medication because of religious Policy. “This ruling sets a dangerous precedent principles violates the ‘do no harm’ principle of PrEP is a bedrock component of both the U.S. that could prompt other jurisdictions to erect the Hippocratic Oath. This ruling legalizes bigotry National HIV/AIDS Strategy and the Ending the similar barriers to accessing PrEP, and it has the against the gay community.” Blinded by Our Own Data amfAR report evaluates PEPFAR’s HIV recency testing strategy HIV recency tests were developed to indicate simply whether an with the highest transmission rates, the report outlines how recency- individual “recently” acquired the virus. For years, these tests have been based testing is limited: It fails to diagnose individuals with true recent useful to estimate HIV incidence in populations broadly—at national and infections (infected less than six months) between 35% and 68% of sub-national regional levels, according to age and sex. the time; recency testing alone in the field returns false positive results between 15% and 90% of the time because being on treatment, having PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) began advanced HIV disease, and other factors can affect the accuracy of the introducing an HIV recency test-based surveillance system in 2019. It’s now partially test; reading of results is often inconsistent; implemented in at least 24 countries, with a routine program data are likely to bias results large scale-up expected in 2022 and 2023. in unpredictable ways; and recency testing The goal of recency surveillance for PEPFAR is doesn’t provide real-time information. to identify and respond to new transmissions in small geographic areas and sub-populations MAY 2022 as quickly as possible to halt any further transmission and better target HIV prevention Blinded The approach also raises ethical and human and testing resources. by Our rights concerns and requires substantial Own Data financial and human resources that come But is recency testing the right approach for — Recency directly at the cost of core HIV service what PEPFAR’s “hot-spot” surveillance hopes to Testing in delivery, say the report’s authors. accomplish? A recent report by amfAR’s Public Policy Office says no. PEPFAR Ultimately, the report concludes that a recency-based surveillance system cannot While understanding PEPFAR’s commitment to overcome its limitations to provide actionable focus testing resources on areas and populations data to identify real and potential HIV “hot spots” and does not warrant PEPFAR’s nor ministries of health’s re-allocation of already- limited resources. 6 INNOVATIONS, NOVEMBER 2022

POLICY CLM: A Powerful Tool for Improving HIV Services CLM country team members participated in a training workshop in Johannesburg led by amfAR staff. Community-led monitoring (CLM) has emerged to provide technical support on electronic data facilities on facility hours and staff, clinic conditions, as a powerful tool to improve the quality of HIV collection methods and build country-specific HIV-related services, COVID-19 disruptions, TB services and hold duty bearers accountable using databases to quickly transform data from the field programming, and other accountability indicators. community-designed data systems. Through into a useable format for advocacy. its Andelson Office of Public Policy, amfAR After the workshop, the amfAR reps joined the supports the development of CLM programs in Recently, amfAR Public Policy Manager Jennifer Ritshidze Community-led Monitoring Program five countries: South Africa, Malawi, Zimbabwe, Sherwood, Ph.D., and Project Coordinator Elise key population data collection teams for the rest Uganda, and Haiti. amfAR partners with CLM teams Lankiewicz, M.P.H., traveled to Johannesburg, of the week and attended the Treatment Action South Africa, to facilitate a multi-day training Campaign Congress. workshop with CLM country teams on how to generate the most useful data possible for advocacy. The workshop hosted 22 participants from Malawi, South Africa, Uganda, and Zimbabwe, with an additional seven facilitators from five global organizations. Sessions covered best practices, how advocacy can be strengthened by impactful data, key populations data in CLM, managing CLM work plans, linking CLM to funding opportunities, and using qualitative data, among other topics. amfAR’s Elise Lankiewicz (left) and Jennifer Sherwood flank Several in-depth sessions covered collecting and Source: People’s COP22 South Africa: Community Priority Ndivhuwo Rambau, Project Officer of the Ritshidze Project in managing data using the electronic data collection Recommendations for PEPFAR South Africa in COP 2022 South Africa. software CommCare and using country-specific dashboards for evidence-based advocacy. These dashboards display information collected from www.amfar.org 7

COVER STORY How Many Have Been Cured? A summary of HIV cure, or treatment-free control, cases to date By Rowena Johnston, Ph.D. It’s a sure sign of cure research progress that today Previous cases it can be hard to keep track of the various cases Berlin patient – The first known case of HIV cure of HIV having been cured or controlled in the was Timothy Ray Brown, who had been living with absence of antiretroviral therapy (ART). The cases HIV for over a decade when he developed acute that tend to make headlines are those resulting myeloid leukemia. He received chemotherapy, from high-risk stem cell transplants, which are total body irradiation, and two stem cell only an option for a very small number of people transplants. Each transplant came from the same with both HIV and certain blood cancers. More donor, who had the CCR5 delta32 genetic numerous are those cases where virus still remains but is somehow kept in check by the immune “While we’re still some system. While we’re still some distance from distance from having a cure having a cure that’s easy to administer, affordable that’s easy to administer, and, above all, widely available, researchers are affordable, and, above learning from all of these cases. all, widely available, researchers are learning So today, we’re curing some people, some of the from all of the cases.” time, the first step toward curing most people, most of the time. To help you make sense of it mutation. The case was published in 2009 and was all, we’ve put together this summary of cure, or subject to intense scrutiny before scientists agreed treatment-free control, cases to date. he was likely cured. Although he remained free of any signs of HIV infection, Timothy passed away in STEM CELL TRANSPLANTATION September 2020 following a relapse of his leukemia. City of Hope patient – At the recent AIDS 2022 conference, researchers London patient – In 2019 Adam Castillejo reported that a man living with HIV was reported likely cured following a CCR5 had been treated for acute myeloid delta32 stem cell transplant to treat his Hodgkin leukemia using stem cells from lymphoma. He received a reduced intensity a donor with the CCR5 delta32 preparatory chemotherapy but no irradiation prior genetic mutation, which renders to his transplant. He stopped taking ART under cells almost impervious to HIV close supervision in 2017 and remains HIV-free. infection. The man had stopped taking antiretroviral therapy (ART) Düsseldorf patient – Like the London patient, for 14 months with no sign of the Düsseldorf patient is a member of amfAR’s rebounding HIV. ICISTEM cohort of people living with HIV and Dr. Rowena Johnston spoke with Loreen Willenberg, the “San Francisco patient,” at amfAR’s Cure Summit in 2019. 8 INNOVATIONS, NOVEMBER 2022

cancer who received stem cell transplants. His Previous cases At AIDS 2022, Gabriela Turk of University of Buenos Aires, acute myeloid leukemia was treated with a CCR5 San Francisco patient – Loreen Willenberg was Argentina, discussed her research on the Esperenza patient, delta32 stem cell transplant in 2013. A few months diagnosed with HIV in 1992. Unlike almost all an exceptional elite controller like Loreen Willenberg. amfAR after the transplant he experienced a relapse of his people living with HIV, she has never needed grantees Drs. Xu Yu and Mathias Lichterfeld collaborated with leukemia, which was treated successfully without to take antiretroviral therapy to control her Dr. Turk and researchers in Argentina to help confirm the additional stem cell transplantation. Despite HIV infection. In 2020, Drs. Xu Yu and Mathias findings. (Photo© Marcus Rose/IAS) discontinuing ART in 2018, again under closely Lichterfeld (both amfAR grantees) announced that monitored conditions, he continues to show no they were unable to find any intact HIV in her body child has maintained undetectable HIV for more signs of HIV infection. despite searching in more than one billion cells, than 13 years. Researchers are unable to find any raising the intriguing possibility that her immune intact HIV in his body. He was the only one of New York patient – In February 2022, researchers system not only controls the virus but may have, for 227 infants enrolled in the study to achieve this reported that a woman living with HIV in New York all intents and purposes, eliminated it. outcome. had been treated for her acute myeloid leukemia using CCR5 delta32 stem cells from cord blood Esperanza patient – A second such case was A previous case, known as the Mississippi child, combined with adult stem cells from a relative, the announced in 2022 in a woman named after her was thought to have cleared her HIV infection after first such haplo-cord blood transplant leading to hometown in Argentina. She was diagnosed with a period of time during which she had not taken a potential HIV cure. At the time of the report, the HIV in 2013 and has taken antiretroviral therapy ART, but the virus rebounded just over two years woman had stopped ART for 14 months with no only for brief periods during two pregnancies. after stopping therapy. sign of HIV infection. Nonetheless, researchers including Drs. Yu and Lichterfeld, as well as collaborators in Argentina, MOVING FORWARD EXCEPTIONAL ELITE CONTROL have been unable to find intact or replication- competent virus in her. Figuring out how to fine-tune or supercharge the At the AIDS 2022 conference, Dr. Javier Martinez- immune system to unleash its full potential could Picado discussed the phenomenon of exceptional POST-TREATMENT CONTROL (PTC) hold the key to inducing treatment-free control of elite control—people who, without the use of ART, HIV. Similarly, CCR5, a co-receptor that enables control HIV viral replication and do not experience Barcelona patient – Researchers from Barcelona HIV to enter and infect cells and has been central to immune dysfunction. There is no disease reported at AIDS 2022 that a woman who had the stem cell transplantation cures to date, remains progression and they have extraordinarily low participated in a clinical trial of several immune- a prime target for cure researchers. burdens of HIV. They may experience a loss of anti- modifying interventions that variously suppress HIV antibodies over time, and have relatively weak and stimulate immune function had stopped taking amfAR continues to support studies that build immune responses against HIV, both signs that the ART with no rebound of HIV for 15 years. She was on all of these cases and attack HIV, and the body is no longer fighting HIV infection. Six such diagnosed with HIV early during infection and took persistent HIV reservoir, from every possible individuals have been followed for more than 30 ART for several months in combination with the angle. Additional studies are testing cell and gene years, and Dr. Martinez-Picado proposed that they immune treatments. Her HIV can still be detected therapy, immunotherapy and other approaches to may be considered a good model for an HIV cure. in laboratory tests, but her immune system appears curing HIV. to be keeping it under control without We will continue to pursue every possible avenue the use of ART. Several measures of her until we have a cure, or cures, that can be made reservoir indicate a decline over time in the available to all 38 million people living with HIV. amount of persistent virus in her body. Dr. Johnston is an amfAR vice president and director Cases of ART-free control, in varying of research. degrees, have been identified previously among the participants of the VISCONTI cohort and the CHAMP study. EARLY TREATMENT Dr. Javier Martinez-Picado of irsiCaixa AIDS Research Institute, Spain, South African child – An update was presented on the phenomenon of exceptional elite control at AIDS 2022 in provided at AIDS 2022 on an infant who July (Photo© Marcus Rose/IAS) was born HIV-positive and was enrolled in an NIH clinical trial testing the effect on the reservoir of early ART. He started ART soon after birth and was treated for 40 weeks, during which time his viral load decreased to undetectable after around 40 days of treatment. ART was then stopped and the www.amfar.org 9

RESEARCH New amfAR HIV Cure Grants Total More Than $3 Million Five awards support strategies aimed at eradicating the HIV reservoir The largest in a round of grants announced in July, With a $148,500 grant, Keith Jerome, M.D., Ph.D., worth $1 million, was awarded to Xu Yu, M.D., of the University of Washington in Seattle, will of Massachusetts General Hospital in Boston. study whether or not the presence of ART might Dr. Yu will study 50 people who have been on adversely impact the efficacy of one of the most antiretroviral therapy (ART) for at least 15 years and widely used means of delivering gene therapy— describe the loss of replication-competent viruses adeno-associated virus (AAV). Individuals who and relative accumulation of viruses in so-called receive gene therapy most likely will be taking ART, gene deserts to determine if HIV has been cleared. so the question of compatibility is a vital one. “Dr. Yu’s recent findings point to the intriguing Dr. Saar Gill Anjie Zhen, Ph.D., of the University of California, possibility that a small fraction of people might Los Angeles, will use a $210,000 grant to fine- have cleared HIV infection without realizing it,” Finally, in a nod to the promise of future tune CAR-T cell therapy, which has shown limited amfAR CEO Kevin Robert Frost said. “If that’s true, technologies, three grants will explore a variety success against HIV. Dr. Zhen will create stem cells it would not only be life-changing for the fortunate of gene therapies to eliminate HIV-infected cells. participants in this study, but would also renew Saar Gill, Ph.D., of the University of Pennsylvania Wally Wennerberg, Hwee Ng, Dr. Li Wang, Nicholas Tien, hope for the millions of people taking ART that their in Philadelphia, was awarded $180,000 to design Dr. Anjie Zhen (PI), Dr. Caitlin Kan, Dr. Shallu Tomer treatment may not need to be lifelong.” a transplant intervention for individuals living with HIV using a person’s own gene-edited cells. using blood-derived stem cells, selected for their While Dr. Yu’s grant will describe the upshot of the Before the transplant, Dr. Gill plans a series of potential to persist and self-renew. She will explore past fifteen years or more of effective combination immunotherapy and gene therapy interventions that would eliminate most or perhaps all of the their capacity to mature into not only Dr. Qigui Yu viral reservoir. The transplanted cells will be CAR-T cells, but also CAR-natural killer gene-edited to protect them from HIV infection. cells and CAR-macrophages, all three ART, Qigui Yu, M.D., Ph.D., of Indiana University in After the transplant, he will use chimeric antigen of which have the potential to attack Indianapolis, received a grant of $100,000 to test a receptor (CAR)-T cell immunotherapy to help clear HIV-infected cells. class of drugs approved to treat cancer to eradicate out the remainder of the original immune system, HIV-infected T follicular helper (Tfh) cells. Tfh cells which might still harbor HIV. This process will be “This set of grants takes advantage of usually function to educate B cells in making the tested in a small animal model. progress made in the past, explores the most appropriate antibodies to fight infection. But promise of current drugs, and looks to when HIV-infected, Tfh cells may play a significant Dr. Keith Jerome the future of HIV cure research,” amfAR role in spreading infection, given their position Vice President and Director of Research in the lymph node, in proximity to other immune Dr. Rowena Johnston said. “By attacking cells. Dr. Yu will test several compounds in a class HIV from every angle, these projects of drugs that inhibit the protein BIRC5, whose will bring us a step closer to a cure for usual function is to keep cells alive, and see if these the millions of people who need it.” BIRC5 inhibitors will allow infected Tfh cells to die. 10 INNOVATIONS, NOVEMBER 2022

RESEARCH October awards support a range of innovative research strategies Anna Hearps, Ph.D., of the Burnet Institute in a study using the delivery system that worked so Melbourne, Australia, will use her $106,088 grant to fill in gaps in what scientists know about well for two very effective COVID-19 vaccines— macrophages, an important but understudied reservoir of HIV. These long-lived cells are very messenger RNA (mRNA) encased in a lipid good at resisting the immune system’s attempts nanoparticle. This mRNA vehicle will transport Dr. Anna Hearps latency-reversing agents (LRAs) to HIV-infected to kill them, even when they are infected and ostensibly prime targets for antibodies. Dr. Hearps reservoir cells in order to reactivate them, thus will first identify those anti-HIV antibodies that best recognize infected macrophages as these will likely making them a target for eradication. No LRA differ from antibodies that perform well against infected CD4+ T cells. In this targeted approach, has so far proven powerful enough to force the antibodies would help eradicate the reservoir by recruiting natural killer (NK) cells to kill the HIV-infected cells to start replicating in a way infected macrophages. She also aims to determine which subset of NK cells are best at killing that makes them Professor Sharon Lewin (Photo: The Doherty Institute) vulnerable to cell Dr. Pamela Skinner macrophages, so that these can be expanded and death. In order against the HIV reservoir in part because they do used as part of an immunotherapy to cure HIV. not easily access the regions of the lymph node to boost the where a major reservoir persists. In addition, these cells, as with normal cells, are prone to potency of the exhausting themselves. Pamela Skinner, Ph.D., of the University of Minnesota, will use her $480,000 LRAs, Dr. Lewin grant to engineer CAR T and NK cells so that are able to migrate specifically to the lymph nodes plans to modify to enhance their chances of success. In addition, she will modify these cells so that they are able the approach by to overcome exhaustion, resist becoming HIV- infected themselves, and endure long enough to targeting lipid kill HIV-infected cells. She will use a new genetic engineering method that could reduce the cost nanoparticles and complexity that currently surrounds CAR-T cell therapy in cancer. more specifically A fifth grantee, Aleksandar Antanasijevic, Ph.D., Dr. Luis Montaner to infected cells. of the École Polytechnique Fédérale de Lausanne, Using CRISPR-Cas Switzerland, was awarded $50,000 to continue technology, the LRA will be gene-edited to bind the work funded by his 2021 Mathilde to the viral DNA and directly force the virus to start Krim Fellowship. He is using a sophisticated replicating. Once the components have been imaging technology called cryoEMPEM to optimized, Dr. Lewin will test the effectiveness of address the obstacles that make developing this intervention in mice. an HIV vaccine so challenging. Immunotherapy using natural killer cells has been shown to be effective in the treatment of certain Dr. Aleksandar Antanasijevic types of cancer. Increasingly, HIV researchers are exploring the potential of NK cells to kill HIV- infected cells. Luis Montaner, M.D., of The Wistar Institute, who has been awarded $372,662, will build on cancer research know-how to engineer and optimize NK cells so that they can bind to antibodies that have already proven effective against HIV. These antibodies will also be modified to better trigger cell death whenever they meet infected cells. Dr. Montaner will test this engineered approach in mice to determine whether the product migrates to the appropriate regions of the body and if HIV can be controlled once antiretroviral therapy is stopped. Sharon Lewin, M.D., Ph.D., of the University of Cytotoxic T cells and NK cells, some of the immune Melbourne, was awarded a $480,000 grant for system’s most effective killers, are ineffective www.amfar.org 11

RESEARCH Anthony S. Fauci, M.D.: A Prodigious Legacy Dr. Anthony Fauci is set to retire in December around the world. For his work on PEPFAR, as director of the National Institute of Allergy President Bush awarded him the Presidential and Infectious Diseases (NIAID) at the National Medal of Freedom in 2008. Institutes of Health, a position he has held since 1984. He first joined NIAID in 1968 and has As the leading advisor on infectious disease since become one of the most cited scientists for the past 40 years, including advising seven of all time. presidents, starting with Ronald Reagan, Fauci has provided guidance on numerous public health Many came to know Dr. Fauci for his work threats, from the West Nile virus and Ebola to on HIV/AIDS in the 1980s and subsequent COVID and monkeypox. decades. While he did have his critics among treatment activists and others early on, he In 2021, amfAR honored Dr. Fauci with its Award came to be lauded for his ability to respond of Courage, presented virtually by actress and to the needs of the AIDS community. With amfAR supporter Julia Roberts during one of the guidance from activists, for example, Dr. Fauci coronavirus lockdowns. developed a parallel track to grant wider and quicker access to clinical trials in an era when “The enormity of Anthony Fauci’s legacy is hard no efficacious treatment for HIV existed and individuals sought to try as to put into words,” said Kevin Robert Frost, amfAR CEO. “His contributions many options as possible. to HIV research and global public health and his steadfast leadership in the face of every major infectious disease threat of the last four decades place In 2002, President George W. Bush tapped Fauci to serve as a principal him in a league of his own. We’re profoundly grateful to Dr. Fauci for his architect of PEPFAR (the U.S. President’s Emergency Plan for AIDS partnership over the years and will greatly miss his leadership Relief), which has since become the largest funder of HIV programming and guidance.” New Chair Appointed to amfAR’s Scientific Advisory Committee Lishomwa “Lish” Ndhlovu, M.D., Ph.D., pictured is key. I think it’s going to be exciting to see if we deliberations and ensuring that our precious above, has been appointed to a three-year term as can put our heads together and address this funds are invested wisely.” chair of amfAR’s Scientific Advisory Committee, a complex issue.” volunteer group of leading researchers that reviews At Weill Cornell Medicine, Dr. Ndhlovu is also grant applications submitted to amfAR. Dr. Ndhlovu is Professor of Immunology in a faculty member of the Feil Family Brain and Medicine at Weill Cornell Medicine in the Division Mind Research Institute, where his focus is on “I’m honored to help any funding agency that’s of Infectious Diseases, where he is the director HIV and the brain. He is co-editor-in-chief of going to help us achieve the goal of a cure,” said of the Laboratory of HIV Immunopathogenesis AIDS Research and Human Retroviruses and has Dr. Ndhlovu about the appointment. “We have to and Emerging Pathogens. Recently, Dr. Ndhlovu published over 100 articles in scientific journals. think outside the box with this virus and teamwork and co-researchers Susana Valente, Ph.D., of Scripps Research, and Melanie Ott, M.D., Ph.D., of Dr. Ndhlovu earned his medical degree at Gladstone Institute of Virology, were awarded a $26 the University of Zambia Medical School and million grant as a Martin Delaney Collaboratory, the his Ph.D. in immunology at Tohoku University premier National Institutes of Health program for School of Medicine in Japan. He also completed HIV cure research. postdoctoral training at the University of California, San Francisco. “We are delighted that Dr. Ndhlovu has agreed to take the helm of our Scientific Advisory Committee,” “Dr. Ndhlovu is a highly respected scientist said Kevin Robert Frost, amfAR’s chief executive whose background and research goals are officer. “He brings the perfect mix of expertise and perfectly aligned with amfAR’s single-minded experience to the role and I have no doubt he’ll pursuit of a cure for HIV,” said Dr. Rowena do an excellent job of overseeing the committee’s Johnston, amfAR VP and director of research. 12 INNOVATIONS, NOVEMBER 2022

RESEARCH Identifying New Targets in Host Cells to Attack HIV By Jeffrey Laurence, M.D. RESEARCH QUESTION half of these factors had never been associated HIV could not function without hijacking multiple with HIV function. pathways involved in the growth and functioning of the host cell it infects. Yet attempts to identify IMPACT the specific factors involved in this interaction, The authors concluded that their strategy may using standard genetic and biochemical tests, serve as a roadmap for host factor discovery and have yielded very few important targets that affect potential intervention, not only for HIV but for other viral function. Development of new methods to emerging or under-studied infections as well. rapidly evaluate such factors would be invaluable. FINDINGS amfAR’S ROLE The authors of this study successfully examined amfAR was a funder of this research. Authors of this 364 genes that had previously been implicated paper include amfAR grantees Dr. Judd F. Hultquist as important to the lifecycle of HIV. They used of Northwestern University and Dr. Ujjwal Rathore protein interaction studies and CRISPR technology of the University of California, San Francisco. to suppress such genes in primary human CD4+ T cells and found that 6% of these normal cellular ORIGINAL ARTICLE Dr. Ujjwal Rathore of the University of California, San Francisco genes, representing 23 factors, had the capacity http://www.ncbi.nlm.nih.gov/ (top) and Dr. Judd F. Hultquist of Northwestern University to restrict HIV growth in T cells from different pubmed/35365639 blood donors. Other factors played some functional role in HIV growth. Importantly, over Dr. Laurence is amfAR’s senior scientific consultant. Dismantling HIV Silencing Factors A novel mechanism for awakening dormant HIV By Jeffrey Laurence, M.D. RESEARCH QUESTION FINDINGS Using gene-editing technology based on CRISPR, the researchers identified Cells serving as HIV reservoirs have limited to no expression of viral 18 possible silencing factors. They focused on one, SLTM, not previously known to affect HIV growth. Knocking down the gene encoding SLTM proteins. With expression limited or absent, antiretroviral therapy increased HIV expression more than fourfold in T-cell lines. Using CD4+ T cells derived directly from 10 people living with HIV on effective ART, they also is ineffective and the cells may remain unrecognized and resistant demonstrated that suppressing SLTM induced death of the HIV-infected cells. to clearance by the immune IMPACT The authors concluded that their model “may enable future strategies to system. While HIV persistence reactivate HIV-1 in infected individuals so that infected cells can be killed by immune cells, drug treatment, or the virus itself.” in reservoirs remains the amfAR’S ROLE major obstacle to an HIV cure, amfAR was a funder of this research. there is limited knowledge of ORIGINAL ARTICLE http://www.ncbi.nlm.nih.gov/pubmed/35730977 the mechanisms by which HIV Dr. Laurence is amfAR’s senior scientific consultant. expression is blocked in such cells. A team of researchers led by Dr. Ya-Chi Ho of Yale University School of Medicine sought to identify normal cell proteins that might serve as HIV “silencing factors.” They hypothesized that inhibiting one or more of these proteins Dr. Ya-Chi Ho would enable HIV expression. www.amfar.org 13

GLOBAL ARV Stockouts in India Created a Health Crisis for People Living with HIV “ARV Is Our Lifeline. End Stockout Now,” read one to address the already growing nationwide or more. In contrast, some children were given sign taped to the wall of The National AIDS Control stockout. Some were switched to different adult versions of lopinavir/ritonavir because of a Organization (NACO) office in New Delhi, India. regimens, but without first checking HIV viral load shortage of pediatric formulations for that ARV. Protesters held a sit-in there, July 21–August 31, to test for pre-existing treatment failure or to guide to demand the government immediately restore future management. “Twenty years ago, there was no treatment in the supply of antiretrovirals (ARVs) to people living India. Now we have about [1.5 million] accessing with HIV (PLWH) nationwide. Letters and emails The stockout affected dosing as well. Instead of treatment. That’s a big change,” says Loon Gangte, were sent to authorities, including national and being given a one-month supply, PLWH were founder and president of Delhi Network of Positive international agencies, alerting them to the urgent given only enough ARVs to last a week or two, People (DNP+), an amfAR community partner. situation and calling for action. resulting in individuals coming back four or five times a month to obtain their medicines. For those “I call it a chronic virus. NACO claimed that 95% of PLWH were not taking abacavir, which was in even shorter supply, People say HIV is the chronic facing any shortages during that period, but PLWH had to pay higher prices for their medicines virus, but the chronic virus is advocates disputed the accuracy of their data at local pharmacies. A stockout of one particular the stockout.”—Loon Gangte, DNP+ and emphasized that 5% still translated to 75,000 form of the ARV dolutegravir meant that PLWH people being turned away from HIV treatment who needed it for second- and third-line therapies According to UNAIDS, 2.4 million people are living centers empty-handed. could not access it. with HIV in India. Of the 1.9 million who know their status, approximately 65% are on treatment. In a communication sent to all State AIDS Control Some adults were offered pediatric formulations An estimated 1.3 million have achieved viral Societies in May, NACO requested a change to as a way to continue on the same ARVs, which suppression. “Everyone has personal challenges existing regimens for PLWH as an interim measure increased the pill burden from one a day to 10 [accessing healthcare] but this isn’t personal. The stockout shouldn’t have happened.” “It’s been 17 years now since we’ve had treatment rollout in India [and this problem] has been recurring. I call it a chronic virus,” says Gangte. “People say HIV is the chronic virus, but the chronic virus is the stockout.” Stockouts and shortages of ARVs and other HIV- related supplies have happened before, notably in 2014 and 2017. It’s seemingly not a problem with local production but more about missed timeframes in the initiation and completion of procurement processes. Gangte was frustrated that NACO continually asked the protestors to disband prior to the shipment of ARV supplies starting on August 31. “That’s what I tell NACO: Okay, we will call off our protest but can you tell the virus in our body not to do any harm until next month, until you sort out this shortage?...No. The virus won’t simply listen. Every day we have to take our medicine on time. No matter what. Rain or shine. There’s no holiday. We’re not going to call off the protest unless our demands are met. Our demands are simple: Everyone gets medicine according to the NACO guidelines.” Members of DNP+ protesting in the NACO office. 14 INNOVATIONS, NOVEMBER 2022

GLOBAL Members of DNP+ endured 42 days in front During the stockout, some of the NACO office, demanding appropriate adults received pediatric supplies of ARVs for PLWH. Over that time, formulations, which many PLWH made multiple visits to HIV upped the pill burden. treatment centers to collect their life-saving medicines while medical staff also had to cope with the increased number of visits. Time will tell how this stockout has impacted the risk of future treatment failures and the strength of the immune systems of those who struggled to maintain access to their medicines. Stock shortages or complete stockouts must be avoided through consistent planning and effective implementation of national procurement processes. Analyzing Service Gaps in India and Indonesia Advocates in India and Indonesia know that in training the two national partners—Community who were not always friendly and welcoming. HIV and hepatitis C (HCV) services could be im- Network for Empowerment (CoNE) in Manipur, The report also found substandard counseling proved and expanded, but where should they India, and Peduli Hati in Indonesia—and TREAT in some health facilities; inadequate health start? A new report detailing the results of two Asia staff. facility infrastructure; and overcrowding and Community Treatment Observatories (CTOs) unnecessary waiting. Many of the same issues initiated by amfAR’s TREAT Asia program and Country-specific quantitative and qualitative were found when HCV services were analyzed. three partner organizations has now provided indicators on HIV and HCV services were solid guidance. developed for the CTOs. The data collected INDONESIA focused on the state of HIV and HCV programs, The project was implemented with the treatment procurement systems, drug stocks, and One barrier to HIV services in Indonesia was International Treatment Preparedness Coalition diagnostics facilities that test for viral load and for the fact that while HIV testing was a simple (ITPC) as a technical partner, which assisted common co-infections and opportunistic infections. process with a quick turnaround time, and generally available at community health INDIA centers, not all centers have created linkages between HIV testing and treatment services. Focus group discussion with people who inject drugs in India Barriers to care for people Access to multi-month supplies of antiretrovirals living with HIV (PLWH) (ARVs) varied across provinces. Unavailability have been created by of pediatric formulations of ARVs in places staff shortages, limited led to workarounds, such as using crushed services as a result tablets and smaller doses of adult formulations. of broken machines, For HCV services, barriers included limited extended travel times, operating days and partial coverage of HCV out-of-pocket expenses services leading to financial burdens for when free services at some. Stockouts in recent years have led government facilities to treatment interruptions. were not available, administrative red tape, Phase I of the CTOs’ analysis has been and health facility staff completed and Phase II is underway. www.amfar.org 15

GLOBAL TREAT Asia Fellows Pay Visit to amfAR’s Offices Dr. Annette Sohn, amfAR VP and director of amfAR’s TREAT Asia program (front row, second from left), led a delegation of CHIMERA D43 fellows on a visit to amfAR’s Manhattan offices, September 19. CHIMERA is a five-year HIV, mental health, and implementation science research training program that is building capacity among Asia-Pacific clinicians and researchers to study the intersection between HIV and mental health. It was established by TREAT Asia and Columbia University and is funded by the Fogarty International Center and the National Institute of Mental Health of the U.S. NIH. The contingent spent a week in New York City attending a series of professional development and educational workshops at the New York State Psychiatric Institute and the Mailman School of Public Health, both at Columbia University. Dr. Sohn was joined by TREAT Asia Director of Research, Dr. Jeremy Ross (back row, left), and Katiphot Kanoknorrasade, Project Manager, Education and Training (back row, right). On Dangerous Ground UNAIDS report shows that progress in addressing the epidemic has stalled UNAIDS recently released its report on the declining for a decade but now they are on The report underscores that deaths in 2021— global HIV response during the last two years the rise, and UNAIDS describes the numbers an estimated 650,000, or one AIDS-related of COVID-19 and other global crises. The as “alarming.” As they have over the past death every minute—were preventable in this simple title says it all: In Danger. decade, new infections in Eastern Europe and age of lifesaving treatments. The number of central Asia, the Middle East and North Africa, people accessing combination antiretroviral According to the new data, progress in and Latin America continued to increase. While therapy increased by only 1.47 million in 2021, substantial declines in new HIV infections have the smallest increase in over a decade. prevention and treatment has diminished been recorded in western and central Africa and in the Caribbean, UNAIDS points out that “Leaders must not mistake the huge red to the point where critical action is needed a lack of resources threatens these gains. warning light for a stop sign,” said UNAIDS to address the inequalities driving AIDS and NEW INFECTIONS BY THE NUMBERS Executive Director Winnie Byanyima at prevent millions of new HIV infections and AIDS 2022, where the report was first AIDS-related deaths. released. “This must Among the report’s main 1 become a moment findings, stats on new for a surge of inter- national support.” infections demand urgent attention. New HIV infections in the 1.5M 3.6% 38 Asia-Pacific region, the world’s most populous New infections Decline in new infections in 2021 Countries have shown New infection occurred every region, had been compared to 2020, the smallest increases in annual HIV minute among adolescent infections since 2015 women and girls in 2021 annual decrease since 2016 16 INNOVATIONS, NOVEMBER 2022

DONORS Fifty Years Jerry Dyer (left) and Jerald Jerome Kaseman of Sharing Continues Jerry Dyer, who hailed from Mt. Hope, Kansas, Jerry K. lent his time and energy to Children of Throughout the past decades, Jerry D. and Jerry K. and Jerald Jerome Kaseman, of Wishek, the Dream, a project sponsored by the Anti- lost many friends to AIDS-related causes and, to North Dakota, first met as colleagues in Defamation League to combat prejudice based on honor their memory, they included amfAR in a trust the Santa Ana school district in southern race, culture, and religion and to promote unity they set up to benefit eight charities. California but soon discovered they shared more and empathy among all people, no matter their than the same name, Jerry—they shared a desire to Jerry K., who passed away on September 10, 2021, spend their lives together and did so for fifty years. “Through their generous at age 76, shared this about his partner, who trust, Jerry K. and Jerry predeceased him some seven months earlier on Settling down in Laguna Niguel, they shared a D. will continue their January 13, 2021: “My life would not have been love of teaching and, in their free time, painted lifelong commitment to complete and as full as it has been if it had not landscapes and flowers in watercolors and acrylics helping both people and been for my friend and companion, Jerry Dyer, of (they themselves had green thumbs, spending animals in need far into more than fifty years. We have always been there countless hours on their garden and yard). They the future.” for each other during the difficult as well as the shared the joy of adventure, traveling to over 25 ‘best’ of times.” countries (some revisited multiple times) and toting differences. Relying on his educational expertise, back mementoes for loved ones. They enjoyed he was in charge of in-servicing participating “Through their generous trust, Jerry K. and Jerry spending weekends and vacations at their second teachers across Orange County. D. will continue their lifelong commitment to home in San Diego. Over the years, they loved to helping both people and animals in need far entertain family and friends in their home or in the As animal lovers, they always included dogs into the future,” said Kyle Clifford, amfAR’s chief area (like the beach), hosting dinner parties and as a part of their family and, no surprise, loyally development officer. “All of us at amfAR are so family reunions where every get-together was an supported the ASPCA and the San Clemente-Dana grateful for their legacy gift to help us find a cure event of love and laughter. And they both shared Point Animal Shelter in San Clemente, California. for AIDS that will work for everyone, everywhere.” a commitment to giving back to the community, which included volunteering at a local hospital. QUESTIONS ABOUT PLANNED GIVING? PLEASE CONTACT US AT [email protected]. YOU SHOULD ALWAYS CONSULT WITH YOUR FINANCIAL ADVISOR AND/OR TAX PROFESSIONAL BEFORE INITIATING A CHARITABLE GIFT ARRANGEMENT. www.amfar.org 17

EVENTS amfAR GALA 1 34 CANNES 2 67 Over $19 million was raised for amfAR’s HIV/AIDS research 11 programs at amfAR Gala Cannes, May 26. Legendary actor, director and producer Robert De Niro was guest of honor. Held at the fabled Hôtel du Cap-Eden-Roc, the black-tie evening included a dinner, a live auction of luxury one-of-a kind items and contemporary art (introduced by Event Chairs Cynthia Erivo and Lakeith Stanfield and presided over by Simon de Pury), a fashion show curated by Carine Roitfeld that celebrated tying the knot, and spectacular performances by Christina Aguilera, Ricky Martin, and Charli XCX. Guests were also treated to a surprise performance by Matteo Bocelli, who helped raise over 2 million euros in the auction with the sale of two private dinners and performances with his father, Andrea, at their family home. Special thanks: Presenting Sponsors FTX, the official cryptocurrency partner for amfAR Gala Cannes, and Red Sea International Film Festival. Signature sponsors were Chopard and Jelenew. The official beauty partner of the fashion show was Charlotte Tilbury. 1. Left to right: amfAR Board Co-Chairs 5 Kevin McClatchy and T. Ryan Greenawalt; Trustees Donald Dye, Phill Wilson, Vin Roberti; CEO Kevin Robert Frost; and Trustee Larry Milstein 2. Honored Guest Robert De Niro 3. Event Chair Caroline Scheufele of Chopard 4. Event Chairs Baz Luhrmann and Tom Hanks 5. Event Chairs Eva Longoria and Milla Jovovich present the Let’s Get Married Fashion Show curated by Carine Roitfeld (right) 6. Event Chair Cynthia Erivo, Edward Enninful, and Ricky Martin 7. Charlie XCX 8. Event Chair Lauren Remington Platt of FTX 9. Christina Aguilera 10. Matteo Bocelli and Hermann Bühlbecker 11. Naomi Campbell, Event Chairs Mohammed Al-Turki and Michelle Rodriguez (Photos: Getty Images for amfAR: 1, 3, 11 by Gareth Cattermole; 2, 4 by Pascal Le Segretain; 5, 8 by Germain Larkin; 6 by Kevin Tachman; 7 by John Phillips; 9 by Dominique Charriau; 10 by Gisele Schober) 89 10 18 INNOVATIONS, NOVEMBER 2022

EVENTS amfAR HAMPTONS amfAR Trustee Michael Lorber hosted an intimate soiree in the Hamptons on July 30 to raise awareness and support for amfAR’s HIV cure research. During the evening, Board Co-Chair T. Ryan Greenawalt (left) presented amfAR Trustee David Bohnett (center) with the Philanthropic Legacy Award for his generous contributions to amfAR over the past two decades. At right is amfAR VP and Director of Research Dr. Rowena Johnston. (Photo by Ryan Emberley/Getty Images for amfAR) amfAR GALA 1 2 VENEZIA 3 4 On September 7 at the Arsenale in Venice, Italy, amfAR Gala Venezia offered guests a dazzling evening in the closing days of the Venice Film Festival. amfAR honored acclaimed director Ferzan Ozpetek with the Award of Courage and longtime amfAR supporter Achille Boroli with the Philanthropic Leadership Award for their contributions to the fight against HIV/AIDS. One of the highlights of the evening’s live auction, conducted by Simon de Pury, was a stunning bronze sculpture by Enrique Cabrera, which sold for $1 million. Other auction highlights included a Christopher Makos photo portfolio and an Alec Monopoly x Campari custom bar cart. At the end of the gala, Ellie Goulding enthralled the audience with five of her hits, including her new song, “Easy Lover.” Special thanks: Presenting Sponsors Campari and the Red Sea International Film Festival; San Clemente Palace, the event’s official hotel partner; and Picticular. This was a fantastic week. I was part 56 of the amfAR Gala in Venice. This event raised funds for amfAR’s lifesaving 1. Honoree Achille Boroli 2. Event Chair Marisa Tomei 3. Event Chair Jodi Turner-Smith AIDS research programs. I was proud 4. Ellie Goulding 5. CEO Kevin Robert Frost and honoree Ferzan Ozpetek 6. Event Chair Rachel to be a part of it with my donation of Brosnahan (Photos: Getty Images for amfAR: 1, 3 by Victor Boyko; 2, 4, 5 by Ryan Emberley; 6 by ‘Miniature Serena’ to raise money for Andreas Rentz) this wonderful cause. 19 #gala #amfar #charity www.amfar.org

freewill.com/amfar A planned gift—bequest, trust, life insurance policy—cements your legacy and helps secure your family’s future. What’s more, you can help amfAR secure an AIDS-free future. While we have made impressive progress on the path to a cure for HIV, we still have a way to go. Including amfAR in your giving plans is a long-term investment that will help ensure we accomplish our mission. You’ll join a select group—the amfAR Legacy Circle —committed to bringing us to the finish line in our search for a cure for HIV. amfAR has partnered with FreeWill on a free webtool to easily and quickly make a will. Get started today at www.freewill.com/amfar. Thank you for your support. PLEASE NOTE that if you wish to benefit amfAR through your will, your attorney will discuss with you the best way to realize your goal. SUBSCRIBE DONATE SHOP Not a subscriber to Innovations? Support our critical work with If you shop at AmazonSmile, you Sign up today for this free twice a one-time or recurring can benefit amfAR with every monthly donation. purchase – at no cost to you! yearly digital newsletter. Click here Click here Click here amfAR, The Foundation for AIDS Research 120 Wall Street, 13th Floor, New York, NY 10005-3908 www.amfar.org