The International AIDS Vaccine InitiativeHIV prevention

The International AIDS Vaccine InitiativeHIV prevention, like contraception and
other forms of self-protection, works
best when people have a range of
options to choose from. Just as good
treatment requires combination
therapy, effective prevention requires
a combination of strategies that target
the virus at different stages of its lifecycle.
In recent years, efforts have
focused on expanding the range of HIV
prevention tool.
Microbicides could offer women - for the
first time - a method they can initiate that
does not require the active co-operation
of a male partner. Although many
women in acceptability surveys indicate
that they do not plan to hide their
microbicide use from their partners, they
nevertheless would like a product that
is unobtrusive and doesn’t have to be
discussed each time they have sex.
Critically, many women also want a
product that will allow them to conceive
without risk of becoming HIV infected.
Non-contraceptive microbicides could
be a way for women – including those
already living with HIV - to ensure that
they have healthy pregnancies and bear
healthy children. A European Unionfunded
social marketing survey revealed
a strong interest in using microbicides
among women – and men – in
developing countries including South
Africa, Uganda and Zimbabwe.
Modelling studies have indicated that
even with a 60% effective microbicide,
over 2.5 million HIV cases could be
averted over 3 years among women,
men and children. So why are they not
available now? The answer is not just
about science. New drug development
is usually funded by large pharmaceutical
companies. These multi-national
corporations, however, have demonstrated
very little interest in microbicides to date
because they see too much uncertainty
and too little potential profit. Universities
and small, independent biopharmaceutical
firms have, therefore, taken the lead.
These researchers have to rely on
governmental and philanthropic grantsefforts. Thus, the responsibility for funding
the work required to make microbicides
a reality falls on the public sector.
Most candidate microbicides are being
developed within public-private
partnerships, such as the United
Kingdom Microbicides Development
Programme and the International
Partnership for Microbicides. Roughly
US$140 million was invested in 2004 in
microbicide research and development,
more than double the amount invested
globally in 2000. Yet, experts estimate
that this annual investment must double
again and that US$280 million is needed
annually to ensure that a safe and
effective microbicide becomes publicly
available as rapidly as possible.
Not surprisingly, microbicides have
attracted both excitement and
scepticism. Some fear that people will
However, in light of the devastating
impact of AIDS on families and
communities, many more see
microbicides as offering hope for their
daughters and a lifeline to those who,
unable to control their risk factors,
currently have absolutely no way to
protect themselves from HIV.
Microbicides will not be – and must not
be regarded as - a magic bullet. No one
technology or strategy will ‘solve’ the
AIDS pandemic. Enthusiasm about
these new methods must not be allowed
to deflect attention to the underlying
social, economic and cultural realities
that condition people’s risk. We also
must work to give vulnerable groups
and women especially, the economic
and social power to negotiate with their
partners the terms and conditions under
which sex takes place.
The Global Campaign for Microbicides
works towards three critical goals:
1. to raise awareness and mobilise
political will for increased funding for
microbicide research;
2. to create a supportive policy environment
for their timely development,
introduction and use; and
3. to ensure that as science proceeds,
the public interest is protected and
the rights and interests of trial
participants, users, and communities
are fully represented and respected.
We invite faith-based organisations
supporting our goals to endorse the
Campaign and help us to advocate for
these new prevention options – because
it is only through sustained global
campaigning that the funding and
political will be found to put these
urgently needed prevention tools into
the hands of the women who need them
most without delay.