Microbicides: New Hope for Prevention of HIV and other STIs Your name here

What is a Microbicide? A substance that can reduce the transmission of HIV and other STI pathogens when applied vaginally and, possibly, rectally. They are not yet available. First Generation: Gels and creams In the future: Sponges, vaginal rings Gels with barrier devices © Salam Dahbor, Courtesy Doubleshots Studio

We Need Microbicides That: Are contraceptive and non-contraceptive Reduce risk of other STIs Are safe and non-irritating Are inexpensive and available over the counter Could be used without partner’s cooperation or even awareness

How Effective Will Microbicides Be? First microbicides may be 40-60% protective Second generation may be 60-80% Promoted as a back-up to condoms, not as a replacement. “Use a microbicide with your condom for added pleasure and protection.” “Use a male or female condom every time you have sex; if you absolutely can’t use a condom, use a microbicide.”

Comprehensive Strategies for Protection Protection Technology Economic Opportunities Social Power Source: Brady, Martha. Population Council, Conceptual Framework

Potential Public Health Impact If a 60% effective product Offered to 73 lower income countries Is used by 20% people reached by health care during 50% of unprotected sex acts = 2.5 million HIV infections averted in 3 years including women, men and children

2. surfactants 3. entry inhibitors 4. anti-retrovirals 1. boosts vagina’s natural defenses Source: Shattock, R.; Moore, J. Inhibiting Sexual Transmission of HIV-1 Infection. Nature Reviews Microbiology. Vol 1, October 2003.

Laboratory Testing 2-6 Years Phase III (efficacy) 2 to 4 Years Simultaneous studies in some cases: HIV+, penile & rectal safety 10 or more years 3 products 4 products 30+ products Phase I (safety) 1 to 6 Months Phase II (safety) Up to 2 Years 25 – 40 people people 3,000-10,000 people The Product Pipeline in 2007 Source: Alliance Pipeline Update, first week of every month -

When can we expect a microbicide? Earliest results from current Phase III trials in If shown to be effective, a microbicide may be available in a few countries via introductory studies in the next 5 years If not, we will have to wait for results from second generation products

Public Funding is Essential Why aren’t large pharmaceutical companies investing? –Perceived low profitability –Liability concerns –Lack of in-house expertise –Uncertain regulatory environment Public Sector, 87% Philanthropic Sector, 13%

The Global Campaign for Microbicides works to: Ensure that as science proceeds, the public interest is protected - Accountability Mobilise demand and investment for research and development of new prevention technologies Conduct policy advocacy for development, introduction, access, and use

What You Can Do Visit Get in touch with local advocates Sign up for GC News Write to your public officials! Endorse the Global Campaign Educate others: –Presentations –Events –Web-links – Newsletters – Use our film – Fact sheets

I don’t want to die before I turn 25. I refuse to sit down and watch my generation fall to pieces. I am going to make a difference…Will you? Rumbidzai Grace Mushangi, age 15, Zimbabwe Frank Herholdt, Courtesy of Microbicide Development Project