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The Past, Present and Future of HIV Microbicide Research Advocacy

An Interview With Polly Harrison, Founder of the Alliance for Microbicide Development

Winter 2011

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Where is the field going, and where does it need to go?

We obviously have to finish what we started with tenofovir, including the VOICE trials and any other trials that are seen as necessary, and we have to be sure that the work on the dapivirine ring goes forward as the science indicates. To do all that will require major investment and we have to assure that ahead of time so that we don't have any damaging interruptions. At the same time, we can't forget the rest of the pipeline. There are roughly 70 candidate microbicides of various sorts in the preclinical pipeline and there has to be a strategy for weeding those out and supporting and moving plausible survivors. I want to see work proceed with combination products that hit HIV at various points in its nasty trajectory or can prevent more than one sexually transmitted infection or combine such prevention with contraception. There isn't a pharmaceutical company on the planet that would ignore its earlier pipeline just because there were likely candidates in late-phase research, or ignore improving those candidates, and I'm worried that funding constraints will have that effect. The NIH plays the biggest role in the early science and we have to be sure that there's enough support there for that. If not, other funders are painfully few. We all have to worry about that.

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What are you, as an experienced microbicide advocate, planning to do now that the AMD has closed?

I am really gratified to have been able to take on the role as senior advisor to AVAC. That has been useful to us both. I've been able to assure the appropriate transfer of the intellectual property that the Alliance developed over the years and to also serve as a symbol that the validity of the microbicide concept remains alive. I still seem to have a useful voice and as long as anyone listens to me, I probably will keep on talking. And there's plenty I want to write!

Are there lessons for advocacy?

Many. The most powerful one surprised me. The microbicide movement was most effective when we had few financial resources but many committed hearts and minds, even when the political and socio-cultural environment was not welcoming. Resource imbalances and trial failures have hurt that movement and we have not regrouped as a dedicated constituency. Some think the field has matured to the point where specific microbicide advocacy is no longer required. I disagree; much organized conversation and advocacy remain essential. The final lessons for advocacy for microbicides and women's particular needs have not yet been told but I'm uneasy. Ask me again next year.

Do you have any other reflections you'd like to share?

Just one. In the earliest days, our circle of true friends beyond the microbicide community was small. TAG was very early among those true friends. That hasn't changed and we're so grateful.

Read more about Polly Harrison.


References

  1. ZA Stein. HIV prevention: the need for methods women can use. Am J Public Health 1990 April;80(4):460-62.
  2. Van Damme L, Ramjee G, Alary M, Vuylsteke B, Chandeying V, Rees H, Sirivongrangson P, Mukenge-Tshibaka L, Ettiègne-Traoré V, Uaheowitchai C, Karim SS, Mâsse B, Perriëns J, Laga M; COL-1492 Study Group.
  3. Effectiveness of COL-1492, a nonoxynol-9 vaginal gel, on HIV-1 transmission in female sex workers: a randomised controlled trial. Lancet. 2002 Sep 28;360(9338):971-7.
  4. Abdool Karim Q, Abdool Karim SS, Frohlich JA, Grobler AC, Baxter C, Mansoor LE, Kharsany AB, Sibeko S, Mlisana KP, Omar Z, Gengiah TN, Maarschalk S, Arulappan N, Mlotshwa M, Morris L, Taylor D; CAPRISA 004 Trial Group. Effectiveness and safety of tenofovir gel, an antiretroviral microbicide, for the prevention of HIV infection in women. Science. 2010 Sep 3;329(5996):1168-74. Epub 2010 Jul 19.
  5. Richard Jefferys and Scott Morgan. Microbicide field wrestles with the implications of success.
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This article was provided by Treatment Action Group. It is a part of the publication TAGline.
 
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