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Anna Forbes, MS Comments On the Future of HIV/AIDS Research

Summer 2001

Anna Forbes, MS: Global Campaign for Microbicides

What's closer to fruition than a vaccine, less elusive than a cure and one of the least discussed avenues of AIDS research? Microbicides!

Efforts to develop topical products that can be used vaginally or rectally to reduce risk of infection with HIV and other STDs have expanded in the last few years -- but have drawn little public attention and even less financial support.

Those working in the field agree that, with sufficient political will and investment, an effective microbicide could be developed within five years. About 50 candidate products (excluding Nonoxynol-9) have been identified so far, with the potential of being effective against a range of sexually transmitted infections and all strains of HIV. Four are now being readied for expanded (Phase II/III) safety and efficacy trials that will measure their effectiveness at preventing HIV infection during intercourse.

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Inexpensive to produce and distribute, the new microbicides will come in forms familiar to most users, including gels, creams, suppositories and lubricants. Some may be designed for use in conjunction with devices such as a sponge or vaginal ring.

Some will provide protection by blocking or killing the pathogens directly while others, derived from existing antiretroviral drugs, may work by preventing viral replication in the vagina or rectum. Some are based on existing products used in new ways or new combinations; others are based on completely new compounds.

Despite burgeoning scientific promise and overwhelming public health need, investment in microbicide research has been woefully inadequate. Large pharmaceutical companies -- the normal engines of product development -- have yet to invest because of concerns that products designed to be sold worldwide at low cost will not be profitable enough to recoup the cost of developing them.

The task of microbicide research and development (R&D), therefore, has fallen to non-profit entities, academic researchers, and small bio-pharmaceutical companies, all of which are dependent on government and foundation grants to pursue their research. At present, the NIH invests about 1% of its AIDS-related research budget ($34 million annually) in microbicide R&D. This is supplemented by a modest amount from venture capitalists and private foundations.

Private and public monies for microbicide R&D must expand dramatically. This summer, Congresswoman Connie Morella (R-MD) will introduce the Microbicides Development Act, legislation designed to increase the level of federal investment in microbicide research sufficiently to unblock the research pipeline and assure that promising candidate products don't continue to sit, untested, on laboratory shelves.

Scientists now predict that it will take more than a decade to develop even a partially protective vaccine. With adequate investment, a microbicide could be available in half that time. Over half of all Africans living with HIV/AIDS are women. New infection rates among women are soaring worldwide. Surely these facts make it painfully obvious that receptive sex partners need a way of protecting themselves that they can control. Surely, its worth more than a penny out of every AIDS research dollar to make microbicides happen.





  
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This article was provided by AIDS Community Research Initiative of America. It is a part of the publication CRIA Update. Visit ACRIA's website to find out more about their activities, publications and services.
 

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