Microbicides for HIV Prevention Could be Available by 2007, Initiative Says

The Rockefeller Foundation, the International Center for Research on Women, the Alliance for Microbicide Development and the Global Campaign for Microbicides announced yesterday at a press briefing that a microbicide that could help prevent the transmission of HIV and other STDs could be available to the public in five years (ICRW release, 2/12). The groups, all members of the Rockefeller Foundation-sponsored Microbicide Initiative, released five reports yesterday describing the results of a two-year project that examined the scientific development, advocacy efforts, barriers to access, pharmaco-economics and public health impact of microbicides. "We now have the hard data to make a strong case for investments in clinical trials," ICRW President Geeta Gupta said. The development of HIV microbicides is "doable," Lori Heise, director of the Global Campaign for Microbicides, said, adding that a microbicide that is 60% effective against HIV could prevent 2.5 million to 3.7 million new HIV infections annually (Susannah Hunter, Kaiser Daily HIV/AIDS Report, 2/12). Three of the eleven microbicide "candidate products" that have been approved for human testing -- Carraguard, Pro2000 and BufferGel -- are scheduled to begin Phase III efficacy trials this year. However, the Microbicide Initiative estimates that the cost of getting one or more of these products on the market within five years could total $775 million, and current estimates of funding support for microbicide development only come to $230 million. The international community should "seiz[e] the moment and mobiliz[e] for accelerated microbicides research, development, approval, and distribution -- now," the executive summary of the reports states (Rockefeller Foundation Microbicide Initiative, "Mobilization for Microbicides: The Decisive Decade," 2/12). The microbicide projects have "so far failed" to attract investment from large pharmaceutical firms, and the groups yesterday asked federal agencies and philanthropic organizations to provide the estimated $545 million still needed to bring a microbicide to market. "There is practically no big pharma, which is why we need public sector support," Heise said (Zwillich, Reuters Health, 2/12).

Good News for Women
The idea behind microbicides "didn't come from the halls of science" but instead from "the minds and visions of women," Heise said. Women "desperately need" a method of HIV prevention that they can control, Gupta added. Because a prevention product is "effective only to the extent that it is used," microbicides, though "theoretically less effective" than condoms, would have the advantage of allowing a woman to be in control of their use (Susannah Hunter, Kaiser Daily HIV/AIDS Report, 2/12). Microbicides, which can be applied vaginally or rectally, could provide "the best response" to the cultural barriers that prevent many women from "requiring" that their partner wear a condom, according to the ICRW release. "The development of a safe, effective microbicide would represent the most significant advance in women's reproductive health since the pill," Heise said (ICRW release, 2/12). A kaisernetwork.org HealthCast of the press conference, as well as related press releases and fact sheets, is available online. For more information on microbicide development, read " Microbicides: Safe Sex and the Powerless," an installment in kaisernetwork.org's ongoing series on emerging and underreported issues in HIV and reproductive health. This and other stories in the series can be viewed online.