Letters from the Director: Opportunities to Address HIV and COVID-19: Past and Present Research Funding
Just one year ago, while the coronavirus disease 2019 (COVID-19) was taking a significant toll in many of our communities, the nation was contending with sequester-in-place measures, face masks, thousands of COVID-19 cases, hospitalizations, and deaths. The pandemic laid bare health disparities that have been evident in the HIV pandemic for decades. New infections and deaths from COVID-19 have now declined significantly and many restrictions have been lifted. The biggest difference since last summer is that more than 300 million COVID-19 vaccine doses have been administered in the United States.
The U.S. response to the COVID-19 crisis was supported by significant investments in biomedical research and by multi-sector partnerships to develop vaccines and treatments. As part of the response, the White House Office of Management and Budget (OMB) instituted an all-of-government approach and issued a series of memoranda on March 9, March 19, and June 18, 2020 (M 20-11, M 20-17, & M 20-26, respectively) that directed Federal departments and agencies to rally all legally available federal resources to combat the crisis. The OMB memoranda gave the National Institutes of Health (NIH) short-term flexibilities to allow researchers, including HIV investigators, to pivot grant funds to COVID-19 studies.
In June 2020 when the flexibilities were scheduled to expire, OMB issued memorandum M 20-26 extending the flexibilities through Sept 30, 2020, with no additional extensions. The NIH Office for Extramural Research website has a wealth of information about the OMB flexibilities.
As these time-limited flexibilities are expired, NIH and OAR are required by foundational 1993 legislation to ensure that HIV funds are used to continue to support the highest priorities for HIV research to end the global HIV pandemic in accordance with the NIH Strategic Plan for HIV and HIV-Related Research and the research priorities outlined in the NIH HIV/AIDS Research Priorities and Guidelines for Determining AIDS Funding (NOT-OD-15-137 and NOT-OD-20-018).
The last 16 months have brought unprecedented challenges and shed a more focused light on structural racism and social inequities in our society. In June 2020, NIH Director Dr. Francis Collins affirmed NIH’s commitment to addressing structural racism in the biomedical research enterprise.
Meanwhile, the research enterprise continued to focus on discovery to end the COVID-19 pandemic and the contributions by HIV researchers and community past and current to the outcomes are significant: from the mRNA vaccine platform to clinical trials networks for testing candidate vaccines to rapid testing and molecular epidemiology for tracking, the HIV research footprint is apparent. Likewise, many of the approaches and strategies to get ahead of the COVID-19 pandemic have implications for focusing the next phases of the HIV research agenda.
Significant accomplishments in HIV research over 40 years have changed the trajectory of HIV pathogenesis, but vaccines for prevention and strategies for a cure remain essential to end the HIV pandemic domestically and globally. Let’s seize the moment and adopt lessons from the COVID-19 response to accelerate implementation of the mRNA platform for HIV vaccines, increase use of technology for novel testing strategies to follow effectiveness of treatments, solve the mysteries of neurological complications of HIV across the lifespan, capitalize on imaging and modeling to identify new therapeutic targets, and expand the pool of diverse early stage HIV investigators to meet the challenges of 21st Century HIV research. Much needs to be done, but with the amazing talents and continued dedication of the HIV research community, the investigators, community partners, advocates, NIH and other government colleagues, the private sector, and people with HIV, we can do this together.
Maureen M. Goodenow, Ph.D.
Associate Director for AIDS Research and
Director, Office of AIDS Research
National Institutes of Health