Unfortunately, women are extremely limited in the number of choices they have to fight HIV and STD infection. Presently, women are largely dependent on their male partners' willingness to use condoms in order to protect themselves from STDs. Additionally, some men who have sex with men are also unable to insist on male condom use. The lack of prevention alternatives both compromises public health and hastens the spread of the HIV pandemic.
While an alternative to condoms is not currently available in the market, there are over 50 products classified as microbicides that are stuck in the research pipeline. Microbicides, also known as germ killers, are substances that can be found in many forms (including gels, creams, suppositories, films, lubricants, or a sponge) that, after being inserted in the vagina or rectum, can substantially reduce the transmission of STDs including HIV. Microbicides can work in a number of different ways. One way is by either killing or otherwise immobilizing pathogens (organisms that cause a disease).
Other ways include blocking infection by creating a barrier between the pathogen and the vagina or rectum or preventing the infection from taking hold after it has entered the body. Another way microbicides could work is by combining any of these approaches. While microbicides are not meant to be a substitute for condoms but rather an alternative to condom use. For women who are unable or unwilling to use condoms, microbicides will offer some protection that the woman can control.
With all of the different types of condoms on the market, why should there not be various types of microbicides on the market? Not only could these products offer an alternative to condom use and prevention against HIV and STDs, it is also possible that they could offer women an alternative to present birth control methods by acting as a contraceptive. Why not an entire array of microbicides on the market -- some that prevent contraception and others that prevent HIV and STD infection but allow the woman to become pregnant? The alternatives are out there being developed; they just have yet to make it into the hands of the public.
In spite of the obvious need for these products, there are no microbicides currently on the market. Additionally, the products that are currently undergoing clinical testing for Federal Drug Administration (FDA) approval do not have sufficient funding to make their way onto the market at the present time. Large pharmaceutical companies are refusing to invest their time and monies in microbicide development leaving the work to small biotechnology companies and university researchers who are largely dependent on government monies and private foundations to fund their product developments.
In fiscal year 2000, the National Institute of Health (NIH) invested only $30 million in microbicide development. This amount is less than 2 percent of its entire AIDS research budget and almost 10 times less than the amount invested in AIDS vaccine research (while AIDS vaccine research is an extremely important investment, research efforts into all modes of prevention need to be pursued). This is unfortunate because, in order for a microbicide to move from discovery through Phase II trials, $20 million is needed. Furthermore, the costs for Phase III trials alone, the final phase of human testing, range from $20 to $30 million. Multiply this by 50 different products and you have an astronomical amount of funding needed to make these products available to the public within a reasonable time span. It is estimated however, that if just $100 million is invested by the NIH in microbicide development each year, then these products will be available within the next five to seven years.
These obstacles are not insurmountable. The Global Campaign for Microbicides is a broad-based, international effort to increase access to HIV and STD prevention technologies other than male condoms. The goals of the Global Campaign are threefold:
AIDS Survival Project is involved as a co-sponsor of the Global Campaign along with other HIV/AIDS, reproductive health, gay health, and women's empowerment organizations representing the nation as well as the world. As a co-sponsor, we share the task of educating our community and advocating for microbicides at the local and national levels.
In December of 2000, AIDS Survival Project held a community treatment forum entitled "Beyond Condoms: Is the Invisible Condom Somewhere in Our Future." At this forum we introduced ourselves to the community as a local campaign site and are now rekindling our involvement in the Global Campaign. We are now creating a contact network of individuals and organizations who support the goals of the Global Campaign and would like to be involved in educational or advocacy events as they occur. We will be taking advantage of opportunities to educate our community about the need for microbicides as well as the advocacy efforts that can be undertaken to bring microbicides to market.
There are a number of things that can be done by individuals and organizations in addition to the work of AIDS Survival Project that will help make these alternative HIV and STD prevention products available to the public.
The Microbicide Development Act of 2001 has been reintroduced into the US House of Representatives. This act would make adequate federal research funds available to develop microbicides. Individuals and organizations can write or call their legislators and ask them to co-sponsor the Microbicide Development Act. If individuals have forgotten who their legislator is, visit www.aidssurvivalproject.org to find a link to that information, or look for your congressperson at congress.org/congressorg/dbq/officials.
Individuals and organizations can also contact AIDS Survival Project and ask to be added to our contact network in order to receive updates on educational and advocacy opportunities regarding microbicides as they arise. Organizations can host programs on microbicides and the Global Campaign. Educational programs can be provided by AIDS Survival Project or materials can be provided to organizations in order to introduce the information themselves. Individuals and organizations can also provide a link to the Global Campaign's Internet site, www.global-campaign.org, through their website. By contacting the Global Campaign, organizations can sign on as co-sponsors and endorse the goals of the campaign and help bring microbicides to the market.
With sufficient investment and political will, microbicides could appear on the market in five years. As stated best by the Global Campaign in their motto, an African proverb, "The best time to plant a tree is 20 years ago, the next best time is now."
For more information at the local or national level please contact:
AIDS Survival Project
159 Ralph McGill Blvd., Suite 500
Atlanta, GA 30308
404-874-4926 ext. 14
Dázon Dixon Diallo
713 Cascade Ave., SW
Atlanta, GA 30310