Feminization of AIDS spurs need for microbicide
The increasing toll on women from the AIDS epidemic has spurred research for a protective gel or cream and one could be on the market in five years if all goes well, a leading researcher said Wednesday.
With women making up nearly 60 percent of all HIV infections in Africa, and because being young, married and faithful is no protection against infection, the need has never been greater.
“There could be a product on the market in five years if the current products in large scale trials work,” Dr. Zeda Rosenberg, of the non-profit International Partnership for Microbicides (IPM), told Health News Online at a global AIDS conference.
“If they do not, then it will be seven to nine years.”
AIDS experts estimate that even a partially effective microbicide - a cream, gel, foaming tablet or a vaginal ring that acts like an invisible condom - could prevent 2.5 million deaths from AIDS over three years.
With no AIDS vaccine likely to be on the market for years, a microbicide offers one of the best chances to thwart the global pandemic, experts say.
Last year alone, almost three million people died and five million were infected with the virus. The most vulnerable group are poor, young women and, increasingly, married women whose husbands refuse to use condoms.
U.N. Secretary General Kofi Annan, in his opening address to the 15th International AIDS Conference, stressed the importance of helping women.
“We must ensure they have full access to the practical options that can protect them from HIV - including microbicides, as they become available,” he said.
THREE WAYS OF ATTACKING THE VIRUS
Condoms are still the best means of protection against the virus, but microbicides would allow women to protect themselves if their husbands or partners refuse to use them.
Rosenberg said there were many products in different stages of clinical trials. Two have begun efficacy testing and four more are due to follow soon. The trials will involve 20,000 women over the next three years.
The microbicides would either kill HIV in semen, block the attachment of the virus to its target cell, or prevent HIV from multiplying if the virus enters the cell.
“You keep it at a local infection and stop it locally before the virus spreads throughout the body. The ideal microbicide eventually may be one that combines all three stages,” Rosenberg said.
The IPC, which receives funding from governments and foundations, is developing its own microbicides and is working with other groups which have promising candidates.
The ideal product would be easy to produce so companies around the world could make them as rapidly as possible to ensure wide use and availability.
“We’re looking for pennies a dose, but even that will be beyond the reach of many people around the world,” said Rosenberg. The IPC was also looking at ways to finance purchase and distribution, she said.
IPC reached a royalty-free agreement with Tibotec, a Belgian subsidiary of U.S. healthcare group Johnson & Johnson, in March to develop a drug known as TMC120 for use as a microbicide in developing countries.
“Microbicides will help give women control over their reproductive health and that will help in easing the inequity, but we need education for women,” Rosenberg said.
“We need them to be economically independent. There is a lot that needs to be done to help women and microbicides are one tool,” she said.
“The feminization of the epidemic has brought the need for a microbicide clearly into the limelight.”
Revision date: July 4, 2011
Last revised: by Dave R. Roger, M.D.