Advancing Advocacy for HIV Prevention Research Funding in Rwanda

On November 30th, 2021 at Gorilla Hotel-Kigali; Rwanda NGOs Forum on HIV/AIDS and Health Promotion organized the Biomedical HIV Prevention Forum (BHPF) which is a biannual Forum which is considered as an official pre-conference of the International Conference on AIDS and STI’s in Africa (ICASA) aiming at strengthening advocacy for biomedical HIV prevention research in Rwanda.

The Mini BHPF hosted participants from stakeholders including Researchers, government institutions, People Living with HIV, Advocates, Faith Based Organizations and community-based organizations from Country Level.

During His Opening Remarks the HIV Division Manager at Rwanda Biomedical Center Highlighted the Need of Partners Joined Efforts to invest more in Biomedical HIV Prevention Research; “To strengthen Rwandan Health System, We should collaborate more to reinforce research process and publication, This will help us generate strong evidence and information to the communities we serve” said Dr. Rwibasira Gallican.

Since 2001, positive momentum against the epidemic has led to some major achievements. This progress, however, masks existing inequalities and challenges that continue to persist, putting at risk the progress made during the past decade, with implications for people’s lives, economies, health security, and sustainable development.

A total of 59% of all new HIV infections in Sub-Saharan Africa in 2019 were among women and girls, with 4500 girls and young women between 15 and 24 years old becoming infected every week. Thus, a growing number of young women are getting New HIV infection, despite only making up 10% of the population in sub-Saharan Africa. There is, however, a significant reduction in HIV transmission levels where comprehensive HIV services are provided.

Over the past 40 years HIV/AIDS has been a burden worldwide, According to UNAIDS data of year 2020, 37.7 million people were living with HIV worldwide and Rwanda NGOs Forum on HIV/AIDS & Health Promotion (RNGOF) has been working with key and vulnerable communities in health promotion and HIV prevention activities to reduce the burden of HIV/AIDS.

In Rwanda, HIV prevalence remains stable at 3.0% since 2005 among the adult general population, The prevalence of HIV among FSW is almost 12 times higher (35.5%) and more than 2 times (7%) among MSM (RBC, 2018).

The Executive Secretary of Rwanda NGOs Forum, Mrs. Kabanya Nooliet Acknowledged Rwanda’s Efforts in Advancing and Strengthening Responses to combat AIDS and New Infections, However called up on increased Funding in Biomedical HIV Prevention Research to abolish gaps in this particular Sector.

        “Numerous studies have been conducted around HIV prevention. However, there is still a gap in biomedical HIV prevention research to discover more on HIV and AIDS in order to end HIV by 2030, With Outstanding leaderships and Available basic research infrastructures in Rwanda we can improve the biomedical HIV prevention research” She Said

In many countries funding in this area has found to be a major bottleneck and impediment to achieve this milestone of ending HIV by 2030. It is in this perspective that Rwanda NGOs Forum conducted a situational analysis on funding allocated in biomedical HIV prevention research from both government and other donors in Rwanda to get a comprehensive analysis on biomedical HIV prevention research funding in Rwanda with the following objectives:

  • To assess the research funding opportunity in biomedical HIV prevention in Rwanda.
  • To acquaint health and HIV advocates with knowledge on current biomedical HIV prevention research
  • To identify challenges in funding biomedical HIV prevention research
  • To strengthen advocacy around biomedical HIV prevention research funding.
  • To describe common biomedical HIV prevention services/programs available and used in Rwanda

Rwanda has managed to reduce HIV new cases gradually for the past few decades thanks to many prevention programs that entail tackling specifically to reduce new infection. The most effective interventions that the country has integrated for HIV prevention include:

  • Prevention of mother-to-child transmission (PMTCT)
  • Condoms
  • Pre-exposure prophylaxis
  • Post-exposure prophylaxis
  • HIV Testing
  • Voluntary Medical Male Circumcision (VMMC)
  • Vaginal Ring

The Need for Biomedical HIV Prevention Research

During the desk review many bottlenecks in biomedical HIV prevention research have been found, mainly in writing, applying for research grants, funding and publications as highlighted below:

  • Out of more than a hundred articles published in Rwanda Journal of Medicine & Health Sciences (RJMHS) only 3 are HIV/AIDS related and they don’t include Biomedical HIV prevention.
  • Among 58 researches registered in Research Registry at RBC including 26 ongoing, only 8 are related to HIV and none of them was conducted on biomedical HIV.
  • The Health sector budget has increased from RWF 245.4 billion in 2019/2020 budget to RWF 253.2 billion in 2020/2021, reflecting a nominal increase of 3.2%.(MOH 2021)
  • According to the World Health Organization there has not been enough research in low- and middle-income countries on biomedical HIV prevention research,finding the appropriate methods to prevent new infections is still a challenge. It is highly needed to find appropriate methods to be used alone or combined, prompting for more research on biomedical prevention methods among others.
  • According to National HIV/AIDS Targets 2018-2020-2030, the current trend shows a rapid decline in external funding for HIV prevention activities, while domestic funding increases at a slower rate. In addition, these funds mainly go into HIV prevention and treatment with less focus on biomedical HIV prevention research.(MOH 2021)
  • Since the establishment of Excellent Research Grant at NCST Rwanda, Only 11 Health projects has been funded through the National Research and Innovation Fund, 7 of them were related to health, and none of them was related to Biomedical HIV prevention.
  • In 2020/21 the domestic resources accounted for 48.3 percent of the total Health Sector budget, down from 49 percent, demonstrating the government’s commitment to reduce reliance on external funds.(MINICOFIN-2021)

Even though different partners in HIV response provide funding in various area of HIV prevention and treatment in Rwanda, there is no specific funding for Biomedical HIV prevention research.

“There is a need to strengthen the capacity of health care providers in conducting both biomedical and non-biomedical HIV prevention research. Concerned institutions should advocate for investment in this area.” “KII”

Ending the HIV epidemic is a reality where there is a collective effort to use evidence-informed and effective interventions, we need HIV prevention Tools that respond to the needs of the communities to ensure increased efficiencies and effectiveness of available resources to Health.

“Together We End AIDS”