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AFRICA: Frustration over pace of microbicide development

[This report does not necessarily reflect the views of the United Nations]

CAPE TOWN, 24 April (PLUSNEWS) - Progress in developing an effective anti-HIV microbicide was far too slow, delegates attending the international microbicide conference in Cape Town, South Africa, heard this week.

Sunday's colourful opening ceremony had been billed as a "celebration of women", but as speaker after speaker rose to stress women's urgent need for a female-controlled prevention method such as a microbicide, it became apparent that the celebrations were premature.

Women's rights advocate Graca Machel pointed out that it was "completely unacceptable" that almost 30 years in to the HIV/AIDS pandemic, women still lacked the means to protect themselves.

According to Machel, existing prevention methods were failing women. Marriage was one of the biggest HIV risk factors for young African women, and while condoms were important, women often could not negotiate their use.

"I am impatient for change ... [this] slowness has resulted in the loss of millions of lives," she added.

Calling for more investment in research and development, Machel said current global funding for microbicides needed to be doubled to US $280-million a year for the next five years.

Activists from AIDS lobby group, the Treatment Action Campaign (TAC) and other civil society groups had marched to the conference centre ahead of the opening ceremony, and called for greater investment by international institutions and the pharmaceutical industry in developing microbicides, and a commitment to making them widely available and affordable, when they were ready.

As the head of the Women and AIDS programme for the Centre for the Programme of Research in South Africa (CAPRISA) Dr Quarraisha Abdool-Karim, is sympathetic to the frustration surrounding the pace of microbicide research.

"But we must understand that this research is not for today, but for 10 years down the road," she told PlusNews. The challenge now, however, was to make sure that people were aware of existing prevention methods, and used them.

According to Karim, although enrolment had been completed in current clinical trials, it would still be a couple of years before there were any results.

In South Africa, four products are in Phase 3 trials, the most advanced stage of microbicide testing, said conference co-chair Prof Gita Ramjee.

The largest trial involves 9,673 women in South Africa, Uganda, Tanzania and Zambia.

But South African health minister Dr Manto-Tshabalala-Msimang, on Monday raised concerns about the ethics of current clinical trials on microbicides.

The recruitment and compensation of candidates who suffered complications from clinical trials in developing countries needed to be discussed further, Manto-Tshabalala-Msimang said.

"In a community that is poor, providing financial compensation could prove to be perverse incentives. As we know, the poor may become desperate to receive these incentives despite risk. Therefore, informed consent becomes even more critical," she told delegates.

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