Microbicide Update

Two years ago, the Rockefeller Foundation invited leading experts in the field of scientific research, product development, public health, economics and advocacy to come together to find ways to accelerate the development of safe, effective and accessible microbicide products that could help prevent HIV transmission. Microbicides are compounds that could applied either intra-vaginally or intra-rectally to prevent HIV transmission. The advantages of microbicides are that they could be used by a woman even if her partner did not want to use a condom, provide added protection if a condom broke, or could potentially allow for pregnancy while still preventing HIV transmission.

Press Event Highlights New Evidence in Making the Case for Microbicides

On February 12, at the National Press Club in Washington, DC, the Rockefeller Foundation, Alliance for Microbicide Development, the Global Campaign for Microbicides, and the International Center for Research on Women presented a news conference called "Microbicides: HIV Prevention's New Hope." The group had commissioned five working papers and presented compelling results at the news conference around microbicide development.

The event represented the first public release of the long-awaited results of a consultative process assessing needs and opportunities in the field of microbicides research, development, and introduction. Expert working groups were formed in five areas: science, pharmaco-economics, public health impact, access and use, and advocacy. Their conclusions strengthen more than ever the argument in favor of increased commitment to microbicides as a scientifically feasible and urgently needed tool for HIV prevention. One of the papers mentioned that "a first-generation microbicide could save 2.5 million lives over three years in low-income countries," a compelling result advocating for the need for microbicides.

Briefs on the findings of these groups follow:

The scientific working group concluded that while clinical testing of microbicides presents certain challenges, these challenges are manageable, and a safe and effective microbicide could be available within 5 years.

The pharmaco-economics working group determined that there is a shortfall of about $545 million over the next 5 years in public funding for microbicide research. However, the analysis also showed that once a first-generation microbicide is available through public investment, market forces should take over and private industry will be motivated to invest in future products.

The public health impact working group developed a mathematical model that showed that even a microbicide has a 60 percent effectiveness rate, when used half of the time that condoms aren't used, by people who are easily reached by existing distribution systems, could avert 2.5 million new infections over a 3-year period. The working group notes that this is particularly meaningful when compared to the 1.8 million new infections among women that occur each year.

The access and use working group advocates note that a microbicide may prevent HIV infections only if it is used regularly and by people most at risk. They call on researchers and donors to dedicate significant time and investment to creating the mechanisms and conditions for widespread access to and use of an eventual microbicide. This would mean conducting acceptability and behavioral research along with clinical research to determine user preferences, responses, and potential barriers to use at the outset. It also means planning ahead for the mechanisms to purchase and distribute an effective microbicide to those most in need.

The advocacy working group, which was chaired by the Global Campaign, delivered a "Call to Action" for microbicides. Recognizing that there is an advocacy component to each of the other four areas, the working group calls for dedicating a portion of funds raised for microbicide research and development to strengthening the capacity of civil society actors -- such as women's health groups, HIV/AIDS organizations, and community representatives -- to participate in decision-making related to the field's research agenda, clinical trial implementation, and access initiatives.

For additional information, you may visit the Global Microbicide Campaign website, http://www.global-campaign.org/.