HIV/Aids is increasingly regarded as a disease of the poor, blunting the enthusiasm of the rich and powerful to develop tools such as a virus-killing gel that could save millions of lives, delegates at an international conference said on Monday.
Speakers at the conference said development of a microbicide gel that could be used by women to prevent the spread of the virus was slow, in part because products likely to be used by poor women in developing countries do not attract the interest of large drug companies.
They emphasised that the real turning point in the epidemic may only come when women — who bear the brunt of the disease in the worst-hit African countries — are finally given the power to protect themselves without having to rely on men using a condom.
”The invention of an effective microbicide will ensure that the health of women will no longer depend on their ability to negotiate safer sex,” South African Minister of Health Manto Tshabalala-Msimang told the conference on microbicides.
She said their successful development would be a ”breakthrough for science”, but cautioned that poor Africans should not be used as guinea pigs in ongoing trials involving thousands of women.
In sub-Saharan Africa, home to more than 25 million of the nearly 40-million people infected with HIV/Aids around the world, women account for nearly 60% of infections. Most are acquired through heterosexual intercourse with men who are notoriously reluctant to use condoms and often have multiple partners.
”There are 14 000 new HIV infections each day worldwide, half of them in sub-Saharan Africa,” said Bakoko Bakoru, a Ugandan government minister, pointing out that young women were at much greater risk than young men.
Bakoru, mother to 40 children, including Aids orphans, said her career as a midwife had showed to her the evils of ”what women face behind these walls called a bedroom”.
”It is becoming clear that the married women in the home are more at risk than outside because they don’t have a choice on sexuality,” she told the conference of 1 000 delegates. ”The man comes home and he expects us to submit.
”Microbicides would allow women to protect their own health against HIV/Aids,” she said.
Microbicides can take the form of a gel, cream, sponge or ring that releases an ingredient that can kill or deactivate HIV during intercourse.
There are currently five different products being tested on 12 000 women in South Africa alone — and thousands of women in other African nations. Dozens of agents that could interrupt HIV transmission have so far been identified.
There are also hopes that the microbicides could be used to prevent other sexually transmitted diseases and unwanted pregnancies.
Gita Ramjee, director of the HIV-prevention research unit at South Africa’s Medical Research Council, said results from the most advanced trial would be ready at the end of 2008. She said that if governments fast-tracked the regulatory approval process, the gels might be on the market by 2010 — although she cautioned this was the earliest anticipated date.
The hunt for an effective microbicide suffered a devastating blow six years ago when it was revealed that one of the most promising candidates, Nonoxynol 9, increased the risk of contracting HIV, and that sex workers in Thailand and Africa who took part in trials had been dangerously exposed to increased risk.
Joy Phumaphi, an assistant director general at the World Health Organisation, said that lack of involvement by big drug multinationals was also partly to blame for the slow progress.
”The one particular group that we would like to encourage to engage itself more actively is the pharmaceutical industry,” she said.
She also appealed for greater international funding for the research, which is being sponsored by organisations including the United States-based Population Council, Family Health International and the International Partnership for Microbicides.
South Africa’s Minister of Science and Technology, Mosibudi Mangena, said the lack of interest was because HIV/Aids in Africa ”falls into the category of diseases of the poor, like malaria, like TB”.
Helen Rees, head of the Reproductive Health and HIV Research Unit at South Africa’s University of the Witwatersrand and a leading researcher on microbicides for the past 10 years, blamed the slow progress on the fact that the gels would most likely be used by poor women in developing countries and were not expected to be profitable enough to attract the big pharmaceutical companies.
”This is a mistake,” she said. — Sapa-AP