National Working Group on Microbicides Microbicides advocacy Paramita Kundu & Ananthy Thambinayagam Global Campaign for Microbicides, PATH January 2007

National Working Group on Microbicides Prevention trials differ from treatment trials HIV treatment trials: Enroll those needing treatment -- individual urgency Proving a positive impact on disease Historically, strong activist “PUSH” on researchers for community involvement HIV prevention trials: Enrolling healthy people – no immediate benefit to individual Proving a negative Historically, communities in need less powerful, less educated researchers “PULL” community into involvement

National Working Group on Microbicides Also differences within HIV prevention Familiarity with concept Perception of high efficacy Disassociated from sex Medical legitimacy Considered “cutting edge” Consistent with biomedical model of disease control “Provider-controlled Novel idea; no proof of concept Talk about vaginas & power Considered “unsexy” science User-initiated At the nexus of 3 movements: –women’s health, –family planning and –HIV/AIDS Allows for broader political base With vaccines: With microbicides:

National Working Group on Microbicides Microbicides-Treatment-Vaccine Synergy (MTV) Prevention and treatment advocates have a great deal to learn from each other our successes and mistakes show us the way forward Just as treatment and prevention are interdependent endeavours…. so must our research partnerships be collaborative and interdependent “We must all hang together or assuredly we shall all hang separately.” Benjamin Franklin, July 4, 1776

National Working Group on Microbicides Public funding for microbicides development 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%

National Working Group on Microbicides Annual funding needs for microbicides Annual funding needs to double! All combined: Need $280M $3M

National Working Group on Microbicides The Global Campaign for Microbicides (GCM) An umbrella coalition of over 200 NGOs, forming the civil society arm of microbicides movement. Ensure that as science proceeds, the public interest is protected - Accountability Mobilize demand and investment for research and development of new prevention technologies Conduct policy advocacy for development, introduction, access, and use

National Working Group on Microbicides The GCM advocacy model Researchers Donors Government Community & Civil Society Advocacy

National Working Group on Microbicides public awareness political support public demand increased resources for R&D ($$$) safe and effective microbicides on the market Goal: All people know about & have access to affordable microbicides Microbicides advocacy in the “global north”

National Working Group on Microbicides GCM international partners United States: CA, CT, DC, IL, NY, MA, OH, PA, WA African: Kenya, Ghana, Nigeria, Uganda, and South Africa. Europe: UK, Ireland, Netherlands, Scandinavia, Spain, Portugal, Germany, France, Belgium, and Russia Canada Asia: Thailand and India Australia

National Working Group on Microbicides Microbicides advocacy in the “global south” Community involvement initiative –Facilitating authentic public engagement among communities hosting trials –Providing trainings and a resource kit Research ethics initiative –Finding a balance between urgency and ethical standards –Facilitating dialogue, ethics training course Support national advocacy efforts

National Working Group on Microbicides Microbicides advocacy & research in India India is an important player in microbicides development –Home of local & international research & trials –Has capacity for microbicides production –Has history of strong health advocacy movements Civil society-driven advocacy campaign for microbicides in India since 2001 (currently facilitated by GCM/PATH in India) National Working on Microbicides formed in 2003 (convened by PATH in India)

National Working Group on Microbicides Key GCM/PATH resources Website: Fact sheets Film List serve (to be launched) In-country technical experts

National Working Group on Microbicides GCM international partners United States: CA, CT, DC, IL, NY, MA, OH, PA, WA African: Kenya, Ghana, Nigeria, Uganda, and South Africa. Europe: UK, Ireland, Netherlands, Scandinavia, Spain, Portugal, Germany, France, Belgium, and Russia Canada Asia: Thailand and India Australia

National Working Group on Microbicides GCM initiatives with positive people Integrates MTV strategy; follows a joint advocacy agenda, not a competition Part of international working group on HIV positive women and microbicides Collaborated w/ ICW to draft advocacy brief on positive women and microbicides at M2004 Conference Convened positive people round-table discussion at M2006 Conference w/ ICW GCM collaborates with several positive people’s groups:

National Working Group on Microbicides Positive women and microbicides: What is the advocacy message? All microbicides must be tested for safety among positive women before entering into effectiveness trials All trials protect confidentiality, provide adequate SRH prevention & care and HIV treatment for those who seroconvert After “proof of concept” of candidate microbicide is demonstrated, bi-directional protection is assessed Field must invest in more background research on SRH of pos. women and HIV transmission from positive women to negative men

National Working Group on Microbicides The Microbicides Conference Bi-annual international conference, for the past six years Provides an update on microbicides research and info exchange among researchers, advocates & civil society M2006 –Introduction of track D (Advocacy & Community) –Roundtable consultation with positive people M2008 –Hosted New Delhi, India –Aim to have more of community and civil society representation. An opportunity for information exchange & advocacy!