Collaborative Initiative for Paediatric HIV Education and Research (CIPHER)

MISSION: Optimize clinical management and delivery of services to infants, children and adolescents affected by HIV in resource-limited settings.

Despite notable progress in reducing vertical transmission of HIV, the paediatric population remains significantly disadvantaged regarding access to treatment, with only 49% of children in need receiving treatment in 2015. As the HIV epidemic matures, there is a growing population of adolescents living with HIV; in recent years, this particularly vulnerable group has seen a 50% increase in AIDS-related mortality compared with a decrease of 30% globally. These populations face unique challenges, which the Collaborative Initiative for Paediatric HIV Education and Research (CIPHER) is committed to placing firmly on the global public health agenda.

CIPHER is guided by a world-class Scientific Technical and Advisory Committee (STAC) of experts in paediatric HIV. It is designed to complement existing global initiatives and create partnerships to maximize investment in paediatric HIV research and improve paediatric health outcomes.

CIPHER has three primary objectives:

  • Promote and invest in targeted research to address priority knowledge gaps in paediatric HIV
  • Convene stakeholders and facilitate collaboration to strengthen communication, knowledge transfer and exchange among paediatric HIV cohorts
  • Undertake advocacy to support evidence-informed clinical, policy and programmatic decision making.

Learn more about CIPHER's committees and working groups


POLICY

Setting a global policy research agenda for paediatric and adolescent HIV

Achieving the Joint United Nations Programme on HIV/AIDS (UNAIDS) 90-90-90 targets by 2020 will remain an aspirational goal unless efforts to fill vital gaps in the HIV response for children and adolescents are intensified. At a policy level, CIPHER works to guide and promote targeted research – in particular, that which improves HIV programme implementation through an improved understanding of “what works” for children and adolescents – to inform policy and programmatic decision making for a more efficient and impactful response for these groups.

Featured work:

A global research agenda for increased impact
CIPHER and the World Health Organization have developed global prioritized research agendas for children and adolescents affected by HIV to help focus future research and funding to inform policy and programming and ensure better outcomes for these populations.

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RESEARCH

Building the next generation of researchers

In a context of reduced funding, opportunities for young investigators from low-and middle-income countries are needed. CIPHER’s approach to addressing research gaps focuses on capacity building for the next generation of researchers in paediatric and adolescent HIV in these settings.

Working together to inform policy

As the largest collaboration of paediatric and adolescent HIV observational cohorts to date, the CIPHER Global Cohort Collaboration works together to answer key questions of global public health impact that cannot be answered by one network alone.

Featured work:

Providing opportunities for young investigators
The CIPHER Grant Programme awards early-stage investigators worldwide up to $75,000 for up to two years to addresses critical research gaps in paediatric and adolescent HIV in resource-limited settings; 80% of funds awarded each year are reserved for researchers from low- and middle-income countries.

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The CIPHER Growing the Leaders of Tomorrow Fellowship provides support for two years for young investigators from sub-Saharan Africa to work with a senior investigator on priority research topics in paediatric HIV clinical science in the region.

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Global Cohort Collaboration
The CIPHER Global Cohort Collaboration is currently supporting studies on the duration of first-line antiretroviral (ARV) therapy in children and on the epidemiology of perinatally HIV-infected adolescents. Data generated by the group is also being used to inform UNAIDS estimates on the number of children living with HIV worldwide.

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STRUCTURAL BARRIERS

A stakeholder in paediatric HIV drug optimization

Compared with adults, treatment coverage among children remains low, and currently available therapeutic options are limited and often inadequate. Aspects of and inefficiencies in research, development and regulatory approval processes present key barriers to optimizing paediatric treatment. CIPHER is working on a number of fronts to address these barriers in order to increase treatment access for children and adolescents.

Featured work:

Better drugs for kids faster
With the IAS Industry Liaison Forum (ILF), CIPHER holds a roundtable series to bring stakeholders together to find solutions for overcoming barriers to making optimal paediatric ARVs and diagnostics available. CIPHER is also a partner in several initiatives focused on increasing access to paediatric ARVs, including the Global Accelerator for Paediatric Formulations (GAP-f).