World AIDS Day 2009
Statement of Dr. Zeda Rosenberg
CEO of the International Partnership for Microbicides
As an AIDS activist in Cape Town recently noted, the global economy may be in recession, but the global HIV/AIDS crisis is not. According to a recently released report from the World Health Organization on women and health, AIDS is the leading cause of death among women of reproductive age (between 15 and 49 years) globally. A combination of biology and social reality renders women especially vulnerable to HIV.
Public health experts recognize that a comprehensive HIV prevention strategy that includes a broad range of methods will be the most effective in stopping new infections. While we already have an array of effective HIV prevention tools, such as condoms, male circumcision and behavioural interventions, unfortunately, these have not succeeded in significantly reducing HIV infections. Condoms are very effective, but are only as reliable as those using them. And condoms are not practical for those who want to conceive children or for women who cannot always persuade their partners to use one.
Microbicides remain potentially the best way to specifically address one of the central gaps in such a strategy — the lack of a discreet method that women can use to avoid sexual transmission of HIV.
Microbicides are medicinal products being developed to prevent the transmission of HIV, and designed specifically for women in Africa and other regions where the disease has hit the hardest. Microbicides could come in different forms: vaginal gels, capsules and films that could be applied discreetly every day, or easy-to-use vaginal rings that would provide longer term protection and need changing only once a month.
By allowing women to protect themselves, microbicides could add considerable muscle to HIV prevention programs. Early studies indicate that many men would also welcome the addition of microbicides to the range of prevention methods — as an opportunity to help protect their loved ones and share responsibility for HIV prevention with their partners, an underlying theme for World AIDS Day.
Research to develop new HIV prevention tools such as microbicides has been challenging, and we are still several years away from the day when a woman could walk into a clinic and ask for a microbicide or buy it at a pharmacy. Recent data from one early microbicide candidate, PRO2000 gel, provides hope that an effective microbicide is possible. The outcome of a decisive larger trial on PRO2000 is expected very soon.
The microbicide field is also moving in an exciting new direction by developing a new class of products based on the same powerful anti-retroviral (ARV) drugs used successfully in AIDS treatment and in the prevention of mother-to-child HIV transmission. Research on this next generation of microbicides is in progress in Africa, Europe, the US and elsewhere by a variety of not-for-profit organizations, including the International Partnership for Microbicides. A small efficacy study of an ARV microbicide known as “tenofovir gel” is now being completed in South Africa, with results expected to be announced next year. Other potent ARV-based microbicide products are undergoing important safety and acceptability studies, and will then move forward to be tested for efficacy.
Women’s input is vital to the development of successful microbicides that might one day help stem the HIV/AIDS epidemic. Researchers are working directly with women to understand their needs and product preferences, conducting consumer and other studies in developing countries to guide the development of future microbicide formulations. By creating opportunities for an open dialogue with potential users, microbicide researchers increase the prospects that future microbicides will be acceptable to and used by women.
Developing any medical product is a long and complex process, but the next generation of microbicides offers great reason for optimism. As a not-for-profit field, microbicide researchers are committed to ensuring that successful microbicides once developed are quickly made affordable to all those in need.
Success will require innovative research coupled with sustained leadership and commitment to women’s health. Recently, there has been unprecedented recognition in countries across the globe that improving women’s health strengthens communities and societies. Now is the time to channel this momentum and empower women living in the shadow of HIV/AIDS. Urgency is called for. We need to be working a lot harder to implement programs already proven to prevent HIV, and we also need new and better biomedical tools for the job. Preventing HIV infection is our shared responsibility.
About IPM: IPM is a nonprofit product development partnership dedicated to developing new HIV prevention technologies and making them available to women in developing countries. IPM has offices in the United States, South Africa and Belgium.