Microbicide Research Promising; More Delivery Options Will Be Needed, Researchers Say

Microbicide research is promising, though several obstacles remain before they can reach the market, attendees at the XVI International AIDS Conference in Toronto said Tuesday, Toronto's Globe and Mail reports (Picard, Globe and Mail, 8/16). Microbicides include a range of products -- such as gels, films and sponges -- that could help prevent the sexual transmission of HIV and other infections (Kaiser Daily HIV/AIDS Report, 8/14). According to a recent study from the London School of Hygiene and Tropical Medicine, a microbicide that is 60% effective against HIV and used by 20% of women in 73 developing countries could prevent 2.5 million cases over three years (Kaiser Daily HIV/AIDS Report, 4/24). Results from five clinical trials involving thousands of people worldwide should be ready by 2008, and, if governments accelerate the approval process, a microbicide could be available by 2010 at the earliest, Gita Ramjee, director of the HIV prevention research unit at South Africa's Medical Research Council, has said (Kaiser Daily HIV/AIDS Report, 4/24). According to the Toronto Star, the process of getting microbicides to the market has been affected by clinical trial costs; a lack of trial sites and health workers in developing countries; and ethical issues researchers face when conducting trials, such as covering the cost of health care for participants who become HIV-positive during trials. Another obstacle is that 20% of women who enroll in microbicide trials become pregnant and must be taken out of the study, according to Ramjee, who spoke Tuesday at the conference. Researchers then must find new participants, further delaying the trial's completion, Ramjee said (Daly, Toronto Star, 8/16). Zeda Rosenberg, CEO of the International Partnership for Microbicides, at the conference said variety in microbicides is essential because "women have different needs at different stages in their lives." She added, "Women need multiple drugs with multiple delivery options." Alex Coutinho, executive director of the AIDS Support Organisation in Uganda, said, "It's not just about microbicides, it's how you deliver microbicides that really matters. Women need something they can fit and forget." U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis said, "The prospect of a microbicide is thrilling," adding, "Regardless of its effectiveness, it will inevitably save millions of lives" (Globe and Mail, 8/16). "We need to put the power to prevent HIV in the hands of women," Bill Gates, co-founder of the Bill & Melinda Gates Foundation, said Sunday at the conference, adding, "No matter where she lives, who she is, or what she does, a woman should never need her partner's permission to save her own life." Gates on Sunday also said that the Bill & Melinda Gates Foundation plans to increase funding for microbicides research, though he did not specify how much additional money the foundation would provide (Kaiser Daily HIV/AIDS Report, 8/14).

Broadcast Coverage
Several broadcast programs examined microbicide research presented at the AIDS conference. Summaries appear below.

• CNN's "American Morning": The segment includes comments from Gates; Jessica Justman, assistant professor of clinical epidemiology at Columbia University's Mailman School of Public Health and program director of the University Technical Assistance Program at the International Center for AIDS Care; Rosenberg; and an HIV-negative sex worker in India (Gupta, "American Morning," CNN, 8/15). A transcript of the segment is available online. Video of the segment is available online.
  
  
• CTV's "Newsnet": The segment includes comments from Clinton; Musa Njoko, a South African activist and performer who was one of the first women in her country to publicly discuss her HIV-positive status; Ramjee; and George Usher, president and CEO of Polydex Pharmaceuticals Limited, a co-sponsor of the conference which produces microbicides (Favaro, "Newsnet," CTV, 8/15). The complete segment is available online in Windows Media.
  
  
• PBS' "NewsHour with Jim Lehrer": The program on Tuesday included an interview with Charlayne Hunter-Gault, foreign correspondent for NPR and former "NewsHour" correspondent, about several issues at the conference, including microbicide research, the role of women in the pandemic, efforts to reduce stigma, and HIV testing and prevention efforts (Ifill, "NewsHour with Jim Lehrer," PBS, 8/15). The complete transcript is available online. The complete segment is available online in RealPlayer.